Am J Obstet Gynecol:不出所料,孕妇感染新冠病毒后的种种预后不良!

2021-02-01 MedSci原创 MedSci原创

越来越多的证据表明,新冠肺炎(COVID-19)增加了孕妇住院和机械通气以及早产的风险。然而,COVID-19及其严重程度对产妇死亡率的影响尚不清楚。

越来越多的证据表明,新冠肺炎COVID-19)增加了孕妇住院和机械通气以及早产的风险。然而,COVID-19及其严重程度对产妇死亡率的影响尚不清楚。

近日发表在《美国妇产科杂志》“Am J Obstet Gynecol”上的“Disease Severity, Pregnancy Outcomes and Maternal Deaths among Pregnant Patients with SARS-CoV-2 Infection in Washington State”一文报告了华盛顿州孕妇感染新冠病毒(SARS-CoV-2)的严重程度和结局,包括妊娠并发症、住院时间和病死率。

这是一项多中心回顾性队列研究,纳入了2020年3月1日-6月30日期间经PCR证实感染新冠病毒的孕妇。这些中心囊括了该州每年61%的分娩量。将受试者的病死率与同龄成人的妊娠病死率和新冠肺炎病死率进行比较。并根据感染的三个月和分娩时的疾病严重程度来分层对比产妇和新生儿的结局。

分析结果显示:

  1) 华盛顿州240例妊娠合并新冠病毒感染的患者中,1/11发展为重症或危重症,1/10因新冠肺炎住院治疗,1/80死亡;

  2) 与新冠肺炎相关的住院率是华盛顿州同龄成人的3.5倍(10.0% vs 2.8%,比率比[RR]3.5,95%CI 2.3~5.3);

  3) 因呼吸道疾病住院的孕妇更有可能有共发疾病或潜在疾病,包括哮喘、高血压、2型糖尿病、自身免疫性疾病和III型肥胖症;

  4) 3例产妇死亡(1.3%)归因于新冠肺炎,产妇死亡率为1250/10万;

  5) 在华盛顿州,发生新冠肺炎的孕妇的死亡率是同龄孕妇的13.6倍(95%CI 2.7-43.6),死亡率的绝对差异为1.2%(95%CI 0.3-2.6);

  6) 患有重度/危重度新冠肺炎的孕妇早产率显著高于已从新冠肺炎康复的孕妇(重度/危重新冠肺炎 vs 轻度新冠肺炎:45.4% vs 5.2%,p<0.001)。

在华盛顿州,孕妇的新冠肺炎住院率和病死率明显高于同龄人。这一数据表明,与未怀孕的成年人相比,孕妇感染新冠病毒后发展成重症或危重症以及死亡和早产的风险都明显升高。

原始出处:

Lokken Erica M,Huebner Emily M,Taylor G Gray et al. Disease Severity, Pregnancy Outcomes and Maternal Deaths among Pregnant Patients with SARS-CoV-2 Infection in Washington State. Am J Obstet Gynecol, 2021, 10.1016/j.ajog.2020.12.1221.

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    2021-02-23 yhy100200
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    2021-02-01 公卫新人

    新冠肺炎,疫情何时才能消失

    0

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    2021-02-01 zb1235672

    来学习了#新冠肺炎#

    0

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