Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis
Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis
复制标题
DOI：
10.1111/1471-0528.16278
复制
发表时间：
2020-05-28
影响因子：
5.8
通讯作者：
Cetin, I
中科院分区：
文献类型：
--
作者：
Ferrazzi, E.;Frigerio, L.;Cetin, I
目的报告COVID-19感染妇女的分娩方式和即刻新生儿结局。设计回顾性研究。设置北方意大利的12家医院。参与者为确诊COVID-19感染并分娩的孕妇。妊娠期暴露COVID-19感染。方法2020年3月1日至20日入院并分娩的SARS-CoV-2感染妇女。使用标准化问卷从临床记录中收集数据，包括产妇一般特征、任何内科或产科合并症、妊娠过程、临床体征和症状、COVID 19感染的治疗、分娩方式、新生儿数据和母乳喂养。主要结果和测量数据分娩方式和新生儿结果。结果共有42名COVID-19妇女在参与中心分娩; 24例（57.1%，95%CI 41.0-72.3）经阴道分娩。在18/42例（42.9%，95%CI 27.7-59.0）病例中进行了择期剖腹产：在8例病例中，适应症与COVID-19感染无关。19/42例（45.2%，95% CI 29.8-61.3）病例诊断为肺炎：其中，7/19例（36.8%，95% CI 16.3-61.6）需要氧气支持，4/19例（21.1%，95% CI 6.1-45.6）入住重症监护室。两名感染COVID-19的妇女在没有口罩的情况下进行母乳喂养，因为感染是在产后期间被诊断出来的：她们的新生儿检测出SARS-Cov-2感染呈阳性。在一例病例中，一名新生儿在阴道手术分娩后检测呈阳性。结论虽然产后感染不能100%排除，但这些发现表明阴道分娩与分娩期SARS-Cov-2传播给新生儿的风险低相关。
Objective To report mode of delivery and immediate neonatal outcome in women infected with COVID-19.Design Retrospective study.Setting Twelve hospitals in northern Italy.Participants Pregnant women with COVID-19-confirmed infection who delivered.Exposure COVID 19 infection in pregnancy.Methods SARS-CoV-2-infected women who were admitted and delivered from 1 to 20 March 2020 were eligible. Data were collected from the clinical records using a standardised questionnaire on maternal general characteristics, any medical or obstetric co-morbidity, course of pregnancy, clinical signs and symptoms, treatment of COVID 19 infection, mode of delivery, neonatal data and breastfeeding.Main outcome and measures Data on mode of delivery and neonatal outcome.Results In all, 42 women with COVID-19 delivered at the participating centres; 24 (57.1%, 95% CI 41.0-72.3) delivered vaginally. An elective caesarean section was performed in 18/42 (42.9%, 95% CI 27.7-59.0) cases: in eight cases the indication was unrelated to COVID-19 infection. Pneumonia was diagnosed in 19/42 (45.2%, 95% CI 29.8-61.3) cases: of these, 7/19 (36.8%, 95% CI 16.3-61.6) required oxygen support and 4/19 (21.1%, 95% CI 6.1-45.6) were admitted to a critical care unit. Two women with COVID-19 breastfed without a mask because infection was diagnosed in the postpartum period: their newborns tested positive for SARS-Cov-2 infection. In one case, a newborn had a positive test after a vaginal operative delivery.Conclusions Although postpartum infection cannot be excluded with 100% certainty, these findings suggest that vaginal delivery is associated with a low risk of intrapartum SARS-Cov-2 transmission to the newborn.Tweetable abstract This study suggests that vaginal delivery may be associated with a low risk of intrapartum SARS-Cov-2 transmission to the newborn.