不同妊娠期感染新型冠状病毒Omicron变异株行剖宫产的妊娠结局及产褥期随访

Pregnancy Outcome and Puerperal Follow-up of Cesarean Section with SARS-CoV-2 Omicron Variant in Different Periods of Pregnancy

目的:探讨妊娠不同时期孕妇感染新型冠状病毒(SARS-CoV-2)变异株Omicron并行剖宫产分娩的妊娠结局及产褥期(产后42天)母婴随访情况。方法:选择2022年11月20日至2023年1月25日确诊感染SARS-CoV-2并在广东省妇幼保健院剖宫产分娩的330例孕产妇为研究对象,按孕妇感染孕周分为孕早期组(80例)、孕中期组(151例)、孕晚期组(99例),比较各组孕产妇的一般资料、妊娠并发症和合并症、妊娠结局及产褥期母婴随访情况。结果:孕妇的临床分型为无症状型(9例)和轻型(321例)。孕早期组和孕晚期组妊娠期糖尿病(GDM)发生率高于孕中期组(P<0.05)。3组胎盘早剥、胎儿生长受限、胎儿窘迫、羊水污染、早产、产后出血、巨大儿、低体质量儿发生率及母亲重症监护病房(MICU)转入率、新生儿出生体质量、新生儿窒息率及新生儿重症监护病房(NICU)转入率比较,差异均无统计学意义(P>0.05),孕中期组胎膜早破发生率高于孕晚期组(P<0.05)。产褥期母婴随访结果示,3组产妇子宫切口愈合不良、子宫复旧不良、阴道微生态失衡和新生儿急性上呼吸道感染、肺炎、消化系统疾病、心血管系统疾病发生率比较,差异无统计学意义(P>0.05)。结论:妊娠合并Omicron感染的孕妇绝大多数为轻症型;妊娠不同时期孕妇感染Omicron行剖宫产分娩的妊娠结局及产褥期随访无显著差异;未发现GDM和胎膜早破与不同妊娠期Omicron感染有明显关联。

Objective:To investigate the pregnancy outcome and the maternal and infant follow-up in the puerperal period(42 days after delivery)of cesarean section with SARS-CoV-2 Omicron variant in different periods of pregnancy.Methods:330 pregnant women who were diagnosed with SARS-CoV-2 infection and delivered by cesarean section in Guangdong Women and Children Hospital from November 20,2022 to January 25,2023 were selected as the research subjects.They were divided into the early(80 cases),middle(151 cases)and late(99 cases)pregnancy group according to the gestational age of infection.The general information,pregnancy complications and comorbidities,pregnancy outcomes,and postpartum maternal and infant follow-up of each group of pregnant women were compared.Results:The clinical classification of pregnant women was asymptomatic and mild,with 9 cases of asymptomatic and 321 cases of mild.The incidence of gestational diabetes mellitus(GDM)in the early and late group was higher than that in the middle group(P<0.05).There was no statistically significant difference in the incidence of placental abruption,fetal growth restriction,fetal distress,amniotic fluid contamination,preterm labor,postpartum hemorrhage,macrosomia,low-birth-weight infants and the maternal intensive care unit(MICU)transfer rate,newborn birth weight,neonatal asphyxia rate and NICU transfer rate among the three groups(P>0.05).The incidence of preterm rupture of membranes in the middle group was higher than that in the late group(P<0.05).Puerperal follow-up results showed that there was no statistically significant difference in the incidence of poor maternal uterine incision healing,poor uterine involution,vaginal microecological imbalance and neonatal acute upper respiratory tract infection,pneumonia,digestive system disease,cardiovascular system disease among the three groups(P>0.05).Conclusions:The majority of pregnant women with Omicron infection during pregnancy are mild.Omicron infection in different periods of pregnancy has no significant effect on pregnancy outcome and puerperal follow-up of cesarean section.No evidence was found that GDM and premature rupture of membranes are significantly associated with Omicron infection in different periods of pregnancy.