RESUMEN
BACKGROUND: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is causing an outbreak of pneumonia in Wuhan, Hubei Province, China, and other international areas. OBJECTIVE: Here, we report the clinical characteristics of the newborns delivered by SARS-CoV-2 infected pregnant women. METHODS: We prospectively collected and analyzed the clinical features, laboratory data and outcomes of 7 newborns delivered by SARS-CoV-2 infected pregnant women in Zhongnan Hospital of Wuhan University during January 20 to January 29, 2020. RESULTS: 4 of the 7 newborns were late preterm with gestational age between 36 weeks and 37 weeks, and the other 3 were full-term infants. The average birth weight was 2096 ± 660 g. All newborns were born without asphyxia. 2 premature infants performed mild grunting after birth, but relieved rapidly with non-invasive continuous positive airway pressure (nCPAP) ventilation. 3 cases had chest X-ray, 1 was normal and 2 who were supported by nCPAP presented mild neonatal respiratory distress syndrome (NRDS). Samples of pharyngeal swab in 6 cases, amniotic fluid and umbilical cord blood in 4 cases were tested by qRT-PCR, and there was no positive result of SARS-CoV-2 nucleic acid in all cases. CONCLUSIONS: The current data show that the infection of SARS-CoV-2 in late pregnant women does not cause adverse outcomes in their newborns, however, it is necessary to separate newborns from mothers immediately to avoid the potential threats.
Asunto(s)
Infecciones por Coronavirus/diagnóstico , Transmisión Vertical de Enfermedad Infecciosa , Neumonía Viral/diagnóstico , Complicaciones Infecciosas del Embarazo/virología , Líquido Amniótico/virología , Betacoronavirus , Peso al Nacer , COVID-19 , China/epidemiología , Presión de las Vías Aéreas Positiva Contínua , Infecciones por Coronavirus/epidemiología , Femenino , Sangre Fetal/virología , Edad Gestacional , Humanos , Salud del Lactante , Recién Nacido , Recien Nacido Prematuro , Masculino , Pandemias , Neumonía Viral/epidemiología , Embarazo , Estudios Prospectivos , Medición de Riesgo , SARS-CoV-2 , Tórax/diagnóstico por imagen , Tórax/virología , Tomografía Computarizada por Rayos XRESUMEN
Objective The vertical transmission of HIV, from mother to child remains one of the most important challenges all over the world. This study evaluated the implementation and effectiveness of prevention of mother to child HIV transmission program (PMTCT) from 2012 to 2019 in Suzhou. Methods The data used in this study were obtained from the PMTCT program carried out in hospitals and maternal and child health care centers of Suzhou from 2012 to 2019. The basic information of the HIV positive mothers including marital status, gravidity and parity history, educational background, date of HIV diagnosis, transmission route of HIV, information about the sexual partner, last menstrual period, current pregnancy outcome, and neonatal information were collected. The characteristics of the HIV positive mothers from 2012 to 2019 were analyzed. The statistical difference between the groups was evaluated by the χ2-test or Fisher's exact test as appropriate. P<0.05 was considered statistically significant. Results A total of 116 HIV positive women were diagnosed through prenatal examination. Among the 116 pregnant women, 75 gave birth to 76 live neonates. Only one infant was diagnosed HIV infected because of the HIV positive mother didn't take the anti-virus drugs until delivery. Conclusion The HIV prevalence of Suzhou city showed a low-level tendency. It's important to perform early diagnosis and early prevention for HIV positive pregnant women. There are improvements to make in the program implementation in Suzhou city.
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Objective To explore the safer and more reasonable time of withdrawing nucleoside analogues antiviral therapy in women with chronic HBV infection during immune tolerance period. Methods The patients included in this study were 343 pregnant women with chronic HBV infection who received nucleoside antiviral therapy in Obstetrics and Gynecology Center of 302 Military Hospital of China. According to the time of withdrawing antiviral therapy after delivery, the patients were assigned to P0 group, i.e., withdrawal immediately after delivery, and the patients who stopped the drug 6 weeks after delivery were assigned to P6w group. The patients were compared between these two groups in terms of prevalence of ALT abnormality during pregnancy and postpartum, the peak value and occurrence time of postpartum ALT, and mother-to-child vertical transmission. Results The prevalence of postpartum ALT abnormality was 30.2％ in P0 group and 20.7％ in P6w group (χ2=4.129, P=0.046). Specifically, for the patients with abnormal liver function during pregnancy, the prevalence of postpartum ALT abnormality was 88.0％ and 39.4％ in the two groups respectively (χ2=14.043, P=0.001). While for the patients with normal liver function during pregnancy, the prevalence of postpartum ALT abnormality was 19.4％ and 16.6％ respectively (χ2=0.392, P=0.531). Mother-to-infant HBV transmission was blocked successfully in all the patients in spite of the time of withdrawing antiviral therapy. Conclusions For the pregnant women with chronic HBV infection who received oral nucleoside analogue antiviral agents to interrupt motherto-child transmission, the time of withdrawing antiviral agents did not show significant effect on the prevalence of postpartum liver function abnormality and rate of successful blocking mother-toinfant HBV transmission. However, for the patients with abnormal ALT during pregnancy, it is appropriate to continue the nucleoside analogue antiviral therapy after delivery.