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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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Created on : 23 Jan 2021
Modified on : 28 Jan 2021

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Bibliographical entry (without author) :

Clinical Characteristics and Outcomes of Hospitalized Women Giving Birth With and Without COVID-19

Author(s) :

APA Jering, K. S., Claggett, B. L., Cunningham, J. W., Rosenthal, N., Vardeny, O., Greene, M. F., & Solomon, S. D.

Year of publication :

2021

URL(s) :

https://jamanetwork.com/journals/jamainternalmedic…
https://doi.org/10.1001/jamainternmed.2020.9241

Résumé (français)  :

Parmi les 406446 femmes hospitalisées pour accoucher au cours des 8 mois de l’étude, 6380 (1,6%) avaient la COVID-19. Par rapport aux femmes enceintes sans COVID-19 (n = 400066), les femmes atteintes de COVID-19 étaient plus jeunes et plus souvent noires et / ou hispaniques et atteintes de diabète et d’obésité (tableau 1).

Sur les 6380 femmes atteintes de COVID-19 qui ont accouché, 6309 (98,9%) ont été renvoyées à domicile, 212 (3,3%) avaient besoin de soins intensifs, 86 (1,3%) avaient besoin d’une ventilation mécanique et 9 (0,1%) sont décédées à l’hôpital. (Tableau 2). Bien que la mortalité hospitalière soit faible, elle était significativement plus élevée chez les femmes atteintes de COVID-19 que chez celles sans COVID-19 (141 [IC à 95%, 65-268] vs 5,0 [IC à 95%, 3,1-7,7] décès par 100000 femmes). Les taux d’infarctus du myocarde et de thromboembolie veineuse (TEV) étaient plus élevés chez les femmes avec COVID-19 qui ont accouché que chez celles sans COVID-19 (infarctus du myocarde : 0,1% vs 0,004% ; TEV : 0,2% vs 0,1% ; P <. 001).
La COVID-19 était associée à une probabilité plus élevée de prééclampsie (odds ratio ajusté [aOR] , 1,21 [IC 95%, 1,11-1,33] ) et de naissance prématurée (aOR, 1,17 [IC 95%, 1,06-1,29] ) mais pas de probabilité plus élevée de mortinaissance (aOR, 1,23 [IC à 95%, 0,87-1,75] ). L’utilisation de l’imagerie thoracique, des soins intensifs et de la ventilation mécanique était plus élevée chez les femmes qui ont accouché avec la COVID-19 par rapport à celles sans COVID-19 (tableau 2).

Parmi les femmes atteintes de COVID-19 qui ont accouché, l’âge (OR, 1,91 [IC à 95%, 1,31-2,77] pour 10 ans), l’obésité morbide (OR, 3,85 [IC à 95%, 2,05-7,21] ), le diabète (OR, 4,51 [IC 95%, 2,10-9,70] ), une maladie rénale (OR, 21,57 [IC 95%, 7,73-60,10] ), l’éclampsie (OR, 116,1 [IC 95%, 22,91-588,50] ), les événements thrombotiques (OR, 45,10 [IC à 95%, 17,13-118,8] ) et la mortinaissance (OR, 7,88 [IC à 95%, 2,39-25,98] ) étaient associées à des probabilités plus élevées d’utilisation de la ventilation mécanique ou de décès à l’hôpital.

Abstract (English)  :

Among the 406 446 women hospitalized for childbirth over the 8 months of the study, 6380 (1.6%) had COVID-19. Compared with pregnant women without COVID-19 (n = 400 066), the women with COVID-19 were younger and more often Black and/or Hispanic and with diabetes and obesity (Table 1).

Of the 6380 women with COVID-19 who gave birth, 6309 (98.9%) were discharged to home, 212 (3.3%) needed intensive care, 86 (1.3%) needed mechanical ventilation, and 9 (0.1%) died in the hospital (Table 2). Although in-hospital mortality was low, it was significantly higher in the women with COVID-19 than in those without COVID-19 (141 [95% CI, 65-268] vs 5.0 [95% CI, 3.1-7.7] deaths per 100 000 women). Rates of myocardial infarction and venous thromboembolism (VTE) were higher in the women with COVID-19 who gave birth than in those without COVID-19 (myocardial infarction: 0.1% vs 0.004%; VTE: 0.2% vs 0.1%; P < .001). COVID-19 was associated with higher odds of preeclampsia (adjusted odds ratio [aOR] , 1.21 [95% CI, 1.11-1.33] ) and preterm birth (aOR, 1.17 [95% CI, 1.06-1.29] ) but not with significantly higher odds of stillbirth (aOR, 1.23 [95% CI, 0.87-1.75] ). Use of chest imaging, intensive care treatment, and mechanical ventilation was higher among the women who gave birth with COVID-19 compared with those without COVID-19 (Table 2).

