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SARS-CoV-2 的垂直传播:来自一家三级中心的前瞻性横断面研究。

Vertical transmission of SARS-CoV-2: A prospective cross-sectional study from a tertiary center.

机构信息

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.

出版信息

J Med Virol. 2021 Oct;93(10):5864-5872. doi: 10.1002/jmv.27128. Epub 2021 Jun 12.


DOI:10.1002/jmv.27128
PMID:34081331
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8242620/
Abstract

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.

摘要

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。

相似文献

[1]
Vertical transmission of SARS-CoV-2: A prospective cross-sectional study from a tertiary center.

J Med Virol. 2021-10

[2]
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JAMA Netw Open. 2020-12-1

[3]
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[4]
Clinical characteristics and outcomes of pregnant women with COVID-19 and the risk of vertical transmission: a systematic review.

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[5]
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Int J Environ Res Public Health. 2022-2-13

[6]
Evidence of possible SARS-CoV-2 vertical transmission according to World Health Organization criteria in asymptomatic pregnant women.

Ultrasound Obstet Gynecol. 2021-12

[7]
Association of Maternal Perinatal SARS-CoV-2 Infection With Neonatal Outcomes During the COVID-19 Pandemic in Massachusetts.

JAMA Netw Open. 2021-4-1

[8]
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Arch Gynecol Obstet. 2021-6

[9]
Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2: A Systematic Review.

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[10]
Evaluation of vertical transmission of SARS-CoV-2 in utero: Nine pregnant women and their newborns.

Placenta. 2021-8

引用本文的文献

[1]
Maternal SARS-CoV-2 infection: The potential vertical transmission of SARS-CoV-2 and impact on neonates: A review.

Pediatr Discov. 2023-8-22

[2]
BM study: a monocentric prospective observational cohort study on neonatal humoral immunity against COVID-19 secondary to transplacental antibody transfer and breastfeeding.

Ital J Pediatr. 2025-7-1

[3]
Investigating the mode of transmission of COVID-19 through genital secretions, semen, the birth canal, and lactation: A systematic review.

J Educ Health Promot. 2024-7-29

[4]
Impact of SARS-CoV-2 infection during pregnancy on the placenta and fetus.

Semin Perinatol. 2024-6

[5]
Viral shedding of SARS-CoV-2 in body fluids associated with sexual activity: a systematic review and meta-analysis.

BMJ Open. 2024-2-21

[6]
Inflammation and Immune Reactions in the Fetus as a Response to COVID-19 in the Mother.

J Clin Med. 2023-6-25

[7]
Investigation of SARS-CoV-2 using RT-PCR in vaginal swab samples of female patients with a diagnosis of severe COVID-19.

Taiwan J Obstet Gynecol. 2023-3

[8]
Mixed Intervillositis in SARS-CoV-2 Infection Associated with Fetal Death: A Case Report.

Case Rep Obstet Gynecol. 2022-12-2

[9]
The Impact of Coronavirus Disease 2019 on Maternal and Fetal Wellbeing in New Mexico.

Diagnostics (Basel). 2022-11-18

[10]
Clinical Manifestation and Obstetric Outcomes in Pregnant Women with SARS-CoV-2 Infection at Delivery: A Retrospective Cohort Analysis.

J Pers Med. 2022-9-9

本文引用的文献

[1]
Cesarean Section or Vaginal Delivery to Prevent Possible Vertical Transmission From a Pregnant Mother Confirmed With COVID-19 to a Neonate: A Systematic Review.

Front Med (Lausanne). 2021-2-17

[2]
Investigating the risk of maternal-fetal transmission of SARS-CoV-2 in early pregnancy.

Placenta. 2021-3

[3]
Updated experience of a tertiary pandemic center on 533 pregnant women with COVID-19 infection: A prospective cohort study from Turkey.

Int J Gynaecol Obstet. 2021-3

[4]
Vaginal delivery in women with COVID-19: report of two cases.

BMC Pregnancy Childbirth. 2020-10-2

[5]
Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS-CoV-2 infection among hospitalized pregnant women: A systematic review.

Int J Gynaecol Obstet. 2020-8-30

[6]
Maternal and neonatal characteristics and outcomes among COVID-19 infected women: An updated systematic review and meta-analysis.

Eur J Obstet Gynecol Reprod Biol. 2020-7-22

[7]
Transplacental transmission of SARS-CoV-2 infection.

Nat Commun. 2020-7-14

[8]
Intrauterine Transmission of SARS-COV-2 Infection in a Preterm Infant.

Pediatr Infect Dis J. 2020-9

[9]
Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-June 7, 2020.

MMWR Morb Mortal Wkly Rep. 2020-6-26

[10]
SARS-CoV-2 infection of the placenta.

J Clin Invest. 2020-9-1

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