Association of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection With Maternal Mortality and Neonatal Birth Outcomes in Botswana by Human Immunodeficiency Virus Status.
Association of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection With Maternal Mortality and Neonatal Birth Outcomes in Botswana by Human Immunodeficiency Virus Status.
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根据人类免疫缺陷病毒状况，严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 感染与博茨瓦纳孕产妇死亡率和新生儿出生结果之间的关系。
DOI：
10.1097/aog.0000000000005020
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发表时间：
2023
影响因子：
7.2
通讯作者：
中科院分区：
文献类型：
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作者：
Jackson-Gibson,Maya;Diseko,Modiegi;Caniglia,EllenC;Mayondi,GloriaK;Mabuta,Judith;Luckett,Rebecca;Moyo,Sikhulile;Lawrence,Pamela;Matshaba,Mogomotsi;Mosepele,Mosepele;Mmalane,Mompati;Banga,Jaspreet;Lockman,Shahin;Makhema,Joseph;
目的：评估严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）和人类免疫缺陷病毒（HIV）感染的不良出生结局在艾滋病流行region.METHODS的联合关联：Tsepamo研究从产前和产科记录中提取数据在博茨瓦纳各地的政府产科病房。我们评估了2020年9月至2021年11月中旬在13个Tsepamo地点进行的所有单胎妊娠的孕产妇死亡率和不良分娩结局，这些孕妇接受了记录在案的SARS-CoV-2筛查测试和已知的HIV状态。结果：在20，410名分娩的个体中，11，483人（56.3%）接受了SARS-CoV-2感染筛查; 4.7%检测呈阳性。艾滋病毒感染者检测阳性的可能性（144/2，421，5.9%）高于未感染艾滋病毒的人（392/9，030，4.3%）（P=. 001）。在SARS-CoV-2检测结果阳性的人群中，孕产妇死亡率为3.7%，而在检测结果阴性的人群中，孕产妇死亡率为0.1%（调整后的相对风险[aRR] 31.6，95%CI 15.4-64.7）。孕产妇死亡率没有因艾滋病毒状况而异。SARS-CoV-2感染者的后代经历了更多的总体不良出生结局（34.5% vs 26.6%; aRR 1.2，95% CI 1.1-1.4），重度不良出生结局（13.6% vs 9.8%; aRR 1.2，95% CI 1.0-1.5）、早产（21.4% vs 13.4%; aRR 1.4，95% CI 1.2-1.7）和死产（5.6% vs 2.7%; aRR 1.7，95% CI 1.2-2.5）。暴露于SARS-CoV-2和HIV感染的新生儿不良出生结局的患病率最高（43.1%vs22.6%，aRR 1.7，95%CI 1.4-2.0）。结论：在博茨瓦纳，分娩时感染SARS-CoV-2与3.7%的孕产妇死亡率和5.6%的死胎相关。大多数不良出生结果在暴露于SARS-CoV-2和HIV感染的新生儿中更糟。
OBJECTIVE:To evaluate the combined association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and human immunodeficiency virus (HIV) infection on adverse birth outcomes in an HIV-endemic region.METHODS:The Tsepamo Study abstracts data from antenatal and obstetric records in government maternity wards across Botswana. We assessed maternal mortality and adverse birth outcomes for all singleton pregnancies from September 2020 to mid-November 2021 at 13 Tsepamo sites among individuals with documented SARS-CoV-2 screening tests and known HIV status.RESULTS:Of 20,410 individuals who gave birth, 11,483 (56.3%) were screened for SARS-CoV-2 infection; 4.7% tested positive. People living with HIV were more likely to test positive (144/2,421, 5.9%) than those without HIV (392/9,030, 4.3%)(P=. 001). Maternal deaths occurred in 3.7% of those who had a positive SARS-CoV-2 test result compared with 0.1% of those who tested negative (adjusted relative risk [aRR] 31.6, 95% CI 15.4–64.7). Maternal mortality did not differ by HIV status. The offspring of individuals with SARS-CoV-2 infection experienced more overall adverse birth outcomes (34.5% vs 26.6%; aRR 1.2, 95% CI 1.1–1.4), severe adverse birth outcomes (13.6% vs 9.8%; aRR 1.2, 95% CI 1.0–1.5), preterm delivery (21.4% vs 13.4%; aRR 1.4, 95% CI 1.2–1.7), and stillbirth (5.6% vs 2.7%; aRR 1.7 95% CI 1.2–2.5). Neonates exposed to SARS-CoV-2 and HIV infection had the highest prevalence of adverse birth outcomes (43.1% vs 22.6%; aRR 1.7, 95% CI 1.4–2.0).CONCLUSION:Infection with SARS-CoV-2 at the time of delivery was associated with 3.7% maternal mortality and 5.6% stillbirth in Botswana. Most adverse birth outcomes were worse among neonates exposed to both SARS-CoV-2 and HIV infection.