Elgin T G, Fricke E M, Hernandez Reyes M E, Tsimis M E, Leslein N S, Thomas B A, Sato T S, McNamara P J
Stead Family Children's Hospital Department of Pediatrics, Neonatology Division, University of Iowa, Iowa City, IA, USA.
Spectrum Health Medical Group, Maternal Fetal Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA.
J Neonatal Perinatal Med. 2020;13(3):293-305. doi: 10.3233/NPM-200460.
The COVID-19 pandemic represents the greatest challenge to date faced by the medical community in the 21st century. The rate of rapid dissemination, magnitude of viral contagiousness, person to person transmission at an asymptomatic phase of illness pose a unique and dangerous challenge for all patients, including neonatal and obstetric patients. Although scientific understanding of the pathophysiology of the disease, nature of transmission, and efficacy of mitigation strategies is growing, neither a cure or vaccine have been developed. While COVID-19 is primarily a disease of older patients, infection is now seen across all age demographics with reports of illness in pregnant patients and infants. Altered hormone status and predominance of Th-2 immune helper cells may result in increased predisposition to SARS-CoV-2. Case reports of pregnant patients demonstrate a clinical presentation comparable to non-pregnant adults, but evidence of vertical transmission to the fetus is controversial. Neonatal reports demonstrate an inconsistent and non-specific phenotype, and it is often difficult to separate COVID-19 from the underlying conditions of prematurity or bacterial infection. The development of international registries to enable risk profiling of COVID-19 positive pregnant mothers and/or their offspring may facilitate the development of enhanced mitigation strategies, medical treatments and effective vaccinations.
新型冠状病毒肺炎（COVID-19）大流行是21世纪医学界迄今面临的最大挑战。其快速传播速度、病毒传染性强度以及在疾病无症状阶段的人际传播，对包括新生儿和产科患者在内的所有患者构成了独特而危险的挑战。尽管对该疾病的病理生理学、传播性质以及缓解策略的效果的科学认识在不断增加，但尚未研发出治愈方法或疫苗。虽然COVID-19主要是老年患者的疾病，但现在在所有年龄人群中都有感染病例报告，包括孕妇和婴儿患病的报道。激素状态改变和Th-2免疫辅助细胞占优势可能导致对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）易感性增加。孕妇的病例报告显示其临床表现与非孕妇成年人相似，但病毒垂直传播给胎儿的证据存在争议。新生儿报告显示出不一致且非特异性的表型，而且通常很难将COVID-19与早产或细菌感染等潜在疾病区分开来。建立国际登记系统以对COVID-19阳性孕妇及其后代进行风险评估，可能有助于制定强化缓解策略、医学治疗方法和有效的疫苗。
