Li S J, Zhang L, Yuan H, Zhang X B, Wang C Q, Liu G B, Gu Y, Yang T L, Zhu X T, Zhai X W, Shi Y, Jiang S Y, Zhang K, Yan K, Zhang P, Hu X J, Liu Q, Gao R W, Zhao J, Zhou J G, Cao Y, Li Z H
Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.
Department of Respiratory Medicine, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.
Zhonghua Er Ke Za Zhi. 2022 Nov 2;60(11):1163-1167. doi: 10.3760/cma.j.cn112140-20220613-00545.
To summarize the management and short-term outcomes of neonates delivered by mothers infected with SARS-CoV-2 Omicron variant. A retrospective study was performed on 158 neonates born to mothers infected with SARS-CoV-2 Omicron variant admitted to the isolation ward of Children's Hospital of Fudan University from March 15, 2022 to May 30, 2022. The postnatal infection control measures for these neonates, and their clinical characteristics and short-term outcomes were analyzed. They were divided into maternal symptomatic group and maternal asymptomatic group according to whether their mothers had SARS-CoV-2 symptoms. The clinical outcomes were compared between the 2 groups using Rank sum test and Chi-square test. All neonates were under strict infection control measures at birth and after birth. Of the 158 neonates, 75 (47.5%) were male. The gestational age was (38±1) weeks and the birth weight was (3 201±463)g. Of the neonates included, ten were preterm (6.3%) and the minimum gestational age was 30 weeks. Six neonates (3.8%) had respiratory difficulty and 4 of them were premature and required mechanical ventilation. All 158 neonates were tested negative for SARS-COV-2 nucleic acid by daily nasal swabs for the first 7 days. A total of 156 mothers (2 cases of twin pregnancy) infected with SARS-CoV-2 Omicron variant, the time from confirmed SARS-CoV-2 infection to delivery was 7 (3, 12) days. Among them, 88 cases (56.4%) showed clinical symptoms, but none needed intensive care treatment. The peripheral white blood cell count of the neonates in maternal symptomatic group was significantly higher than that in maternal symptomatic group (23.0 (18.7, 28.0) × 10 19.6 (15.4, 36.6) × 10/L, =2.44, 0.05). Neonates of mothers infected with SARS-CoV-2 Omicron variant during third trimester have benign short-term outcomes, without intrauterine infection through vertical transmission. Strict infection control measures at birth and after birth can effectively protect these neonates from SARS-CoV-2 infection.
总结感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）奥密克戎变异株的母亲所分娩新生儿的管理情况及短期结局。对2022年3月15日至2022年5月30日入住复旦大学附属儿科医院隔离病房、母亲感染SARS-CoV-2奥密克戎变异株的158例新生儿进行回顾性研究。分析这些新生儿的产后感染控制措施、临床特征及短期结局。根据母亲是否有SARS-CoV-2症状将其分为母亲有症状组和母亲无症状组。采用秩和检验和卡方检验比较两组的临床结局。所有新生儿在出生时及出生后均采取严格的感染控制措施。158例新生儿中，男75例（47.5%）。胎龄为（38±1）周，出生体重为（3201±463）g。纳入的新生儿中，10例为早产儿（6.3%），最小胎龄为30周。6例新生儿（3.8%）有呼吸困难，其中4例为早产儿，需机械通气。前7天每日经鼻拭子检测，所有158例新生儿的SARS-CoV-2核酸均为阴性。共有156例感染SARS-CoV-奥密克戎变异株的母亲（2例为双胎妊娠），从确诊SARS-CoV-2感染至分娩的时间为7（3，12）天。其中88例（56.4%）有临床症状，但均无需重症监护治疗。母亲有症状组新生儿的外周血白细胞计数显著高于母亲无症状组（23.0（18.7，28.0）×10⁹/L对19.6（15.4，36.6）×10⁹/L，Z = 2.44，P<0.05）。孕晚期感染SARS-CoV-2奥密克戎变异株母亲的新生儿短期结局良好，无经垂直传播的宫内感染。出生时及出生后采取严格的感染控制措施可有效保护这些新生儿免受SARS-CoV-2感染。
