AlQurashi Mansour A, Alattas Amjed, Shirah Bader, Mustafa Ahmad, Al-Hindi Mohammed Y, Alrefai Alyaa, Faden Yaser A, Al-Shareef Ali, Al Thuibaiti Eman, Hasosah Mohammed
Department of Pediatrics, Neonatology Division, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Western Region, Jeddah, SAU.
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.
Cureus. 2021 Oct 7;13(10):e18573. doi: 10.7759/cureus.18573. eCollection 2021 Oct.
Introduction In Saudi Arabia and countries around the world, clinical health practice has been transformed by the coronavirus 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). During the early days of the pandemic, it was a major challenge to care for pregnant women with laboratory-confirmed COVID-19 and their newborn infants. In this article, we share our experience in the management of newborn infants delivered to mothers with laboratory-confirmed COVID-19. Methods A prospective single-center observational study was conducted at King Abdulaziz Medical City in Jeddah, National Guard Health Affairs, Saudi Arabia. Data collection started in March 2020 and was completed in October 2020. The inclusion criteria included mothers with laboratory-confirmed COVID-19 and their newborn infants. Results A total of 45 pregnant women with polymerase chain reaction (PCR)-confirmed COVID-19 were included in the study. Their mean age was 30.23±5.92 years. The mode of delivery was spontaneous vaginal delivery in 27 women (60%), cesarean section in 15 women (33.3%), and assisted vaginal delivery in three women (6.7%). Three mothers (6.7%) required intensive care unit admission. A total of 45 babies were born and 25 were females (55.6%), 20 males (44.4%). None of the babies had specific symptoms related to COVID-19. All babies were tested negative on the two COVID-19 nasopharyngeal swabs. Babies were initially admitted to the NICU and one baby required prolonged NICU stay due to extreme prematurity (23 weeks), one baby died due to hypoxic-ischemic encephalopathy and respiratory distress syndrome, and the remaining babies were discharged home in a stable condition. Conclusion Our experience suggests that maternal outcomes are generally favorable and no difference between vaginal and cesarean delivery in the risk of virus transmission. With strict implementation of infection prevention measures, mother-to-infant transmission is very unlikely. Early bathing of the newborn infant is preferred to reduce the risk of transmission of infection to newborn infants and the hospital staff. Breastfeeding is safe if performed under strict infection prevention measures.
引言 在沙特阿拉伯及世界各国，2019年冠状病毒病（COVID-19）疫情由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引发，已改变了临床健康实践。在疫情初期，护理实验室确诊感染COVID-19的孕妇及其新生儿是一项重大挑战。在本文中，我们分享了对实验室确诊感染COVID-19的母亲所分娩新生儿的管理经验。
方法 在沙特阿拉伯国民警卫队卫生事务部位于吉达的阿卜杜勒阿齐兹国王医疗城开展了一项前瞻性单中心观察性研究。数据收集于2020年3月开始，2020年10月完成。纳入标准包括实验室确诊感染COVID-19的母亲及其新生儿。
结果 共有45名经聚合酶链反应（PCR）确诊感染COVID-19的孕妇纳入研究。她们的平均年龄为30.23±5.92岁。分娩方式为自然阴道分娩27例（60%），剖宫产15例（33.3%），助产阴道分娩3例（6.7%）。3名母亲（6.7%）需要入住重症监护病房。共分娩45名婴儿，其中25名女性（55.6%），20名男性（44.4%）。没有婴儿出现与COVID-19相关的特定症状。所有婴儿的两次COVID-19鼻咽拭子检测均为阴性。婴儿最初入住新生儿重症监护病房（NICU），1名婴儿因极度早产（23周）需要在NICU长期住院，1名婴儿因缺氧缺血性脑病和呼吸窘迫综合征死亡，其余婴儿病情稳定后出院回家。
结论 我们的经验表明，母亲的结局总体良好，阴道分娩和剖宫产在病毒传播风险方面没有差异。严格实施感染预防措施后，母婴传播非常 unlikely。建议尽早给新生儿洗澡，以降低感染传播给新生儿和医院工作人员的风险。在严格的感染预防措施下进行母乳喂养是安全的。 （注：原文中“very unlikely”后少了个“发生”之类的词，翻译时按通顺意思补充了）
