From the Department of Pathology, Medical College of Georgia, Augusta University, Augusta.
Arch Pathol Lab Med. 2020 Jul 1;144(7):799-805. doi: 10.5858/arpa.2020-0901-SA.
The emergence of a novel coronavirus, termed SARS-CoV-2, and the potentially life-threatening respiratory disease that it can produce, COVID-19, has rapidly spread across the globe, creating a massive public health problem. Previous epidemics of many emerging viral infections have typically resulted in poor obstetric outcomes including maternal morbidity and mortality, maternal-fetal transmission of the virus, and perinatal infections and death. This article reviews the effects of 2 previous coronavirus infections-severe acute respiratory syndrome (SARS) caused by SARS-CoV and Middle East respiratory syndrome (MERS) caused by MERS-CoV-on pregnancy outcomes. In addition, it analyzes literature describing 38 pregnant women with COVID-19 and their newborns in China to assess the effects of SARS-CoV-2 on the mothers and infants, including clinical, laboratory, and virologic data, and the transmissibility of the virus from mother to fetus. This analysis reveals that unlike coronavirus infections of pregnant women caused by SARS and MERS, in these 38 pregnant women COVID-19 did not lead to maternal deaths. Importantly, and similar to pregnancies with SARS and MERS, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses. All neonatal specimens tested, including placentas in some cases, were negative by RT-PCR for SARS-CoV-2. At this point in the global pandemic of COVID-19 infection there is no evidence that SARS-CoV-2 undergoes intrauterine or transplacental transmission from infected pregnant women to their fetuses. Analysis of additional cases is necessary to determine if this remains true.
一种新型冠状病毒(SARS-CoV-2)的出现及其可能导致的危及生命的呼吸道疾病 COVID-19,迅速在全球范围内蔓延,造成了巨大的公共卫生问题。以前许多新发病毒性感染的流行通常会导致不良的产科结局,包括孕产妇发病率和死亡率、病毒在母婴之间的传播,以及围产期感染和死亡。本文回顾了前两种冠状病毒感染(SARS-CoV 引起的严重急性呼吸综合征 SARS 和 MERS-CoV 引起的中东呼吸综合征 MERS)对妊娠结局的影响。此外,还分析了描述中国 38 例 COVID-19 孕妇及其新生儿的文献,以评估 SARS-CoV-2 对母亲和婴儿的影响,包括临床、实验室和病毒学数据,以及病毒从母亲向胎儿的传播能力。这项分析表明,与 SARS 和 MERS 引起的孕妇冠状病毒感染不同,在这 38 名孕妇中,COVID-19 并未导致母亲死亡。重要的是,与 SARS 和 MERS 的妊娠情况相似,没有确诊的 COVID-19 母亲将 SARS-CoV-2 传染给胎儿的宫内传播病例。所有新生儿标本(包括胎盘)经 RT-PCR 检测均为 SARS-CoV-2 阴性。在 COVID-19 感染的全球大流行中,目前尚无证据表明 SARS-CoV-2 会从感染的孕妇经宫内或胎盘传播给胎儿。需要分析更多的病例来确定这是否仍然正确。