母亲新型冠状病毒Omicron变异株感染的新生儿近期临床结局

Short-term outcomes of neonates born to mothers infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2

摘要

目的 探讨母亲新型冠状病毒(SARS-CoV-2)Omicron变异株感染对新生儿近期临床结局的影响。方法 以2022年12月8日至2023年1月8日在钦州市妇幼保健院产科收治的423例孕妇及其分娩的活产新生儿为研究对象,根据孕妇是否确诊新型SARS-CoV-2 Omicron变异株感染,分为SARS-CoV-2阳性组和SARS-CoV-2阴性组,分析孕妇感染Omicron变异株的临床特征,比较两组母亲和新生儿近期临床结局。结果 研究期间共收治的423例孕妇中,SARS-CoV-2 Omicron变异株感染者133例,未感染者290例;双胎妊娠6例,单胎妊娠417例,有症状感染者占多数(92例,69.2%),均为轻型,常见症状为发热(71例,53.4%)、咳嗽(45例,33.8%).SARS-CoV-2阳性组胎儿窘迫、剖宫产发生率高于SARS-CoV-2阴性组(23.7% vs. 10.5%、52.6% vs. 42.1%,χ²=12.788、4.104,P<0.05).两组孕妇妊娠年龄、住院天数、妊娠期糖尿病、妊娠期高血压、胎膜早破情况的差异无统计学意义(P>0.05).与SARS-CoV-2阴性组相比,SARS-CoV-2阳性组新生儿生后需收治新生儿病房治疗的比例明显增高(37.8% vs. 25.5%,χ²=6.712,P<0.05).两组新生儿早产、低出生体重儿、小于胎龄儿、新生儿呼吸窘迫综合征(RDS)发生率差异均无统计学意义(P>0.05).两组需要氧疗、无创呼吸支持、有创呼吸支持的比例差异无统计学意义(P>0.05)。结论 妊娠晚期感染新型冠状病毒Omicron变异株孕妇以轻型为主,常见症状为发热、咳嗽.SARS-CoV-2阳性母亲胎儿窘迫、剖宫产比例增加,分娩的新生儿收治新生儿病房比例增加,但这部分新生儿未出现与新型冠状病毒相关的临床症状或并发症,且近期结局良好.

Abstract

Objective To explore the short-term clinical outcomes of neonates born to mothers infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods A total of 423 pregnant women and their live-born neonates, admitted to the Department of Obstetrics at Qinzhou Maternal and Child Health Hospital from December 8, 2022, and January 8, 2023, were included as the research subjects. The participants were divided into a SARS-CoV-2 positive group and a SARS-CoV-2 negative group based on whether the pregnant women were diagnosed with SARS-CoV-2 Omicron variant infection. The clinical characteristics of pregnant women infected with the Omicron variant were analyzed, and the short-term clinical outcomes of both mothers and their neonates were compared between the two groups. Results Among the 423 pregnant women admitted during the study period, 133 cases were infected with the SARS-CoV-2 Omicron variant and 290 were not infected. There were 6 cases of twin pregnancies and 417 cases of singleton pregnancies. The majority of those infected were symptomatic (92 cases, 69.2%), all of which were mild. The most common symptoms were fever (71 cases, 53.4%) and cough (45 cases, 33.8%). The incidence of fetal distress and cesarean section in the SARS-CoV-2 positive group was higher than that in the SARS-CoV-2 negative group (23.7% vs. 10.5% and 52.6% vs. 42.1%, χ²=12.788 and 4.104, respectively, P<0.05). There were no statistically significant differences between the two groups of pregnant women in terms of gestational age, length of hospital stay, gestational diabetes, gestational hypertension, and premature rupture of membranes (P>0.05). Compared with the SARS-CoV-2 negative group, the proportion of neonates in the SARS-CoV-2 positive group who required admission to the neonatal ward after birth was significantly higher (37.8% vs. 25.5%, χ²=6.712, P<0.05). There were no statistically significant differences in the incidence of preterm birth, low birth weight, small for gestational age, and neonatal RDS between the two groups (P>0.05). There were no statistically significant differences between the two groups in the proportion of neonates requiring oxygen therapy, non-invasive respiratory support, or invasive respiratory support (P>0.05). Conclusion Pregnant women infected with SARS-CoV-2 Omicron variant in the third trimester are mainly mild, and the common symptoms are fever and cough. The proportion of fetal distress and cesarean section and the proportion of newborns admitted to the neonatal ward in mothers infected with SARS-CoV-2 increased, however, none of these newborns developed clinical symptoms or complications related to SARS-CoV-2 Omicron variant, and their short-term outcomes were good.

关键词

新生儿 / 新型冠状病毒 / Omicron变异株 / 临床特征 / 预后

Key words

neonate / SARS-CoV-2 / Omicron variant / clinical characteristic / outcome

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