Maternal and perinatal outcomes in high compared to low risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection (phase 2): the World Association of Perinatal Medicine working group on coronavirus disease 2019.
Maternal and perinatal outcomes in high compared to low risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection (phase 2): the World Association of Perinatal Medicine working group on coronavirus disease 2019.
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DOI：
10.1016/j.ajogmf.2021.100329
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发表时间：
2021-07
影响因子：
6.3
通讯作者：
On the behalf of the World Association of Perinatal Medicine working group on coronavirus disease 2019
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文献类型：
--
作者：
D'Antonio F;Sen C;Mascio DD;Galindo A;Villalain C;Herraiz I;Arisoy R;Ovayolu A;Eroğlu H;Canales MG;Ladella S;Cojocaru L;Turan O;Turan S;Hadar E;Brzezinski-Sinai NA;Dollinger S;Uyaniklar O;Ocakouglu SR;Atak Z;Premru-Srsen T;Kornhauser-Cerar L;Druškovič M;Ples L;Gündüz R;Ağaçayak E;Schvartzman JA;Malbran MN;Liberati M;Sebastiano FD;Oronzi L;Cerra C;Buca D;Cagnacci A;Ramone A;Barra F;Carosso A;Benedetto C;Cosma S;Pintiaux A;Daelemans C;Costa E;Özel A;Muhçu M;Lopez JSJ;Alvarado C;Piqueras AL;Oliva DE;Schera GBL;Volpe N;Frusca T;Samardjiski I;Simeonova S;Papestiev IA;Hojman J;Turkcuoglu I;Cromi A;Laganà AS;Ghezzi F;Sirico A;Familiari A;Scambia G;Sukhikh ZKGT;Gorina KA;de Sa RAM;Vaz M;Feuerschuette OHM;Gatta AND;Youssef A;Donna GD;Martinez-Varea A;Loscalzo G;Morales Roselló J;Stefanovic V;Nupponen I;Nelskylä K;Ayala R;Molpeceres RG;Vázquez AP;Sandri F;Cataneo I;Lenzi M;Haberal ET;Huertas E;Sanchez A;Arango P;Bermejo A;Alcantara MMG;Göynümer G;Okuyan E;Madalina C;Guisan AC;Schulte AM;Esposito V;De Robertis V;Zdjelar S;Lackovic M;Mihajlovic S;Jekova N;Saccone G;Aslan MM;Dedda MCD;Chalid M;Canache JEM;Daskalakis G;Antsaklis P;Vega EC;Cueto E;Taccaliti C;Aykanat Y;Özlem Genç Ş;Froessler B;Radulova PA;Morano D;Bianchi B;Marino MGL;Meccariello G;Rohatgi B;Schiattarella A;Morlando M;Colacurci N;Villasco A;Biglia N;Marques ALS;Gatti A;Luvero D;Angioli R;Pittaro A;Lila A;Zlatohlávková B;On the behalf of the World Association of Perinatal Medicine working group on coronavirus disease 2019
与低风险妊娠相比，妊娠期感染严重急性呼吸综合征冠状病毒2是否与母体和胎儿结局更差有关仍有待确定。本研究旨在评估高风险和低风险妊娠合并严重急性呼吸综合征冠状病毒2感染的孕产妇和围产期结局。这是一项跨国回顾性队列研究，涉及2020年4月4日至2020年10月28日期间来自欧洲、美国、南美、亚洲和澳大利亚25个国家76个中心的实验室确诊的严重急性呼吸综合征冠状病毒2型感染的女性。主要终点是产妇死亡率和发病率的综合指标，包括入住重症监护病房、使用机械通气或死亡。次要结局是围产期不良结局的综合衡量指标，包括流产、胎儿丢失、新生儿和围产期死亡以及进入新生儿重症监护病房。所有的结果都是在高风险和低风险怀孕中评估的。如果怀孕期间已有慢性疾病或怀孕期间出现产科疾病，则怀孕被认为是高风险的。采用Fisher精确检验和logistic回归分析对数据进行分析。采用鼻咽拭子逆转录-聚合酶链反应检测出严重急性呼吸综合征冠状病毒2型感染阳性的单胎孕妇共887例纳入研究。高危妊娠发生综合不良结局的风险高于低危妊娠（优势比为1.52；95%可信区间为1.03-2.24；P= 0.035）。此外，高危妊娠妇女住院（优势比为1.48,95%可信区间为1.07-2.04，P= 0.002）、出现严重呼吸道症状（优势比为2.13,95%可信区间为0.41-3.21，P= 0.001）、入住重症监护病房（优势比为2.63,95%可信区间为1.42-4.88）和有创机械通气（优势比为2.65,95%可信区间为1.19-5.94，P= 0.002）的风险更高。在调查围产期结局时，高危妊娠的围产期不良结局风险较高（优势比为1.78；95%可信区间为0.15-2.72；P= 0.009）。然而，这种关联主要是因为高危妊娠的流产发生率高于低危妊娠（5.3% vs 1.6%， P= 0.008）；此外，两个研究组之间的其他探索结果没有差异。经logistic回归分析，产妇年龄（优势比1.12,95%可信区间1.02 ~ 1.22，P= 0.023）和高危妊娠（优势比4.21,95%可信区间3.90 ~ 5.11，P< 0.001）与产妇不良结局独立相关。高危妊娠合并严重急性呼吸综合征冠状病毒2感染的孕产妇不良结局风险高于低危妊娠合并严重急性呼吸综合征冠状病毒2感染的孕产妇不良结局风险。
