METHODS: In this study, we recruited 304 SARS-CoV-2 infected pregnant women and 910 SARS-CoV-2 non-infected pregnant women who were admitted for delivery. Peripartum and neonates\' outcomes response to SARS-CoV-2 infection were analyzed. Furthermore, we characterized the antibody and cytokines profile in SARS-CoV-2 infected maternal blood (MB) and cord blood (CB). We also assessed routine laboratory tests and liver function tests in MB before labor. Unpaired T test, Mann-Whitney test and Spearman test were used to analyze the data.
RESULTS: SARS-CoV-2 infected pregnant women were significantly associated with increased risk of adverse pregnancy outcomes, including preterm labor (13.8% vs. 9.5%, p = 0.033) and meconium-stained amniotic fluid (8.9% vs. 5.5%, p = 0.039). The risk of low birth weight (< 2500 g) (10.5% vs. 6.5%, p = 0.021) and Apgar score < 8 at 1-minute (9.2% vs. 5.8%, p = 0.049) significantly increased in newborns from COVID-19 positive mothers than their counterparts. Our results showed that antibodies were increased in adverse-outcome SARS-CoV-2 infected mothers and their neonates, and abnormal proportion of immune cells were detected in SARS-CoV-2 infected mothers. While the immune response showed no difference between adverse-outcome infected pregnant women and normal-outcome infected pregnant women. Thus, SARS-CoV-2 infection during the third trimester of pregnancy induced a unique humoral and cellular response at delivery.
CONCLUSIONS: SARS-CoV-2 infection closer to delivery could incline to adverse pregnancy outcomes. Therefore, the utmost care is required for SARS-CoV-2 infected pregnant women and their newborns.
BACKGROUND: The study protocol was approved by the Institutional Review Board of the First Hospital of Jilin University with the approval code number 23K170-001, and informed consent was obtained from all enrolled patients prior to sample collection.
方法:在本研究中,我们招募了304名感染SARS-CoV-2的孕妇和910名接受分娩的非感染SARS-CoV-2的孕妇.分析了围产期和新生儿对SARS-CoV-2感染的反应。此外,我们表征了SARS-CoV-2感染的母体血液(MB)和脐带血(CB)中的抗体和细胞因子谱。我们还评估了分娩前MB的常规实验室检查和肝功能检查。不成对T检验,采用Mann-Whitney检验和Spearman检验进行数据分析。
结果:感染SARS-CoV-2的孕妇与不良妊娠结局的风险增加显著相关,包括早产(13.8%与9.5%,p=0.033)和胎粪染色的羊水(8.9%vs.5.5%,p=0.039)。低出生体重(<2500g)的风险(10.5%vs.6.5%,p=0.021),1分钟时Apgar得分<8(9.2%vs.5.8%,p=0.049)与COVID-19阳性母亲的新生儿相比显着增加。我们的结果表明,在感染SARS-CoV-2的母亲和她们的新生儿中,抗体增加,在SARS-CoV-2感染的母亲中检测到免疫细胞比例异常。而免疫反应在不良结局感染的孕妇和正常结局感染的孕妇之间没有差异。因此,妊娠晚期的SARS-CoV-2感染在分娩时引起了独特的体液和细胞反应。
结论:接近分娩的SARS-CoV-2感染可能导致不良妊娠结局。因此,感染SARS-CoV-2的孕妇及其新生儿需要最大的照顾。
背景:该研究方案得到吉林大学第一医院机构审查委员会的批准,批准号为23K170-001,并且在样本收集前获得了所有入选患者的知情同意。