Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.
Division of Neonatology, Department of Pediatrics, Ministry of Health, Ankara City Hospital, Ankara, Turkey.
J Med Virol. 2021 Oct;93(10):5864-5872. doi: 10.1002/jmv.27128. Epub 2021 Jun 12.
The aim was to investigate the association of the delivery mode and vertical transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) through the samples of vaginal secretions, placenta, cord blood, or amniotic fluid as well as the neonatal outcomes. This cross-sectional study presents an analysis of prospectively gathered data collected at a single tertiary hospital. Sixty-three pregnant women with confirmed coronavirus disease 2019 (COVID-19) participated in the study. Vertical transmission of SARS-CoV-2 was analyzed with reverse transcriptase-polymerase chain reaction (RT-PCR) tests and blood tests for immunoglobulin G (IgG)-immunoglobulin M (IgM) antibodies. All patients were in the mild or moderate category for COVID-19. Only one placental sample and two of the vaginal secretion samples were positive for SARS-CoV-2. Except for one, all positive samples were obtained from patients who gave birth by cesarean. All cord blood and amniotic fluid samples were negative for SARS-CoV-2. Two newborns were screened positive for COVID-19 IgG-IgM within 24 h after delivery, but the RT-PCR tests were negative. A positive RT-PCR result was detected in a neof a mother whose placenta, cord blood, amniotic fluid, and vaginal secretions samples were negative. He died due to pulmonary hemorrhage on the 11th day of life. In conclusion, we demonstrated that SARS-CoV-2 can be detectable in the placenta or vaginal secretions of pregnant women. Detection of the virus in the placenta or vaginal secretions may not be associated with neonatal infection. Vaginal delivery may not increase the incidence of neonatal infection, and cesarean may not prevent vertical transmission. The decision regarding the mode of delivery should be based on obstetric indications and COVID-19 severity.
目的:通过阴道分泌物、胎盘、脐带血或羊水样本,以及新生儿结局,调查严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的分娩方式和垂直传播的相关性。本横断面研究对一家三级医院前瞻性收集的数据进行了分析。63 名确诊为 2019 年冠状病毒病(COVID-19)的孕妇参与了这项研究。采用逆转录-聚合酶链反应(RT-PCR)试验和 IgG-免疫球蛋白 M(IgM)抗体血液检测分析 SARS-CoV-2 的垂直传播。所有患者的 COVID-19 均处于轻度或中度。仅一个胎盘样本和两个阴道分泌物样本 SARS-CoV-2 呈阳性。除了一个,所有阳性样本均来自行剖宫产分娩的患者。所有脐带血和羊水样本均为 SARS-CoV-2 阴性。有 2 名新生儿在分娩后 24 小时内筛查出 COVID-19 IgG-IgM 阳性,但 RT-PCR 检测结果为阴性。一位母亲的胎盘、脐带血、羊水和阴道分泌物样本均为阴性,但 RT-PCR 结果呈阳性。她因肺出血于第 11 天死亡。总之,我们表明 SARS-CoV-2 可在孕妇的胎盘或阴道分泌物中检测到。病毒在胎盘或阴道分泌物中的检出可能与新生儿感染无关。阴道分娩可能不会增加新生儿感染的发生率,剖宫产也不能预防垂直传播。分娩方式的决定应基于产科指征和 COVID-19 的严重程度。
Int J Environ Res Public Health. 2022-2-13
Ultrasound Obstet Gynecol. 2021-12
Arch Gynecol Obstet. 2021-6
Semin Perinatol. 2024-6
Taiwan J Obstet Gynecol. 2023-3
Case Rep Obstet Gynecol. 2022-12-2
Diagnostics (Basel). 2022-11-18
BMC Pregnancy Childbirth. 2020-10-2
Eur J Obstet Gynecol Reprod Biol. 2020-7-22
Nat Commun. 2020-7-14
Pediatr Infect Dis J. 2020-9
J Clin Invest. 2020-9-1