It has still to be ascertained whether severe acute respiratory syndrome coronavirus 2 infection in pregnancy is associated with worse maternal and fetal outcomes compared to low risk gestations. This study aimed to evaluate maternal and perinatal outcomes in high- and low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection. This was a multinational retrospective cohort study involving women with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection from 76 centers from 25 countries in Europe, the United States, South America, Asia, and Australia from April 4, 2020, to October 28, 2020. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit, use of mechanical ventilation, or death. The secondary outcome was a composite measure of adverse perinatal outcome, including miscarriage, fetal loss, neonatal and perinatal death, and admission to the neonatal intensive care unit. All outcomes were assessed in high- and low-risk pregnancies. Pregnancies were considered high risk in case of either preexisting chronic medical conditions in pregnancy or obstetrical disorders occurring in pregnancy. The Fisher exact test and logistic regression analysis were used to analyze the data. A total of 887 singleton pregnancies who tested positive for severe acute respiratory syndrome coronavirus 2 infection using reverse transcription-polymerase chain reaction of nasal and pharyngeal swab specimens were included in the study. The risk of composite adverse maternal outcomes was higher in high-risk pregnancies than in low-risk pregnancies (odds ratio, 1.52; 95% confidence interval, 1.03–2.24; P=.035). In addition, women carrying high-risk pregnancies were at higher risk of hospital admission (odds ratio, 1.48; 95% confidence interval, 1.07–2.04; P=.002), presence of severe respiratory symptoms (odds ratio, 2.13; 95% confidence interval, 0.41–3.21; P=.001), admission to the intensive care unit (odds ratio, 2.63; 95% confidence interval, 1.42–4.88), and invasive mechanical ventilation (odds ratio, 2.65; 95% confidence interval, 1.19–5.94; P=.002). When exploring perinatal outcomes, high-risk pregnancies were at high risk of adverse perinatal outcomes (odds ratio, 1.78; 95% confidence interval, 0.15–2.72; P=.009). However, such association was mainly because of the higher incidence of miscarriage in high-risk pregnancies compared with that in low-risk pregnancies (5.3% vs 1.6%, P=.008); furthermore, there was no difference in other explored outcomes between the 2 study groups. At logistic regression analysis, maternal age (odds ratio, 1.12; 95% confidence interval, 1.02–1.22; P=.023) and high-risk pregnancy (odds ratio, 4.21; 95% confidence interval, 3.90–5.11; P<.001) were independently associated with adverse maternal outcomes. High-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection were at higher risk of adverse maternal outcomes than low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection.
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DOI：
10.15557/pimr.2020.0003
发表时间：
2020-01-01
影响因子：
3.6
作者：
通讯作者：
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影响因子：
7.1
作者：
Saccone, Gabriele;Sen, Cihat;D'Antonio, Francesco
通讯作者：
D'Antonio, Francesco
影响因子：
15.8
作者：
Harrison, Stephanie L.;Fazio-Eynullayeva, Elnara;Lip, Gregory Y. H.
通讯作者：
Lip, Gregory Y. H.
影响因子：
2.4
作者：
Di Mascio, Daniele;Sen, Cihat;D'Antonio, Francesco
通讯作者：
D'Antonio, Francesco
影响因子：
158.5
作者：
Guan, W.;Ni, Z.;Zhong, N.
通讯作者：
Zhong, N.