孕期SARS-CoV-2感染与不良妊娠结局的关联
创作:Epi汪 审核:Epi汪 2021年04月02日
  • 检索并筛选相关的文献,最终纳入6项研究,包含728例严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)阳性的病例和3836例阴性孕妇;
  • 阳性组孕妇宫内死亡(>20周)发生率为1.1%,与阴性组无统计学差异(1.1%);
  • 阳性和阴性组新生儿死亡率无统计学差异(0% vs 0.2%),早产率无统计学差异(13.3% vs 11.9%);
  • 两组孕妇死亡率分别为0.5% 和0.3%,无统计学差异;
  • 暂未发现孕期SARS-CoV-2阳性与不良妊娠结局的关联。
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Epi汪
本研究通过不同研究数据的荟萃分析后发现,孕期SARS-CoV-2感染可能并不会增加胎儿死亡、新生儿死亡以及早产的风险。
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Adverse Pregnancy Outcomes Among Individuals With and Without Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Systematic Review and Meta-analysis

患有和不患有严重急性呼吸综合征冠状病毒2型的个体的不良妊娠结局:一项系统评价与荟萃分析

10.1097/AOG.0000000000004320

2021-03-10, Review

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Objective: To compare the risk of intrauterine fetal death (20 weeks of gestation or later) and neonatal death among individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared with those who tested negative for SARS-CoV-2 on admission for delivery.
Data sources: MEDLINE, Ovid, EMBASE, Cumulative Index to Nursing and Allied Health, and Cochrane Library were searched from their inception until July 17, 2020. Hand search for additional articles continued through September 24, 2020. ClinicalTrials.gov was searched on October 21, 2020.
Methods of study selection: The inclusion criteria were publications that compared at least 20 cases of both pregnant patients who tested positive for SARS-CoV-2 on admission to labor and delivery and those who tested negative. Exclusion criteria were publications with fewer than 20 individuals in either category or those lacking data on primary outcomes. A systematic search of the selected databases was performed, with co-primary outcomes being rates of intrauterine fetal death and neonatal death. Secondary outcomes included rates of maternal and neonatal adverse outcomes.
Tabulation, integration, and results: Of the 941 articles and completed trials identified, six studies met criteria. Our analysis included 728 deliveries to patients who tested positive for SARS-CoV-2 and 3,836 contemporaneous deliveries to patients who tested negative. Intrauterine fetal death occurred in 8 of 728 (1.1%) patients who tested positive and 44 of 3,836 (1.1%) who tested negative (P=.60). Neonatal death occurred in 0 of 432 (0.0%) patients who tested positive and 5 of 2,400 (0.2%) who tested negative (P=.90). Preterm birth occurred in 95 of 714 (13.3%) patients who tested positive and 446 of 3,759 (11.9%) who tested negative (P=.31). Maternal death occurred in 3 of 559 (0.5%) patients who tested positive and 8 of 3,155 (0.3%) who tested negative (P=.23).
Conclusion: The incidences of intrauterine fetal death and neonatal death were similar among individuals who tested positive compared with negative for SARS-CoV-2 when admitted to labor and delivery. Other immediate outcomes of the newborns were also similar among those born to individuals who tested positive compared with negative for SARS-CoV-2.

First Authors:
Benjamin J F Huntley

Correspondence Authors:
Benjamin J F Huntley

All Authors:
Benjamin J F Huntley,Isabelle A Mulder,Daniele Di Mascio,William S Vintzileos,Anthony M Vintzileos,Vincenzo Berghella,Suneet P Chauhan

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