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中华实验和临床感染病杂志(电子版) ›› 2021, Vol. 15 ›› Issue (02) : 73 -77. doi: 10.3877/cma.j.issn.1674-1358.2021.02.001

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综述

妊娠期新型冠状病毒肺炎研究进展
梁毓1, 王树玉1,()   
  1. 1. 100026 北京,首都医科大学附属北京妇产医院生殖医学科
  • 收稿日期:2020-07-24 出版日期:2021-04-15
  • 通信作者: 王树玉
  • 基金资助:
    北京市属医院科研培育项目(No. PX2021054)

Advances in pregnant women with coronavirus disease 2019

Yu Liang1, Shuyu Wang1,()   

  1. 1. Human Reproductive Medicine Department, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
  • Received:2020-07-24 Published:2021-04-15
  • Corresponding author: Shuyu Wang
引用本文:

梁毓, 王树玉. 妊娠期新型冠状病毒肺炎研究进展[J]. 中华实验和临床感染病杂志(电子版), 2021, 15(02): 73-77.

Yu Liang, Shuyu Wang. Advances in pregnant women with coronavirus disease 2019[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2021, 15(02): 73-77.

新型冠状病毒肺炎(COVID-19)为新发急性呼吸道传染病,是严重的突发卫生公共事件。孕妇作为一类特殊群体,为新型冠状病毒(SARS-CoV-2)易感人群,因其特殊生理状态,病毒感染时会有与妊娠相关的临床特点,诊断和治疗也更为棘手。此外,妊娠期COVID-19对胎儿的影响亦是目前研究非常关注的问题。妊娠期COVID-19的临床表现与非妊娠患者相似,主要表现为发烧、咳嗽、呼吸困难和淋巴细胞计数减少;大部分COVID-19孕妇预后良好,但随着疫情的蔓延,部分国家和地区逐渐有孕妇因COVID-19而导致临床结局不佳的报道。截至2020年9月,尚未发现SARS-CoV-2通过胎盘垂直传播引起胎儿宫内感染的证据,但与普通人群相比,妊娠期COVID-19子痫前期、早产、胎儿宫内发育受限发生率更高。但现阶段对孕产妇COVID-19的认知仍十分有限,需在临床实践中不断总结经验教训,加强科研攻关,进一步深入了解COVID-19对母胎的影响。本文对妊娠期COVID-19的疾病特点、诊断、治疗及对胎儿、新生儿的影响进行综述。

The novel COVID-19 is a new acute respiratory infectious disease, which is a serious public health emergency. As a special group, pregnant women are susceptible to severe acute respiraory syndrome coronavirus 2 (SARS-CoV-2). Due to their special physiological state, pregnant women with SARS-CoV-2 infection will have pregnancy related clinical characteristics, while the diagnosis and treatment are more difficult. In addition, the impact of pregnant COVID-19 on the fetus is also a matter of great concern. Similar to nonpregnant patients, the predominant features of COVID-19 in pregnant patients are fever, cough, dyspnea and lymphopenia. Most patients have good prognosis, however, with the spread of the epidemic, some countries and regions have reported that pregnant women had poor clinical outcomes due to COVID-19 disease. Up to September 2020, the evidence of intrauterine infection caused by vertical transmission of SARS-CoV-2 through placenta had not been found. However, compared with general population, the rates of incidence of preeclampsia, premature delivery and intrauterine growth restriction of COVID-19 during pregnancy were higher. At present, the understanding of COVID-19 is still very limited. The experience and lessons in clinical practice should be summed up continuely, scientific research should be strengthened to tackle key problems and further understand of the influence of COVID-19 on mother and fetus should be done. This paper presents a review of characteristics, diagnosis, treatment and influence on fetal newborns of COVID-19 during pregnancy.

