与SARS-CoV-2感染相关的全球孕产妇死亡率:系统性审查和元分析
Kathryn Barry1, Silvia Fernández-García2, Alya Khashaba1
1College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
BMJ global health
|April 21, 2025
概括
感染SARS-CoV-2的孕妇面临更高的死亡风险,特别是在撒哈拉以南非洲和低收入国家. COVID-19是这些产妇死亡的主要原因,凸显了全球健康差异.
科学领域:
- 产科和妇科 产科和妇科
- 传染性疾病 传染性疾病
- 全球健康 全球健康
背景情况:
- 与非孕妇相比,感染SARS-CoV-2 (COVID-19) 的孕妇和最近怀孕的孕妇的死亡率和严重并发症风险较高.
- 在COVID-19的孕妇中,死亡率和死亡原因的显著区域差异以前是未知的.
研究的目的:
- 系统地审查和分析不同地理区域和国家收入群体感染SARS-CoV-2的孕妇死亡率的变化.
- 为了确定这一脆弱群体中主要的死亡原因.
主要方法:
- 从2019年12月到2023年1月,对主要数据库 (Medline, LILACS, BIREME, Embase) 进行了全面的搜索.
- 包括报告至少10名连续怀孕或近期怀孕已确认感染SARS-CoV-2的妇女死亡的研究.
- 使用多层随机效应逻辑回归模型计算总结死亡率估计,并使用ICD-MM对死亡原因进行分类.
主要成果:
- 分析了169项涉及319,172名确诊感染SARS-CoV-2的妇女的研究,其中包括4,253例死亡.
- 总体而言,孕产妇死亡率为0.87%,撒哈拉以南非洲 (3.48%) 和拉丁美洲/加勒比海 (3.16%) 的死亡率明显更高.
- 在低收入国家观察到的最高死亡率 (4.66%),COVID-19占报告死亡人数的98.6%.
结论:
- 感染SARS-CoV-2的孕妇的死亡率呈现出显著的地理和社会经济差异,不成比例地影响撒哈拉以南非洲和低收入国家.
- COVID-19被确定为该人口中死亡的主要原因,这强调了针对性干预和改善医疗保健准入的必要性.
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