Farhadi Roya, Ghaffari Vajiheh, Mehrpisheh Shahrokh, Moosazadeh Mahmood, Haghshenas Mohammadreza, Ebadi Aghdas
Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Ann Med Surg (Lond). 2022 Jun;78:103839. doi: 10.1016/j.amsu.2022.103839. Epub 2022 May 23.
Despite the rapid increase in knowledge about coronavirus disease 2019 (COVID-19), there is limited data on vertical transmission, viral loads in mother-neonate pairs, and health outcomes. We aimed to describe the characteristics, viral loads, and short-and mid-term outcomes of neonates born to mothers with confirmed COVID-19 infection in northern Iran.
In a cross-sectional study, we prospectively collected and analyzed the clinical features, reverse transcription-polymerase chain reaction (RT-PCR) results, viral loads, and outcomes of 60 neonates delivered by 58 SARS-CoV-2 infected pregnant women in maternity hospitals of Mazandaran University of Medical Sciences (northern Iran) during first three waves of the pandemic from March 1 to December 31, 2020. We assessed neonates' short and mid-term outcomes up to 24 months after the pandemic. We also described the timing of mother-to-infant transmission based on the classification presented by the World Health Organization.
Of the 17767 deliveries, 58 mothers had confirmed and probable COVID-19 infection. Twenty (33.3%) neonates were positive for SARS-CoV-2, two of whom had possible in utero transmission. Twenty-five (41.2%) neonates were preterm, most of whom were born during the first and second waves in which mothers were critically ill. 19 (31.7%) patients needed resuscitation in the delivery room. 34 (56.7%) neonates were isolated in the neonatal intensive care unit. We observed a significant relationship between the maternal and neonatal viral load (correlation coefficient = 0.983, P = 0.00). No neonatal death was observed and all babies had a good outcome.
The results showed that vertical transmission of SARS-CoV-2 is possible but rare. Regional factors and severity of mother's disease may influence the clinical course of neonates. With increasing experience, proper observance of health precautions, and rapid development of evidence-based response systems for regional and global disasters, the transmission rate of SARS-CoV-2 from mother to newborn is reduced.
尽管关于2019冠状病毒病（COVID-19）的知识迅速增加，但关于垂直传播、母婴对中的病毒载量以及健康结局的数据有限。我们旨在描述伊朗北部确诊感染COVID-19的母亲所生新生儿的特征、病毒载量以及短期和中期结局。
在一项横断面研究中，我们前瞻性地收集并分析了2020年3月1日至12月31日大流行前三波期间，在伊朗北部马赞德兰医科大学妇产医院由58名感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的孕妇分娩的60名新生儿的临床特征、逆转录聚合酶链反应（RT-PCR）结果、病毒载量及结局。我们评估了大流行后长达24个月的新生儿短期和中期结局。我们还根据世界卫生组织提出的分类描述了母婴传播的时间。
在17767例分娩中，58名母亲确诊或可能感染COVID-19。20例（33.3%）新生儿SARS-CoV-2检测呈阳性，其中2例可能存在宫内传播。25例（41.2%）新生儿早产，其中大多数在母亲病情危重的第一波和第二波期间出生。19例（31.7%）患者在产房需要复苏。34例（56.7%）新生儿在新生儿重症监护病房隔离。我们观察到母婴病毒载量之间存在显著关系（相关系数=0.983，P=0.00）。未观察到新生儿死亡，所有婴儿结局良好。
结果表明，SARS-CoV-2垂直传播是可能的，但很罕见。地区因素和母亲疾病的严重程度可能影响新生儿的临床病程。随着经验的增加、对健康预防措施的正确遵守以及针对地区和全球灾难的循证应对系统的迅速发展，SARS-CoV-2从母亲到新生儿的传播率降低。
