دورية أكاديمية
Effects of prenatal exposure to maternal COVID-19 and perinatal care on neonatal outcome: results from the INTERCOVID Multinational Cohort Study.
العنوان: | Effects of prenatal exposure to maternal COVID-19 and perinatal care on neonatal outcome: results from the INTERCOVID Multinational Cohort Study. |
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المؤلفون: | Giuliani F; Neonatal Special Care Unit, Regina Margherita Children's Hospital, Turin, Italy. Electronic address: giuliani.pediatria@gmail.com., Oros D; Aragon Institute of Health Research, Obstetrics Department, Hospital Clínico Universitario Lozano Blesa Zaragoza, Zaragoza, Spain., Gunier RB; Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, CA., Deantoni S; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom; Neonatal Care Unit, School of Medicine, Department of Public Health and Pediatrics, University of Turin, Turin, Italy., Rauch S; Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, CA., Casale R; Maternal and Child Department, Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina., Nieto R; Division Neonatología, Hospital Materno Infantil Ramón Sarda, Buenos Aires, Argentina., Bertino E; Neonatal Unit of the University, City of Health and Science of Turin, Turin, Italy., Rego A; Departamento de Pediatria, Faculdade Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Menis C; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy., Gravett MG; Departments of Obstetrics and Gynecology and of Global Health, University of Washington, Seattle, WA., Candiani M; Obstetrics and Gynaecology Department, IRCCS San Raffaele Hospital and University, Milan, Italy., Deruelle P; Department of Obstetrics and Gynecology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France., García-May PK; Hospital Regional Lic. Adolfo López Mateos ISSSTE, Mexico City, Mexico., Mhatre M; Tufts Medical Center, Boston, MA., Usman MA; Department of Obstetrics and Gynaecology, Muhammad Abdullahi Wase Teaching Hospital, Kano State, Nigeria., Abd-Elsalam S; Faculty of Medicine, Tropical Medicine and Infectious Diseases Department, Tanta University, Tanta, Egypt., Etuk S; University of Calabar Teaching Hospital, Calabar, Nigeria., Napolitano R; Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, United Kingdom; Fetal Medicine Unit, University College London Hospitals NHS Foundation Trust, London, United Kingdom., Liu B; St George's University Hospitals NHS Foundation Trust, London, United Kingdom., Prefumo F; Division of Obstetrics and Gynecology, ASST Spedali Civili di Brescia, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Savasi V; Ospedale Luigi Sacco University Hospital, Department of BioMedical and Clinical Sciences, University of Milan, Milan, Italy., Do Vale MS; Universidade Federal do Maranhão, São Luís, Brazil., Baafi E; Holy Family Hospital, Nkawkaw, Ghana., Ariff S; Department of Paediatrics & Child Health, The Aga Khan University Hospital, Karachi, Pakistan., Maiz N; Department of Obstetrics, Hospital Universitari Vall d'Hebron, Barcelona Hospital Campus, Barcelona, Spain., Aminu MB; Department of Obstetrics and Gynaecology, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria., Cardona-Perez JA; Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico., Craik R; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom., Tavchioska G; Department of Pediatrics, General Hospital Borka Taleski, Prilep, Republic of North Macedonia., Bako B; Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medical Sciences, Gombe State University, Gombe, Nigeria., Benski C; Hôpitaux Universitaires de Genève, Département de la Femme, de l'Enfant et de l'Adolescent, Geneva, Switzerland., Hassan-Hanga F; Bayero University Kano, Nigeria; Aminu Kano Teaching Hospital, Kano State, Nigeria., Savorani M; Hospital de Moron, Moron, Buenos Aires, Argentina., Sentilhes L; Department of Obstetrics and Gynecology Bordeaux University Hospital, Bordeaux, France., Carola Capelli M; Servicio de Neonatologia del Departamento Materno Infantil del Hospital Universitario Austral, Pilar, Buenos Aires, Argentina., Takahashi K; Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan., Vecchiarelli C; Sanatorio Otamendi, Buenos Aires, Argentina., Ikenoue S; Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan., Thiruvengadam R; Translational Health Science and Technology Institute, Faridabad, India., Soto Conti CP; Division Neonatología, Hospital Materno Infantil Ramón Sarda, Buenos Aires, Argentina., Cetin I; Ospedale Vittore Buzzi Children's Hospital, Department of BioMedical and Clinical Sciences, University of Milan, Milan, Italy., Nachinab VB; Fr. Thomas Alan Rooney Memorial Hospital, Asankragwa, Ghana., Ernawati E; Department of Obstetrics & Gynecology, Medical Faculty, Universitas Airlangga, Surabaya, Indonesia; Soetomo General Academic Hospital, Surabaya, Indonesia., Duro EA; Universidad de Buenos Aires, Buenos Aires, Argentina; Universidad de Moron, Moron, Argentina., Kholin A; National Medical Research Center for Obstetrics, Gynecology & Perinatology, Moscow, Russia., Teji JS; Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern Feinberg School of Medicine, Chicago, IL., Easter SR; Division of Maternal-Fetal Medicine and Division of Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Salomon LJ; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université de Paris, France., Ayede AI; College of Medicine, University of Ibadan, Ibadan, Nigeria; University College Hospital, Ibadan, Nigeria., Cerbo RM; Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Agyeman-Duah J; Nuffield Department of Women's & Reproductive Health, Green Templeton College, University of Oxford, Oxford, United Kingdom., Roggero P; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Department of Woman, Child and Neonate, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy., Eskenazi B; Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, CA., Langer A; Women and Health Initiative, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA., Bhutta ZA; Center for Global Child Health, Hospital for Sick Children, Toronto, Canada., Kennedy SH; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom., Papageorghiou AT; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom; St George's University Hospitals NHS Foundation Trust, London, United Kingdom., Villar J; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom. |
