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韩国孕妇及其新生儿感染严重急性呼吸综合征冠状病毒2的临床特征及垂直传播

Clinical Characteristics and Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Pregnant Women and Their Neonates in Korea.

作者信息

Lee Jiyoung, Lee Mi-Young, Lee Jina, Jang Euijin, Bae Seongman, Jung Jiwon, Kim Min Jae, Chong Young Pil, Won Hye-Sung, Jung Euiseok, Kim Sung-Han

机构信息

Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Infect Chemother. 2023 Sep;55(3):346-354. doi: 10.3947/ic.2022.0077. Epub 2023 Jun 7.

Abstract

BACKGROUND

There are limited data on the clinical characteristics and the vertical transmission rate of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and their neonates in Korea.

MATERIALS AND METHODS

Pregnant women who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were retrospectively reviewed in Asan Medical Center from September 1, 2020, to April 26, 2022. All neonates and infected women underwent a polymerase chain reaction test for severe acute respiratory syndrome corona virus 2 within 24 hours of birth and at 48-hour interval if they stayed in the hospital.

RESULTS

A total of 60 pregnant women gave birth by cesarean section (n = 40, 66.7%) or vaginal delivery (n = 20, 33.3%). Among them, 3 women gave birth to twins. Delivery occurred, on average, at 38 weeks (± 2) of gestational age, and 9 patients (15.0%) had underlying diseases. Of these 60 patients, 9 (15.0%) received coronavirus disease 2019 vaccinations. Pneumonia was confirmed by a chest radiograph in 7 patients (11.7%), and 2 patients (3.3%) required supplemental oxygen therapy, both of whom eventually recovered. The mean birthweight of the neonates was 3,137 g (± 557.6). Further, 8 neonates (12.7%) were of low-birth weight (< 2,500 g), and 11 neonates (17.5%) were preterm (<37 weeks of gestation). Apgar score was median 8 (8 - 9) at 1 minute and 9 (9 - 9.5) at 5 minutes. Four neonates (6.3%) required invasive mechanical ventilation. All neonates had negative SARS-CoV-2 test results. Therefore, there was no vertical transmission in 63 of the neonates (0%, 95% confidence interval [CI]: 0 - 6).

CONCLUSION

Pregnant Korean women with SARS-CoV-2-infection had favorable obstetric outcomes, and the risk of vertical transmission to their neonates was low. Managing the infection risks of pregnant women and their neonates during the coronavirus disease 2019 pandemic are required.

摘要

背景

在韩国,关于感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的孕妇及其新生儿的临床特征和垂直传播率的数据有限。

材料与方法

对2020年9月1日至2022年4月26日在峨山医疗中心进行回顾性研究,检测出严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染呈阳性的孕妇。所有新生儿和感染的女性在出生后24小时内以及住院期间每隔48小时接受一次严重急性呼吸综合征冠状病毒2的聚合酶链反应检测。

结果

共有60名孕妇通过剖宫产(n = 40,66.7%)或阴道分娩(n = 20,33.3%)。其中,3名妇女生了双胞胎。分娩平均发生在孕38周(±2),9名患者(15.0%)有基础疾病。在这60名患者中,9名(15.0%)接种了2019冠状病毒病疫苗。7名患者(11.7%)经胸部X光片确诊为肺炎,2名患者(3.3%)需要补充氧气治疗,两人最终均康复。新生儿的平均出生体重为3137克(±557.6)。此外,8名新生儿(12.7%)为低出生体重儿(<2500克),11名新生儿(17.5%)为早产儿(<37孕周)。1分钟时阿氏评分中位数为8(8 - 9),5分钟时为9(9 - 9.5)。4名新生儿(6.3%)需要有创机械通气。所有新生儿的SARS-CoV-2检测结果均为阴性。因此,63名新生儿中无垂直传播(0%,95%置信区间[CI]:0 - 6)。

结论

感染SARS-CoV-2的韩国孕妇产科结局良好,其新生儿垂直传播风险较低。在2019冠状病毒病大流行期间,需要管理孕妇及其新生儿的感染风险。

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