孕中期新型冠状病毒感染后分娩早产儿一例

Premature infant born to a convalescent mother with COVID-19 in mid-term pregnancy

本文为一例孕中期新型冠状病毒感染后早产的报道,母儿结局良好。新生儿因"胎龄35周+4,生后30 min"于2020年3月21日入住华中科技大学同济医学院附属协和医院,系第2胎第1产,胎龄35周+4,出生体重2800 g,Apgar评分1 min 7分、5 min 9分,羊水正常。其母孕26周+6时临床诊断新型冠状病毒肺炎,分娩前血清新型冠状病毒IgM阴性,IgG滴度20.77 AU/ml(正常参考值<10 AU/ml)。患儿入院时存在低血糖,迅速纠正后血糖稳定;生后早期存在喂养不耐受,于生后第8天达到全肠道喂养;住院期间一般情况良好。出生后第2、3和8天3次咽拭子新型冠状病毒RNA检测均阴性,出生后第2和8天血清新型冠状病毒IgM均阴性,IgG分别为30.2 AU/ml和25.3 AU/ml,考虑抗体来源于母亲。本例报道显示孕中期感染新型冠状病毒后未发生母婴宫内垂直传播,但仍需更长时间随访。

We report a female infant born preterm to a woman at 35 gestational weeks and four days in a normal pregnancy prior to delivery,with normal liquor volume and good maternal and infant outcomes.The baby was transferred to the neonatal department 30 min after birth at Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,on March 21,2020.The infant weighed 2800 g with 7 and 9 Apgar scores respectively at 1 and 5 min.The mother had been diagnosed with COVID-19 at 26+6 weeks of pregnancy and the maternal serum level of IgM was negative and that of IgG was 20.77 AU/ml(normal reference<10 AU/ml)before delivery.The baby had hypoglycemia on admission,and the blood sugar stabilized after treatment.Though early mild feeding intolerance occurred,the baby was able to feed normal by eight days after birth.The baby was in good condition during hospitalization and discharged.Throat swab specimens obtained from the infant on the 2nd,3rd and 8th day after birth for SARS-Cov-2 RNA detection were all negative.On the 2nd and 8th day after birth,SARS-Cov-2 IgM in the neonatal serum were negative,while elevated IgG levels of 30.2 AU/ml and 25.3 AU/ml(normal reference value<10 AU/ml)were observed,suggesting that the infant's IgG antibody of SARS-CoV-2 may have come from the mother.According to this case report,no intrauterine vertical transmission was found in the pregnancy with SARS-CoV-2 infection in the second trimester,while further follow-up is still needed.