严重急性呼吸系统综合征冠状病毒2型德尔塔变异株(B.1.617.2)对孕产妇和新生儿结局的影响

K. Dolma, Swati John, R. Gulati
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摘要

据报道,妊娠期间感染2019冠状病毒(新冠肺炎)会增加孕产妇和围产期不良后果的风险。来自普通人群的数据表明,德尔塔变异株感染与比阿尔法变异株更严重的疾病有关。然而,关于妊娠期德尔塔变异株感染对围产期结果的影响,现有数据有限。本研究旨在评估妊娠期严重急性呼吸系统综合征冠状病毒2型德尔塔变异株感染对孕产妇和新生儿结局的影响。在这项回顾性的单中心研究中,我们纳入了2020年5月至2021年10月出生的所有婴儿,这些婴儿的母亲在怀孕期间感染了新冠肺炎。在我们的机构,我们于2020年5月29日开始对所有入院的产科患者进行住院检测。在我们地区,从2021年7月起,德尔塔变异株占所有新冠肺炎感染病例的80%以上。比较了德尔塔前组(2020年5月至2021年6月,n=20)和德尔塔组(2021年7月至2021月,n=52)的产妇和新生儿结局。在比较产前组和德尔塔组时,产妇绒毛膜羊膜炎、妊娠高血压、糖尿病、产前出血、剖腹产、产妇入住ICU、产妇新冠肺炎症状和产妇存活率没有显著差异。这些母亲所生的所有新生儿新冠肺炎检测结果均为阴性。两组的早产率、5分钟时Apgar评分低于5分、胎龄小、小头畸形、需要无创或有创呼吸机支持、缺氧缺血性脑病、培养阳性败血症和新生儿存活率没有差异。两组的胎盘检查结果没有差异。然而,德尔塔组中有症状的母亲所生的婴儿早产率较高。根据我们的研究,新冠肺炎的德尔塔变异株会增加有症状母亲的早产率。需要对现有研究进行进一步的荟萃分析,以评估其对新生儿结局的影响。
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Effects of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) Delta variant (B.1.617.2) on maternal and neonatal outcomes
Coronavirus 2019 (COVID-19) infection during pregnancy has been reported to increase the risk of adverse maternal and perinatal outcomes. Data from the general population suggests that the Delta variant infection is associated with more severe disease than the Alpha variant. However, there is limited data available on the impact of delta variant infection during pregnancy on perinatal outcomes. This study aimed to evaluate the effects of SARS-CoV-2 delta variant infection during pregnancy on maternal and neonatal outcomes. In this retrospective, single-center study, we included all infants who were born from May 2020 through October 2021 to mothers with COVID-19 infection during pregnancy. At our institution, we started inpatient testing of all obstetric patients on admission on May 29, 2020. In our region, the Delta variant accounted for more than 80% of all COVID-19 infections from July 2021. Maternal and neonatal outcomes were compared between the pre-Delta (May 2020–June2021, n = 20) and Delta groups (July 2021–October 2021, n = 52). In comparing the Pre-Delta to Delta groups, there were no significant differences in the rates of maternal chorioamnionitis, gestational hypertension, diabetes, antepartum bleeding, c-section, maternal ICU admission, maternal COVID-19 symptoms, and maternal survival. All neonates born to these mothers tested negative for COVID-19. The rates of premature birth, Apgar score of less than 5 at 5 minutes, small for gestational age, microcephaly, need for noninvasive or invasive ventilator support, hypoxic ischemic encephalopathy, culture positive sepsis, and neonatal survival were not different between the two groups. There was no difference in placental findings between the two groups. However, infants born to symptomatic mothers in the Delta group had a higher rate of preterm delivery. Based on our study, the Delta variant of COVID-19 can increase preterm birth rates among symptomatic mothers. Further meta-analysis of available studies is needed to evaluate its effect on neonatal outcomes.
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