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母体感染 SARS-CoV-2 及其垂直传播,以及对整体围产期结局的影响:一篇叙述性综述。

Maternal SARS-CoV-2 Infection, its Vertical Transmission, and Impact on Overall Perinatal Outcomes: A Narrative Review.

机构信息

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bibinagar-508126, Hyderabad Metropolitan Region, Telangana, India.

Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bibinagar -508126, Hyderabad Metropolitan Region, Telangana, India.

出版信息

Curr Pediatr Rev. 2022;18(2):103-109. doi: 10.2174/1573396317666211124095020.

Abstract

BACKGROUND

COVID-19 pandemic caused by single-stranded RNA containing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) started in early December 2019 from the Wuhan city of China and has been affected millions of people, including pregnant women worldwide. Research from all over the world has shown that the SARS-CoV-2 infection can be transmitted vertically from mother to fetus but is very rare. Neonatal infection with COVID-19 accounts for only a small proportion of the total population infected. Furthermore, very few studies have observed the impact of maternal SARS-CoV-2 infection on neonatal outcomes. Thus, the literature about neonatal transmission and outcomes in COVID-19 infected antenatal women is very scattered and limited. The present review briefs on the transmission of SARS-CoV-2 infection from mother to fetus and its impact on perinatal outcomes.

METHODOLOGY

English language articles from various databases including PubMed, Scopus, EMBASE, Scholar, MedRxiv, and Web of Science and from the World Health Organization site were searched from the beginning of the COVID-19 pandemic up to June 2021. The search terms used were "SARS-CoV-2 and pregnancy outcome, "COVID-19 and neonatal outcome", "Placental changes in COVID-19 infected pregnant women", "Vertical transmission of COVID-19".

CONCLUSION

Maternal SARS-CoV-2 infection can be transmitted to the fetus, though uncommon, and can lead to adverse perinatal outcomes, including preterm births, intrauterine growth restriction, NICU admission, stillbirths. The data on transmission and the adverse neonatal outcome is sparse, and many more studies are needed to fully understand the mechanism by which maternal COVID-19 infection can affect fetuses and neonates.

摘要

背景

由单链 RNA 组成的严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的 COVID-19 大流行始于 2019 年 12 月初的中国武汉市,已影响了包括全球孕妇在内的数百万人。来自世界各地的研究表明,SARS-CoV-2 感染可以从母亲垂直传播给胎儿,但非常罕见。新生儿感染 COVID-19 仅占总感染人群的一小部分。此外,很少有研究观察到母体 SARS-CoV-2 感染对新生儿结局的影响。因此,关于 COVID-19 感染产前妇女的新生儿传播和结局的文献非常分散且有限。本综述简述了 SARS-CoV-2 感染从母亲传播给胎儿及其对围产期结局的影响。

方法

从 COVID-19 大流行开始到 2021 年 6 月,我们在包括 PubMed、Scopus、EMBASE、Scholar、MedRxiv 和 Web of Science 在内的各种数据库以及世界卫生组织网站上搜索了英文文献。使用的搜索词包括“严重急性呼吸系统综合征冠状病毒 2 和妊娠结局”、“COVID-19 和新生儿结局”、“COVID-19 感染孕妇的胎盘变化”、“COVID-19 的垂直传播”。

结论

母体 SARS-CoV-2 感染虽不常见,但可传播给胎儿,并可导致不良围产期结局,包括早产、宫内生长受限、NICU 入院、死产。关于传播和不良新生儿结局的数据很少,需要更多的研究来充分了解母体 COVID-19 感染如何影响胎儿和新生儿的机制。

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