Departamento de Pediatria da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Departamento de Pediatria da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2022 Jan-Dec;77:100136. doi: 10.1016/j.clinsp.2022.100136. Epub 2022 Nov 2.
Limited data are available on pregnant women with COVID-19 and their neonates.
This study aimed to describe clinical characteristics and evolution from birth to discharge of a retrospective cohort of 71 neonates, with one set of twins, born to women with COVID-19 diagnosed at the end of pregnancy. The authors included all newborns admitted into a neonatal unit of a tertiary hospital in Brazil, between March 2020 and March 2021, whose unvaccinated mothers had COVID-19 symptoms and RT-PCR (Real-Time Polymerase Chain Reaction) for SARS-CoV-2 positive within fourteen days prior to delivery. Newborns to mothers with COVID-19 symptoms and negative tests for SARS-CoV-2 were excluded.
The main route of birth delivery was cesarean, corresponding to 60 pregnant women (84.5%). The foremost indications for cesarean were pregnant with critical disease (24.6%) and acute fetal distress (20.3%). The mean birth weight was 2452 g (865‒3870 g) and the mean gestational age was 34 weeks (25‒40 weeks). There were 45 premature newborns (63.3%), of which 21 newborns (29.5%) were less than 32 weeks of gestational age. RT-PCR for SARS-CoV-2 on oropharyngeal swabs was positive in 2 newborns (2.8%) and negative in the other 69 newborns (97.2%). Most newborns (51.4%) needed respiratory support. Therapeutic interventions during hospitalization were inotropic drugs (9.9%), antibiotics (22.8%), parenteral nutrition (26.8%), and phototherapy (46.5%).
Maternal COVID-19 diagnosticated close to delivery has an impact on the first days of neonatal life.
关于患有 COVID-19 的孕妇及其新生儿的资料有限。
本研究旨在描述 71 例新生儿的临床特征和从出生到出院的演变情况，其中包括一组双胞胎，他们的母亲在妊娠末期被诊断患有 COVID-19。作者纳入了 2020 年 3 月至 2021 年 3 月期间在巴西一家三级医院新生儿病房住院的所有新生儿，其未接种疫苗的母亲在分娩前 14 天内出现 COVID-19 症状和 SARS-CoV-2 的 RT-PCR（实时聚合酶链反应）阳性。排除了有 COVID-19 症状和 SARS-CoV-2 检测阴性的母亲所生的新生儿。
主要的分娩方式是剖宫产，对应于 60 位孕妇（84.5%）。剖宫产的首要指征是孕妇患有重症疾病（24.6%）和急性胎儿窘迫（20.3%）。平均出生体重为 2452 克（865-3870 克），平均胎龄为 34 周（25-40 周）。有 45 例早产儿（63.3%），其中 21 例新生儿（29.5%）胎龄不足 32 周。2 例新生儿（2.8%）口咽拭子 SARS-CoV-2 的 RT-PCR 阳性，69 例新生儿（97.2%）为阴性。大多数新生儿（51.4%）需要呼吸支持。住院期间的治疗干预措施包括：儿茶酚胺类药物（9.9%）、抗生素（22.8%）、肠外营养（26.8%）和光疗（46.5%）。
接近分娩时诊断出的产妇 COVID-19 对新生儿生命的最初几天有影响。
