Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection
Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection
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DOI：
10.1002/uog.23107
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发表时间：
2021-01-21
影响因子：
7.1
通讯作者：
D'Antonio, Francesco
中科院分区：
文献类型：
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作者：
Saccone, Gabriele;Sen, Cihat;D'Antonio, Francesco
目的评价SARS-CoV-2感染孕妇的孕产妇及围产儿结局。方法本研究是一项多国回顾性队列研究，纳入了欧洲、美国、南美、亚洲和澳大利亚22个不同国家的72个中心，于2020年2月1日至2020年4月30日期间进行的单胎妊娠和实验室确诊的SARS-CoV-2感染妇女。鼻咽拭子标本实时逆转录聚合酶链反应（RT-PCR）检测阳性为确诊的SARS-CoV-2感染。主要终点是孕产妇死亡率和发病率的综合指标，包括入住重症监护病房（ICU）、使用机械通气和死亡。结果共有388名单胎妊娠妇女在鼻咽拭子RT-PCR检测中检测出SARS-CoV-2阳性，并被纳入该研究。47/388（12.1%）名妇女观察到综合不良产妇结局；43例（11.1%）入住ICU， 36例（9.3%）需要机械通气，3例（0.8%）死亡。在纳入研究的388名女性中，122名（31.4%）在数据分析时仍处于怀孕状态。在其他266名妇女中，有6名（占31名妊娠早期感染妇女的19.4%）流产，3名（1.1%）终止妊娠，6名（2.3%）死产，251名（94.4%）分娩了一个活产婴儿。37周前早产率为26.3%（70/266）。251例活产婴儿中，69/251例（27.5%）入住新生儿重症监护病房，5例（2.0%）新生儿死亡。围产儿总死亡率为4.1%（11/266）。在妊娠晚期检测呈阳性的母亲所生的婴儿中，只有一名（1/251,0.4%）在RT-PCR中被发现呈SARS-CoV-2阳性。结论SARS-CoV-2感染与孕产妇死亡率相关，孕产妇死亡率为0.8%，重症监护病房入院率为11.1%。垂直传播的风险似乎可以忽略不计。(C) 2020年国际妇产科超声学会。
Objectives To evaluate the maternal and perinatal outcomes of pregnancies affected by SARS-CoV-2 infection.Methods This was a multinational retrospective cohort study including women with a singleton pregnancy and laboratory-confirmed SARS-CoV-2 infection, conducted in 72 centers in 22 different countries in Europe, the USA, South America, Asia and Australia, between 1 February 2020 and 30 April 2020. Confirmed SARS-CoV-2 infection was defined as a positive result on real-time reverse-transcription polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab specimens. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit (ICU), use of mechanical ventilation and death.Results In total, 388 women with a singleton pregnancy tested positive for SARS-CoV-2 on RT-PCR of a nasopharyngeal swab and were included in the study. Composite adverse maternal outcome was observed in 47/388 (12.1%) women; 43 (11.1%) women were admitted to the ICU, 36 (9.3%) required mechanical ventilation and three (0.8%) died. Of the 388 women included in the study, 122 (31.4%) were still pregnant at the time of data analysis. Among the other 266 women, six (19.4% of the 31 women with first-trimester infection) had miscarriage, three (1.1%) had termination of pregnancy, six (2.3%) had stillbirth and 251 (94.4%) delivered a liveborn infant. The rate of preterm birth before 37 weeks' gestation was 26.3% (70/266). Of the 251 liveborn infants, 69/251(27.5%) were admitted to the neonatal ICU, and there were five (2.0%) neonatal deaths. The overall rate of perinatal death was 4.1% (11/266). Only one (1/251, 0.4%) infant, born to a mother who tested positive during the third trimester, was found to be positive for SARS-CoV-2 on RT-PCR.Conclusions SARS-CoV-2 infection in pregnant women is associated with a 0.8% rate of maternal mortality, but an 11.1% rate of admission to the ICU. The risk of vertical transmission seems to be negligible. (C) 2020 International Society of Ultrasound in Obstetrics and Gynecology.