[1]
曾慧慧, 蒋荣猛. 儿童冠状病毒感染[J/CD]. 中华实验和临床感染病杂志(电子版),2020,14(1):11-19.
[2]
赵颂涛, 毛青. 新型冠状病毒肺炎的临床特征与病原体检测[J]. 检验医学与临床,2020,17(9):1153-1156, 1160.
[3]
陈敦金, 杨慧霞. 妊娠期与产褥期新型冠状病毒感染专家建议[J]. 中华围产医学杂志,2020,23(2):73-79.
[4]
Juan J, Gil MM, Rong Z, et al. Effect of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcome: systematic review[J]. Ultrasound Obstet Gynecol,2020,56(1):15-27.
[5]
Wong SF, Chow KM, Leung TN, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome[J]. Am J Obstet Gynecol,2004,191(1):292-297.
[6]
Narang K, Enninga EAL, Gunaratne MDSK, et al. SARS-CoV-2 infection and COVID-19 during pregnancy: A multidisciplinary review[J]. Mayo Clin Proc,2020,95(8):1750-1765.
[7]
Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records[J]. Lancet, 2020,395(10226):809-815.
[8]
雷帝, 王晨, 李春燕, 等. 妊娠合并新型冠状病毒肺炎九例临床分析[J]. 中华围产医学杂志,2020,23(3):159-165.
[9]
刘耀丹, 李隽, 魏敏. 妊娠合并新型冠状病毒肺炎治愈17例临床分析[J]. 实用妇产科杂志,2020,36(4):271-275.
[10]
黄礼群, 王君平, 熊楚梅, 等. 首例妊娠合并危重型新型冠状病毒肺炎的成功救治[J]. 解放军医药杂志,2020,32(4):1-4.
[11]
何淑明, 王冬纳, 池锐彬, 等. 妊娠晚期危重型新型冠状病毒肺炎一例[J]. 中华围产医学杂志,2020,23(4):220-223.
[12]
Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies[J]. Acta Obstet Gynecol Scand,2020,99(7):823-829.
[13]
Breslin N, Baptiste C, Miller R, et al. Coronavirus disease 2019 in pregnancy: early lessons[J]. Am J Obstet Gynecol MFM,2020,2(2): 100111
[14]
Pierce-Williams RAM, Burd J, Felder L, et al. Clinical course of severe and critical coronavirus disease 2019 in hospitalized pregnancies: a United States cohort study[J]. Am J Obstet Gynecol MFM,2020,2(3):100134.
[15]
Takemoto MLS, Menezes MO, Andreucci CB, et al. The tragedy of COVID-19 in Brazil: 124 maternal deaths and counting[J]. Int J Gynaecol Obstet,2020,151(1):154-156.
[16]
Hantoushzadeh S, Shamshirsaz AA, Aleyasin A, et al. Maternal death due to COVID-19 disease[J]. Am J Obstet Gynecol,2020,223(1):109. e1-109. e16.
[17]
Plaçais L, Richier Q. COVID-19: Clinical, biological and radiological characteristics in adults, infants and pregnant women. An up-to-date review at the heart of the pandemic[J]. Rev Med Interne,2020,41(5):308-318.
[18]
中华人民共和国国家卫生健康委员会. 新型冠状病毒肺炎诊疗方案(试行第七版)[EB/OL]. [2020-03-03].

URL    
[19]
Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro[J]. Cell Res,2020,30(3):269-271.
[20]
Kaplan YC, Ozsarfati J, Nickel C, et al. Reproductive outcomes following hydroxychloroquine use for autoimmune diseases: a systematic review and meta-analysis[J]. Br J Clin Pharmacol,2016,81(5):835-848.
[21]
Gao J, Tian Z, Yang X. Breakthrough: chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies[J]. Biosci Trends,2020,14(1):72-73.
[22]
Liu F, Xu A, Zhang Y, et al. Patients of COVID-19 may benefit from sustained lopinavir-combined regimen and the increase of eosinophil may predict the outcome of COVID-19 progression[J]. Int J Infect Dis,2020,95(6):183-191.
[23]
中华人民共和国国家卫生健康委员会. 新型冠状病毒肺炎诊疗方案(试行第八版)[EB/OL]. [2020-08-18].

URL    
[24]
Liu D, Li L, Wu X, et al. Pregnancy and perinatal outcomes of women with coronavirus disease (COVID-19) pneumonia: A preliminary analysis[J]. Am J Roentgenol,2020,215(1):127-132.
[25]
Tisoncik JR, Korth MJ, Simmons CP, et al. Into the eye of the cytokine storm[J]. Microbiol Mol Biol Rev,2012,76(1):16-32.
[26]
World Health Organization (WHO). Novel coronavirus technical guidance: patient management[EB/OL]. [2020-02-20].

