Lee Sung Hee, Jin Ju Hyun, Yoo Jong Ha, Yoon Shin Won
Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Clin Exp Pediatr. 2023 Nov;66(11):493-500. doi: 10.3345/cep.2023.00563. Epub 2023 Oct 24.
Limited clinical reports have investigated the effects of maternal coronavirus disease 2019 (COVID-19) on fetuses and neonates.
This retrospective study aimed to assess the impact of maternal COVID-19 on neonates during the perinatal period, including neonatal clinical outcomes, versus the outcomes of neonates of mothers without COVID-19.
Neonates born to COVID-19-infected mothers at the National Health Insurance Service Ilsan Hospital between February 2021 and March 2022 were included. Those with gestational age (GA) ≥35+0 weeks who were born within 2 weeks of the maternal infection were matched 1:2 with a control group based on GA. The main outcomes were respiratory diseases, including transient tachypnea of the newborn (TTN), respiratory distress syndrome, meconium aspiration syndrome, the need for respiratory support, and length of hospital stay. Uni- and multivariate logistic regression analyses were performed and adjusted for relevant covariates, including maternal age, obstetric complications (hypertension and gestational diabetes), delivery mode, birth weight, sex, and small-for-gestational-age status.
The case group comprised 103 neonates (mean GA, 38.5±1.3 weeks; mean birth weight, 3,121±397 g), while the control group included 206 neonates (mean GA, 38.4±1.2 weeks; mean birth weight, 3088±428 g). In the case and control groups, the proportion of cesarean sections was 91% and 40%, respectively, while the proportion of male infants was 56% and 47%, respectively. After adjusting for covariates, the case group had a higher risk of TTN (adjusted odd ratio [AOR], 3.69; 95% confidence interval [CI], 1.69-8.07), noninvasive respiratory ventilator use (AOR, 2.28; 95% CI, 1.05-4.97), and oxygen support (AOR, 4.83; 95% CI, 1.46-15.95).
Newborns born to COVID-19-infected mothers are at increased risk of TTN and may require respiratory support. Close monitoring of respiratory symptoms is crucial in neonates.
仅有有限的临床报告研究了母亲感染2019冠状病毒病（COVID-19）对胎儿和新生儿的影响。
这项回顾性研究旨在评估母亲感染COVID-19对围产期新生儿的影响，包括新生儿临床结局，并与未感染COVID-19的母亲所生新生儿的结局进行对比。
纳入2021年2月至2022年3月期间在韩国国民健康保险公团一山医院出生的、母亲感染COVID-19的新生儿。孕周（GA）≥35+0周且在母亲感染后2周内出生的新生儿，根据孕周以1:2的比例与对照组进行匹配。主要结局包括呼吸系统疾病，如新生儿短暂性呼吸急促（TTN）、呼吸窘迫综合征、胎粪吸入综合征、呼吸支持需求及住院时间。进行单因素和多因素逻辑回归分析，并对相关协变量进行调整，这些协变量包括母亲年龄、产科并发症（高血压和妊娠期糖尿病）、分娩方式、出生体重、性别及小于胎龄状态。
病例组包括103例新生儿（平均GA，38.5±1.3周；平均出生体重，3121±397g），而对照组包括206例新生儿（平均GA，38.4±1.2周；平均出生体重，3088±428g）。病例组和对照组的剖宫产比例分别为91%和40%，男婴比例分别为56%和47%。在对协变量进行调整后，病例组发生TTN的风险更高（调整后的比值比[AOR]，3.69；95%置信区间[CI]，1.69 - 8.07）、无创呼吸通气使用风险更高（AOR，2.28；95%CI，1.05 - 4.97）以及氧气支持需求风险更高（AOR，4.83；95%CI，1.46 - 15.95）。
母亲感染COVID-19所生新生儿发生TTN的风险增加，可能需要呼吸支持。对新生儿密切监测呼吸症状至关重要。
