COVID-19大流行的首要影响:妊娠并发症、新生儿健康和预期的生殖损失

I. V. Zhukovets, I. A. Аndrievskaya, N. A. Кrivoshchekova, N. Smirnova, K. K. Petrova, M. Kharchenko, D. A. Nikachalo
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A general clinical study of pregnant women and newborns was performed, as well as an analysis of the vaccination of women registered for pregnancy in 2022. Standard statistical data processing methods were used.Results. 966 women were registered who underwent NCI during pregnancy, which accounted for 6.13% of all births, of which in 2020 – 16.9%, in 2021 –83%. In the Amur Region, the maternal mortality rate, as in the Russian Federation, increased during the pandemic and amounted to 38.2 in 2020, and 68.1 per 100 000 population in 2021; particularly from COVID-19 in 2020 – 12.8, in 2021 – 40.9 per 100 thousand population. At the same time, 17.8% had an asymptomatic course of the disease, 63.4% had a mild course, 17.7% had a moderate course, and 11.14% had a severe course with pathological changes in the lungs. The risk of lung tissue damage was increased by infection in the third trimester of pregnancy (RR – 1.73; 95% CI: 1.04-2.9), age over 30 years (RR – 1.24; 95% CI: 1.01-1 .53), overweight (RR –1.8; 95% CI: 1.5–2.14), and obesity (RR – 1.53: 95% CI: 1.2–1.8). The risk of developing complications of pregnancy significantly increased in women with pathological changes in the lungs (moderate and severe course), in comparison with pregnant women with mild NCI. It was found that 14.4% of newborns from mothers with NCI were born prematurely, 3.6% – in moderate asphyxia. The vertical transmission path was not registered in any case. In 33% of children infected in the neonatal period, NCI proceeded in the moderate, in 67% – in mild severity. Only one in three pregnant women are currently vaccinated. Of these, at the stage of preconception preparation, 77%, during pregnancy – 23%.Conclusion. 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引用次数: 3

摘要

介绍。新型冠状病毒感染COVID-19 (NCI)的大流行给人类带来了一系列问题,首先是感染对夫妇的妊娠能力、妊娠结局及其并发症的影响,最后是对后代健康的影响,包括生殖健康。分析阿穆尔河地区NCI孕妇和新生儿的登记情况,以确定妊娠和新生儿期的直接并发症。材料和方法。对2020年5月1日至2022年1月1日期间NCI孕妇(n=966)、NCI母亲的新生儿(n=111)和家庭成员感染的新生儿(n=21)进行了分析。对孕妇和新生儿进行了一般临床研究,并对2022年登记怀孕妇女的疫苗接种情况进行了分析。采用标准的统计数据处理方法。登记的966名妇女在怀孕期间接受了NCI,占所有出生人数的6.13%,其中2020年为16.9%,2021年为83%。在阿穆尔河地区,与俄罗斯联邦一样,孕产妇死亡率在疫情期间有所上升,2020年达到38.2 / 10万人,2021年达到68.1 / 10万人;特别是2019冠状病毒病,2020年为12.8人,2021年为每10万人40.9人。同时,17.8%的患者无症状病程,63.4%为轻度病程,17.7%为中度病程,11.14%为重度病程,伴有肺部病变。妊娠晚期感染增加了肺组织损伤的风险(RR = 1.73;95% CI: 1.04-2.9),年龄超过30岁(RR - 1.24;95% CI: 1.01- 1.53),超重(RR -1.8;95% CI: 1.5-2.14)和肥胖(RR: 1.53; 95% CI: 1.2-1.8)。与轻度NCI的孕妇相比,肺部病理改变(中度和重度)的孕妇发生妊娠并发症的风险显著增加。结果发现,14.4%的NCI母亲的新生儿早产,3.6%为中度窒息。在任何情况下,垂直传播路径都没有登记。在33%的新生儿期感染的儿童中,NCI进展为中度,67%为轻度严重。目前只有三分之一的孕妇接种了疫苗。其中,在孕前准备阶段,77%,在怀孕期间- 23%。非传染性疾病是导致病情严重的一个因素,在肺部发生病理变化的妇女中也会出现妊娠并发症,这增加了母婴死亡的风险。
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First effects of the COVID-19 pandemic: pregnancy complications, newborn health and expected reproductive losses
Introduction. The pandemic of the novel coronavirus infection COVID-19 (NCI) has posed a number of questions for humanity, starting with the impact of the infection on the ability of fetation in a couple, pregnancy outcomes, its complications, and ending with the impact on the health of future generations, including the reproductive one.Aim. To analyze the register of pregnant women and newborns in the Amur Region with NCI to identify immediate complications of pregnancy and the neonatal period.Materials and methods. An analysis was made of the registry of pregnant women (n=966) with NCI, newborns from mothers with NCI (n=111) and infected from family members (n=21) in the period from May 1, 2020 to January 1, 2022. A general clinical study of pregnant women and newborns was performed, as well as an analysis of the vaccination of women registered for pregnancy in 2022. Standard statistical data processing methods were used.Results. 966 women were registered who underwent NCI during pregnancy, which accounted for 6.13% of all births, of which in 2020 – 16.9%, in 2021 –83%. In the Amur Region, the maternal mortality rate, as in the Russian Federation, increased during the pandemic and amounted to 38.2 in 2020, and 68.1 per 100 000 population in 2021; particularly from COVID-19 in 2020 – 12.8, in 2021 – 40.9 per 100 thousand population. At the same time, 17.8% had an asymptomatic course of the disease, 63.4% had a mild course, 17.7% had a moderate course, and 11.14% had a severe course with pathological changes in the lungs. The risk of lung tissue damage was increased by infection in the third trimester of pregnancy (RR – 1.73; 95% CI: 1.04-2.9), age over 30 years (RR – 1.24; 95% CI: 1.01-1 .53), overweight (RR –1.8; 95% CI: 1.5–2.14), and obesity (RR – 1.53: 95% CI: 1.2–1.8). The risk of developing complications of pregnancy significantly increased in women with pathological changes in the lungs (moderate and severe course), in comparison with pregnant women with mild NCI. It was found that 14.4% of newborns from mothers with NCI were born prematurely, 3.6% – in moderate asphyxia. The vertical transmission path was not registered in any case. In 33% of children infected in the neonatal period, NCI proceeded in the moderate, in 67% – in mild severity. Only one in three pregnant women are currently vaccinated. Of these, at the stage of preconception preparation, 77%, during pregnancy – 23%.Conclusion. NCI is a factor in the severe course of the disease and the development of pregnancy complications in women with pathological changes in the lungs, which increases the risk of maternal and infant mortality.
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