Among women with COVID-19 who gave birth, age (OR, 1.91 [95% CI, 1.31-2.77] per 10 years), morbid obesity (OR, 3.85 [95% CI, 2.05-7.21] ), diabetes (OR, 4.51 [95% CI, 2.10-9.70] ), kidney disease (OR, 21.57 [95% CI, 7.73-60.10] ), eclampsia (OR, 116.1 [95% CI, 22.91-588.50] ), thrombotic events (OR, 45.10 [95% CI, 17.13-118.8] ), and stillbirth (OR, 7.88 [95% CI, 2.39-25.98] ) were associated with higher odds of mechanical ventilation use or in-hospital death.

Sumário (português)  :

Entre as 4.06446 mulheres hospitalizadas para parto durante os 8 meses do estudo, 6.380 (1,6%) tiveram COVID-19. Em comparação com mulheres grávidas sem COVID-19 (n = 4.00066), as mulheres com COVID-19 eram mais jovens e mais frequentemente negras e / ou hispânicas e com diabetes e obesidade (Tabela 1).

Das 6.380 mulheres com COVID-19 que deram à luz, 6.309 (98,9%) tiveram alta para casa, 212 (3,3%) necessitaram de cuidados intensivos, 86 (1,3%) necessitaram de ventilação mecânica e 9 (0,1%) morreram no hospital (Mesa 2). Embora a mortalidade hospitalar tenha sido baixa, foi significativamente maior nas mulheres com COVID-19 do que naquelas sem COVID-19 (141 [95% CI, 65-268] vs 5,0 [95% CI, 3,1-7,7] mortes por 100.000 mulheres). As taxas de infarto do miocárdio e tromboembolismo venoso (TEV) foram maiores nas mulheres com COVID-19 que deram à luz do que naquelas sem COVID-19 (infarto do miocárdio: 0,1% vs 0,004%; VTE: 0,2% vs 0,1%; P <. 001). COVID-19 foi associado a maiores chances de pré-eclâmpsia (odds ratio ajustada [aOR] , 1,21 [95% CI, 1,11-1,33] ) e nascimento prematuro (aOR, 1,17 [95% CI, 1,06-1,29] ), mas não com significativamente maior chance de natimorto (aOR, 1,23 [95% CI, 0,87-1,75] ). O uso de imagens de tórax, tratamento de terapia intensiva e ventilação mecânica foi maior entre as mulheres que deram à luz com COVID-19 em comparação com aquelas sem COVID-19 (Tabela 2).

Entre as mulheres com COVID-19 que deram à luz, idade (OR, 1,91 [IC 95%, 1,31-2,77] por 10 anos), obesidade mórbida (OR, 3,85 [IC 95%, 2,05-7,21] ), diabetes (OR, 4,51 [IC 95%, 2,10-9,70] ), doença renal (OR, 21,57 [IC 95%, 7,73-60,10] ), eclâmpsia (OR, 116,1 [IC 95%, 22,91-588,50] ), eventos trombóticos (OR, 45,10 [IC de 95%, 17,13-118,8] ) e natimorto (OR, 7,88 [IC de 95%, 2,39-25,98] ) foram associados com maior chance de uso de ventilação mecânica ou morte intra-hospitalar.

Full text (public) :

Comments :

Argument (français) :

Dans cette étude 98.9% des patientes ayant accouché en ayant la covid ont pu rentrer à leur domicile. Il est cependant constaté que la morbidité maternelle est plus élevée pour les femmes accouchant en ayant la covid 19. La covid était associée à un risque plus élevé de pré-éclampsie et de naissance prématurée, le risque de mortinaissance en revanche reste inchangé. La présence de pathologies pré-existante était associée à des probabilités plus élevées de complications (recours à une ventilation mécanique ou décès à l’hôpital).

Argument (English):

Maternal morbidity is higher for women giving birth with covid 19. Presence of pre-existing pathologies was associated with higher odds of using mechanical ventilation or of death in hospital.

Argumento (português):

A morbidade materna é maior para mulheres que dão à luz com gravidez 19. A presença de patologias pré-existentes foi associada a maiores chances de uso de ventilação mecânica ou de morte no hospital.

Keywords :

➡ premature baby ; public health ; interventions during childbirth ; maternal health ; eclampsia (pre-) ; perinatal death rates ; maternal death rate ; CoVID-19

Author of this record :

Alison Passieux — 23 Jan 2021
➡ latest update : Alison Passieux — 28 Jan 2021

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