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1.
Embase; 2021.
Preprint in English | EMBASE | ID: ppcovidwho-331114

ABSTRACT

Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to escalate worldwide and has become a pressing global health concern. This article comprehensively reviews the current knowledge on the impact of COVID-19 over pregnant women and neonates, as well as current recommendations for their management. We also analyse previous evidences from viral respiratory diseases such as SARS, Middle East respiratory syndrome, and influenza that may help to guide clinical practice during the current pandemic. We collected 23 case reports, case series, and case-control studies (18 from China) comprising 174 pregnant women with COVID-19. The majority of mothers showed a clinical presentation of the disease similar to that of non-infected adults. Preliminary evidences point towards a potentially increased risk of pregnancy adverse outcomes in women with COVID-19, with preterm delivery the most frequently observed (16.7%) followed by fetal distress (9.77%). The most commonly reported adverse neonatal outcomes included respiratory symptoms (7.95%) and low birth weight (6.81%). A few studies reported other maternal comorbidities that can influence these outcomes. Mothers with other comorbidities may be at higher risk of infection. Mother-tochild transmission of SARS-CoV-2 appears unlikely, with no study observing intrauterine transmission, and a few cases of neonatal infection reported a few hours after birth. Although the WHO and other health authorities have published interim recommendations for care and management of pregnant women and infants during COVID-19 pandemic, many questions remain open. Pregnant women should be considered in prevention and control efforts, including the development of drugs and vaccines against SARS-CoV-2. Further research is needed to confirm the exact impact of COVID-19 infection during pregnancy. To fully quantify this impact, we urgently need to integrate the current knowledge about viral characteristics, epidemiology, disease immunopathology, and potential therapeutic strategies with data from the clinical practice.

2.
Pediatria Catalana ; 81(2):102-107, 2021.
Article in Catalan | EMBASE | ID: covidwho-1766470

ABSTRACT

Background. Since the beginning of the SARS-CoV-2 pandemic, most neonatal units around the world have restricted parents’ access, aiming to protect the staff and the babies against the infection. Objective. To evaluate the side effects of the limitation of parents presence with their babies in neonatal units and those related to restrictions on maternity wards access. Method. Literature review. A search using ‘SARS-CoV-2’ and ‘COVID-19’ as keywords combined to ‘neonatal’, ‘NICU’, ‘parents’, ‘family centered care’ and ‘neurodevelopmental care’. Consultation of websites containing updated and summarized scientific literature about the pandemic and its consequences in newborns has also been performed: www.dontforgetthebubles.com and www.seneo.es. The voice of the families has been mainly obtained through the websites of their associations and the social networks. Results. The family-centered care model has shown positive effects on the health of sick newborns and on premature infants’ neurodevelopment. This model of care is under threat if parental access is limited. It has been shown that these restrictions have also adverse effects on breastfeeding and on caregivers’ psychological wellbeing. Data from different neonatal series report a benign course of COVID-19 infection in neonates and preterm babies. Conclusions. At a crucial moment for the implementation of the developmental centered care model in Catalan neonatal units, and with the available data, it is essential to redesign the policies regarding parents who accompany their babies admitted to the units.

3.
Journal of Paediatrics and Child Health ; 57(8):1341, 2021.
Article in English | EMBASE | ID: covidwho-1623528
4.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617065

ABSTRACT

Background: The COVID-19 pandemic has changed the paradigm when it comes to infection control. However, there are still many doubts about pregnancy and the perinatal period in this context, even though many studies suggest the benignity of infection in this phase. The present study took place in a Level II Hospital with differentiated perinatal care and describes the newborns whose mothers were infected with COVID-19 during pregnancy. We aim to understand the mother-newborn pattern of transmission and clinical, analytical and serologic follow-up. Methods: Prospective observational study from 1/4/2020 to 31/5/2021, using the clinical files of every SARS-COV-2 PCR-positive mother and their newborns. Among others, we evaluated the state of infection of the newborn at 12 and 48h and after 14 days with SARS-Cov-2 PCR tests. In the first three months, serologic and clinical evaluation were performed. Results: Of the 1684 live births, 60 (3,6%) mothers were infected with SARS-COV-2 during pregnancy, 43% of which were diagnosed in the screening performed during/before labour. The median value of gestational age was 39 weeks, and the average weight was 3171g. 81,7% of the newborns remained with their mother in the hospital ward, and 85% were breastfed. 7 newborns (11,7%) needed NICU, one of which was born at 32 weeks because the mother needed ICU support due to COVID-19. Of the 26 newborns whose mothers were positive in labour, 15 were tested for SARS-Cov-2 PCR in the first 12 h, and 21 within 48h: all of them were negative.16 were tested after 14 days. Only one of them (6,2%) tested positive but remained asymptomatic. Serologic anti-spike and anti-nucleocapsid analyses were performed in 32 babies: 10 of them (31.3%) showed positive antibodies. In these cases, 80% of the mothers were positive in the 3rd trimester and 20% in the 2nd trimester. The clinical follow-up showed a positive outcome in all of them. Conclusions: This study supports others that show the benignity of perinatal SARS-COV-2 infection. There were no more significant rates of prematurity or NICU need. None of the newborns tested positive in SARS-Cov-2 PCR tests in the first 48h, supporting the rarity of the vertical infection, and only one has been affected by horizontal transmission.

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