产后出血是整个孕期感染新冠病毒奥密克戎变异株的孕产妇的一项关键结局。
Postpartum hemorrhage emerges as a key outcome of maternal SARS-CoV-2 omicron variant infection surge across pregnancy trimesters.
作者信息
Xu Zhou, Li Er-Han, Liu Jia, Zhang Yong-Jia, Xiao Rui, Chen Xin-Zhen, Zhong Zhao-Hui, Tang Xiao-Jun, Fu Li-Juan, Zhang Hua, Bao Mei-Hua, Qi Hong-Bo, Chen Gong-Li, Ding Yu-Bin
机构信息
Department of Obstetrics and Gynecology, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, Sichuan 610011, China.
Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing 401147, China; Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing 400016, China.
出版信息
J Infect Public Health. 2025 Jun;18(6):102733. doi: 10.1016/j.jiph.2025.102733. Epub 2025 Mar 6.
BACKGROUND
Despite evidence showing changes in disease severity with the virus's evolution and vaccination efforts, the link between maternal, perinatal, and neonatal outcomes and SARS-CoV-2 infections during different pregnancy trimesters remains unclear, especially with the BA.5 and BF.7 Omicron subvariant surge in China in December 2022. This study investigates the correlation between maternal, perinatal, and neonatal outcomes and SARS-CoV-2 infection across various pregnancy trimesters.
METHODS
This prospective cohort study was conducted at two hospitals in southwest China, examining the clinical records and infection status of 2158 pregnant women registered between January 1, 2022, and September 30, 2023. Initially shielded from COVID-19, the population later experienced a significant infection surge. A comparative analysis evaluated maternal, perinatal, and neonatal outcomes between infected and uninfected subjects. Primary outcomes included pregnancy complications and premature births, while secondary outcomes encompassed cesarean sections, delivery complications, and neonatal outcomes.
RESULTS
Pregnant women infected with SARS-CoV-2 had higher incidence of placenta increta/percreta and postpartum hemorrhage compared to uninfected women. First trimester infections were associated with a lower incidence of intrahepatic cholestasis of pregnancy [aOR = 0.29, 95 % CI 0.13-0.63] but a higher incidence of preterm birth [aOR = 2.16, 95 % CI 1.25-3.71]. Third trimester infections increased the risk of postpartum hemorrhage [aOR = 2.74, 95 % CI 1.21-6.18].
CONCLUSION
SARS-CoV-2 infection during pregnancy is linked to increased incidence of placenta increta/percreta and postpartum hemorrhage. First trimester infections are associated with higher incidence of premature birth and lower incidence of intrahepatic cholestasis of pregnancy, while third trimester infections are linked to higher incidence of postpartum hemorrhage.
背景
尽管有证据表明随着病毒的演变和疫苗接种工作，疾病严重程度发生了变化，但不同孕期的孕产妇、围产期和新生儿结局与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染之间的联系仍不明确，尤其是在2022年12月中国出现奥密克戎BA.5和BF.7亚变体激增期间。本研究调查了不同孕期的孕产妇、围产期和新生儿结局与SARS-CoV-2感染之间的相关性。
方法
这项前瞻性队列研究在中国西南部的两家医院进行，检查了2022年1月1日至2023年9月30日期间登记的2158名孕妇的临床记录和感染状况。该人群最初对2019冠状病毒病（COVID-19）具有免疫力，后来经历了一次显著的感染激增。通过比较分析评估感染组和未感染组的孕产妇、围产期和新生儿结局。主要结局包括妊娠并发症和早产，次要结局包括剖宫产、分娩并发症和新生儿结局。
结果
与未感染的孕妇相比，感染SARS-CoV-2的孕妇胎盘植入/穿透和产后出血的发生率更高。孕早期感染与妊娠期肝内胆汁淤积症的发生率较低相关[调整后比值比（aOR）=0.29，95%置信区间（CI）0.13 - 0.63]，但早产发生率较高[aOR = 2.16，95%CI 1.25 - 3.71]。孕晚期感染增加了产后出血的风险[aOR = 2.74，95%CI 1.21 - 6.18]。
结论
孕期SARS-CoV-2感染与胎盘植入/穿透和产后出血发生率增加有关。孕早期感染与早产发生率较高和妊娠期肝内胆汁淤积症发生率较低相关，而孕晚期感染与产后出血发生率较高相关。
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