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COVID-19 Enfeksiyonu ile Komplike Gebe Hastalarda Maternal ve Neonatal Sonuçların Değerlendirilmesi

Year 2021, Volume: 28 Issue: COVİD-19 ÖZEL SAYI, 119 - 124, 01.05.2021
https://doi.org/10.17343/sdutfd.905596

Abstract

Özet
Amaç: Çalışmanın amacı; gebelik sırasında maternal Coronavirus Disease 2019 (COVID-19) enfeksiyonunun anne sağlığı üzerine etkilerinin belirlenmesi ve neonatal sonuçlar üzerine etkisinin değerlendirilmesidir.
Gereç- yöntem: Bu çalışmada, 1 Şubat 2020- 1 mart 2021 tarihleri arasında yayınlanmış makalelerin, Pubmed ve Google Scholar üzerinden kapsamlı bir literatür taraması yapılmıştır. Anahtar kelimeler ‘COVID-19, SARS-CoV-2, pregnancy, maternal complications, fetal complications, maternal mortality, fetal mortality’ şeklinde olup ingilizce dil kısıtlaması yapılmıştır. Bu kriterlere uygun 8 çalışma dahil edilmiştir. Toplam 724 nazal sürüntü örneğinde polimeraz zincir reaksiyonu (PCR) ile COVID-19 enfeksiyonu doğrulanmış gebe hasta ve kontrol grubu olarak nazal sürüntü örneğinde COVID-19 PCR ile enfeksiyon olmadığı kanıtlanmış olan 6001 gebe dahil edilmiştir. Analiz edilen değişkenler: maternal yaş, eşlik eden komorbidite durumu, COVID-19 hastalık semptomları, pnömoni varlığı, maternal yoğun bakım ihtiyacı, maternal mortalite, abortus varlığı, preterm doğum oranı, doğum şekli, yenidoğan yoğun bakım ihtiyacı, yenidoğan COVID-19 PCR durumu ve COVID-19‘a bağlı yenidoğan mortalite oranıdır.
Bulgular: Maternal COVID-19 enfeksiyonu vakalarının %50’sinde asemptomatik seyretti. Klinik semptomlar %39 ile öksürük, %34 ateş, %24 koku kaybı, %16 dispne şeklindedir. Maternal enfeksiyonda hastaların %13’ünde hastanede yatış gerekliliği belirlendi. Akciğer tutulumu %14 olup, hastaların %2’si yoğun bakım şartlarında tedavi edilmiştir. Maternal mortalite %0,7 olarak saptanmıştır. Maternal ve neonatal sonuçlar için yenidoğan yoğun bakım ihtiyacı oranı dışında anlamlı fark saptanmadı. Yenidoğan COVID-19 PCR taramasında %2 pozitiflik saptanmasına rağmen COVID-19 enfeksiyonuna bağlı yenidoğan ölümü saptanmadı.
Sonuçlar: COVID-19 enfeksiyonu ile komplike gebe hastalarda, maternal ve neonatal sonuçların kötüleştiğine dair belirgin ilişki saptanmadı. Doğum şekli obstetrik endikasyonlara göre belirlenmelidir. Anneden bebeğe vertikal geçiş gösterilmemekle beraber %2 yenidoğan PCR ile pozitiflik oranı bildirilmiştir. Hiçbir yenidoğanda hastalık bulgusu saptanmadı ve ölüm bildirilmedi.

