Yang Ziyi, Liu Yi
The First Clinical College of Chongqing Medical University, Chongqing, China.
Department of Obstetrics, Chengdu Jinjiang Maternity and Child Health Hospital, Chengdu, China.
Am J Perinatol. 2020 Aug;37(10):1055-1060. doi: 10.1055/s-0040-1712161. Epub 2020 May 13.
The aim of this study is to summarize currently available evidence on vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
A systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis Statement.
A total of 22 studies comprising 83 neonates born to mothers diagnosed with coronavirus disease 2019 were included in the present systematic review. Among these neonates, three were confirmed with SARS-CoV-2 infection at 16, 36, and 72 hours after birth, respectively, by nasopharyngeal swab real-time polymerase chain reaction (RT-PCR) tests; another six had elevated virus-specific antibody levels in serum samples collected after birth, but negative RT-PCR test results. However, without positive RT-PCR tests of amniotic fluid, placenta, or cord blood, there is a lack of virologic evidence for intrauterine vertical transmission.
There is currently no direct evidence to support intrauterine vertical transmission of SARS-CoV-2. Additional RT-PCR tests on amniotic fluid, placenta, and cord blood are needed to ascertain the possibility of intrauterine vertical transmission. For pregnant women infected during their first and second trimesters, further studies focusing on long-term outcomes are needed.
· We review neonates of mothers diagnosed with coronavirus disease 2019 detected by RT-PCR.. · No direct virologic evidence of vertical transmission has been reported.. · No evidence that cesarean delivery is safer than vaginal delivery.. · More RT-PCR tests on amniotic fluid, placenta, and cord blood are recommended..
本研究旨在总结目前关于严重急性呼吸综合征冠状病毒2（SARS-CoV-2）垂直传播的现有证据。
按照系统评价和Meta分析报告规范（PRISMA）声明的指南进行系统评价。
本系统评价共纳入22项研究，涉及83名母亲被诊断为2019冠状病毒病的新生儿。在这些新生儿中，分别有3名在出生后16、36和72小时通过鼻咽拭子实时聚合酶链反应（RT-PCR）检测确诊为SARS-CoV-2感染；另有6名在出生后采集的血清样本中病毒特异性抗体水平升高，但RT-PCR检测结果为阴性。然而，由于羊水、胎盘或脐带血的RT-PCR检测均未呈阳性，因此缺乏宫内垂直传播的病毒学证据。
目前尚无直接证据支持SARS-CoV-2的宫内垂直传播。需要对羊水、胎盘和脐带血进行额外的RT-PCR检测，以确定宫内垂直传播的可能性。对于在孕早期和孕中期感染的孕妇，需要进一步开展关注长期结局的研究。
·我们回顾了通过RT-PCR检测出的母亲患有2019冠状病毒病的新生儿情况。·尚未报告垂直传播的直接病毒学证据。·没有证据表明剖宫产比阴道分娩更安全。·建议对羊水、胎盘和脐带血进行更多的RT-PCR检测。
