Citu Cosmin, Neamtu Radu, Sorop Virgiliu-Bogdan, Horhat Delia Ioana, Gorun Florin, Tudorache Emanuela, Gorun Oana Maria, Boarta Aris, Tuta-Sas Ioana, Citu Ioana Mihaela
Department of Obstetrics and Gynecology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania.
ENT Department, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania.
J Clin Med. 2021 Nov 11;10(22):5253. doi: 10.3390/jcm10225253.
We designed and implemented a prospective study to analyze the maternal and neonatal outcomes associated with COVID-19 and determine the likelihood of viral transmission to the fetus and newborn by collecting samples from amniotic fluid, placenta, umbilical cord blood, and breast milk. The study followed a prospective observational design, starting in July 2020 and lasting for one year. A total of 889 pregnant women were routinely tested for SARS-CoV-2 infection in an outpatient setting at our clinic, using nasal swabs for PCR testing. A total of 76 women were diagnosed with COVID-19. The positive patients who accepted study enrollment were systematically analyzed by collecting weekly nasal, urine, fecal, and serum samples, including amniotic fluid, placenta, umbilical cord, and breast milk at hospital admission and postpartum. Mothers with COVID-19 were at a significantly higher risk of developing gestational hypertension and giving birth prematurely by c-section than the general pregnant population. Moreover, their mortality rates were substantially higher. Their newborns did not have negative outcomes, except for prematurity, and an insignificant number of newborns were infected with SARS-CoV-2 (5.4%). No amniotic fluid samples were positive for SARS-CoV-2, and only 1.01% of PCR tests from breast milk were confirmed positive. Based on these results, we support the idea that SARS-CoV-2 positive pregnant women do not expose their infants to an additional risk of infection via breastfeeding, close contact, or in-utero. Consequently, we do not support maternal-newborn separation at delivery since they do not seem to be at an increased risk of SARS-CoV-2 infection.
我们设计并开展了一项前瞻性研究，以分析与新型冠状病毒肺炎（COVID-19）相关的孕产妇和新生儿结局，并通过收集羊水、胎盘、脐带血和母乳样本，确定病毒传播给胎儿和新生儿的可能性。该研究采用前瞻性观察设计，于2020年7月开始，为期一年。共有889名孕妇在我们诊所的门诊接受了严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的常规检测，使用鼻拭子进行聚合酶链反应（PCR）检测。共有76名女性被诊断为COVID-19。接受研究入组的阳性患者通过每周收集鼻、尿、粪便和血清样本进行系统分析，包括入院时和产后的羊水、胎盘、脐带和母乳样本。与一般孕妇群体相比，感染COVID-19的母亲发生妊娠期高血压和剖宫产早产的风险显著更高。此外，她们的死亡率也高得多。除早产外，她们的新生儿没有出现不良结局，感染SARS-CoV-2的新生儿数量极少（5.4%）。没有羊水样本的SARS-CoV-2检测呈阳性，母乳的PCR检测只有1.01%被确认为阳性。基于这些结果，我们支持这样的观点，即SARS-CoV-2阳性孕妇不会通过母乳喂养、密切接触或宫内感染使婴儿面临额外的感染风险。因此，我们不支持分娩时母婴分离，因为她们似乎没有增加感染SARS-CoV-2的风险。
