Zhu Huaping, Wang Lin, Fang Chengzhi, Peng Sicong, Zhang Lianhong, Chang Guiping, Xia Shiwen, Zhou Wenhao
Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Wuhan 430070, China.
Department of Neonatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Transl Pediatr. 2020 Feb;9(1):51-60. doi: 10.21037/tp.2020.02.06.
The newly identified 2019-nCoV, which appears to have originated in Wuhan, the capital city of Hubei province in central China, is spreading rapidly nationwide. A number of cases of neonates born to mothers with 2019-nCoV pneumonia have been recorded. However, the clinical features of these cases have not been reported, and there is no sufficient evidence for the proper prevention and control of 2019-nCoV infections in neonates.
The clinical features and outcomes of 10 neonates (including 2 twins) born to 9 mothers with confirmed 2019-nCoV infection in 5 hospitals from January 20 to February 5, 2020 were retrospectively analyzed.
Among these 9 pregnant women with confirmed 2019-nCoV infection, onset of clinical symptoms occurred before delivery in 4 cases, on the day of delivery in 2 cases, and after delivery in 3 cases. In most cases, fever and a cough were the first symptoms experienced, and 1 patient also had diarrhea. Of the newborns born to these mothers, 8 were male and 2 were female; 4 were full-term infants and 6 were born premature; 2 were small-for-gestational-age (SGA) infants and 1 was a large-for-gestational-age (LGA) infant; there were 8 singletons and 2 twins. Of the neonates, 6 had a Pediatric Critical Illness Score (PCIS) score of less than 90. Clinically, the first symptom in the neonates was shortness of breath (n=6), but other initial symptoms such as fever (n=2), thrombocytopenia accompanied by abnormal liver function (n=2), rapid heart rate (n=1), vomiting (n=1), and pneumothorax (n=1) were observed. Up to now, 5 neonates have been cured and discharged, 1 has died, and 4 neonates remain in hospital in a stable condition. Pharyngeal swab specimens were collected from 9 of the 10 neonates 1 to 9 days after birth for nucleic acid amplification tests for 2019-nCoV, all of which showed negative results.
Perinatal 2019-nCoV infection may have adverse effects on newborns, causing problems such as fetal distress, premature labor, respiratory distress, thrombocytopenia accompanied by abnormal liver function, and even death. However, vertical transmission of 2019-nCoV is yet to be confirmed.
新发现的2019新型冠状病毒（2019-nCoV）似乎起源于中国中部湖北省省会武汉，正在全国迅速传播。已有多例母亲患有2019-nCoV肺炎的新生儿病例记录。然而，这些病例的临床特征尚未见报道，且缺乏足够证据用于新生儿2019-nCoV感染的恰当防控。
对2020年1月20日至2月5日期间在5家医院出生的10例新生儿（包括2对双胞胎）进行回顾性分析，这些新生儿的母亲均确诊感染2019-nCoV。
在这9例确诊感染2019-nCoV的孕妇中，4例临床症状在分娩前出现，2例在分娩当天出现，3例在分娩后出现。多数情况下，发热和咳嗽是首发症状，1例患者还伴有腹泻。这些母亲所生的新生儿中，男婴8例，女婴2例；足月儿4例，早产儿6例；小于胎龄儿（SGA）2例，大于胎龄儿（LGA）1例；单胎8例，双胞胎2例。新生儿中，6例儿科危重病评分（PCIS）低于90分。临床上，新生儿的首发症状为呼吸急促（n = 6），但也观察到其他初始症状，如发热（n = 2）、血小板减少伴肝功能异常（n = 2）、心率加快（n = 1）、呕吐（n = 1）和气胸（n = 1）。截至目前，5例新生儿已治愈出院，1例死亡，4例新生儿仍住院，病情稳定。10例新生儿中的9例在出生后1至9天采集咽拭子标本进行2019-nCoV核酸扩增检测，结果均为阴性。
围产期2019-nCoV感染可能对新生儿产生不良影响，导致胎儿窘迫、早产、呼吸窘迫、血小板减少伴肝功能异常，甚至死亡。然而，2019-nCoV的垂直传播尚未得到证实。
