Hypertensive Schwangerschaftserkrankungen und SARS-CoV-2/COVID-19: Auswertung des nationalen CRONOS-Registers

Zusammenfassung

SARS-CoV-2-Infektion und COVID-19-Erkrankung sind in internationalen Registerstudien mit einem erhöhten Risiko für hypertensive Schwangerschaftserkrankungen assoziiert. Hypertensive Erkrankungen stellen zudem einen Risikofaktor eines schweren COVID-19-Verlaufes in der Schwangerschaft dar. Als pathophysiologische Gemeinsamkeit beider Erkrankungen wird die Schädigung des Endothels angesehen.

Daten des nationalen CRONOS-Registers (Datenstand 05/2021; 1104 schwangere Frauen mit SARS-CoV-2-Infektion) wurden hinsichtlich des Zusammenhangs zu hypertensiven Schwangerschaftserkrankungen und dem Outcome von Mutter, Schwangerschaft, Neugeborenen und COVID-19-Erkrankung analysiert. Bei Vorliegen einer hypertensiven Schwangerschaftserkrankung war signifikant häufiger ein schweres kombiniertes Outcome der Schwangerschaft (17,3 vs. 4,3%, p=0,001), der Mutter (25,0 vs. 9,4%, p=0,001) und des Neugeborenen (28,8 vs. 9,1%, p<0,0005) zu verzeichnen. Das Outcome der COVID-19-Erkrankung unterschied sich hingegen nicht (3,8 vs. 7,5%, p=0,424). Hypertensive Schwangerschaftserkrankungen sollten im Management einer SARS-CoV-2-Infektion in der Schwangerschaft als Risikofaktor angesehen werden. Dies kann Implikationen auf die Therapie haben, wie zum Beispiel mit monoklonalen Antikörpern haben.

Abstract

SARS-CoV-2 infection and COVID-19 disease are associated with an increased risk of hypertensive pregnancy disease in international registry studies. Preexisting hypertensive disorders are recognized as a risk factor of severe COVID-19 progression in pregnancy. The respective damage to the endothelium is discussed as a pathophysiological commonality of both diseases.

Data of the national CRONOS registry (data status 05/2021; 1104 pregnant women with SARS-CoV-2 infection) were analyzed regarding the association of hypertensive pregnancy disease and maternal, pregnancy, neonatal, and COVID-19 disease outcomes. In the presence of hypertensive pregnancy disease, a severe combined outcome of pregnancy (17.3 vs. 4.3%, p=0.001), mother (25.0 vs. 9.4%, p=0.001), and newborn (28.8 vs. 9.1%, p<0.0005) occurred significantly more frequent. In contrast, the outcome of COVID-19 disease did not differ (3.8 vs. 7.5%, p=0.424). The co-occurrence of SARS-CoV-2 infection and hypertensive pregnancy disease should be acknowledged as risk factor during management decisions.

Schlüsselwörter

SARS-CoV-2 - COVID-19 - Schwangerschaft - Hypertensive Schwangerschaftserkrankungen - Präeklampsie

Key words

SARS-CoV-2 - COVID-19 - pregnancy - hypertensive pregnancy diseases - preeclampsia

Publication History

Received: 12 June 2022

Accepted after revision: 06 October 2022

Article published online:
11 November 2022

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