المصدر: | American journal of obstetrics and gynecology [Am J Obstet Gynecol] 2022 Sep; Vol. 227 (3), pp. 488.e1-488.e17. Date of Electronic Publication: 2022 Apr 19. |
نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 0370476 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6868 (Electronic) Linking ISSN: 00029378 NLM ISO Abbreviation: Am J Obstet Gynecol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: <2005->: New York : Elsevier Original Publication: St. Louis. |
مواضيع طبية MeSH: | COVID-19*/epidemiology , Pregnancy Complications* , Pregnancy Complications, Infectious*/diagnosis , Pregnancy Complications, Infectious*/epidemiology , Premature Birth*/epidemiology , Prenatal Exposure Delayed Effects*, COVID-19 Testing ; Child ; Cohort Studies ; Female ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Perinatal Care ; Pregnancy ; Pregnancy Outcome |
مستخلص: | Background: The effect of COVID-19 in pregnancy on maternal outcomes and its association with preeclampsia and gestational diabetes mellitus have been reported; however, a detailed understanding of the effects of maternal positivity, delivery mode, and perinatal practices on fetal and neonatal outcomes is urgently needed. Objective: To evaluate the impact of COVID-19 on fetal and neonatal outcomes and the role of mode of delivery, breastfeeding, and early neonatal care practices on the risk of mother-to-child transmission. Study Design: In this cohort study that took place from March 2020 to March 2021, involving 43 institutions in 18 countries, 2 unmatched, consecutive, unexposed women were concomitantly enrolled immediately after each infected woman was identified, at any stage of pregnancy or delivery, and at the same level of care to minimize bias. Women and neonates were followed up until hospital discharge. COVID-19 in pregnancy was determined by laboratory confirmation and/or radiological pulmonary findings or ≥2 predefined COVID-19 symptoms. The outcome measures were indices of neonatal and perinatal morbidity and mortality, neonatal positivity and its correlation with mode of delivery, breastfeeding, and hospital neonatal care practices. Results: A total of 586 neonates born to women with COVID-19 diagnosis and 1535 neonates born to women without COVID-19 diagnosis were enrolled. Women with COVID-19 diagnosis had a higher rate of cesarean delivery (52.8% vs 38.5% for those without COVID-19 diagnosis, P<.01) and pregnancy-related complications, such as hypertensive disorders of pregnancy and fetal distress (all with P<.001), than women without COVID-19 diagnosis. Maternal diagnosis of COVID-19 carried an increased rate of preterm birth (P≤.001) and lower neonatal weight (P≤.001), length, and head circumference at birth. In mothers with COVID-19 diagnosis, the length of in utero exposure was significantly correlated to the risk of the neonate testing positive (odds ratio, 4.5; 95% confidence interval, 2.2-9.4 for length of in utero exposure >14 days). Among neonates born to mothers with COVID-19 diagnosis, birth via cesarean delivery was a risk factor for testing positive for COVID-19 (odds ratio, 2.4; 95% confidence interval, 1.2-4.7), even when severity of maternal conditions was considered and after multivariable logistic analysis. In the subgroup of neonates born to women with COVID-19 diagnosis, the outcomes worsened when the neonate also tested positive, with higher rates of neonatal intensive care unit admission, fever, gastrointestinal and respiratory symptoms, and death, even after adjusting for prematurity. Breastfeeding by mothers with COVID-19 diagnosis and hospital neonatal care practices, including immediate skin-to-skin contact and rooming-in, were not associated with an increased risk of newborn positivity. Conclusion: In this multinational cohort study, COVID-19 in pregnancy was associated with increased maternal and neonatal complications. Cesarean delivery was significantly associated with newborn COVID-19 diagnosis. Vaginal delivery should be considered the safest mode of delivery if obstetrical and health conditions allow it. Mother-to-child skin-to-skin contact, rooming-in, and direct breastfeeding were not risk factors for newborn COVID-19 diagnosis, thus well-established best practices can be continued among women with COVID-19 diagnosis. (Copyright © 2022. Published by Elsevier Inc.) |
التعليقات: | Comment in: Am J Obstet Gynecol. 2023 Mar;228(3):358-359. (PMID: 36288753) Comment in: Am J Obstet Gynecol. 2023 Mar;228(3):358. (PMID: 36306858) Comment in: Evid Based Nurs. 2023 Apr;26(2):61. (PMID: 36788009) |
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معلومات مُعتمدة: | United Kingdom DH_ Department of Health |
فهرسة مساهمة: | Keywords: COVID-19; SARS-CoV-2; SARS-CoV-2 exposure; birthweight; breastfeeding; cesarean delivery; cohort; feeding problems; hospital stay; infections; intrauterine growth restriction; morbidity; mortality; multicenter study; neonatal intensive care unit admission; neonatal outcomes; neonate; neurologic outcome; newborn; perinatal practices; preeclampsia; pregnancy; preterm birth; respiratory support; respiratory symptoms; risk ratio; rooming-in; skin-to-skin; small for gestational age |
تواريخ الأحداث: | Date Created: 20220422 Date Completed: 20220829 Latest Revision: 20230509 |
رمز التحديث: | 20230509 |
مُعرف محوري في PubMed: | PMC9017081 |
DOI: | 10.1016/j.ajog.2022.04.019 |
PMID: | 35452653 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1097-6868 |
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DOI: | 10.1016/j.ajog.2022.04.019 |