URL    
[27]
Hulme KD, Gallo LA, Short KR. Influenza virus and glycemic variability in diabetes: A killer combination?[J]. Front Microbiol,2017,8:861.
[28]
Dashraath P, Wong JLJ, Lim MXK, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy[J]. Am J Obstet Gynecol,2020,222(6):521-531.
[29]
Wastnedge EAN, Reynolds RM, van Boeckel SR, et al. Pregnancy and COVID-19[J]. Physiol Rev,2021,101(1):303-318.
[30]
Wang L, Shi Y, XiaoT, et al. Chinese expert consensus on the perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection (First edition)[J]. Ann Transl Med,2020,8(3):47.
[31]
Poon LC, Yang H, Lee J, et al. ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals[J]. Ultrasound Obstet Gynecol,2020,55(5):700-708.
[32]
张露, 江燕, 魏敏, 等. 湖北地区新型冠状病毒肺炎流行期间孕妇的妊娠结局分析[J]. 中华妇产科杂志,2020,55(3):166-171.
[33]
Martins-Filho PR, Santos VS, Santos HP Jr. To breastfeed or not to breastfeed? Lack of evidence on the presence of SARS-CoV-2 in breastmilk of pregnant women with COVID-19[J]. Rev Panam Salud Publica,2020,44:e59.
[34]
Yu N, Li W, Kang Q, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study[J]. Lancet Infect Dis,2020,20(5):559-564.
[35]
Zeng H, Xu C, Fan J, et al. Antibodies in infants born to mothers with COVID-19 pneumonia[J]. JAMA,2020,323(18):1848-1849.
[36]
Dong L, Tian J, He S, et al. Possible vertical transmission of SARS-CoV-2 from an infected mother to her newborn[J]. JAMA,2020,323(18):1846-1848.
[37]
Alzamora MC, Paredes T, Caceres D, et al. Severe COVID-19 during pregnancy and possible vertical transmission[J]. Am J Perinatol,2020,37(8):861-865.
[38]
Di Mascio D, Khalil A, Saccone G, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID 1-19) during pregnancy: a systematic review and meta-analysis[J]. Am J Obstet Gynecol MFM,2020,2(2):100107.
[39]
Baergen RN, Heller DS. Placental pathology in COVID-19 positive mothers: preliminary findings[J]. Pediatr Dev Pathol,2020,23(3):177- 180.
[40]
James JL, Stone PR, Chamley LW. The regulation of trophoblast differentiation by oxygen in the first trimester of pregnancy[J]. Hum Reprod Update,2006,12(2):137-144.
[41]
Gilbert JS, Ryan MJ, LaMarca BB, et al. Pathophysiology of hypertension during preeclampsia: linking placental ischemia with endothelial dysfunction[J]. Am J Physiol Heart Circ Physiol,2008,294(2):H541-H550.
[42]
Mendoza M, Garcia-Ruiz I, Maiz N, et al. Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study[J]. BJOG,2020,127(11):1374-1380.
[43]
Hansen JN, Hine J, Strout TD. COVID-19 and preeclampsia with severe features at 34-weeks gestation[J]. Am J Emerg Med, 2021,39:252.e3-252. e5.
[44]
Abbas AM, Ahmed OA, Shaltout AS. COVID-19 and maternal pre-eclampsia: A synopsis[J]. Scand J Immunol,2020,92(3):e12918.
[45]
Le Gouez A, Benachi A, Mercier FJ. Fever and pregnancy[J]. Anaesth Crit Care Pain Med,2016,35(Suppl 1):S5-S12.
[46]
Madsen-Bouterse SA, Romero R, Tarca AL, et al. The transcriptome of the fetal inflammatory response syndrome[J]. Am J Reprod Immunol,2010,63(1):73-92.
[47]
Shi L, Smith SE, Malkova N, et al. Activation of the maternal immune system alters cerebellar development in the offspring[J]. Brain Behav Immun,2009,23(1):116-123.
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