Cimolai Nevio
Faculty of Medicine, The University of British Columbia, Vancouver, Canada.
Children's and Women's Health Centre of British Columbia, 4480 Oak Street, Vancouver, B.C. V6H3V4 Canada.
SN Compr Clin Med. 2021;3(6):1272-1294. doi: 10.1007/s42399-021-00836-0. Epub 2021 Mar 17.
The maternal-fetal/newborn unit is established at risk for COVID-19 infection. This narrative review summarizes the contemporary and cumulative publications which detail maternal infection, antenatal and newborn infections, and maternal/fetal/newborn management and prevention. There is a wide spectrum of maternal disease, but the potential for severe disease albeit in a minority is confirmed. COVID-19 carries risk for preterm delivery. Pregnant females can suffer multisystem disease, and co-morbidities play a significant role in risk. Congenital infection has been supported by several anecdotal reports, but strong confirmatory data are few. No typical congenital dysmorphisms are evident. Nevertheless, placental vascular compromise must be considered a risk for the fetus during advanced maternal infections. Clinical manifestations of newborn infection have been mild to moderate and relatively uncommon. Proven antiviral therapy is of yet lacking. The mode of delivery is a medical decision that must include patient risk assessment and patient directives. Both presymptomatic and asymptomatic mothers and offspring can complicate infection control management with the potential for spread to others in several regards. In the interim, infections of the maternal-fetal-newborn unit must be taken seriously both for the disease so caused and the potential for further dissemination of disease.
母婴/新生儿科室被认定为存在感染新冠病毒的风险。本叙述性综述总结了当代及累积发表的文献,这些文献详细阐述了孕产妇感染、产前及新生儿感染,以及孕产妇/胎儿/新生儿的管理与预防。孕产妇疾病范围广泛,但尽管少数病例会出现重症,这一可能性已得到证实。新冠病毒会增加早产风险。怀孕女性可能会出现多系统疾病,合并症在风险中起重要作用。几份轶事报告支持了先天性感染的存在,但有力的确证数据较少。未发现典型的先天性畸形。然而,在孕产妇晚期感染期间,必须考虑胎盘血管受损对胎儿构成的风险。新生儿感染的临床表现为轻至中度,且相对不常见。目前仍缺乏经证实有效的抗病毒疗法。分娩方式是一项医疗决策,必须包括对患者风险的评估以及患者的意愿。症状出现前和无症状的母亲及其后代都可能使感染控制管理复杂化,存在在多个方面传播给他人的可能性。在此期间,必须认真对待母婴/新生儿科室的感染,既要关注由此引发的疾病,也要关注疾病进一步传播的可能性。