多胎妊娠是sars - cov -2相关不良孕产妇结局的危险因素:来自COVID-19相关产科和新生儿结局研究(CRONOS)的数据

IF 2.4 4区 医学 Q2 OBSTETRICS & GYNECOLOGY
Geburtshilfe Und Frauenheilkunde Pub Date : 2023-11-30 eCollection Date: 2023-12-01 DOI:10.1055/a-2196-6224
Marina Sourouni, Ariane Germeyer, Manuel Feißt, Alexandra Balzer, Helen Köster, Annemarie Minte, Dörthe Brüggmann, Celine Kohll, Kristin Reinhardt, Michaela Möginger, Anja Leonhardt, Constanze Banz-Jansen, Michael Bohlmann, Christiane Fröhlich, Clara Backes, Dietrich Hager, Lisa Kaup, Elsa Hollatz-Galuschki, Charlotte Engelbrecht, Filiz Markfeld-Erol, Carsten Hagenbeck, Hening Schäffler, Jennifer Winkler, Johannes Stubert, Katharina Rathberger, Laura Lüber, Linda Hertlein, Antonia Machill, Manuela Richter, Martin Berghäuser, Michael Weigel, Mirjam Morgen, Nora Horn, Peter Jakubowski, Bastian Riebe, Babett Ramsauer, Robert Sczesny, Ute Margaretha Schäfer-Graf, Susanne Schrey, Sven Kehl, Julia Lastinger, Sven Seeger, Olaf Parchmann, Antonella Iannaccone, Jens Rohne, Luise Gattung, Christine A Morfeld, Michael Abou-Dakn, Markus Schmidt, Michaela Glöckner, Anja Jebens, Kathleen Marie Sondern, Ulrich Pecks, Ralf Schmitz, Mareike Möllers
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引用次数: 0

摘要

研究表明,与非孕妇相比,感染COVID-19的孕妇入住重症监护病房和有创机械通气支持的风险更高。妊娠相关的呼吸功能生理变化可能导致风险升高。肺容量和肺活量的改变可归因于胎儿生长所引起的机械障碍。因此,多胎妊娠可能比单胎妊娠更早损害肺功能,并导致COVID-19的严重呼吸道症状。材料和方法:纳入在COVID-19相关产科和新生儿结局研究中登记的5514名有症状的妊娠期SARS-CoV-2感染的妇女。比较了165例多胎妊娠和5349例单胎妊娠中与covid -19相关的不良孕产妇结局。综合不良产妇结局定义为出现与covid -19相关的住院和/或肺炎和/或给氧和/或转至ICU和/或死亡。采用多变量logistic回归估计比值比,并计算95%置信区间。结果:两组患者在妊娠周内发生呼吸困难的频率、发生呼吸困难的可能性以及COVID-19感染症状期的持续时间均无差异。平均而言,与单胎妊娠相比,多胎妊娠期间与covid -19相关的综合不良后果发生得更早。与covid -19相关的单一和联合不良孕产妇结局的总体发生率在组间无显著差异。然而,回归分析显示,多胎妊娠、孕前BMI > 30 kg/ m2和胎龄与合并不良产妇结局的风险增加显著相关。相反,产妇年龄和医疗辅助生殖不是综合不良产妇结局的重要危险因素。结论:我们的数据显示,单胎妊娠是covid -19相关联合不良孕产妇结局的危险因素。此外,与单胎妊娠相比,多胎妊娠妇女出现COVID-19严重病程的时间更早。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Multiple Gestation as a Risk Factor for SARS-CoV-2-Associated Adverse Maternal Outcome: Data From the COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS).

Introduction: Studies have shown that pregnant women with COVID-19 have a higher risk of intensive care unit admission and invasive mechanical ventilation support than non-pregnant women. Pregnancy-associated physiological changes in respiratory function may contribute to the elevated risk. Alteration in lung volumes and capacities are attributed to the mechanical impediment caused by the growing fetus. Multiple pregnancies may therefore compromise functional lung capacity earlier than singleton pregnancies and contribute to severe respiratory symptoms of COVID-19.

Materials and methods: A total of 5514 women with a symptomatic SARS-CoV-2 infection during pregnancy registered in the COVID-19 Related Obstetric and Neonatal Outcome Study were included. The COVID-19-related adverse maternal outcomes were compared in 165 multiple versus 5349 singleton pregnancies. Combined adverse maternal outcome was defined as presence of COVID-19-related hospitalization and/or pneumonia and/or oxygen administration and/or transfer to ICU and/or death. Multivariate logistic regression was used to estimate the odds ratios and 95% confidence intervals were calculated.

Results: The frequency of dyspnea, likelihood of developing dyspnea in a defined pregnancy week and duration of the symptomatic phase of the COVID-19 infection did not differ between the two groups. On average, COVID-19-related combined adverse outcome occurred earlier during pregnancy in women expecting more than one child than in singleton pregnancies. The overall incidence of singular and combined COVID-19-associated adverse maternal outcomes was not significantly different between groups. However, regression analysis revealed that multiple gestation, preconceptional BMI > 30 kg/m 2 and gestational age correlated significantly with an increased risk of combined adverse maternal outcome. Conversely, maternal age and medically assisted reproduction were not significant risk factors for combined adverse maternal outcome.

Conclusion: Our data show that multiple gestation alone is a risk factor for COVID-19-associated combined adverse maternal outcome. Moreover, severe courses of COVID-19 in women expecting more than one child are observed earlier in pregnancy than in singleton pregnancies.

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来源期刊
Geburtshilfe Und Frauenheilkunde
Geburtshilfe Und Frauenheilkunde 医学-妇产科学
CiteScore
2.50
自引率
22.20%
发文量
828
审稿时长
6-12 weeks
期刊介绍: Geburtshilfe und Frauenheilkunde (GebFra) addresses the whole field of obstetrics and gynecology and is concerned with research as much as with clinical practice. In its scientific section, it publishes original articles, reviews and case reports in all fields of the discipline, namely gynecological oncology, including oncology of the breast obstetrics and perinatal medicine, reproductive medicine, and urogynecology. GebFra invites the submission of original articles and review articles. In addition, the journal publishes guidelines, statements and recommendations in cooperation with the DGGG, SGGG, OEGGG and the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF, Association of Scientific Medical Societies, www.awmf.org). Apart from the scientific section, Geburtshilfe und Frauenheilkunde has a news and views section that also includes discussions, book reviews and professional information. Letters to the editors are welcome. If a letter discusses an article that has been published in our journal, the corresponding author of the article will be informed and invited to comment on the letter. The comment will be published along with the letter.
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