围产期 SARS-CoV-2 感染的孕产妇和新生儿医院结局：一项全国性登记研究。
Maternal and Newborn Hospital Outcomes of Perinatal SARS-CoV-2 Infection: A National Registry.
机构信息
Division of Neonatology, Department of Pediatrics, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida.
Division of Neonatology.
出版信息
Pediatrics. 2023 Feb 1;151(2). doi: 10.1542/peds.2022-059595.
OBJECTIVES
The American Academy of Pediatrics National Registry for the Surveillance and Epidemiology of Perinatal coronavirus disease 2019 (COVID-19) (NPC-19) was developed to provide information on the effects of perinatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
METHODS
National Registry for the Surveillance and Epidemiology of Perinatal COVID-19 participating centers entered maternal and newborn data for pregnant persons who tested positive for SARS-CoV-2 infection between 14 days before and 10 days after delivery. Incidence of and morbidities associated with maternal and newborn SARS-CoV-2 infection were assessed.
RESULTS
From April 6, 2020 to March 19, 2021, 242 centers in the United States centers reported data for 7524 pregnant persons; at the time of delivery, 78.1% of these persons were asymptomatic, 18.2% were symptomatic but not hospitalized specifically for COVID-19, 3.4% were hospitalized for COVID-19 treatment, and 18 (0.2%) died in the hospital of COVID-related complications. Among 7648 newborns, 6486 (84.8%) were tested for SARS-CoV-2, and 144 (2.2%) were positive; the highest rate of newborn infection was observed when mothers first tested positive in the immediate postpartum period (17 of 125, 13.6%). No newborn deaths were attributable to SARS-CoV-2 infection. Overall, 15.6% of newborns were preterm: among tested newborns, 30.1% of polymerase chain reaction-positive and 16.2% of polymerase chain reaction-negative were born preterm (P < .001). Need for mechanical ventilation did not differ by newborn SARS-CoV-2 test result, but those with positive tests were more likely to be admitted to a NICU.
CONCLUSIONS
Early in the pandemic, SARS-CoV-2 infection was acquired by newborns at variable rates and without apparent short-term effects. During a period that preceded widespread availability of vaccines, we observed higher than expected numbers of preterm births and maternal in-hospital deaths.
目的
美国儿科学会（AAP）围产期 2019 年冠状病毒病（COVID-19）（NPC-19）国家监测和流行病学登记处旨在提供围产期严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染影响的相关信息。
方法
NPC-19 监测和流行病学登记处的参与中心收集了自分娩前 14 天至分娩后 10 天期间 SARS-CoV-2 检测呈阳性的孕妇及其新生儿的数据。评估了产妇和新生儿 SARS-CoV-2 感染的发病率和与感染相关的并发症。
结果
自 2020 年 4 月 6 日至 2021 年 3 月 19 日，美国 242 个中心报告了 7524 名孕妇的数据；分娩时，78.1%的孕妇无症状，18.2%的孕妇有症状但未因 COVID-19 专门住院，3.4%因 COVID-19 治疗住院，18 名（0.2%）孕妇死于 COVID-19 相关并发症。在 7648 名新生儿中，6486 名（84.8%）接受了 SARS-CoV-2 检测，144 名（2.2%）呈阳性；当母亲在产后早期首次检测呈阳性时，新生儿感染率最高（125 例中 17 例，13.6%）。没有新生儿死亡归因于 SARS-CoV-2 感染。总体而言，15.6%的新生儿为早产儿：在接受检测的新生儿中，聚合酶链反应阳性者中 30.1%和聚合酶链反应阴性者中 16.2%为早产儿（P<.001）。新生儿 SARS-CoV-2 检测结果与需要机械通气无关，但阳性检测结果者更有可能入住新生儿重症监护病房（NICU）。
结论
在大流行早期，新生儿以不同的速度获得 SARS-CoV-2 感染，且没有明显的短期影响。在广泛使用疫苗之前的一段时间内，我们观察到早产儿和产妇院内死亡的数量高于预期。
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