Ishod infekcija korona virusnog spektra (SARS, MERS, COVID-19) tokom trudnoće: sistematski pregled i meta-analiza.
American journal of obstetrics & gynecology MFM
Sažetak istraživanja
Cilj
Cilj ovog sistematskog pregleda bio je da se izvijesti o trudnoći i perinatalnim ishodima infekcija iz spektra koronavirusa, a posebno bolesti coronavirus 2019 (COVID-19) zbog teškog akutnog respiratornog sindroma – infekcije koronavirusom-2 tokom trudnoće. Izvori podataka Baza podataka Medline, Embase, Cinahl i Clinicaltrials.gov pretražena je elektroničkim putem koristeći kombinacije varijanti riječi za koronavirus ili teški akutni respiratorni sindrom ili SARS ili bliskoistočni respiratorni sindrom ili MERS ili COVID-19 i trudnoću. Kriterijumi pretraživanja i odabira bili su ograničeni na engleski jezik. Kriterijumi prihvatljivosti za studiju Kriterijumi za uključivanje bili su hospitalizirane trudnice s potvrđenom bolešću povezanom s koronavirusom, definiranom kao teški akutni respiratorni sindrom (SARS), bliskoistočni respiratorni sindrom (MERS) ili COVID-19.
Metode procjene i sinteze studije Koristili smo meta-analizu proporcija da kombinujemo podatke i prijavljene objedinjene proporcije, tako da se objedinjeni udio možda ne podudara sa stvarnim sirovim udjelom u rezultatima. Uočeni ishodi trudnoće uključivali su pobačaj, prijevremeni porođaj, preeklampsiju, prijevremeni preporođajni rupture membrana, ograničenje rasta fetusa i način porođaja. Uočeni perinatalni ishodi bili su fetalni distres, rezultati Apgar skora Devetnaest studija koje su uključivale 79 hospitaliziranih žena imalo je pravo na ovaj sistematski pregled: 41 trudnoća (51,9%) zahvaćena COVID-19, 12 (15,2%) zbog MERS-a i 26 (32,9%) od SARS-a. Otvorena dijagnoza pneumonije postavljena je u 91,8%, a najčešći simptomi su bili temperatura (82,6%), kašalj (57,1%) i dispneja (27,0%). Za sve infekcije koronavirusom, zbirni udio pobačaja bio je 64,7% (8/12; 95% interval povjerenja, 37,9-87,3), iako je prijavljen samo za žene pogođene SARS-om u dvije studije bez kontrolne grupe; zbirni udio prijevremenog porođaja
Zaključak Kod hospitaliziranih majki zaraženih infekcijama koronavirusom, uključujući COVID-19, od kojih je >90% također imalo upalu pluća, prijevremeni porođaj je najčešći neželjeni ishod trudnoće. Infekcija COVID-19 povezana je s većom stopom (i udruženim proporcijama) prijevremenog porođaja, preeklampsije, carskog reza i perinatalne smrti. Nije bilo objavljenih slučajeva kliničkih dokaza vertikalne transmisije. Dokazi se brzo gomilaju, tako da će ovi podaci možda morati biti ažurirani uskoro.
Nalazi ove studije mogu usmjeravati i poboljšati prenatalno savjetovanje žena sa infekcijom COVID-19 tokom trudnoće, iako ih treba tumačiti s oprezom s obzirom na vrlo mali broj uključenih slučajeva.
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Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis.
Objective The aim of this systematic review was to report pregnancy and perinatal outcomes of coronavirus spectrum infections, and particularly coronavirus 2019 (COVID-19) disease because of severe acute respiratory syndrome-coronavirus-2 infection during pregnancy. Data sources Medline, Embase, Cinahl, and Clinicaltrials.gov databases were searched electronically utilizing combinations of word variants for coronavirus or severe acute respiratory syndrome or SARS or Middle East respiratory syndrome or MERS or COVID-19 and pregnancy. The search and selection criteria were restricted to English language. Study eligibility criteria Inclusion criteria were hospitalized pregnant women with a confirmed coronavirus related-illness, defined as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), or COVID-19. Study appraisal and synthesis methods We used meta-analyses of proportions to combine data and reported pooled proportions, so that a pooled proportion may not coincide with the actual raw proportion in the results. The pregnancy outcomes observed included miscarriage, preterm birth, preeclampsia, preterm prelabor rupture of membranes, fetal growth restriction, and mode of delivery. The perinatal outcomes observed were fetal distress, Apgar score
Results Nineteen studies including 79 hospitalized women were eligible for this systematic review: 41 pregnancies (51.9%) affected by COVID-19, 12 (15.2%) by MERS, and 26 (32.9%) by SARS. An overt diagnosis of pneumonia was made in 91.8%, and the most common symptoms were fever (82.6%), cough (57.1%), and dyspnea (27.0%). For all coronavirus infections, the pooled proportion of miscarriage was 64.7% (8/12; 95% confidence interval, 37.9-87.3), although reported only for women affected by SARS in two studies with no control group; the pooled proportion of preterm birth
Conclusion In hospitalized mothers infected with coronavirus infections, including COVID-19, >90% of whom also had pneumonia, preterm birth is the most common adverse pregnancy outcome. COVID-19 infection was associated with higher rate (and pooled proportions) of preterm birth, preeclampsia, cesarean, and perinatal death. There have been no published cases of clinical evidence of vertical transmission. Evidence is accumulating rapidly, so these data may need to be updated soon. The findings from this study can guide and enhance prenatal counseling of women with COVID-19 infection occurring during pregnancy, although they should be interpreted with caution in view of the very small number of included cases.
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- DOI
- 10.1016/j.ajogmf.2020.100107
- PMID
- 32292902
- PMCID
- PMC7104131
- Provjereno
- 2026-07-26
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