COVID-19对马尼托巴省第一民族和所有其他母亲及其后代围产期结局的影响

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2025-04-26 DOI:10.1016/j.ejogrb.2025.114006

Amy Hui , Roxana Dragan , Elizabeth Decaire , Vivian Omarr , Connie Kuzdak , Jennifer Yamamoto , Brandy Wicklow , Elizabeth Sellers , Jonathan McGavock , Christy Pylypjuk , Nathan Nickel , Depeng Jiang , Garry X. Shen

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引用次数: 0

摘要

covid -19严重扰乱了医疗保健，但其对马尼托巴省围产期结局的影响尚不清楚。方法本研究采用回顾性数据库研究，在2019冠状病毒病（2020年3月至2021年12月）期间，与对照期（2018年3月至2020年3月）相比，调查了马尼托巴省第一民族和所有其他妇女和婴儿的围产期结局。主要结果：与COVID-19期间或对照期间的所有其他妊娠相比，原住民妊娠的妊娠糖尿病、妊娠前糖尿病（PPD）、早产、死产、胎龄大的婴儿、新生儿重症监护病房（NICU）入院和配方喂养的发生率显著高于其他妊娠，纯母乳喂养率较低。在新冠肺炎期间，原住民新生儿的早产（aOR为1⋅17,95%可信区间或CI为1⋅06,1⋅30）和肩难产（aOR为1⋅33,95% CI为1⋅08,1⋅64）的年龄调整优势比（aOR为1⋅17,95% CI为1⋅08,1⋅64）均较对照期有所增加，但并非所有其他新生儿的年龄调整优势比均有所增加。与对照组相比，在COVID-19期间怀孕的所有其他孕妇中，先兆子痫、子痫和自然流产的aORs都增加了，但原住民没有。Logistic线性回归分析显示PPD是早产、死产、肩难产和入住新生儿重症监护病房的主要因素。结论研究结果表明，COVID-19在原住民后代中引起了更严重的新生儿不良结局。产妇糖尿病在不良新生儿结局中起重要作用。通过加强围产期教育和护理来预防孕产妇糖尿病可能有助于减少未来大流行中原住民人口不良新生儿结局的风险。

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Impact of COVID-19 on perinatal outcomes in First Nations and all other mothers and their offspring in Manitoba

Purpose of research

COVID-19 substantially disrupted healthcare, but its impact on perinatal outcome in Manitoba remains unclear.

Methods

The present study examined perinatal outcomes in First Nations and all other women and infants in Manitoba during COVID-19 (March 2020-December 2021) compared to a control period (March 2018-March 2020) using a retrospective database study.

Principal results

First Nations pregnancies had significantly higher rates of gestational diabetes, pre-pregnancy diabetes (PPD), preterm birth, stillbirth, large-for-gestational-age infants, neonatal intensive care unit (NICU) admission and formula feeding, and lower rates of exclusive breastfeeding compared to all other pregnancies during COVID-19 or the control period. Age-adjusted odds ratio (aORs) for preterm birth (aOR 1⋅17, 95% confidence interval or CI: 1⋅06, 1⋅30) and shoulder dystocia (aOR 1⋅33, 95% CI: 1⋅08, 1⋅64) among First Nations, but not all other, newborns were increased during COVID-19 compared to the control period. The aORs for preeclampsia, eclampsia, and spontaneous abortion were increased in all other, but not First Nations, pregnancies during COVID-19 versus the control period. Logistic linear regression analyses indicated that PPD was the leading contributor to the increase of preterm birth, stillbirth, shoulder dystocia and NICU admission.

Conclusions

The findings imply that COVID-19 caused more profound adverse neonatal outcomes in First Nations offspring. Maternal diabetes played an important role in the unfavorable neonatal outcomes. Prevention of maternal diabetes by strengthening perinatal education and care may help to reduce the risk of adverse neonatal outcomes in First Nations population in future pandemic.

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来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.