References

  • 1. Ng PC. Infection control for SARS in a tertiary neonatal centre. Arch Dis Child - Fetal Neonatal Ed [Internet]. 2003 Sep 1;88(5):405F – 409.
  • 2. Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: Report of two cases & review of the literature. J Microbiol Immunol Infect [Internet]. 2019 Jun;52(3):501–3.
  • 3. Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ [Internet]. 2020;
  • 4. Yanes-Lane M, Winters N, Fregonese F, Bastos M, Perlman-Arrow S, Campbell JR, et al. Proportion of asymptomatic infection among COVID-19 positive persons and their transmission potential: A systematic review and meta-analysis. PLoS One. 2020;
  • 5. Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–October 3, 2020. MMWR Morb Mortal Wkly Rep [Internet]. 2020 Nov 6;69(44):1641–7.
  • 6. Cosma S, Carosso AR, Cusato J, Borella F, Carosso M, Bovetti M, et al. Coronavirus disease 2019 and first-trimester spontaneous abortion: a case-control study of 225 pregnant patients. Am J Obstet Gynecol [Internet]. 2020 Oct 8;
  • 7. Liu W, Wang Q, Zhang Q, Chen L. Coronavirus disease 2019 (COVID-19) during pregnancy: a case series. Preprint. 2020;
  • 8. Simões e Silva AC, Leal CRV. Is SARS-CoV-2 Vertically Transmitted? Front Pediatr [Internet]. 2020 May 15;8.
  • 9. Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol [Internet]. 2004 Jul;191(1):292–7.
  • 10. Mullins E, Evans D, Viner RM, O’Brien P, Morris E. Coronavirus in pregnancy and delivery: rapid review. Ultrasound in Obstetrics and Gynecology. 2020.
  • 11. Yu N, Li W, Kang Q, Xiong Z, Wang S, Lin X, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis [Internet]. 2020 May;20(5):559–64.
  • 12. Qiancheng X, Jian S, Lingling P, Lei H, Xiaogan J, Weihua L, et al. Coronavirus disease 2019 in pregnancy. Int J Infect Dis [Internet]. 2020 Jun;95:376–83.
  • 13. Della Gatta AN, Rizzo R, Pilu G, Simonazzi G. Coronavirus disease 2019 during pregnancy: a systematic review of reported cases. Am J Obstet Gynecol [Internet]. 2020 Jul;223(1):36–41.
  • 14. Ashraf MA, Keshavarz P, Hosseinpour P, Erfani A, Roshanshad A, Pourdast A, et al. Coronavirus disease 2019 (COVID-19): A systematic review of pregnancy and the possibility of vertical transmission. Journal of Reproduction and Infertility. 2020.
  • 15. Salem D, Katranji F, Bakdash T. COVID‐19 infection in pregnant women: Review of maternal and fetal outcomes. Int J Gynecol Obstet [Internet]. 2021 Mar 27;152(3):291–8.
  • 16. Mullins E, Hudak ML, Banerjee J, Getzlaff T, Townson J, Barnette K, et al. Pregnancy and neonatal outcomes of COVID-19 – co-reporting of common outcomes from the PAN-COVID and AAP SONPM registry. medRxiv. 2021;

Evaluation of Maternal and Neonatal Outcomes in Pregnant Patients Complicated by COVID-19 İnfection

Year 2021, Volume: 28 Issue: COVİD-19 ÖZEL SAYI, 119 - 124, 01.05.2021
https://doi.org/10.17343/sdutfd.905596

Abstract

Abstract

Objectives: The purpose of the study; Determining the effects of maternal Coronavirus Disease 2019 (COVID-19) infection during pregnancy on maternal health and evaluating its effect on neonatal outcomes.
Materials and methods: In this study, a comprehensive literature review was carried out on Pubmed and Google Scholar for articles published between February 1, 2020 and March 1, 2021. The keywords are 'COVID-19, SARS-CoV-2, pregnancy, maternal complications, fetal complications, maternal mortality, fetal mortality' and English language restriction has been applied. Eight studies were included. Pregnant patients with confirmed COVID-19 infection by polymerase chain reaction (PCR) in a total of 724 nasal swab samples and 6001 pregnant women who were proven to be free of infection by COVID-19 PCR in the nasal swab sample were included as a control group. The variables analyzed: maternal age, comorbidity status, symptoms of COVID-19 disease, presence of pneumonia, maternal intensive care need, maternal mortality, presence of abortion, preterm delivery rate, delivery type, neonatal intensive care need, neonatal COVID-19 PCR status and neonatal mortality rate due to COVID-19.
Results: It was asymptomatic in 50% of the cases of maternal COVID-19 infection. Clinical symptoms are 39% cough, 34% fever, 24% loss of smell, 16% dyspnea. The requirement for hospitalization was determined in 13% of the patients in maternal infection. Lung involvement is 14%, and 2% of the patients have been treated in intensive care conditions. Maternal mortality was found to be 0.7%. No significant difference was found for maternal and neonatal outcomes, except for the rate of neonatal intensive care need (p=0,03). Although 2% positivity was detected in the newborn COVID-19 PCR scan, no neonatal death due to COVID-19 infection was detected.
Conclusions: There was no significant correlation between maternal and neonatal outcomes in pregnant patients complicated by COVID-19 infection. Delivery method should be determined according to obstetric indications. Although vertical transmission from mother to baby was not shown, a positivity rate of 2% with neonatal PCR has been reported. There were no signs of disease in any newborns, and no deaths were reported.

