新型冠状病毒感染对妊娠晚期孕妇凝血功能及产科并发症的影响  

Changes in coagulation indices and obstetric complications in third trimester pregnant women with COVID-19

作　　者：张玲玉 张命金 ZHANG Lingyu;ZHANG Mingjin(Affiliated Matern&Child Care Hospital of Nantong University,Jiangsu Province,Nantong 226018,China)

机构地区：[1]南通大学附属南通妇幼保健院产科,江苏南通226018

出　　处：《中国校医》2024年第6期455-457,475,共4页Chinese Journal of School Doctor

摘　　要：目的分析新型冠状病毒感染的妊娠晚期孕妇凝血因子的相关指标及冠状病毒感染对产科并发症的影响。方法选择2022年12月10日-2023年1月10日在南通市妇幼保健院孕28周后分娩的541例孕妇为研究对象,其中感染新冠的151例孕妇设为感染组,未感染新冠的390例孕妇为未感染组,分析比较2组孕妇的一般资料、凝血相关指标及产科并发症。结果感染组孕妇血小板计数为(197.21±60.20)×10^(9)/L、纤维蛋白原为(4.61±1.29)g/L,低于未感染组的(209.52±53.51)×10^(9)/L、(5.08±1.07)g/L,差异均有统计学意义(t值分别为2.318、4.290,P均<0.05);感染组孕妇凝血酶原时间为(11.76±7.91)s、国际标准化比值为0.96±0.06、部分凝血活酶时间为(27.98±4.96)s、纤维蛋白原降解产物为(13.32±13.01)μg/mL、D-二聚体为(3.66±2.89)mg/L,均高于未感染组的(10.78±0.53)s、(0.94±0.05)、(25.12±2.29)s、(9.89±6.44)μg/mL、(2.93±2.04)mg/L,差异均有统计学意义(t值分别为2.425、5.590、9.160、4.068、3.296,P均<0.05);感染组孕妇产后出血率(6.62%)高于未感染组(2.82%),差异有统计学意义(χ^(2)=4.217,P=0.004)。结论新型冠状病毒感染的孕妇存在凝血功能异常,更易发生产后出血,必须采取对应措施防止并发症的发生。Objective This study analyzed coagulation-related indices in pregnant women infected with COVID-19,and the effects on obstetric complications.Methods A total of 541 pregnant women admitted to Nantong Maternal and Child Health Hospital between December 10,2022 and January 10,2023 were selected for a retrospective cohort study.A total of 151 pregnant women infected with COVID-19 were selected as the infected group,and 390 pregnant women uninfected with COVID-19 were selected as the non-infected group.The general clinical data,obstetric complications,and coagulation-related indices of the two groups were analyzed and compared.Results The platelet count and fibrinogen levels in pregnant women in the infected group(197.21±60.20)×10^(9)/L and(4.61±1.29)g/L,respectively)were significantly lower than those in the non-infected group(209.52±53.51)×10^(9)/L and(5.08±1.07)g/L,respectively)(t=2.318,4.290,both P<0.05).The prothrombin time,international standardized ratio,partial thromboplastin time,fibrinogen degradation products,and D-dimer among pregnant women in the infected group(11.76±7.91)s,(0.96±0.06),(27.98±4.96)s,(13.32±13.01)μg/mL,and(3.66±2.89)mg/L,respectively)were significantly higher than those in the non-infected group(10.78±0.53)s,(0.94±0.05),(25.12±2.29)s,(9.89±6.44)μg/mL,and(2.93±2.04)mg/L,respectively)(t=2.425,5.590,9.160,4.068,3.296;all P<0.05).The postpartum bleeding rate of pregnant women in the infected group(6.62%)was significantly higher than that in the non-infected group(2.82%)(χ^(2)=4.217;P=0.004).Conclusion Coagulation disorder was observed in pregnant women with COVID-19,who were more likely to have postpartum hemorrhage than those without infection.Therefore,measures must be taken to prevent complications during pregnancy and childbirth.

关 键 词：新型冠状病毒感染 孕产妇卫生 凝血功能 产科并发症 

分 类 号：R714[医药卫生—妇产科学]