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在COVID-19之前和期间的分娩方式和出生结果 - - 加拿大安大略省的一项基于人口的研究
Teresa To1,2,3, Jingqin Zhu2,3, Emilie Terebessy2
1Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
PloS one
|May 10, 2024
概括
在COVID-19期间的怀孕中,剖腹产产量增加了9%,但安大略省的早产和NICU入院率下降. 医疗保健的使用发生了转变,急诊次数减少,但医生咨询次数增加,特别是对于那些患有慢性疾病的人来说.
科学领域:
- 孕产妇和胎儿的医学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- COVID-19大流行对加拿大安大略省怀孕结果和医疗保健利用的影响尚不清楚.
- 了解这些影响对于优化产前和产后护理策略至关重要.
研究的目的:
- 在COVID-19大流行之前和期间,在安大略省的孕妇中比较分娩方式,分娩结果和卫生服务使用 (HSU).
- 在大流行期间调查先前存在的慢性疾病对这些结果的影响.
主要方法:
- 对大流行前 (2018年6月至2020年2月) 和期间 (2020年7月至2022年3月) 323,359次分娩的卫生行政数据的分析.
- 多变量逻辑回归用于分娩和分娩结果 (剖腹产,低出生体重,早产,新生儿重症监护室入院).
- 对HSU的负二项式回归 (住院治疗,急救访问,医生访问),对慢性病的分层和相互作用的检查.
主要成果:
- 疫情期间与剖腹产几率上升9% (aOR=1.09) 相关,但早产几率下降15% (aOR=0.85) 和新生儿重症监护室入院几率下降10% (aOR=0.90).
- 紧急部门的访问减少了17% (aRR=0.83),而医生访问增加了16% (aRR=1.16).
- 这些影响在患有先前慢性疾病的女性中更为明显.
结论:
- COVID-19大流行改变了分娩方式和出生结果,剖腹产增加,但在安大略省减少了早产和NICU入院.
- 医疗保健利用模式发生了转变,急诊室使用量显著下降.
- 在公共卫生危机期间保持一致的产前护理对于减轻不良结果和急性护理需求至关重要.
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