Álvarez-Del Río Blanca, Sánchez-de Prada Laura, Arroyo-Hernantes Irene, Álvarez F Javier, Tamayo Eduardo, Gutiérrez-Abejón Eduardo
Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain.
BioCritic, Grupo de investigación de Biomedicina en Cuidados Críticos, Valladolid, Spain.
Front Med (Lausanne). 2025 May 8;12:1548245. doi: 10.3389/fmed.2025.1548245. eCollection 2025.
Pregnant women are considered a vulnerable group for COVID-19 with an increased risk for complications. The objective of this study is to describe in-hospital mortality, pregnancy outcomes, and direct hospital costs associated with COVID-19 in women at the time of childbirth.
This retrospective nationwide population-based registry study collects data on complications, outcomes, and direct hospital costs from women hospitalized for childbirth, recorded in the Minimum Basic Data Set obtained from the National Surveillance System for Hospital Data in Spain between 2020-2022. Hospitalization characteristics, complications related to pregnancy and childbirth, outcomes, and hospitalization costs are compared between COVID-19-positive and non-COVID-19 women at the time of childbirth.
A total of 779,387 women were admitted between 2020 and 2022 with a record of childbirth in Spanish hospitals. Of these, 15,792 (2.06%) had COVID-19 at the time of delivery. These women had a longer length of stay (3.53 days), higher rates of intensive care unit (ICU) admission (2.53%), ventilation/intubation (0.91%), and in-hospital mortality (0.06%) ( < 0.0001). This group also exhibited higher rates of spontaneous premature onset of labor (7%) and postpartum hemorrhage (3.45%), as well as a higher rate of labor induction (6.27%) ( < 0.001). Additionally, a higher single stillbirth rate (0.73%) was found among COVID-19-positive women ( = 0.0002). A significant higher risk of postpartum hemorrhage (OR = 1.14), embolism (OR = 7.98), acute respiratory distress syndrome (OR = 35.5), temporary tracheostomy (OR = 4.89), ventilation/intubation (OR = 6.85), and single stillbirth (OR = 1.32) was found in COVID-19 women ( < 0.05). The mean cost per patient was €4,066.48, 25.06% higher than that for non-COVID-19 women ( < 0.0001). Stratification by age showed an increasing trend in costs with age, reaching €6,492.12 in women ≥45 years old, where the ICU admission rate reached 8.09%.
These findings show that COVID-19 at the time of childbirth occurs in 2 out of every 100 cases and increases the risk of complications related to pregnancy and childbirth, as well as mortality and hospitalization costs. These data are related to SARS-CoV-2 variants circulating from 2020-2022, and current variants could give different risks. Our evaluation should be useful for health authorities to allocate resources and professionals to implement preventive measures, such as vaccination and screening, due to the increased morbidity, mortality and costs in this group.
孕妇被视为感染新冠病毒的脆弱群体，出现并发症的风险更高。本研究的目的是描述分娩时感染新冠病毒的女性的院内死亡率、妊娠结局及直接住院费用。
这项基于全国人群的回顾性登记研究收集了2020年至2022年间在西班牙住院分娩女性的并发症、结局及直接住院费用数据，这些数据记录在从西班牙国家医院数据监测系统获取的最低基本数据集里。比较分娩时新冠病毒检测呈阳性和阴性的女性的住院特征、与妊娠和分娩相关的并发症、结局及住院费用。
2020年至2022年间，西班牙医院共收治了779387名有分娩记录的女性。其中，15792名（2.06%）在分娩时感染了新冠病毒。这些女性住院时间更长（3.53天），重症监护病房（ICU）收治率更高（2.53%），通气/插管率更高（0.91%），院内死亡率更高（0.06%）（P<0.0001）。该组还表现出更高的自发性早产率（7%）和产后出血率（3.45%），以及更高的引产率（6.27%）（P<0.001）。此外，新冠病毒检测呈阳性的女性中单胎死产率更高（0.73%）（P=0.0002）。新冠病毒感染女性发生产后出血（比值比[OR]=1.14）、栓塞（OR=7.98）、急性呼吸窘迫综合征（OR=35.5）、临时气管切开术（OR=4.89）、通气/插管（OR=6.85）和单胎死产（OR=1.32）的风险显著更高（P<0.05）。每位患者的平均费用为4066.48欧元，比未感染新冠病毒的女性高25.06%（P<0.0001）。按年龄分层显示，费用随年龄呈上升趋势，45岁及以上女性的费用达到6492.12欧元，其ICU收治率达到8.09%。
这些研究结果表明，每100例分娩中就有2例发生分娩时感染新冠病毒的情况，这增加了与妊娠和分娩相关的并发症风险、死亡率及住院费用。这些数据与2020年至2022年期间传播的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）变体有关，当前变体可能带来不同风险。鉴于该群体发病率、死亡率及费用增加，我们的评估对卫生当局分配资源和专业人员实施预防措施（如疫苗接种和筛查）应会有所帮助。
