Pietrasanta Carlo, Ronchi Andrea, Agosti Massimo, Mangili Giovanna, Sinelli Mariateresa, Ghirardello Stefano, Barachetti Roberta, Crimi Riccardo, Fasolato Valeria, Martinelli Stefano, Bellan Cristina, Crippa Beatrice, Artieri Giacomo, Perniciaro Simona, Saruggia Martina, Ventura Maria Luisa, Garofoli Francesca, Pagliotta Claudia, Uceda Renteria Sara Colonia, Piralla Antonio, Bergami Federica, Morandi Grazia, Proto Alice, Pontiggia Federica, Risso Francesco Maria, Bossi Angela, Ferrari Stefania, Cavalleri Valeria, Servi Pierpaolo, Castiglione Aurelia, Spada Elena, Ceriotti Ferruccio, Baldanti Fausto, Mosca Fabio, Pugni Lorenza
Neonatology and NICU.
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Pediatrics. 2023 Nov 1;152(5). doi: 10.1542/peds.2023-062702.
To evaluate the rate of postnatal infection during the first month of life in neonates born to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive mothers during the predominant circulation of the omicron (B.1.1.529) variant.
This prospective, 10-center study enrolled mothers infected by SARS-CoV-2 at delivery and their infants, if both were eligible for rooming-in, between December 2021 and March 2022. Neonates were screened for SARS-CoV-2 RNA at 1 day of life (DOL), 2 to 3 DOL, before discharge, and twice after hospital discharge. Mother-infant dyads were managed under a standardized protocol to minimize the risk of viral transmission. Sequencing data in the study area were obtained from the Italian Coronavirus Disease 2019 Genomic platform. Neonates were included in the final analysis if they were born when the omicron variant represented >90% of isolates.
Eighty-two percent (302/366) of mothers had an asymptomatic SARS-CoV-2 infection. Among 368 neonates, 1 was considered infected in utero (0.3%), whereas the postnatal infection rate during virtually exclusive circulation of the omicron variant was 12.1%. Among neonates infected after birth, 48.6% became positive during the follow-up period. Most positive cases at follow-up were detected concurrently with the peak of coronavirus disease 2019 cases in Italy. Ninety-seven percent of the infected neonates were asymptomatic.
The risk of early postnatal infection by the SARS-CoV-2 omicron variant is higher than that reported for previously circulating variants. However, protected rooming-in practice should still be encouraged given the paucity of symptoms in infected neonates.
评估在奥密克戎（B.1.1.529）变异株主要传播期间，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）阳性母亲所生新生儿出生后第一个月内的感染率。
这项前瞻性、多中心研究纳入了2021年12月至2022年3月期间分娩时感染SARS-CoV-2且母婴均符合母婴同室条件的母亲及其婴儿。新生儿在出生第1天（DOL）、2至3 DOL、出院前以及出院后两次接受SARS-CoV-2 RNA筛查。母婴配对按照标准化方案进行管理，以尽量降低病毒传播风险。研究区域的测序数据来自意大利2019年冠状病毒病基因组平台。如果新生儿出生时奥密克戎变异株占分离株的比例>90%，则纳入最终分析。
82%（302/366）的母亲感染SARS-CoV-2后无症状。在368名新生儿中，1名被认为在子宫内感染（0.3%），而在奥密克戎变异株几乎完全传播期间，产后感染率为12.1%。在出生后感染的新生儿中，48.6%在随访期间呈阳性。随访期间大多数阳性病例是在意大利2019年冠状病毒病病例高峰时同时检测到的。97%的感染新生儿无症状。
SARS-CoV-2奥密克戎变异株产后早期感染风险高于此前流行的变异株。然而，鉴于感染新生儿症状较少，仍应鼓励采取保护性母婴同室措施。
