母亲新型冠状病毒Omicron变异株感染的新生儿管理及近期结局

Management and short-term outcomes of neonates born to mothers infected with SARS-CoV-2 Omicron variant

目的总结母亲新型冠状病毒Omicron变异株感染新生儿的临床管理及近期结局。方法回顾性分析2022年3月15日至5月30日复旦大学附属儿科医院隔离病房收治的158例母亲确诊新型冠状病毒Omicron变异株感染的新生儿的母婴资料,总结新生儿出生后防控隔离措施、临床特征及近期临床结局。根据母亲有无新型冠状病毒肺炎症状分为母亲有症状组和母亲无症状组,采用秩和检验或χ^(2)检验比较2组间的临床结局。结果158例新生儿在产时复苏、转运过程及新生儿隔离病房内均全程严格落实新型冠状病毒感染防控要求。其中男75例(47.5%),出生胎龄(38^(+3)±1^(+3))周,出生体重(3201±463)g,10例(6.3%)早产,最小出生胎龄为30^(+1)周。6例(3.8%)出现呼吸困难,其中4例为早产儿,需要气管插管机械通气。158例新生儿均在出生后7 d每日进行鼻拭子新型冠状病毒核酸检测,结果均为阴性。156例(双胎妊娠2例)母亲确诊新型冠状病毒Omicron变异株感染至分娩的时间为7(3,12)d,其中有症状组88例(56.4%),均无需接受重症监护治疗。母亲有症状组新生儿的末梢血白细胞计数显著高于母亲无症状组[23.0(18.7,28.0)×10^(9)比19.6(15.4,36.6)×10^(9)/L,Z=2.44,P<0.05]。结论母亲妊娠晚期新型冠状病毒Omicron变异株感染的新生儿近期结局良好,病毒未通过胎盘垂直传播引起胎儿宫内感染,新生儿在出生时及出生后给予全程严格的防疫隔离措施可有效避免感染。

Objective To summarize the management and short-term outcomes of neonates delivered by mothers infected with SARS-CoV-2 Omicron variant.Methods A retrospective study was performed on 158 neonates born to mothers infected with SARS-CoV-2 Omicron variant admitted to the isolation ward of Children′s Hospital of Fudan University from March 15th,2022 to May 30th,2022.The postnatal infection control measures for these neonates,and their clinical characteristics and short-term outcomes were analyzed.They were divided into maternal symptomatic group and maternal asymptomatic group according to whether their mothers had SARS-CoV-2 symptoms.The clinical outcomes were compared between the 2 groups using Rank sum test and Chi-square test.Results All neonates were under strict infection control measures at birth and after birth.Of the 158 neonates,75(47.5%)were male.The gestational age was(38^(+3)±1^(+3))weeks and the birth weight was(3201±463)g.Of the neonates included,ten were preterm(6.3%)and the minimum gestational age was 30^(+1) weeks.Six neonates(3.8%)had respiratory difficulty and 4 of them were premature and required mechanical ventilation.All 158 neonates were tested negative for SARS-COV-2 nucleic acid by daily nasal swabs for the first 7 days.A total of 156 mothers(2 cases of twin pregnancy)infected with SARS-CoV-2 Omicron variant,the time from confirmed SARS-CoV-2 infection to delivery was 7(3,12)days.Among them,88 cases(56.4%)showed clinical symptoms,but none needed intensive care treatment.The peripheral white blood cell count of the neonates in maternal symptomatic group was significantly higher than that in maternal symptomatic group(23.0(18.7,28.0)×10^(9)vs.19.6(15.4,36.6)×10^(9)/L,Z=2.44,P<0.05).Conclusions Neonates of mothers infected with SARS-CoV-2 Omicron variant during third trimester have benign short-term outcomes,without intrauterine infection through vertical transmission.Strict infection control measures at birth and after birth can effectively protect these neonates from SARS-CoV-2 infection.