Purpose

Evaluate maternal and neonatal outcomes in peripartum coronavirus disease 2019 (COVID-19) positive women.

Methods

A retrospective cohort study was conducted, comparing outcomes between women with and without peripartum COVID-19. All singleton deliveries from June 2020 to January 2022 were included. Univariate analysis was followed by multivariate analysis.

Results

Of 26,827 singleton deliveries, 563 women had peripartum COVID-19, associated with preterm deliveries both near-term and remote from term [adjusted odds ratio (aOR) 1.6 and 2.0, respectively, p = 0.007 and 0.003]. Women with peripartum COVID-19 had a significantly higher rate of disseminated intravascular coagulation (DIC) (aOR 23.0, p < 0.001). Conversely, peripartum COVID-19 peripartum COVID-19 was negatively associated with premature rupture of membranes and prolonged maternal length of stay (aOR 0.7 and 0.5, respectively, p = 0.006 and <0.001).

In cesarean delivery (CDs), patients with COVID-19 had higher rate of urgent CDs (75.5 vs. 56.1%, p < 0.001), higher rate of regional anesthesia (74.5 vs. 64.9%, p = 0.049), and longer anesthesia duration (86.1 vs. 53.4 min, p < 0.001). CD rate due to non-reassuring fetal heart rate (NRFHR) was significantly higher in women with COVID-19 (29.6 vs. 17.4%, p = 0.002). Conversely, CDs rate due to history of previous single CD was significantly higher in patients without COVID-19 diagnosis (13.6 vs. 4.1%, p = 0.006).

Concerning neonatal outcomes, an association has been observed between COVID-19 and low one-minute APGAR score <5, as well as neonatal COVID-19 infection (aOR 61.8 and 1.7 respectively, p < 0.001 and p = 0.037).

Conclusions

Peripartum COVID-19 is associated with preterm deliveries, urgent CDs and DIC, potentially aligning with the infection’s pathophysiology and coagulation alterations.

中文翻译：

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2019年围产期冠状病毒感染孕妇的围产期结局

目的

评估 2019 年冠状病毒病 (COVID-19) 阳性围产期妇女的孕产妇和新生儿结局。

方法

进行了一项回顾性队列研究，比较了患有和未患有围产期 COVID-19 的女性的结局。 2020 年 6 月至 2022 年 1 月期间的所有单件交付均包含在内。单变量分析之后进行多变量分析。

结果

在 26,827 名单胎分娩中，有 563 名女性患有围产期 COVID-19，与近足月和远期早产相关[调整后的比值比 (aOR) 分别为 1.6 和 2.0，p  = 0.007 和 0.003]。患有围产期 COVID-19 的女性的弥散性血管内凝血 (DIC) 发生率显着较高 (aOR 23.0，p  < 0.001)。相反，围产期 COVID-19 围产期 COVID-19 与胎膜早破和产妇住院时间延长呈负相关（aOR 分别为 0.7 和 0.5，p  = 0.006 和 <0.001）。

在剖宫产 (CD) 中，COVID-19 患者紧急 CD 发生率较高（75.5 vs. 56.1%，p  < 0.001），区域麻醉率较高（74.5 vs. 64.9%，p  = 0.049），且麻醉时间较长持续时间（86.1 分钟与 53.4 分钟，p  < 0.001）。患有 COVID-19 的女性中，由于胎心不稳 (NRFHR) 导致的 CD 率显着较高（29.6% vs. 17.4%，p  = 0.002）。相反，在未诊断出 COVID-19 的患者中，由于既往单次 CD 病史而导致的 CD 率显着较高（13.6% vs. 4.1%，p  = 0.006）。

关于新生儿结局，已观察到 COVID-19 与低于 5 的一分钟 APGAR 评分以及新生儿 COVID-19 感染之间存在关联（aOR 分别为 61.8 和 1.7，p  < 0.001 和p  = 0.037）。

结论

围产期 COVID-19 与早产、紧急 CD 和 DIC 相关，可能与感染的病理生理学和凝血改变相关。