Gentili Amira, Sterpu Irene, Tingström Joanna, Wiberg-Itzel Eva
Department of Clinical Science and Education, Department of Obstetrics and Gynecology, Karolinska Institute, Sodersjukhuset, Stockholm, 118 83, Sweden.
Division of Obstetrics and Gynecology, Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
BMC Pregnancy Childbirth. 2025 Jan 30;25(1):91. doi: 10.1186/s12884-025-07196-w.
Fetal movements are an important indicator of fetal well-being; therefore, reduced fetal movements (RFMs) can indicate fetal compromise. RFM is associated with fetal growth restriction (FGR) and intrauterine fetal death (IUFD). Studies have implied that COVID-19 infection increases the risk of adverse fetal outcomes, such as preterm birth and IUFD. It is unclear how COVID-19 infection may aggravate these fetal outcomes among women presenting with RFM. The aims of the study were to (1) determine whether adverse fetal outcomes in women with RFM increased in 2020 compared to 2019, the year before the pandemic, and (2) evaluate whether maternal COVID-19 infection during pregnancy was a risk factor for adverse fetal outcomes in comparison to previously established risk factors among women seeking care for RFM.
All women who sought care due to RFM and were delivered at Soder Hospital from 2019 to 2020 were included. Fetal composite outcomes were constructed and compared between women with RFM and COVID-19 and women with RFM but without COVID-19.
COVID-19 infection did not increase the risk of adverse fetal outcomes in women who sought care for RFM. A twofold risk for adverse fetal outcomes was found among all primiparous women vs. multiparous women with RFM (98/788 [12.4%] vs 37/644 [9.8%], AOR = 2.5, 95% CI (1.6-3.7).
The proportion of adverse composite outcomes among women with RFM during the first year of the pandemic did not increase compared to the year before. Composite outcomes were marginally higher in the COVID-19-positive group compared to the COVID-19-negative group, but it was not statistically significant.
胎动是胎儿健康的重要指标；因此，胎动减少（RFMs）可能表明胎儿受到损害。胎动减少与胎儿生长受限（FGR）和宫内胎儿死亡（IUFD）有关。研究表明，新冠病毒感染会增加不良胎儿结局的风险，如早产和宫内胎儿死亡。目前尚不清楚新冠病毒感染如何加重出现胎动减少的女性的这些胎儿结局。本研究的目的是：（1）确定与疫情前的2019年相比，2020年出现胎动减少的女性中不良胎儿结局是否增加；（2）评估与因胎动减少寻求护理的女性中先前确定的风险因素相比，孕期感染新冠病毒的母亲是否是不良胎儿结局的风险因素。
纳入2019年至2020年因胎动减少在索德医院寻求护理并分娩的所有女性。构建并比较了感染新冠病毒且胎动减少的女性与未感染新冠病毒但胎动减少的女性的胎儿综合结局。
新冠病毒感染并未增加因胎动减少寻求护理的女性出现不良胎儿结局的风险。在所有初产妇与经产妇且胎动减少的女性中，不良胎儿结局的风险增加了两倍（98/788 [12.4%] 对37/644 [9.8%]，调整后比值比 = 2.5，95%置信区间（1.6 - 3.7））。
与前一年相比，疫情第一年出现胎动减少的女性中不良综合结局的比例并未增加。新冠病毒阳性组的综合结局略高于新冠病毒阴性组，但无统计学意义。
