A snapshot of the Covid-19 pandemic among pregnant women in France
A snapshot of the Covid-19 pandemic among pregnant women in France
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DOI：
10.1016/j.jogoh.2020.101826
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发表时间：
2020-09-01
影响因子：
1.9
通讯作者：
Schmitz, Thomas
中科院分区：
文献类型：
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作者：
Kayem, Gilles;Lecarpentier, Edouard;Schmitz, Thomas
目的：描述严重急性呼吸系统综合征冠状病毒2的病程（SARS-CoV-2）感染的法国妇女从大流行开始到4月中旬，妇女的呼吸系统并发症的风险概况，以及短期妊娠结局。方法：我们于2020年3月1日至4月14日期间在法国33家产科医院的研究网络中收集了一系列COVID-19孕妇的病例。纳入并分析了所有经鼻样本实时逆转录聚合酶链反应检测阳性和/或经计算机断层扫描胸部扫描诊断的SARS-CoV-2感染病例。主要结局指标为COVID-19需要氧气（氧疗或无创通气）和危重COVID-19（需要有创机械通气或体外膜肺氧合，ECMO）。结果：2020年3月1日至31日期间，COVID-19活动性病例呈指数级增长; 3月17日实施封锁后，4月1日至14日期间，这一数字下降。活跃临界COVID-19的曲线形状反映了所有活跃病例的曲线形状。截至4月14日，在617名患有COVID-19的孕妇中，93名妇女（15. 1%; 95% CI 12. 3 - 18. 1）需要氧疗，另有35名妇女（5. 7%; 95% CI 4. 0 - 7. 8）患有COVID-19的危急形式。该疾病的严重程度与年龄大于35岁和肥胖，以及先前存在的糖尿病，先前的先兆子痫和妊娠高血压或先兆子痫有关。1名重症COVID-19女性死亡（0.2%; 95%CI 0-0.9）。在分娩的妇女中，非重症、需氧和危重COVID-19妇女的早产率为13/123 32周前分别为3/123（2.4%）、4/29（13.8%）和14/29（48.3%）。危重组中有1名新生儿（0.5%; 95%CI 0.01-2.9）死于早产。结论：COVID-19可能是导致严重急性、可能致命的呼吸窘迫综合征发病率很高的原因。最脆弱的孕妇，那些患有合并症的孕妇，可能特别受益于封锁等预防措施。(C)2020 Elsevier Masson SAS。All rights reserved.
Objective: To describe the course over time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in French women from the beginning of the pandemic until mid-April, the risk profile of women with respiratory complications, and short-term pregnancy outcomes.Methods: We collected a case series of pregnant women with COVID-19 in a research network of 33 French maternity units between March 1 and April 14, 2020. All cases of SARS-CoV-2 infection confirmed by a positive result on real-time reverse transcriptase polymerase chain reaction tests of a nasal sample and/or diagnosed by a computed tomography chest scan were included and analyzed. The primary outcome measures were COVID-19 requiring oxygen (oxygen therapy or noninvasive ventilation) and critical COVID-19 (requiring invasive mechanical ventilation or extracorporeal membrane oxygenation, ECMO). Demographic data, baseline comorbidities, and pregnancy outcomes were also collected.Results: Active cases of COVID-19 increased exponentially during March 1-31, 2020; the numbers fell during April 1-14, after lockdown was imposed on March 17. The shape of the curve of active critical COVID-19 mirrored that of all active cases. By April 14, among the 617 pregnant women with COVID-19, 93 women (15.1 %; 95 %Cl 12.3-18.1) had required oxygen therapy and 35 others (5.7 %; 95 %CI 4.0-7.8) had had a critical form of COVID-19. The severity of the disease was associated with age older than 35 years and obesity, as well as preexisting diabetes, previous preeclampsia, and gestational hypertension or preeclampsia. One woman with critical COVID-19 died (0.2 %; 95 %CI 0-0.9). Among the women who gave birth, rates of preterm birth in women with non-severe, oxygen-requiring, and critical COVID-19 were 13/123 (10.6 %),14/29 (48.3 %), and 23/29 (79.3 %) before 37 weeks and 3/123 (2.4 %), 4/29 (13.8 %), and 14/29 (48.3 %) before 32 weeks, respectively. One neonate (0.5 %; 95 %CI 0.01-2.9) in the critical group died from prematurity.Conclusion: COVID-19 can be responsible for significant rates of severe acute, potentially deadly, respiratory distress syndromes. The most vulnerable pregnant women, those with comorbidities, may benefit particularly from prevention measures such as a lockdown. (C) 2020 Elsevier Masson SAS. All rights reserved.