Clinical Characteristics and Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Pregnant Women and Their Neonates in Korea
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
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+2 weeks (± 2+0) 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.
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+2 weeks (± 2+0) 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.
참고문헌 (29)
- Zhu N, "A novel coronavirus from patients with pneumonia in China, 2019", N Engl J Med, 382, pp.727~733 (2020)
- Wong SF, "Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome", Am J Obstet Gynecol, 191, pp.292~297 (2004)
- Alfaraj SH, "Middle East Respiratory Syndrome Coronavirus(MERS-CoV)infection during pregnancy : report of two cases & review of the literature", J Microbiol Immunol Infect, 52, pp.501~503 (2019)
- Allotey J, "Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy : living systematic review and meta-analysis", BMJ, 370, pp.m3320~ (2020)
- Angelidou A, "Association of maternal perinatal SARS-CoV-2 infection with neonatal outcomes during the COVID-19 pandemic in Massachusetts", JAMA Netw Open, 4, pp.e217523~ (2021)
- "COVID-19 treatment guidlines. Clinical spectrum of SARS-CoV-2 infection" (2022)[URL]
- Vivanti AJ, "Transplacental transmission of SARS-CoV-2 infection", Nat Commun, 11, pp.3572~ (2020)
- Fenizia C, "Analysis of SARS-CoV-2 vertical transmission during pregnancy", Nat Commun, 11, pp.5128~ (2020)
- Gidlöf S, "COVID-19 in pregnancy with comorbidities : More liberal testing strategy is needed", Acta Obstet Gynecol Scand, 99, pp.948~949 (2020)
- Lee Dong Hwan, "Emergency cesarean section on severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) confirmed patient", Korean Journal of Anesthesiology, 73(4), pp.347~351 (2020), 대한마취통증의학회[DOI]
- "Zhonghua Fu Chan Ke Za Zhi", 2020, 166~171
- Dong L, "Possible vertical transmission of SARS-CoV-2 from an infected mother to her newborn", JAMA, 323, pp.1846~1848 (2020)
- Peng Z, "Unlikely SARS-CoV-2 vertical transmission from mother to child : a case report", J Infect Public Health, 13, pp.818~820 (2020)
- Alzamora MC, "Severe COVID-19 during pregnancy and possible vertical transmission", Am J Perinatol, 37, pp.861~865 (2020)
- Zaigham M, "Maternal and perinatal outcomes with COVID-19 : a systematic review of 108 pregnancies", Acta Obstet Gynecol Scand, 99, pp.823~829 (2020)
- Pettirosso E, "COVID-19 and pregnancy : a review of clinical characteristics, obstetric outcomes and vertical transmission", Aust N Z J Obstet Gynaecol, 60, pp.640~659 (2020)
- Dumitriu D, "Outcomes of neonates born to mothers with severe acute respiratory syndrome coronavirus 2 infection at a large medical center in New York city", JAMA Pediatr, 175, pp.157~167 (2021)
- Karim SSA, "Omicron SARS-CoV-2 variant : a new chapter in the COVID-19 pandemic", Lancet, 398, pp.2126~2128 (2021)
- McClymont E, "CANCOVID-Preg Team. Association of SARS-CoV-2 infection during pregnancy with maternal and perinatal outcomes", JAMA, 327, pp.1983~1991 (2022)
- Trevisanuto D, "Neonatal resuscitation where the mother has a suspected or confirmed novel coronavirus(SARS-CoV-2)infection : suggestion for a pragmatic action plan", Neonatology, 117, pp.133~140 (2020)
- Niles DE, "Incidence and characteristics of positive pressure ventilation delivered to newborns in a US tertiary academic hospital", Resuscitation, 115, pp.102~109 (2017)
- "Interim guidance on breastfeeding and breast milk feeds in the context of COVID-19" (2022)[URL]
- Rubaltelli FF, "Acute neonatal respiratory distress in Italy : a one-year prospective study", Acta Paediatr, 87, pp.1261~1268 (1998)
- Bonafé L, "The incidence of acute neonatal respiratory disorders in Padova county : an epidemiological survey", Acta Paediatr, 85, pp.1236~1240 (1996)
- Shanes ED, "Placental pathology in COVID-19", Am J Clin Pathol, 154, pp.23~32 (2020)
- Moreno-Fernandez J, "COVID-19 during gestation : maternal implications of evoked oxidative stress and iron metabolism impairment", Antioxidants(Basel), 11, pp.184~ (2022)
- Wei SQ, "The impact of COVID-19 on pregnancy outcomes : a systematic review and meta-analysis", CMAJ, 193, pp.E540~8 (2021)
- Vouga M, "Maternal outcomes and risk factors for COVID-19 severity among pregnant women", Sci Rep, 11, pp.13898~ (2021)
- Metz TD, "Disease severity and perinatal outcomes of pregnant patients with coronavirus disease 2019(COVID-19)", Obstet Gynecol, 137, pp.571~580 (2021)