Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study
Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study
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DOI：
10.1136/bmj.m2107
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发表时间：
2020-06-08
影响因子：
105.7
通讯作者：
Kurinczuk, Jennifer J.
中科院分区：
文献类型：
--
作者：
Knight, Marian;Bunch, Kathryn;Kurinczuk, Jennifer J.
描述一个全国性的因严重急性呼吸综合征冠状病毒2型住院的孕妇队列（SARS-CoV-2）在英国的感染，确定与感染相关的因素，并描述结果，包括感染的传播，使用英国产科监测系统（UKOSS）进行的前瞻性全国人群队列研究研究对象：2020年3月1日至2020年4月14日期间因确诊SARS-CoV-2感染而入院的427名孕妇。主要观察指标：孕产妇入院率和婴儿感染率。孕产妇死亡率、3级重症监护病房入院率、胎儿丢失率、剖腹产率、早产率、死产率、早期新生儿死亡率和新生儿病房入院率。233名（56%）因妊娠期间感染SARS-CoV-2而入院的孕妇来自黑人或其他少数民族群体，281名（69%）超重或肥胖，175名（41%）年龄在35岁或以上，145名（34%）先前存在合并症。266名（62%）妇女分娩或流产; 196名（73%）足月分娩。41名（10%）住院妇女需要呼吸支持，5名（1%）妇女死亡。12（5%）的265名婴儿检测SARS-CoV-2 RNA阳性，其中6人在出生后的前12小时内。CONCLUSIONSMost孕妇入院与SARS-CoV-2感染的晚期妊娠中期或晚期妊娠，支持指导继续在怀孕后期的社会距离措施。大多数人的结局良好，SARS-CoV-2传播给婴儿的情况并不常见。黑人或少数民族妇女感染艾滋病毒的比例很高，这一情况需要紧急调查和解释。
OBJECTIVESTo describe a national cohort of pregnant women admitted to hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, identify factors associated with infection, and describe outcomes, including transmission of infection, for mothers and infants.DESIGNProspective national population based cohort study using the UK Obstetric Surveillance System (UKOSS).SETTINGAll 194 obstetric units in the UK.PARTICIPANTS427 pregnant women admitted to hospital with confirmed SARS-CoV-2 infection between 1 March 2020 and 14 April 2020.MAIN OUTCOME MEASURESIncidence of maternal hospital admission and infant infection. Rates of maternal death, level 3 critical care unit admission, fetal loss, caesarean birth, preterm birth, stillbirth, early neonatal death, and neonatal unit admission.RESULTSThe estimated incidence of admission to hospital with confirmed SARS-CoV-2 infection in pregnancy was 4.9 (95% confidence interval 4.5 to 5.4) per 1000 maternities. 233 (56%) pregnant women admitted to hospital with SARS-CoV-2 infection in pregnancy were from black or other ethnic minority groups, 281 (69%) were overweight or obese, 175 (41%) were aged 35 or over, and 145 (34%) had pre-existing comorbidities. 266 (62%) women gave birth or had a pregnancy loss; 196 (73%) gave birth at term. Forty one (10%) women admitted to hospital needed respiratory support, and five (1%) women died. Twelve (5%) of 265 infants tested positive for SARS-CoV-2 RNA, six of them within the first 12 hours after birth.CONCLUSIONSMost pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation.