COVID-19对严重孕产妇发病风险的影响
Nathalie Auger1,2,3,4, U Vivian Ukah5,6, Shu Qin Wei5,7
1University of Montreal Hospital Research Centre, Montreal, QC, Canada. nathalie.auger@inspq.qc.ca.
Critical care (London, England)
|September 5, 2023
概括
患有COVID-19的孕妇患者面临重症孕产妇发病风险的两倍. 这包括严重的并发症,如功能衰竭,栓塞和出血,特别是在严重的感染.
科学领域:
- 产科和妇科 产科和妇科
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 怀孕呈现出独特的生理变化,可以改变对感染的易感性.
- 孕妇COVID-19感染与孕妇和胎儿的不良结果有关.
- 了解怀孕期间与COVID-19相关的特定风险对于临床管理和公共卫生指导至关重要.
研究的目的:
- 调查怀孕期间COVID-19感染与严重孕产妇发病风险之间的关联.
- 分析感染的严重程度,时间 (产前与产周),以及流传的变种如何影响孕产妇的发病风险.
- 量化COVID-19感染孕妇患者特定严重孕产妇死亡事件的风险增加.
主要方法:
- 在加拿大北克进行了一项基于人口的研究,从2020年3月到2022年3月,涉及162,576例怀孕.
- COVID-19感染状态,严重程度,时间和变种被评估为暴露.
- 产后42天的严重孕产妇发病率是主要结局,使用调整后的分位数回归模型进行分析,以估计风险比率 (RR) 和95%置信区间 (CI).
主要成果:
- COVID-19感染与严重孕产妇发病率增加2倍的风险有关 (RR 2.02).
- 观察到急性功能衰竭 (RR 3.01) 和严重出血 (RR 1.49) 的风险增加,并有栓塞,休克,败血症和DIC (RR 1.35) 的趋势.
- 严重的产前和产周感染的风险明显更高 (分别为RR 13.60和20.93),轻微的产前感染也增加了风险 (RR 3.43). 与Omicron相比,野生型,α和delta变种的风险更高.
结论:
- 怀孕期间的COVID-19感染显著增加了危及生命的孕产妇发病风险,包括脏,栓塞和出血并发症.
- COVID-19感染的严重程度和时间 (产前或产周) 是与增加孕产妇发病率相关的关键因素.
- 这些发现强调了疫苗接种和孕妇预防措施的重要性,以减轻COVID-19相关的严重孕产妇并发症.
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