《致编辑的信》2019冠状病毒病大流行期间,女性是否应该推迟生育?

F. Ranjbar, M. Gharacheh
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引用次数: 1

摘要

目前尚不清楚妇女是否可以决定在COVID-19大流行期间怀孕,或者她们是否有风险,因为检查该病毒的长期后果,特别是在怀孕的头几个月,需要进一步的时间和研究。在急性期或恢复期感染新冠病毒的男性的精液和睾丸中没有发现新冠病毒,因此不太可能通过性传播。然而,有报道称,男性生殖系统易受感染,新冠肺炎患者的性激素发生了明显变化,提示性腺功能受损。因此,新冠肺炎康复后想要孩子的年轻男性在决定要孩子时应该接受咨询。由于细胞免疫受损和生理变化,孕妇易患呼吸道疾病,更容易发展为重症肺炎。孕妇患COVID-19严重疾病的风险可能会增加。为减少COVID-19严重疾病,孕妇应意识到严重疾病的潜在风险。因此,应强调在孕妇中预防COVID-19的必要性,并应确定这些措施的潜在障碍。然而,一项系统综述研究发现,COVID-19孕妇的症状比一般人群要轻,尽管有病毒性肺炎的症状,但她们的RT-PCR检测可能是阴性的。与一般人群相比,感染COVID-19的孕妇早产、低出生体重、剖宫产和在新生儿重症监护病房住院的发生率更高。在感染COVID-19的育龄妇女中,怀孕与重症监护病房住院和机械通气的风险增加有关,但并未增加死亡风险。尽管大多数母亲出院时没有出现任何严重并发症,但仍有因COVID-19导致的严重孕产妇发病率、多例孕产妇死亡和产前死亡的报告。尚未排除病毒垂直传播给胎儿的可能性,因此对COVID-19病例的妊娠进行仔细监测并采取措施预防新生儿感染至关重要。据报道,在妊娠晚期分娩前后的几例产妇感染中存在垂直传播,表明胎儿感染,但并不常见。在有风险的新生儿中,在没有其他问题的情况下,新生儿结局如早产或胎盘早剥已被很好地报道。人们对妊娠前三个月和妊娠中期母体感染的后果知之甚少。妊娠前三个月发生器官发生时的发热或高热可能是胎儿异常的环境危险因素,尤其是
本文章由计算机程序翻译,如有差异,请以英文原文为准。
“Letter to Editor”Should women postpone childbearing during the COVID-19 pandemic?
It is not clear whether women can decide to become pregnant during the COVID-19 pandemic or whether they are at risk, because examining the long-term consequences of the virus, especially in the first months of pregnancy, requires further time and research. The COVID19 virus has not been found in the semen and testicles of men infected with the virus in the acute phase or during the recovery period, so it is unlikely that the disease will be transmitted sexually. However, it has been reported that the male reproductive system is vulnerable to the infection, and significant changes have been observed in the sex hormones of patients with COVID-19, suggesting damage to gonadal function. Therefore, young men who have recovered from COVID-19 and are interested in having children should receive counseling when deciding to have children. Due to damage to cellular immunity and physiological changes, pregnant women are susceptible to respiratory diseases and are more likely to develop severe pneumonia. Pregnant women may be at increased risk for severe COVID-19 disease. To reduce severe COVID-19 disease, pregnant women should be aware of the potential risks of the severe form of the disease. Therefore, the need to prevent COVID-19 in pregnant women should be emphasized, and potential barriers to these measures should be identified. However, a systematic review study found that pregnant women with COVID-19 had milder symptoms than the general population, and that despite the symptoms of viral pneumonia, their RT-PCR tests may be negative. Pregnant women with COVID-19 have a higher prevalence of preterm labor, low birth weight, cesarean delivery, and hospitalization in the NICU than in the general population. In reproductive-aged women with COVID-19 infection, pregnancy has been associated with increased risk of hospitalization in the intensive care unit and mechanical ventilation, but has not increased the risk of death. Although most mothers have been discharged from the hospital without any serious complications, severe maternal morbidity, multiple maternal deaths, and prenatal deaths due to COVID-19 have been reported. The possibility of vertical transmission of the virus to the fetus has not been ruled out, and therefore careful monitoring of pregnancy in cases of COVID-19 and measures to prevent neonatal infection are essential. Vertical transmission has been reported in several cases of maternal infection around delivery in the third trimester, suggesting fetal infection but it is not common. In the at risk newborns, neonatal outcomes such as preterm labor or placental abruption have been well reported in the absence of other problems. Little is known about the consequences of maternal infection in the first and second trimesters of pregnancy. Fever or hyperthermia during the first trimester of pregnancy, when organogenesis occurs, may be an environmental risk factor for fetal abnormalities, especially
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