Paediatric Infectious Disease Unit, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
Facultad de Medicina Universidad Complutense de Madrid, Madrid, Spain.
BMC Pregnancy Childbirth. 2021 Apr 26;21(1):326. doi: 10.1186/s12884-021-03784-8.
Knowledge about SARS-CoV-2 infection in pregnancy and newborns is scarce. The objective of this study is to analyse clinical and epidemiological characteristics of a cohort of women infected with SARS-CoV-2 during pregnancy and their newborns exposed to SARS-CoV-2 during gestation.
Multicentric observational study of Spanish hospitals from the GESNEO-COVD cohort, participants in RECLIP (Spanish Network of Paediatric Clinical Assays). Women with confirmed SARS-CoV-2 infection by PCR and/or serology during pregnancy, diagnosed and delivering during the period 15/03/2020-31/07/2020 were included. Epidemiological, clinical, and analytical data was collected.
A total of 105 pregnant women with a median of 34.1 years old (IQR: 28.8-37.1) and 107 newborns were included. Globally, almost 65% of pregnant women had some COVID-19 symptoms and more than 43% were treated for SARS-COV-2. Overall, 30.8% of pregnant women had pneumonia and 5 (4.8%) women were admitted to the intensive care unit needing invasive mechanical ventilation. There was a rate of 36.2% of caesarean sections, which was associated with pneumonia during pregnancy (OR: 4.203, CI 95%: 1.473-11.995) and lower gestational age at delivery (OR: 0.724, CI 95%: 0.578-0.906). The prevalence of preterm birth was 20.6% and prematurity was associated with pneumonia during gestation (OR: 6.970, CI95%: 2.340-22.750) and having a positive SARS-CoV-2 PCR at delivery (OR: 6.520, CI95%: 1.840-31.790). All nasopharyngeal PCR in newborns were negative at birth and one positivized at 15 days of life. Two newborns died, one due to causes related to prematurity and another of unexpected sudden death during early skin-to-skin contact after delivery.
Although vertical transmission has not been reported in this cohort, the prognosis of newborns could be worsened by SARS-CoV-2 infection during pregnancy as COVID-19 pneumonia increased the risk of caesarean section deliveries and preterm births.
关于 SARS-CoV-2 感染孕妇和新生儿的知识尚少。本研究旨在分析感染 SARS-CoV-2 的孕妇及其在妊娠期间暴露于 SARS-CoV-2 的新生儿的临床和流行病学特征。
对西班牙 GESNEO-COVD 队列中的多中心观察性研究，参与者来自 RECLIP（西班牙儿科临床检测网络）。本研究纳入了 2020 年 3 月 15 日至 7 月 31 日期间经 PCR 和/或血清学确诊并在孕期内分娩的 SARS-CoV-2 感染孕妇。收集了流行病学、临床和分析数据。
共纳入了 105 名中位年龄为 34.1 岁（IQR：28.8-37.1）的孕妇及其 107 名新生儿。总体而言，近 65%的孕妇有 COVID-19 症状，超过 43%的孕妇接受了 SARS-COV-2 治疗。30.8%的孕妇患有肺炎，5 名（4.8%）孕妇因肺炎住进重症监护病房，需要有创机械通气。剖宫产率为 36.2%，与孕期肺炎（OR：4.203，95%CI：1.473-11.995）和分娩时较低的胎龄（OR：0.724，95%CI：0.578-0.906）相关。早产的发生率为 20.6%，早产与孕期肺炎（OR：6.970，95%CI：2.340-22.750）和分娩时 SARS-CoV-2 PCR 阳性（OR：6.520，95%CI：1.840-31.790）有关。新生儿出生时所有鼻咽拭子 PCR 均为阴性，其中 1 例在 15 天时阳性。2 名新生儿死亡，1 例因早产相关原因，另 1 例因分娩后早期皮肤接触时意外猝死。
尽管本队列未报告垂直传播，但 COVID-19 肺炎增加了剖宫产分娩和早产的风险，因此 SARS-CoV-2 感染孕妇的新生儿预后可能恶化。
