Characteristics and Outcomes of 241 Births to Women With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection at Five New York City Medical Centers
Characteristics and Outcomes of 241 Births to Women With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection at Five New York City Medical Centers
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DOI：
10.1097/aog.0000000000004025
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发表时间：
2020-08-01
影响因子：
7.2
通讯作者：
Dolan, Siobhan M.
中科院分区：
文献类型：
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作者：
Khoury, Rasha;Bernstein, Peter S.;Dolan, Siobhan M.
目的：描述2020年3月在纽约市检测到社区传播的严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）感染女性的特征和出生结局。方法：我们对2020年3月13日至4月12日期间在纽约市五家医疗中心分娩的实验室确诊SARS-CoV-2感染的孕妇进行了一项前瞻性队列研究。收集分娩住院记录的人口统计学和临床数据，并于2020年4月20日完成随访。研究结果：在这个队列（241名女性）中，使用不断发展的检测标准，61.4%的女性在入院时没有2019年冠状病毒病（COVID-19）症状。在整个分娩住院期间，26.5%的妇女符合世界卫生组织的轻度COVID-19标准，26.1%为重度，5%为危重。剖宫产是52.4%的重症COVID-19妇女和91.7%的危重COVID-19妇女的分娩方式。单胎早产率为14.6%。据报道，17名妇女（7.1%）入住重症监护室，9名妇女（3.7%）在分娩住院期间插管。没有产妇死亡。体重指数（BMI）30或更高与COVID-19的严重程度相关（P=.001）。几乎所有新生儿出生后立即检测SARS-CoV-2感染呈阴性（97.5%）。结论：在纽约市爆发SARS-CoV-2的第一个月期间，随着检测标准的不断发展，大多数被实验室确诊感染的产妇入院分娩时没有COVID-19的症状。几乎三分之一入院时无症状的妇女在分娩住院期间出现症状。肥胖与COVID-19的严重程度相关。疾病严重程度与剖宫产率和早产率较高相关。
OBJECTIVE: To describe the characteristics and birth outcomes of women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as community spread in New York City was detected in March 2020. METHODS: We performed a prospective cohort study of pregnant women with laboratory-confirmed SARS-CoV-2 infection who gave birth from March 13 to April 12, 2020, identified at five New York City medical centers. Demographic and clinical data from delivery hospitalization records were collected, and follow-up was completed on April 20, 2020. RESULTS: Among this cohort (241 women), using evolving criteria for testing, 61.4% of women were asymptomatic for coronavirus disease 2019 (COVID-19) at the time of admission. Throughout the delivery hospitalization, 26.5% of women met World Health Organization criteria for mild COVID-19, 26.1% for severe, and 5% for critical. Cesarean birth was the mode of delivery for 52.4% of women with severe and 91.7% with critical COVID-19. The singleton preterm birth rate was 14.6%. Admission to the intensive care unit was reported for 17 women (7.1%), and nine (3.7%) were intubated during their delivery hospitalization. There were no maternal deaths. Body mass index (BMI) 30 or higher was associated with COVID-19 severity (P=.001). Nearly all newborns tested negative for SARS-CoV-2 infection immediately after birth (97.5%). CONCLUSION: During the first month of the SARS-CoV-2 outbreak in New York City and with evolving testing criteria, most women with laboratory-confirmed infection admitted for delivery did not have symptoms of COVID-19. Almost one third of women who were asymptomatic on admission became symptomatic during their delivery hospitalization. Obesity was associated with COVID-19 severity. Disease severity was associated with higher rates of cesarean and preterm birth.