Pandemic (H1N1) 2009 in neonates, Japan

Neonatal outcome among pregnant women with COVID-19: a systematic review and meta-analysis

BACKGROUND

COVID-19 has raised many concerns about the possible side effects of pregnancy. There is currently no conclusive evidence of the vertical transmission of COVID-19. Accordingly, this paper is a Systematic Review and Meta-Analysis investigated neonatal outcomes among pregnant women with COVID-19.

METHODS

PubMed, Web of Science (WoS), EMBASE, ProQuest, Scopus, and Google Scholar were searched up to November 2020. The Cochran's Q-test and I² statistic were applied to assess heterogeneity, a random-effects model was used to estimate the pooled estimate of the mean, and a meta-regression method was utilized to investigate the factors affecting heterogeneity between studies.

RESULTS

Of 1132 studies, 23 were included in the analysis (sample size: 749 for neonates and 820 for mothers). Most of these studies (n = 13) were conducted in China. The pooled estimate for the mean of birth weight, APGAR score in min 1 and 5 was 3084.97 g (95% CI: 2993.66-3176.29), 8.76 (95% CI: 8.27-9.25), and 9.44 (95% CI: 9.18-9.70), respectively. Also, the pooled prevalence of premature birth, shortness of breath, and neonatal death was 17.80% (95% CI: 12.47-23.13), 8.43% (95% CI: 4.50-12.37), and 7.73% (95% CI: 2.00-13.47), respectively. The meta-regression results indicated that the mother's age, disease duration, and sample size had no significant effect on heterogeneity between studies (p-value all of them was >.05). Finally, 15 studies (65.22%) reported that vertical transmission did not occur.

CONCLUSION

The COVID-19 infection can have adverse outcomes for the newborn. Despite the positive test of neonates, the vertical transmission of COVID-19 from the infected mother to the fetus has not yet been conclusively proven; thus, further research is needed.

American Academy of Nursing on Policy Women's Sexual/Reproductive Health and Access Challenges Amid COVID-19 Pandemic From the Women's Health Expert Panel of the American Academy of Nursing

Challenges to women's health in the context of COVID-19 is based on their unique experience shaped by sex/gender. This paper provides clinical practice-, research-, and policy-related commentary on key COVID-19 pandemic factors impinging on women's sexual/reproductive health (SRH) and care access, particularly in the context of pregnancy, childbirth, sexual/gender variations, and concurrent chronic conditions.

Women tend to have less severe outcomes from COVID-19 than men but certain sub-groups are more vulnerable than others. Yet few United States studies have disaggregated the data accordingly. Forming a basis for well-informed policy generation, needed is more research specific to COVID-19 vulnerability/risk factors and outcomes for groups of women by age, race and socioeconomic and cultural determinants. Access to SRH-related clinical services has been diminished during the pandemic, making a priority for restoring/preserving inclusive SRH care for women, for example, family planning, healthy pregnancies, age-related disease screening and treatment, and health/wellness promotion.

Important concerns include severity of the disease, morbidity in pregnant and postpartum women, increased risk to the fetus, virus transmission to fetus or newborn, and impact of lack care access. Uncertainty in current knowledge is heavily related to lack of sex specific data.

Effect of coronavirus-19 infection on maternal and perinatal outcome: A case control study

Introduction: Coronavirus 2019 virus infections has an impact on the obstetric population. Methods: We performed a single centre, prospective case-control study in a tertiary care centre during the first wave of the pandemic, over a period of six months. All Labouring women who were tested positive for SARS-CoV2 on the date of admission were included in the study (cases). As a control, SARS-CoV2 negative women who delivered before and after the corona virus-positive delivery were included. Results: The control group were significantly younger than the cases ( p = 0.001). The odds of spontaneous labour were observed to be significantly higher among the cases as compared to the control group ( p  =  0.002). The likelihood of NICU admission was significantly higher among the cases as compared to the control group on applying Fischer exact test ( p < 0.001) Conclusion: SARS-CoV2 positive mothers are more likely to deliver neonates with feeding difficulties and requiring NICU admission, compared to SARS-CoV2 negative mothers.

Respiratory viral infections during pregnancy: effects of SARS-CoV-2 and other related viruses over the offspring

Little is known about the consequences of viral infection for pregnant woman or for the fetus. This issue became important with the appearance of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The infection with SARS-CoV-2 causes a respiratory syndrome known as COVID-19. The fast spreading around the world and the fact that without a treatment or vaccine humans are completely exposed, converts emerging viral diseases in a significant risk for pregnant women and their infants. At this time, during SARS-CoV-2 pandemics pregnant women are not considered as a risk population and little is known about the effects of viral infections over the offspring although the amount of emerging evidence showing detrimental effects for the mother and the fetus. This issue highlights the importance to understand the effects of viral infections during pregnancy. In this work, we analyze the effects of viral infections, like SARS-CoV-2 and other related viruses during pregnancy over the mother and the consequences for the offspring.

Clinical manifestations and perinatal outcomes of pregnant women with COVID-19: a systematic review and meta-analysis

This systematic review and meta-analysis aimed to evaluate the impact of COVID-19 on pregnant women. We searched for qualified studies in PubMed, Embase, and Web of Science. The clinical characteristics of pregnant women with COVID-19 and their infants were reported as means and proportions with 95% confidence interval. Eleven studies involving with 9032 pregnant women with COVID-19 and 338 infants were included in the meta-analysis. Pregnant women with COVID-19 have relatively mild symptoms. However, abnormal proportions of laboratory parameters were similar or even increased, compared to general population. Around 30% of pregnant women with COVID-19 experienced preterm delivery, whereas the mean birth weight was 2855.9 g. Fetal death and detection of SARS-CoV-2 were observed in about 2%, whereas neonatal death was found to be 0.4%. In conclusion, the current review will serve as an ideal basis for future considerations in the treatment and management of COVID-19 in pregnant women.

