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Covid-19 in pregnant women and babies: What pediatricians need to know
Henry J Rozycki1, Sailesh Kotecha2
1Children's Hospital of Richmond at VCU, Richmond, VA, USA.
Insights
This review covers COVID-19 effects on neonates. While pregnant women may face risks, preliminary data shows low severe illness in newborns, with unknown vertical transmission risks.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Public Health
Background:
- The novel coronavirus SARS-CoV-2 caused a global pandemic starting in late 2019.
- COVID-19 has had an unprecedented impact on patients and healthcare delivery.
- Understanding the effects on neonates is crucial for healthcare providers.
Purpose of the Study:
- To review current knowledge on SARS-CoV-2 and COVID-19 in neonates.
- To discuss implications for neonatal care, pregnancy, breastfeeding, and milk banks.
Main Methods:
- Literature review of available data on SARS-CoV-2 in pregnant women and neonates.
- Analysis of preliminary epidemiological information and clinical descriptions.
Main Results:
- Viral carriage prevalence in pregnant women varies (3-13%) based on geographic location.
- 3.1% of neonates born to mothers with COVID-19 tested positive within a week.
- Of 26 neonates studied, none died, and only one required intensive care.
Conclusions:
- Preliminary data does not strongly support increased risk for pregnant women despite ACE2 expression.
- Vertical transmission risk is currently unknown but appears low based on limited data.
- Neonates generally experience mild illness, but risks for breastfeeding and milk banks require consideration.
Abstract:
Beginning in late 2019, a novel coronavirus labeled SARS-CoV-2 spread around the world, affecting millions. The impact of the disease on patients and on health care delivery has been unprecedented. Here, we review what is currently known about the effects of the virus and its clinical condition, Covid-19 in areas of relevance to those providing care to neonates. While aspects of pregnancy, including higher expression of the cell receptor for the virus, ACE2, could put these women at higher risk, preliminary epidemiological information does not support this. Viral carriage prevalence based on universal screening show that rates vary from 13% in "hot spots" such as New York City, to 3% in areas with lower cases. Vertical transmission risks are unknown but 3.1% of 311 babies born to mothers with Covid-19 were positive within a week of birth. The clinical description of 26 neonates <30 days of age showed no deaths and only one requiring intensive care. Risks for breast-feeding and for milk banks are discussed.
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