References

  • 1. Ng PC. Infection control for SARS in a tertiary neonatal centre. Arch Dis Child - Fetal Neonatal Ed [Internet]. 2003 Sep 1;88(5):405F – 409.
  • 2. Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: Report of two cases & review of the literature. J Microbiol Immunol Infect [Internet]. 2019 Jun;52(3):501–3.
  • 3. Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ [Internet]. 2020;
  • 4. Yanes-Lane M, Winters N, Fregonese F, Bastos M, Perlman-Arrow S, Campbell JR, et al. Proportion of asymptomatic infection among COVID-19 positive persons and their transmission potential: A systematic review and meta-analysis. PLoS One. 2020;
  • 5. Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–October 3, 2020. MMWR Morb Mortal Wkly Rep [Internet]. 2020 Nov 6;69(44):1641–7.
  • 6. Cosma S, Carosso AR, Cusato J, Borella F, Carosso M, Bovetti M, et al. Coronavirus disease 2019 and first-trimester spontaneous abortion: a case-control study of 225 pregnant patients. Am J Obstet Gynecol [Internet]. 2020 Oct 8;
  • 7. Liu W, Wang Q, Zhang Q, Chen L. Coronavirus disease 2019 (COVID-19) during pregnancy: a case series. Preprint. 2020;
  • 8. Simões e Silva AC, Leal CRV. Is SARS-CoV-2 Vertically Transmitted? Front Pediatr [Internet]. 2020 May 15;8.
  • 9. Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol [Internet]. 2004 Jul;191(1):292–7.
  • 10. Mullins E, Evans D, Viner RM, O’Brien P, Morris E. Coronavirus in pregnancy and delivery: rapid review. Ultrasound in Obstetrics and Gynecology. 2020.
  • 11. Yu N, Li W, Kang Q, Xiong Z, Wang S, Lin X, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis [Internet]. 2020 May;20(5):559–64.
  • 12. Qiancheng X, Jian S, Lingling P, Lei H, Xiaogan J, Weihua L, et al. Coronavirus disease 2019 in pregnancy. Int J Infect Dis [Internet]. 2020 Jun;95:376–83.
  • 13. Della Gatta AN, Rizzo R, Pilu G, Simonazzi G. Coronavirus disease 2019 during pregnancy: a systematic review of reported cases. Am J Obstet Gynecol [Internet]. 2020 Jul;223(1):36–41.
  • 14. Ashraf MA, Keshavarz P, Hosseinpour P, Erfani A, Roshanshad A, Pourdast A, et al. Coronavirus disease 2019 (COVID-19): A systematic review of pregnancy and the possibility of vertical transmission. Journal of Reproduction and Infertility. 2020.
  • 15. Salem D, Katranji F, Bakdash T. COVID‐19 infection in pregnant women: Review of maternal and fetal outcomes. Int J Gynecol Obstet [Internet]. 2021 Mar 27;152(3):291–8.
  • 16. Mullins E, Hudak ML, Banerjee J, Getzlaff T, Townson J, Barnette K, et al. Pregnancy and neonatal outcomes of COVID-19 – co-reporting of common outcomes from the PAN-COVID and AAP SONPM registry. medRxiv. 2021;
There are 16 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Reviews
Authors

Ümran Kılınçdemir 0000-0003-2513-5297

Gökhan Bayhan 0000-0003-0874-0778

Publication Date May 1, 2021
Submission Date March 30, 2021
Acceptance Date April 6, 2021
Published in Issue Year 2021 Volume: 28 Issue: COVİD-19 ÖZEL SAYI

Cite

Vancouver Kılınçdemir Ü, Bayhan G. COVID-19 Enfeksiyonu ile Komplike Gebe Hastalarda Maternal ve Neonatal Sonuçların Değerlendirilmesi. Med J SDU. 2021;28(COVİD-19 ÖZEL SAYI):119-24.

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