ABSTRACT
@#Objectives. The effect of COVID-19 infection in pregnant women and her neonate is not well-understood, with no clear evidence for vertical transmission. This study aims to determine the maternal and neonatal clinical characteristics and the dyad’s outcomes among those infected with COVID-19 infection. Methods. An ambispective cross-sectional study involving pregnant women with confirmed COVID-19 infection was conducted at the Philippine General Hospital from April to August 2020. Two hundred nine obstetric patients were included, 14 of whom consented to specimen collection to determine vertical transmission. Results. The majority of pregnant women with COVID-19 infection and their neonates had good outcomes. Labor, delivery, and the immediate postpartum course were generally uneventful. The all-cause maternal morbidity rate was high at 75.6 per 100 cases during the five-month study period. COVID-19 related morbidities included the development of Guillain-Barré Syndrome. The in-hospital all-cause maternal mortality rate was 1.91 per 100 cases. The causes of maternal death were acute respiratory failure, septic shock, and congenital heart disease (atrial septal defect with Eisenmengerization). The in-hospital, all-cause neonatal mortality rate was 1.04 per 100 neonates of cases. The lone mother and infant deaths were in a postmortem rt-PCR swab negative mother with an rt-PCR swab positive live neonate who eventually succumbed after nine days of life. All 14 dyads with collected specimens that included amniotic fluid, placental tissue, umbilical cord, and neonate nasopharyngeal swab tested negative for SARS-CoV-2 rt-PCR. Conclusion. The prognosis for COVID-19 infected pregnant patients was generally good, with most of the patients discharged improved. Almost all of the neonates born to COVID-19-infected mothers were stable-term infants. There was no evidence for vertical transmission, as shown by negative rt-PCR results for all the additional specimens obtained. In general, the prognosis for COVID-19 infected dyads was good. The majority of the mothers were discharged well with their term infants. All possible maternal sources of COVID-19 infection to the neonate tested negative. This study provided no evidence for vertical transmission.
Subject(s)
Female , Infant, Newborn , COVID-19 , FamilyABSTRACT
@#<p><strong>BACKGROUND:</strong> To determine prevalence of delay in 5 developmental domains among Filipino children at 6, 12 and 24 months and investigate influence of socioeconomic status, maternal intelligence, gender and home stimulation. Variations and developmental domains as reliable indicators of potential delay were determined.</p><p><strong>METHODS:</strong> 754 maternal/ infant dyads were followed up until 2 years old. The Griffiths Mental Development Scales determined sub-quotient scores in locomotor, personal/social, hearing/language, eye-hand coordination and performance subscales before averaging for General Quotient(GQ) score. Score < 85 was considered delayed.</p><p><strong>RESULTS:</strong> Low GQ scores were noted in 5.4% at 6 months, 19.1% at 12 months and 11.0% at 24 months old. GQ scores were lowered by performance subscale at 6 months, hearing/language and performance at 12 months and hearing/language at 24 months. No single subscale consistently lowered GQ across time. Only 4.2% maintained low GQ scores in all three ages.</p><p><strong>CONCLUSION:</strong> Prevalence of developmental delay varied across 24 months with highest rates noted at 12 months of age. No developmental domain consistently lowered test scores and no test age was predictive of future outcome but focused early intervention according to age is suggested. Home environment, higher socioeconomic status, maternal IQ and supervision were associated with improved potential.</p>