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围产期虫媒病毒对新生儿结局的影响:最新综述。

Neonatal Outcomes From Arboviruses in the Perinatal Period: A State-of-the-Art Review.

机构信息

Australian Red Cross Lifeblood, Brisbane, Australia

Australian Red Cross Lifeblood, Brisbane, Australia.

出版信息

Pediatrics. 2021 Apr;147(4). doi: 10.1542/peds.2020-009720. Epub 2021 Mar 18.

Abstract

Since the 2016 Zika outbreak and the understanding of the teratogenic effect of this infection, there has been a newfound interest in arbovirus infections and their effects on pregnancy, resulting in numerous publications in the last 5 years. However, limited literature focuses on arbovirus infection in different stages of pregnancy and their effect on the neonate. There is currently no consensus management of perinatal acquisition of arboviruses, and current evidence is largely anecdotal observational reports. Teratogens can have different effects on the developing fetus depending on the time of infection, so infections during pregnancy should be analyzed by trimester. A better understanding of arbovirus infection in the perinatal period is required to assist obstetric, neonatal, and pediatric clinicians in making decisions about the management of mother and neonate. Our objective was to assess the evidence of adverse neonatal outcomes for several arboviral infections when contracted during the perinatal period to guide clinicians in managing these patients. There are 8 arboviruses for which neonatal outcomes from maternal acquisition in the perinatal period have been reported, with the most data for dengue and Chikungunya virus infections. The evidence reviewed in this article supports the adoption of preventive strategies to avoid ticks and mosquitoes close to the date of delivery. For the other arbovirus infections, further community-based cohort studies during outbreaks are required to evaluate whether these infections have a similar teratogenic impact.

摘要

自 2016 年寨卡病毒爆发以及人们对这种感染的致畸作用的了解以来,人们对虫媒病毒感染及其对妊娠的影响产生了新的兴趣,因此在过去 5 年中出现了大量相关出版物。然而,有限的文献集中在妊娠不同阶段的虫媒病毒感染及其对新生儿的影响。目前,对于围产期获得的虫媒病毒,尚无共识的管理方法,目前的证据主要是轶事观察报告。致畸剂对发育中的胎儿的影响可能因感染时间而异,因此应按妊娠阶段分析妊娠期间的感染。为了帮助产科、新生儿科和儿科临床医生做出关于母婴管理的决策,需要更好地了解围产期虫媒病毒感染。我们的目的是评估几种围产期感染的不良新生儿结局的证据,以指导临床医生管理这些患者。有 8 种虫媒病毒,其在围产期从母体获得时会导致新生儿出现不良结局,其中登革热和基孔肯雅热病毒感染的数据最多。本文回顾的证据支持采取预防策略,以避免在接近分娩日期时接触蜱虫和蚊子。对于其他虫媒病毒感染,需要在暴发期间进行进一步的基于社区的队列研究,以评估这些感染是否具有类似的致畸作用。

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