与 COVID-19 共存的母婴二联体：城市，保障网医院的临床表现和出生结局。

Mother-Infant Dyads with COVID-19 at an Urban, Safety-Net Hospital: Clinical Manifestations and Birth Outcomes.

机构信息

Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.

Baystate Medical Center, University of Massachusetts, Boston, Massachusetts.

出版信息

Am J Perinatol. 2021 Jun;38(7):741-746. doi: 10.1055/s-0041-1726429. Epub 2021 Apr 14.

DOI:10.1055/s-0041-1726429

PMID:33853145

Abstract

OBJECTIVE

This study aimed to describe maternal characteristics and clinical outcomes of infants born to mothers with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests during pregnancy at an urban, safety-net hospital in Boston.

STUDY DESIGN

We abstracted electronic chart data from 75 pregnant women with positive SARS-CoV-2 tests at any stage of gestation until 72 hours after birth who delivered consecutively between March 31 and August 6, 2020 at our center. We collected clinical data on maternal and infant characteristics, including testing, signs, and symptoms of coronavirus disease 2019 (COVID-19), delivery outcomes, newborn care practices (skin-to-skin care, location of care, and breastfeeding) and 30-day postdischarge infant emergency room visits and readmissions. We described categorical characteristics as percentages for this case series.

RESULTS

Among 75 pregnant women, 47 (63%) were Hispanic, 10 (13%) had hypertension, 23 (30%) had prepregnancy obesity, and 57 (76%) had symptomatic SARS-CoV-2 infection. Regarding birth outcomes, 32 (41%) had cesarean delivery and 14 (19%) had preterm birth. Among 75 infants, 5 (7%) had positive SARS-CoV-2 polymerase chain reaction tests in the first week of life, all of whom were born to Hispanic mothers with symptomatic SARS-CoV-2 infection and had clinical courses consistent with gestational age. Six (8%) infants visited the emergency department within 30 days of discharge; one was admitted with a non-COVID-19 diagnosis.

CONCLUSION

At our urban, safety-net hospital among pregnant women with positive SARS-CoV-2 tests, 41% had a cesarean delivery and 19% had a preterm birth. Seven percent of infants had one or more positive SARS-CoV-2 tests and all infants had clinical courses expected for gestational age.

KEY POINTS

· Among 75 pregnant women with SARS-CoV-2 positive testing at our center, five infants (7%) had one or more SARS-CoV-2 positive tests in the first week of life.. · Infants with positive SARS-CoV-2 tests had clinical courses expected for gestational age..

摘要

目的

本研究旨在描述在波士顿一家城市综合性医院中，患有阳性严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的孕妇的母婴特征和临床结局。

研究设计

我们从 2020 年 3 月 31 日至 8 月 6 日期间在我们中心连续分娩的 75 名在妊娠任何阶段 SARS-CoV-2 检测呈阳性的孕妇的电子病历中提取数据。我们收集了母婴特征的临床数据，包括检测、冠状病毒病 2019（COVID-19）的症状和体征、分娩结局、新生儿护理实践（皮肤接触护理、护理地点和母乳喂养）以及 30 天出院后婴儿急诊就诊和再入院情况。我们将分类特征描述为病例系列的百分比。

结果

在 75 名孕妇中，47 名（63%）为西班牙裔，10 名（13%）患有高血压，23 名（30%）患有孕前肥胖，57 名（76%）患有有症状的 SARS-CoV-2 感染。关于分娩结局，32 名（41%）行剖宫产术，14 名（19%）早产。在 75 名婴儿中，有 5 名（7%）在生命的第一周 SARS-CoV-2 聚合酶链反应检测呈阳性，均为患有有症状 SARS-CoV-2 感染的西班牙裔母亲所生，且临床病程与胎龄相符。6 名（8%）婴儿在出院后 30 天内就诊于急诊部；其中 1 名因非 COVID-19 诊断而入院。