Title :

Management and outcomes of pregnant women admitted to intensive care unit for severe pneumonia related to SARS-CoV-2 infection: the multicenter and international COVIDPREG study

Author(s) :

Péju, Edwige [Auteur]
Belicard, Félicie [Auteur]
Silva, Stein [Auteur]
Hraiech, Sami [Auteur]
Painvin, Benoît [Auteur]
Kamel, Toufik [Auteur]
Thille, Arnaud W. [Auteur]
Goury, Antoine [Auteur]
Grimaldi, David [Auteur]
Jung, Boris [Auteur]
Piagnerelli, Michael [Auteur]
Winiszewski, Hadrien [Auteur]
Jourdain, Mercedes [Auteur]
Hôpital Roger Salengro [Lille]
Recherche translationnelle sur le diabète (RTD) - U1190
Jozwiak, Mathieu [Auteur]

Journal title :

Intensive Care Medicine

Abbreviated title :

Intensive Care Med

Volume number :

48

Pages :

1185–1196

Publisher :

Springer Verlag

Publication date :

2022-08-17

ISSN :

1432-1238

English keyword(s) :

Acute respiratory distress syndrome
COVID-19
Mechanical ventilation
Neonates
Oxygenation
Pregnancy
Prone positioning
Prognosis

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Purpose Management and outcomes of pregnant women with coronavirus disease 2019 (COVID-19) admitted to intensive care unit (ICU) remain to be investigated. Methods A retrospective multicenter study conducted in 32 ...
Show more >Purpose Management and outcomes of pregnant women with coronavirus disease 2019 (COVID-19) admitted to intensive care unit (ICU) remain to be investigated. Methods A retrospective multicenter study conducted in 32 ICUs in France, Belgium and Switzerland. Maternal management as well as maternal and neonatal outcomes were reported. Results Among the 187 pregnant women with COVID-19 (33 ± 6 years old and 28 ± 7 weeks’ gestation), 76 (41%) were obese, 12 (6%) had diabetes mellitus and 66 (35%) had pregnancy-related complications. Standard oxygenation, high-flow nasal oxygen therapy (HFNO) and non-invasive ventilation (NIV) were used as the only oxygenation technique in 41 (22%), 55 (29%) and 18 (10%) patients, respectively, and 73 (39%) were intubated. Overall, 72 (39%) patients required several oxygenation techniques and 15 (8%) required venovenous extracorporeal membrane oxygenation. Corticosteroids and tocilizumab were administered in 157 (84%) and 25 (13%) patients, respectively. Awake prone positioning or prone positioning was performed in 49 (26%) patients. In multivariate analysis, risk factors for intubation were obesity (cause-specific hazard ratio (CSH) 2.00, 95% CI (1.05–3.80), p = 0.03), term of pregnancy (CSH 1.07, 95% CI (1.02–1.10), per + 1 week gestation, p = 0.01), extent of computed tomography (CT) scan abnormalities > 50% (CSH 2.69, 95% CI (1.30–5.60), p < 0.01) and NIV use (CSH 2.06, 95% CI (1.09–3.90), p = 0.03). Delivery was required during ICU stay in 70 (37%) patients, mainly due to maternal respiratory worsening, and improved the driving pressure and oxygenation. Maternal and fetal/neonatal mortality rates were 1% and 4%, respectively. The rate of maternal and/or neonatal complications increased with the invasiveness of maternal respiratory support. Conclusion In ICU, corticosteroids, tocilizumab and prone positioning were used in few pregnant women with COVID-19. Over a third of patients were intubated and delivery improved the driving pressure.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Recherche translationnelle sur le diabète (RTD) - U1190

Submission date :

2024-01-19T22:33:53Z
2024-09-18T13:13:49Z