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土耳其新生儿学会关于 125 例感染 COVID-19 的孕妇所分娩新生儿的流行病学和临床特征的多中心研究。

A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society.

机构信息

Department of Pediatrics, Division of Neonatology, School of Medicine, İzmir Katip Çelebi University, İzmir, Turkey.

Division of Neonatology, Tepecik Training and Research Hospital, University of Health Sciences, Konak, 35180, İzmir, Turkey.

出版信息

Eur J Pediatr. 2021 Mar;180(3):733-742. doi: 10.1007/s00431-020-03767-5. Epub 2020 Aug 10.

Abstract

Limited data are available on pregnant women with COVID-19 and their neonates. We aimed to evaluate the epidemiological and clinical characteristics of newborns born to women infected with COVID-19. A multicenter cohort study was conducted among newborns born to mothers with COVID-19 in 34 neonatal intensive care units (NICUs) in Turkey. Pregnant women (n = 125) who had a positive RT-PCR test and their newborns were enrolled. Cesarean section, prematurity, and low-birthweight infant rates were 71.2%, 26.4%, and 12.8%, respectively. Eight of 125 mothers (6.4%) were admitted to an intensive care unit for mechanical ventilation, among whom six died (4.8%). Majority of the newborns (86.4%) were followed in isolation rooms in the NICU. Four of 120 newborns (3.3%) had a positive RT-PCR test result. Although samples taken on the first day were negative, one neonate became positive on the second day and the other two on the fifth day. Sample from deep tracheal aspirate was positive on the first day in an intubated case.Conclusion: COVID-19 in pregnant women has important impacts on perinatal and neonatal outcomes. Maternal mortality, higher rates of preterm birth and cesarean section, suspected risk of vertical transmission, and low rate of breastfeeding show that family support should be a part of the care in the NICU.Trial registration: ClinicalTrials.gov identifier: NCT04401540 What is Known: • The common property of previous reports was the conclusions on maternal outcomes, rather than neonatal outcomes. • Published data showed similar outcomes between COVID-19 pregnant women and others. What is New: • Higher maternal mortality, higher rates of preterm birth and cesarean section, suspected risk of vertical transmission especially in a case with deep tracheal aspiration during the intubation, and the possible role of maternal disease severity on the outcomes are remarkable findings of this study. • In contrast to recommendation for breastfeeding, parents' preference to formula and expressed breast milk due to anxiety and lack of information shows that family support should be a part of the care in the NICU.

摘要

关于感染 COVID-19 的孕妇及其新生儿的数据有限。我们旨在评估感染 COVID-19 的母亲所生新生儿的流行病学和临床特征。在土耳其的 34 个新生儿重症监护病房 (NICU) 中进行了一项针对感染 COVID-19 的母亲所生新生儿的多中心队列研究。纳入了 125 名 RT-PCR 检测阳性的孕妇及其新生儿。剖宫产、早产和低出生体重儿的发生率分别为 71.2%、26.4%和 12.8%。125 名母亲中有 8 名(6.4%)因需要机械通气而入住重症监护病房,其中 6 名死亡(4.8%)。大多数新生儿(86.4%)在 NICU 的隔离病房中接受随访。120 名新生儿中有 4 名(3.3%)的 RT-PCR 检测结果为阳性。尽管第一天采集的样本为阴性,但有 1 名新生儿在第二天呈阳性,另外 2 名在第五天呈阳性。在一名气管插管的病例中,第一天的深部气管抽吸物样本呈阳性。结论:孕妇感染 COVID-19 对围产期和新生儿结局有重要影响。孕产妇死亡率较高,早产和剖宫产率较高,疑似垂直传播风险以及母乳喂养率较低表明,家庭支持应成为 NICU 护理的一部分。试验注册:ClinicalTrials.gov 标识符:NCT04401540 已知情况:• 先前报告的共同特征是关于孕产妇结局的结论,而不是新生儿结局。• 已发表的数据表明,COVID-19 孕妇和其他孕妇的结局相似。新发现:• 本研究的显著发现是,孕产妇死亡率较高,早产和剖宫产率较高,疑似垂直传播风险,尤其是在气管插管期间进行深部气管抽吸时,以及母体疾病严重程度对结局的可能影响。• 与母乳喂养的建议相反,由于焦虑和缺乏信息,父母更喜欢配方奶和表达的母乳,这表明家庭支持应成为 NICU 护理的一部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2d5/7416592/4337393605ea/431_2020_3767_Fig1_HTML.jpg

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