Outcomes of pregnant and post-partum patients admitted to the intensive care unit with COVID-19 in Australia: An analysis of SPRINT-SARI Australia

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology Pub Date : 2024-12-09 DOI:10.1111/ajo.13908

Emma Barnes, Peinan Zhao, Andrew Udy, Nhi Nguyen, Aidan Burrell, the SPRINT-SARI Australia Investigators

{"title":"Outcomes of pregnant and post-partum patients admitted to the intensive care unit with COVID-19 in Australia: An analysis of SPRINT-SARI Australia","authors":"Emma Barnes, Peinan Zhao, Andrew Udy, Nhi Nguyen, Aidan Burrell, the SPRINT-SARI Australia Investigators","doi":"10.1111/ajo.13908","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Background</h3>\n \n <p>Pregnant and post-partum (collectively peri-partum) women may be at increased risk of severe COVID-19 disease.</p>\n </section>\n \n <section>\n \n <h3> Aims</h3>\n \n <p>To describe the characteristics, interventions, and outcomes of peri-partum patients admitted to intensive care units (ICUs) in Australia with COVID-19.</p>\n </section>\n \n <section>\n \n <h3> Materials and methods</h3>\n \n <p>We conducted a prospective, multicentre observational study using the SPRINT-SARI Australia database across 63 ICUs in Australia. All women <45 years of age, admitted to a participating Australian ICU, with laboratory-confirmed COVID-19 between 1 March 2020 and 1 June 2023 were included. Participants were categorised as either peri-partum, defined as pregnant or up to six weeks post-partum, or non-pregnant. The primary outcome was in-hospital mortality.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 737 eligible female patients were admitted to ICUs over the study period: 168/737 (23%) were peri-partum, while 569/737 (77%) were non-pregnant. The median age of peri-partum women was 31 (interquartile range (IQR) 27–36) years old, and median gestation was 28.0 (IQR 4–40) weeks. When compared to non-pregnant women, peri-partum women had lower rates of comorbidities (1.8% vs 14.4% <i>P</i> < 0.001), lower vaccination rates (27.4% vs 45.2%, <i>P</i> < 0.001), similar rates of mechanical ventilation, and greater use of tocilizumab (29.2% vs 4.0%, <i>P</i> < 0.001). Complications were low in both groups. In-hospital mortality was lower in peri-partum patients: 1/168 (0.6%) vs 24/569 (4.2%); <i>P</i> = 0.04.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Peri-partum patients made up ~25% of all women aged <45 years old admitted to Australian ICUs with COVID-19, and nearly 30% required mechanical ventilation. Despite lower vaccination rates in peri-partum patients, in-hospital mortality was lower than in non-pregnant patients.</p>\n </section>\n </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 3","pages":"372-381"},"PeriodicalIF":1.4000,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australian & New Zealand Journal of Obstetrics & Gynaecology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ajo.13908","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Pregnant and post-partum (collectively peri-partum) women may be at increased risk of severe COVID-19 disease.

Aims

To describe the characteristics, interventions, and outcomes of peri-partum patients admitted to intensive care units (ICUs) in Australia with COVID-19.

Materials and methods

We conducted a prospective, multicentre observational study using the SPRINT-SARI Australia database across 63 ICUs in Australia. All women <45 years of age, admitted to a participating Australian ICU, with laboratory-confirmed COVID-19 between 1 March 2020 and 1 June 2023 were included. Participants were categorised as either peri-partum, defined as pregnant or up to six weeks post-partum, or non-pregnant. The primary outcome was in-hospital mortality.

Results

A total of 737 eligible female patients were admitted to ICUs over the study period: 168/737 (23%) were peri-partum, while 569/737 (77%) were non-pregnant. The median age of peri-partum women was 31 (interquartile range (IQR) 27–36) years old, and median gestation was 28.0 (IQR 4–40) weeks. When compared to non-pregnant women, peri-partum women had lower rates of comorbidities (1.8% vs 14.4% P < 0.001), lower vaccination rates (27.4% vs 45.2%, P < 0.001), similar rates of mechanical ventilation, and greater use of tocilizumab (29.2% vs 4.0%, P < 0.001). Complications were low in both groups. In-hospital mortality was lower in peri-partum patients: 1/168 (0.6%) vs 24/569 (4.2%); P = 0.04.

Conclusions

Peri-partum patients made up ~25% of all women aged <45 years old admitted to Australian ICUs with COVID-19, and nearly 30% required mechanical ventilation. Despite lower vaccination rates in peri-partum patients, in-hospital mortality was lower than in non-pregnant patients.

查看原文本刊更多论文

澳大利亚重症监护病房收治的COVID-19孕妇和产后患者的结局：SPRINT-SARI澳大利亚分析

背景：孕妇和产后（统称围产期）妇女患严重COVID-19疾病的风险可能增加。目的：描述澳大利亚重症监护病房（icu）收治的COVID-19围产期患者的特征、干预措施和结局。材料和方法：我们使用SPRINT-SARI澳大利亚数据库对澳大利亚63个icu进行了一项前瞻性、多中心观察性研究。结果：在研究期间，共有737名符合条件的女性患者入住icu: 168/737（23%）为围产期患者，569/737（77%）为未怀孕患者。围产期妇女的中位年龄为31岁（IQR 27-36），中位妊娠期为28.0周（IQR 4-40）。与未怀孕妇女相比，围产期妇女的合并症发生率较低（1.8%比14.4%）。结论：围产期妇女占所有年龄妇女的25%

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Australian & New Zealand Journal of Obstetrics & Gynaecology 医学-妇产科学

CiteScore

3.40

自引率

11.80%

发文量

165

审稿时长

4-8 weeks

期刊介绍： The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.