ObjectiveTo evaluate risk for adverse obstetric outcomes associated with the coronavirus disease 2019 (COVID‐19) pandemic period and with COVID‐19 diagnoses.DesignSerial cross‐sectional study.SettingA national sample of US delivery hospitalisations before (1/2016 to 2/2020) and during the first 10 months of (3/2020 to 12/2020) the COVID‐19 pandemic.PopulationAll 2016–2020 US delivery hospitalisations in the National Inpatient Sample.MethodsDelivery hospitalisations were identified and stratified into pre‐pandemic and pandemic periods and the likelihood of adverse obstetric outcomes was compared using logistic regression models with adjusted odds ratios (aOR) with 95% confidence intervals (CI) as measures of association. Risk for adverse outcomes was also analysed specifically for 2020 deliveries with a COVID‐19 diagnosis.Main Outcome MeasureAdverse maternal outcomes including respiratory complications and cardiac morbidity.ResultsOf an estimated 18.2 million deliveries, 2.9 million occurred during the pandemic. The proportion of delivery hospitalisations with a COVID‐19 diagnosis increased from 0.1% in March 2020 to 3.1% in December. Comparing the pandemic period to the pre‐pandemic period, there were higher adjusted odds of transfusion (aOR 1.12, 95% CI 1.05–1.19), a respiratory complication composite (aOR 1.37, 95% CI 1.29–1.46), cardiac severe maternal morbidity (aOR 1.30, 95% 1.20–1.39), postpartum haemorrhage (aOR 1.19, 95% CI 1.15–1.24), placental abruption/antepartum haemorrhage (OR 1.04, 95% CI 1.00–1.08), and hypertensive disorders of pregnancy (OR 1.23, 95% CI 1.21–1.26). These associations were similar to unadjusted analysis. Risk for these outcomes during the pandemic period was significantly higher in the presence of a COVID‐19 diagnosis.ConclusionsIn a national estimate of delivery hospitalisations, the odds of cardiac and respiratory outcomes were higher in 2020 compared with 2016–2019. COVID‐19 diagnoses were specifically associated with a range of serious complications.

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2020 年 COVID-19 大流行期间的不良分娩住院结果

目的评估与 2019 年冠状病毒病 (COVID-19) 大流行期间和 COVID-19 诊断相关的不良产科结局的风险。设计系列横断面研究。设置美国分娩住院之前（2016 年 1 月至 2020 年 2 月）的全国样本以及在 COVID-19 大流行的前 10 个月（2020 年 3 月至 2020 年 12 月）。人口全国住院患者样本中所有 2016 年至 2020 年美国分娩住院情况。方法确定分娩住院情况并将其分为大流行前和大流行期间以及使用逻辑回归模型比较不良产科结果的可能性，并以调整后的比值比 (aOR) 和 95% 置信区间 (CI) 作为相关性衡量标准。还专门分析了 2020 年诊断为 COVID-19 的分娩的不良结局风险。主要结果指标不良孕产妇结局，包括呼吸系统并发症和心脏病发病率。结果在估计的 1,820 万人次分娩中，有 290 万人发生在大流行期间。诊断出 COVID-19 的分娩住院比例从 2020 年 3 月的 0.1% 增加到 12 月的 3.1%。与大流行前时期相比，调整后的输血几率（aOR 1.12，95% CI 1.05–1.19）、呼吸系统并发症综合风险（aOR 1.37，95% CI 1.29–1.46）、心脏严重产妇发病率更高（aOR 1.30，95% CI 1.20–1.39）、产后出血（aOR 1.19，95% CI 1.15–1.24）、胎盘早剥/产前出血（OR 1.04，95% CI 1.00–1.08）和妊娠期高血压疾病（OR 1.23） ，95% CI 1.21–1.26）。这些关联与未经调整的分析类似。在诊断出 COVID-19 的情况下，大流行期间出现这些结果的风险显着更高。结论根据全国分娩住院估计，2020 年发生心脏和呼吸系统结果的几率高于 2016-2019 年。COVID-19 诊断与一系列严重并发症特别相关。