妊娠中晚期合并COVID-19的母婴表现分析

Analysis of Maternal and Infant Performance on Medium and Late Pregnancy Stage with COVID-19

目的 探讨妊娠中晚期合并COVID-19的母婴临床特性.方法 选择2020年1月18日~2020年2月18日期间诊断为中晚期妊娠合并COVID-19的病例5例(1例临床诊断,4例核酸确诊),比较其分娩前后的临床表现及辅助检查结果特点,并分析新生儿的临床特征.结果 孕妇早期感染症状表现多样,以发热、咳嗽多见,部分可表现为厌食、肌肉酸痛等不典型症状,个别无任何不适.5例孕妇均于产后72 h内出现呼吸困难、氧饱和度下降等呼吸系统症状加重现象,淋巴细胞和嗜酸性粒细胞均下降.新生儿除1例出生后伴有一过性呼吸急促、发热外,其余未出现明显呼吸道症状.结论 妊娠中晚期合并COVID-19孕妇早期感染症状可不典型,但产后72 h内可出现不同程度病情加重,其嗜酸性粒细胞变化与淋巴细胞及临床症状变化趋势相同,甚至早于典型临床症状的出现;新生儿多无特殊异常临床表现,暂未发现母婴垂直传播证据.

Objective To investigate the clinical features of mothers and infants on medium and late pregnancy stage with COVID-19.Methods Five pregnant women with COVID-19 on medium and late pregnancy stage were selected from January 18,2020 to February 18,2020.One case was clinically diagnosed and 4 cases were confirmed by nucleic acid.The clinical features and auxiliary examinations were compared before and after delivery.The clinical features of neonates were also analyzed.ResultsEarly infection symptoms of pregnant women varied,mostly including fever and cough,partially anorexia,muscle pain and other atypical symptoms,and rarely without any discomfort.All 5 pregnant women had aggravated respiratory symptoms such as dyspnea and oxygen desaturation within 72 h after delivery.The accounts of lymphocytes and eosinophils decreased accordingly.Except for one infant with temporary polypnea and fever,no obvious respiratory symptoms were observed.Conclusion The early infection symptoms of pregnant women on medium and late pregnancy stage with COVID-19 are not typical,but the disease may aggravate within 72 h after delivery to varying degrees.Change trend in eosinophils is similar to that in lymphocytes and clinical symptoms,even earlier than the appearance of typical clinical symptoms.Most neonates show no special clinical symptoms,and the evidence of mother-infant transmission has not been found at present.