Obstetric Intervention and Perinatal Outcomes During the Coronavirus Disease 2019 (COVID-19) Pandemic.
Obstetric Intervention and Perinatal Outcomes During the Coronavirus Disease 2019 (COVID-19) Pandemic.
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DOI：
10.1097/aog.0000000000005412
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发表时间：
2023-12-01
影响因子：
7.2
通讯作者：
中科院分区：
文献类型：
--
作者：
2019冠状病毒病（COVID-19）大流行的爆发与产科干预的短暂减少和围产期死亡率的增加有关。量化美国产科干预和围产期结局的流行病相关变化。我们对2015-2021年美国所有活产和胎儿死亡进行了回顾性研究，数据来自国家卫生统计中心的出生率，胎儿死亡和活产婴儿死亡相关文件。对所有单胎、孕前糖尿病、孕前高血压和妊娠期高血压疾病患者的单胎和双胎进行分析。关注的结局包括早产、早产引产或早产剖宫产、巨大儿、过期分娩和围产期死亡。中断时间序列分析用于估计大流行前期（2015年1月至2020年2月）、大流行开始时（2020年3月）和大流行期间（2020年3月至2021年12月）的变化。研究人群包括26，604，392例活产和155，214例死产。大流行前的特点是早产和早产引产或剖宫产率暂时增加，巨大儿、过期分娩和围产期死亡率暂时减少。大流行的发生与早产的绝对减少有关（减少0.322/100活产，95% CI 0.506-0.139）和早产引产或剖宫产（减少0.190/100活产，95% CI 0.334-0.047）和巨大儿的绝对增加（增加0.046/100活产）、早产（增加0.015/100活产）和围产期死亡（增加0.501/1，000总出生，95%CI 0.220-0.783）。这些变化在高危亚群中更大（例如，在孕前糖尿病患者的单胎中）。在单胎妊娠前糖尿病患者中，大流行的发生与早产的减少有关（减少1.634/100活产）和早产引产或剖腹产（每100例活产减少1.521例）和巨大儿增加（增加0.328/100活产）和围产期死亡（增加9.840/1，000总出生，95%CI 3.933-15.75）。大多数变化在大流行爆发后的几个月内发生逆转。2019冠状病毒病（COVID-19）大流行的爆发与产科干预（特别是早产引产或剖宫产）的短暂减少和围产期死亡率的短暂增加有关。
The onset of the coronavirus disease 2019 (COVID-19) pandemic was associated with a transient decrease in obstetric intervention and an increase in perinatal mortality. To quantify pandemic-related changes in obstetric intervention and perinatal outcomes in the United States. We carried out a retrospective study of all live births and fetal deaths in the United States, 2015–2021, with data obtained from the natality, fetal death, and linked live birth–infant death files of the National Center for Health Statistics. Analyses were carried out among all singletons; singletons of patients with prepregnancy diabetes, prepregnancy hypertension, and hypertensive disorders of pregnancy; and twins. Outcomes of interest included preterm birth, preterm labor induction or preterm cesarean delivery, macrosomia, postterm birth, and perinatal death. Interrupted time series analyses were used to estimate changes in the prepandemic period (January 2015–February 2020), at pandemic onset (March 2020), and in the pandemic period (March 2020–December 2021). The study population included 26,604,392 live births and 155,214 stillbirths. The prepandemic period was characterized by temporal increases in preterm birth and preterm labor induction or cesarean delivery rates and temporal reductions in macrosomia, postterm birth, and perinatal mortality. Pandemic onset was associated with absolute decreases in preterm birth (decrease of 0.322/100 live births, 95% CI 0.506–0.139) and preterm labor induction or cesarean delivery (decrease of 0.190/100 live births, 95% CI 0.334–0.047) and absolute increases in macrosomia (increase of 0.046/100 live births), postterm birth (increase of 0.015/100 live births), and perinatal death (increase of 0.501/1,000 total births, 95% CI 0.220–0.783). These changes were larger in subpopulations at high risk (eg, among singletons of patients with prepregnancy diabetes). Among singletons of patients with prepregnancy diabetes, pandemic onset was associated with a decrease in preterm birth (decrease of 1.634/100 live births) and preterm labor induction or cesarean delivery (decrease of 1.521/100 live births) and increases in macrosomia (increase of 0.328/100 live births) and perinatal death (increase of 9.840/1,000 total births, 95% CI 3.933–15.75). Most changes were reversed in the months after pandemic onset. The onset of the coronavirus disease 2019 (COVID-19) pandemic was associated with a transient decrease in obstetric intervention (especially preterm labor induction or cesarean delivery) and a transient increase in perinatal mortality.
在COVID-19大流行的前九个月中，缓解措施对围产期结局的影响：进行荟萃分析的系统综述。
DOI：
10.1016/j.ejogrb.2022.05.007
发表时间：
2022-07
影响因子：
2.6
作者：
Hawco, Sarah;Rolnik, Daniel L.;Woolner, Andrea;Cameron, Natalie J.;Wyness, Victoria;Mol, Ben W.;Black, Mairead
通讯作者：
Black, Mairead
影响因子：
2.9
作者：
Mullin, Anne M.;Handley, Sara C.;Lundsberg, Lisbet;Elovitz, Michal A.;Lorch, Scott A.;McComb, Elias J.;Montoya-Williams, Diana;Yang, Nancy;Dysart, Kevin;Son, Moeun;Greenspan, Jay;Culhane, Jennifer F.;Burris, Heather H.
通讯作者：
Burris, Heather H.