Coronavirus disease 2019 and first-trimester spontaneous abortion: a case-control study of 225 pregnant patients
Coronavirus disease 2019 and first-trimester spontaneous abortion: a case-control study of 225 pregnant patients
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DOI：
10.1016/j.ajog.2020.10.oo5
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发表时间：
2021-04-01
影响因子：
9.8
通讯作者：
Benedetto, Chiara
中科院分区：
文献类型：
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作者：
Cosma, Stefano;Carosso, Andrea R.;Benedetto, Chiara
背景技术背景：由严重急性呼吸综合征冠状病毒2引起的疾病被命名为2019年冠状病毒病，并被列为全球公共卫生紧急事件。与2019年冠状病毒病对妊娠的影响有关的证据仅限于妊娠的第二和第三个三个月，而第一个三个月的数据很少。许多病毒感染可能是有害的胎儿在怀孕的第一个三个月，严重急性呼吸综合征冠状病毒2型是否是其中之一仍然是unknown.OBJECTIVE：通过这项研究，我们评估了严重急性呼吸综合征冠状病毒2型感染的危险因素，早期妊娠丢失在怀孕的第一个三个月。研究设计：2020年2月22日至5月21日，我们在S.安娜医院，都灵，在怀孕的妇女在他们的头三个月，配对的最后一次月经。比较了自然流产妇女（病例组，n=100）和继续妊娠妇女（对照组，n=125）2019年冠状病毒病的累积发病率。通过检测鼻咽拭子中的严重急性呼吸综合征冠状病毒2和血液样本中的严重急性呼吸综合征冠状病毒2免疫球蛋白G和免疫球蛋白M抗体来确定当前或既往感染。收集了患者人口统计学资料、2019年冠状病毒病相关症状以及堕胎的主要风险因素。结果：在225名女性中，23名（10.2%）2019年冠状病毒病检测结果呈阳性。病例组（11/100，11%）和对照组（12/125，9.6%）之间2019年冠状病毒病的累积发病率没有差异（P= 0.73）。Logistic回归分析证实，2019年冠状病毒病不是早期妊娠丢失的独立预测因素（比值比，1.28;置信区间，0.53-3.08）。2019年冠状病毒病相关症状在前三个月为发热、嗅觉丧失、味觉丧失、咳嗽、关节痛和腹泻;没有记录到肺炎病例或因2019年冠状病毒病相关症状住院。症状的发生率没有差异，注意到2 groups.CONCLUSION：严重急性呼吸道综合征冠状病毒2型感染在怀孕的第一个三个月似乎并不倾向于早期妊娠丢失，其累积发病率并没有显着差异，自然流产的妇女和正在进行妊娠的妇女。2019年冠状病毒病似乎在怀孕初期有一个有利的母体过程，这与在第二和第三孕期观察到的情况一致。
BACKGROUND: The disease caused by the severe acute respiratory syndrome coronavirus 2 was named coronavirus disease 2019 and classified as a global public health emergency. The evidence related to the impact of coronavirus disease 2019 on pregnancy is limited to the second and third trimester of pregnancy, whereas data on the first trimester are scant. Many viral infections can be harmful to the fetus during the first trimester of pregnancy, and whether severe acute respiratory syndrome coronavirus 2 is one of them is still unknown.OBJECTIVE: With this study, we evaluated severe acute respiratory syndrome coronavirus 2 infection as a risk factor for early pregnancy loss in the first trimester of pregnancy. Furthermore, coronavirus disease 2019 course in the first trimester was assessed.STUDY DESIGN: Between February 22 and May 21, 2020, we conducted a case-control study at S. Anna Hospital, Turin, among pregnant women in their first trimester, paired for last menstruation. The cumulative incidence of coronavirus disease 2019 was compared between women with spontaneous abortion (case group, n=100) and those with ongoing pregnancy (control group, n=125). Current or past infection was determined by the detection of severe acute respiratory syndrome coronavirus 2 from nasopharyngeal swab and severe acute respiratory syndrome coronavirus 2 immunoglobulin G and immunoglobulin M antibodies in a blood sample. Patient demographics, coronavirus disease 2019-related symptoms, and the main risk factors for abortion were collected.RESULTS: Of 225 women, 23 (10.2%) had a positive test result for coronavirus disease 2019. There was no difference in the cumulative incidence of coronavirus disease 2019 between the cases (11/100, 11%) and the controls (12/125, 9.6%) (P=.73). Logistic regression analysis confirmed that coronavirus disease 2019 was not an independent predictor of early pregnancy loss (odds ratio, 1.28; confidence interval, 0.53-3.08). Coronavirus disease 2019-related symptoms in the first trimester were fever, anosmia, ageusia, cough, arthralgia, and diarrhea; no cases of pneumonia or hospital admission owing to coronavirus disease 2019-related symptoms were recorded. No difference in the incidence of symptoms was noted between the 2 groups.CONCLUSION: Severe acute respiratory syndrome coronavirus 2 infection during the first trimester of pregnancy does not seem to predispose to early pregnancy loss; its cumulative incidence did not differ between women with spontaneous abortion and women with ongoing pregnancy. Coronavirus disease 2019 appears to have a favorable maternal course at the beginning of pregnancy, consistent with what has been observed during the second and third trimesters.