Death of a neonate with suspected coronavirus disease 2019 born to a mother with coronavirus disease 2019 in Iran: a case report

INTRODUCTION

A novel coronavirus named severe acute respiratory syndrome coronavirus 2, was first reported in Wuhan, China, in December 2019. The virus, known as COVID-19, is recognized as a potentially life-threatening disease by causing severe respiratory disease. Since this virus has not previously been detected in humans, there is a paucity of information regarding its effects on humans. In addition, only limited or no information exists about its impact during pregnancy.

CASE PRESENTATION

In the present case study, we report the death of a neonate born to a 32-year-old mother with coronavirus disease 2019 in Ilam, Iran, with Kurdish ethnicity. We report the infection and death of a neonate in Iran with a chest X-ray (CXR) marked abnormality 2 hours after birth demonstrating coronavirus disease 2019 disease. The neonate was born by elective cesarean section, the fetal health was assessed using fetal heart rate and a non-stress test before the birth, and there was no evidence of fetal distress. All the above-mentioned facts and radiographic abnormalities suggested that coronavirus disease 2019 is involved.

CONCLUSIONS

In this case study, we report the death of a neonate born to a mother with coronavirus disease 2019, 11 hours after birth. There is a paucity of data on the vertical transmission and the adverse maternal-fetal consequences of this disease, so vertical transmission from mother to child remains to be confirmed.

Managing Preterm Infants Born to COVID-19 Mothers: Evidence from a Retrospective Cohort Study in Wuhan, China

BACKGROUND

COVID-19 has spread rapidly over the world. Little is known about the outcomes of infections in pregnant women. The management and characteristics of preterm infants born to COVID-19 mothers need to be clarified.

METHODS

In this retrospective, single-center cohort study, we describe the clinical courses of 6 preterm infants born to COVID-19 mothers, the management protocol, and related outcomes.

RESULTS

Six preterm infants were admitted to Tongji Hospital between January 23 and March 19, 2020. Gestational age ranged from 28+5 to 36+3 weeks. One late preterm infant was delivered early due to maternal dyspnea from COVID-19. Five infants were delivered by Caesarean section. None had perinatal asphyxia. Two infants required respiratory support due to respiratory distress syndrome and apnea of prematurity. All infants did not develop severe complications of prematurity and are negative for severe acute respiratory syndrome (SARS)-CoV-2 nucleic acid testing.

CONCLUSION

With an expedited and adequate delivery protocol, less invasive treatment principle, and active infection precautious, we found a limited impact of COVID-19 mothers on preterm delivery and neonatal short-term outcomes. The risk of vertical transmission of SARS-CoV-2 is low in preterm infants born to COVID-19 mothers if appropriate management is implemented.

A Case Report of Neonatal 2019 Coronavirus Disease in China

In December 2019, the 2019 novel coronavirus disease (COVID-19) caused by SARS-CoV-2 emerged in China and now has spread in many countries. Pregnant women are susceptible population of COVID-19 which are more likely to have complications and even progresse to severe illness. We report a case of neonatal COVID-19 infection in China with pharyngeal swabs tested positive by rRT-PCR assay 36 hours after birth. However, whether the case is a vertical transmission from mother to child remains to be confirmed.

Can SARS-CoV-2-infected women breastfeed after viral clearance?

The recently emerged novel coronavirus pneumonia, named the coronavirus disease 2019 (COVID-19), shares several clinical characteristics with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and spread rapidly throughout China in December of 2019 (Huang et al., 2020). The pathogen 2019 novel coronavirus (2019-nCoV) is now named SARS coronavirus 2 (SARS-CoV-2) and is highly infectious. As of Apr. 9, 2020, over 80 000 confirmed cases had been reported, with an estimated mortality rate of 4.0% (Chinese Center for Disease Control and Prevention, 2020). Person-to-person transmission and familial clustering have been reported (Chan et al., 2020; Nishiura et al., 2020; Phan et al., 2020). However, there is no evidence of fetal intrauterine infection in pregnant women who have been infected with SARS-CoV-2 in their third trimester (Chen et al., 2020). It is unclear whether breastfeeding transmits the virus from previously infected and recovered mothers to their babies. Here we report the clinical course of a pregnant woman with COVID-19. In order to determine whether SARS-CoV-2 can be transmitted to newborns through breastfeeding, we measured viral RNA in the patient’s breastmilk samples at different time points after delivery.

Impact of Middle East Respiratory Syndrome coronavirus (MERS-CoV) on pregnancy and perinatal outcome

Background

Middle East Respiratory Syndrome coronavirus (MERS-CoV) is a viral respiratory disease. Most people infected with MERS-CoV develop severe acute respiratory illness. It was first reported in Saudi Arabia in 2012 and has since spread to several other countries. We report the clinical course of MERS-CoV infection in a pregnant woman who acquired the infection during the last trimester.

Case presentation

The patient is a 33-year-old female working as a critical care nurse. She was 32 weeks pregnant when she presented with respiratory symptoms after direct contact with a MERS-COV patient. Although the patient was in respiratory failure, necessitated mechanical ventilation, and intensive care (ICU) admission, a healthy infant was delivered. The mother recovered. To the best of our knowledge, this is the first reported case of a laboratory-confirmed Middle East Respiratory Syndrome Coronavirus in a pregnant woman.

Conclusions

Middle East Respiratory Syndrome coronavirus (MERS-CoV) known to cause severe acute respiratory illness associated with a high risk of mortality Various factors may have contributed to the successful outcome of this patient such as young age, presentation during the last stages of pregnancy, and possible differences in immune response.