Médecins Sans Frontières, Paris, France.
Médecins Sans Frontières, Paris, France.
Lancet Child Adolesc Health. 2020 Dec;4(12):884-888. doi: 10.1016/S2352-4642(20)30278-9.
Few fetuses survive childbirth when the mother is positive for Ebola virus, with almost all being miscarried or stillborn, or dying shortly after birth. Before 2019, only two infants had been reported surviving past 28 days, of whom one tested positive for Ebola virus and subsequently received experimental therapies. Little is understood regarding the care of surviving neonates born to Ebola virus-positive mothers in the postnatal period and how novel anti-Ebola virus therapies might affect neonatal outcomes.
In this case series, we report on two neonates liveborn during the 2018-20 North Kivu Ebola epidemic in the Democratic Republic of the Congo who, along with their Ebola virus-positive mothers, received investigational monoclonal antibody treatment (mAB114 or REGN-EB3) as part of a randomised controlled trial (NCT03719586).
Both infants were born Ebola-negative and progressed well while in the Ebola Treatment Centre. Neither neonate developed evidence of Ebola virus disease during the course of the admission, and both were Ebola-negative at 21 days and remained healthy at discharge.
To our knowledge these neonates are the first documented as Ebola virus-negative at birth after being born to Ebola virus-positive mothers, and only the third and fourth neonates ever documented to have survived into infancy. Although no conclusions can be drawn from this small case series, and further research is required to investigate the neonatal effects of antibody therapies, these cases warrant review regarding whether post-delivery antibody therapy should be considered for all liveborn neonates of Ebola virus-positive mothers. In the context of a low resource setting, where survival of low-birthweight infants is poor, these cases also highlight the importance of adequate neonatal care.
None.
患有埃博拉病毒的母亲所生的胎儿几乎都无法存活到分娩，要么流产或死产，要么在出生后不久就死亡。在 2019 年之前，仅有两名婴儿存活超过 28 天，其中一名婴儿埃博拉病毒检测呈阳性，并随后接受了实验性治疗。对于在产后期间存活的埃博拉病毒阳性母亲所生的新生儿的护理以及新型抗埃博拉病毒治疗方法如何影响新生儿结局，人们知之甚少。
在本病例系列研究中，我们报告了刚果民主共和国北基伍省 2018-20 年埃博拉疫情期间出生的两名新生儿，他们与埃博拉病毒阳性母亲一起接受了研究性单克隆抗体治疗（mAB114 或 REGN-EB3），这是一项随机对照试验的一部分（NCT03719586）。
两名婴儿出生时埃博拉病毒检测均为阴性，并在埃博拉治疗中心进展良好。两名新生儿在住院期间均未出现埃博拉病毒病的证据，且在 21 天时埃博拉病毒检测均为阴性，出院时仍保持健康。
据我们所知，这些新生儿是已知的出生时为埃博拉病毒阴性的首例婴儿，他们的母亲埃博拉病毒检测为阳性，而且也是仅有的第三和第四例存活到婴儿期的新生儿。尽管从这个小病例系列中不能得出任何结论，并且需要进一步研究来调查抗体治疗对新生儿的影响，但这些病例值得审查，即对于所有埃博拉病毒阳性母亲所生的活产新生儿，是否应考虑产后给予抗体治疗。在资源有限的环境下，低出生体重婴儿的存活率较低，这些病例也突显了充分的新生儿护理的重要性。
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