Adverse Pregnancy Outcomes Among Individuals With and Without Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) A Systematic Review and Meta-analysis
Adverse Pregnancy Outcomes Among Individuals With and Without Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) A Systematic Review and Meta-analysis
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DOI：
10.1097/aog.0000000000004320
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发表时间：
2021-04-01
影响因子：
7.2
通讯作者：
Chauhan, Suneet P.
中科院分区：
文献类型：
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作者：
Huntley, Benjamin J. F.;Mulder, Isabelle A.;Chauhan, Suneet P.
目的：比较严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 检测呈阳性的个体与入院时 SARS-CoV-2 检测呈阴性的个体的宫内胎儿死亡（妊娠 20 周或以后）和新生儿死亡的风险。 数据来源：MEDLINE、Ovid、EMBASE、Cumulative Index to Nursing and Allied Health 和 Cochrane Library 从开始到 2020 年 7 月 17 日。对其他文章的手动搜索持续到 2020 年 9 月 24 日。ClinicalTrials.gov 于 2020 年 10 月 21 日进行搜索。 研究选择方法：纳入标准是对至少 20 例在临产和分娩时 SARS-CoV-2 检测呈阳性的孕妇与检测呈阴性的孕妇进行比较的出版物。排除标准是出版物中任一类别的人数少于 20 人，或者缺乏主要结局数据。对选定的数据库进行了系统搜索，共同主要结果是宫内胎儿死亡率和新生儿死亡率。次要结局包括孕产妇和新生儿不良结局的发生率。制表、整合和结果：在确定的 941 篇文章和已完成的试验中，有 6 项研究符合标准。我们的分析包括 728 次向 SARS-CoV-2 检测呈阳性的患者进行的分娩，以及向 3,836 次检测呈阴性的患者同时进行的分娩。 728 名检测呈阳性的患者中有 8 名 (1.1%) 发生宫内胎儿死亡，而 3,836 名检测呈阴性的患者中有 44 名 (1.1%) 发生宫内胎儿死亡 (P=.60)。 432 名检测呈阳性的患者中有 0 名 (0.0%) 发生新生儿死亡，2,400 名检测呈阴性的患者中有 5 名 (0.2%) (P=.90)。 714 名检测呈阳性的患者中有 95 名 (13.3%) 发生早产，3,759 名检测呈阴性的患者中有 446 名 (11.9%) 发生早产 (P=.31)。 559 名检测呈阳性的患者中，有 3 名 (0.5%) 发生孕产妇死亡，3,155 名检测呈阴性的患者中，有 8 名 (0.3%) 发生孕产妇死亡 (P=0.23)。结论：入院和分娩时 SARS-CoV-2 检测呈阳性的个体与阴性个体相比，宫内胎儿死亡和新生儿死亡的发生率相似。 SARS-CoV-2 检测呈阳性与阴性的新生儿的其他直接结果也相似。
OBJECTIVE: To compare the risk of intrauterine fetal death (20 weeks of gestation or later) and neonatal death among individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared with those who tested negative for SARS-CoV-2 on admission for delivery.DATA SOURCES: MEDLINE, Ovid, EMBASE, Cumulative Index to Nursing and Allied Health, and Cochrane Library were searched from their inception until July 17, 2020. Hand search for additional articles continued through September 24, 2020. ClinicalTrials.gov was searched on October 21, 2020.METHODS OF STUDY SELECTION: The inclusion criteria were publications that compared at least 20 cases of both pregnant patients who tested positive for SARS-CoV-2 on admission to labor and delivery and those who tested negative. Exclusion criteria were publications with fewer than 20 individuals in either category or those lacking data on primary outcomes. A systematic search of the selected databases was performed, with co-primary outcomes being rates of intrauterine fetal death and neonatal death. Secondary outcomes included rates of maternal and neonatal adverse outcomes.TABULATION, INTEGRATION, AND RESULTS: Of the 941 articles and completed trials identified, six studies met criteria. Our analysis included 728 deliveries to patients who tested positive for SARS-CoV-2 and 3,836 contemporaneous deliveries to patients who tested negative. Intrauterine fetal death occurred in 8 of 728 (1.1%) patients who tested positive and 44 of 3,836 (1.1%) who tested negative (P=.60). Neonatal death occurred in 0 of 432 (0.0%) patients who tested positive and 5 of 2,400 (0.2%) who tested negative (P=.90). Preterm birth occurred in 95 of 714 (13.3%) patients who tested positive and 446 of 3,759 (11.9%) who tested negative (P=.31). Maternal death occurred in 3 of 559 (0.5%) patients who tested positive and 8 of 3,155 (0.3%) who tested negative (P=.23).CONCLUSION: The incidences of intrauterine fetal death and neonatal death were similar among individuals who tested positive compared with negative for SARS-CoV-2 when admitted to labor and delivery. Other immediate outcomes of the newborns were also similar among those born to individuals who tested positive compared with negative for SARS-CoV-2.