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Tytuł pozycji:

Clinical Implications of SARS-CoV-2 Infection in the Viable Preterm Period.

Tytuł :
Clinical Implications of SARS-CoV-2 Infection in the Viable Preterm Period.
Autorzy :
Gulersen M; Department of Obstetrics and Gynecology, North Shore University Hospital-Northwell Health, Manhasset, New York.
Blitz MJ; Department of Obstetrics and Gynecology, Southside Hospital-Northwell Health, Bay Shore, New York.
Rochelson B; Department of Obstetrics and Gynecology, North Shore University Hospital-Northwell Health, Manhasset, New York.
Nimaroff M; Department of Obstetrics and Gynecology, North Shore University Hospital-Northwell Health, Manhasset, New York.
Shan W; Biostatistics Unit, Feinstein Institutes for Medical Research, Manhasset, New York.
Bornstein E; Department of Obstetrics and Gynecology, Lenox Hill Hospital-Northwell Health, New York.
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Źródło :
American journal of perinatology [Am J Perinatol] 2020 Sep; Vol. 37 (11), pp. 1077-1083. Date of Electronic Publication: 2020 Jul 02.
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Original Publication: New York, NY : Thieme-Stratton, 1983-
MeSH Terms :
Birth Rate*
Coronavirus Infections*/diagnosis
Coronavirus Infections*/epidemiology
Coronavirus Infections*/physiopathology
Coronavirus Infections*/therapy
Pandemics*
Pneumonia, Viral*/diagnosis
Pneumonia, Viral*/epidemiology
Pneumonia, Viral*/physiopathology
Pneumonia, Viral*/therapy
Pregnancy Complications, Infectious*/diagnosis
Pregnancy Complications, Infectious*/epidemiology
Pregnancy Complications, Infectious*/physiopathology
Pregnancy Complications, Infectious*/therapy
Betacoronavirus/*isolation & purification
Obstetric Labor, Premature/*epidemiology
Adult ; Cross-Sectional Studies ; Female ; Gestational Age ; Hospitalization/statistics & numerical data ; Humans ; Infant, Newborn ; Infant, Premature ; Maternal Age ; New York/epidemiology ; Pregnancy ; Prenatal Care/methods ; Time Factors
References :
JAMA. 2020 Apr 7;323(13):1239-1242. (PMID: 32091533)
Am J Obstet Gynecol. 1991 Feb;164(2):467-71. (PMID: 1992685)
Am J Obstet Gynecol. 2020 Jul;223(1):111.e1-111.e14. (PMID: 32335053)
Pediatrics. 2013 Mar;131(3):548-58. (PMID: 23400611)
Am J Obstet Gynecol MFM. 2020 May;2(2):100118. (PMID: 32292903)
Lancet. 2020 Mar 7;395(10226):809-815. (PMID: 32151335)
Lancet. 2008 Jan 19;371(9608):261-9. (PMID: 18207020)
Am J Obstet Gynecol. 2020 Aug;223(2):290-291. (PMID: 32387323)
Lancet. 2008 Jan 5;371(9606):75-84. (PMID: 18177778)
Am J Obstet Gynecol MFM. 2020 Aug;2(3):100134. (PMID: 32391519)
JAMA. 2020 May 26;323(20):2052-2059. (PMID: 32320003)
Lancet. 2020 Mar 28;395(10229):1054-1062. (PMID: 32171076)
SCR Disease Name :
COVID-19
Entry Date(s) :
Date Created: 20200703 Date Completed: 20200916 Latest Revision: 20201001
Update Code :
20201023
PubMed Central ID :
PMC7516388
DOI :
10.1055/s-0040-1713851
PMID :
32615621
Czasopismo naukowe
Objective: This study aimed to determine the rate of preterm birth (PTB) during hospitalization among women diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between 23 and 37 weeks of gestation and whether this rate differs by gestational age at diagnosis of infection.
Study Design: Retrospective, cross-sectional study of all women diagnosed with SARS-CoV-2 infection between 23 and 37 weeks of gestation within a large integrated health system from March 13 to April 24, 2020. Cases with severe fetal structural malformations detected prior to infection were excluded. Women were stratified into two groups based on gestational age at diagnosis: early preterm (23 0/7 to 33 6/7 weeks) versus late preterm (34 to 36 6/7 weeks). We compared the rate of PTB during hospitalization with infection between the two groups. Statistical analysis included use of Wilcoxon rank sum and Fisher exact tests, as well as a multivariable logistic regression. Statistical significance was defined as a p -value <0.05.
Results: Of the 65 patients included, 36 (53.7%) were diagnosed in the early preterm period and 29 (46.3%) were diagnosed in the late preterm period. Baseline demographics were similar between groups. The rate of PTB during hospitalization with infection was significantly lower among women diagnosed in the early preterm period compared with late preterm (7/36 [19.4%] vs. 18/29 [62%], p -value = 0.001). Of the 25 patients who delivered during hospitalization with infection, the majority were indicated deliveries (64%, 16/25). There were no deliveries <33 weeks of gestation for worsening coronavirus disease 2019 and severity of disease did not alter the likelihood of delivery during hospitalization with SARS-CoV-2 infection (adjusted odds ratio [aOR]: 0.64; 95% confidence interval [CI]: 0.24-1.59). Increased maternal age was associated with a lower likelihood of delivery during hospitalization with SARS-CoV-2 infection (aOR: 0.77; 95% CI: 0.58-0.96), while later gestational age at diagnosis of infection was associated with a higher likelihood of delivery during hospitalization (aOR: 2.9; 95% CI: 1.67-8.09).
Conclusion: The likelihood of PTB during hospitalization with SARS-CoV-2 infection is significantly lower among women diagnosed in the early preterm period compared with late preterm. Most women with SARS-CoV-2 infection in the early preterm period recovered and were discharged home. The majority of PTB were indicated and not due to spontaneous preterm labor.
Key Points: · Preterm delivery is less likely among women diagnosed in the early preterm compared with late preterm.. · Most women infected in the early preterm period recovered and were discharged home undelivered.. · The majority of preterm birth were indicated and not due to spontaneous preterm labor..
(Thieme. All rights reserved.)

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