Background

Despite the increasingly recognized impact of novel coronavirus disease (COVID-19), caused by severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), on many aspects of health in adults and children, its effects on neonates born to infected mothers remain unclear. We conducted this study to investigate the outcomes of neonates born to mothers with COVID-19.

Methods

We searched the medical databases from inception to March 31, 2020 to perform a systematic review of outcomes in neonates born to mothers with COVID-19. Data were pooled using a random effects regression model. Primary and secondary outcomes were neonatal clinical outcomes and infectious status, respectively.

Results

Fourteen studies involving 105 neonates fulfilling the study criteria were identified. The rates of preterm neonates and those small for gestational age (SGA) were 25 (23.8%) and 10 (11.2%), respectively. Among 91 neonates who were tested, 8 (8.8%) were positive for nucleic acids or antibodies for SARS-CoV-2. Additionally, 28 (26.7%) of the neonates were symptomatic and two test-negative neonates died, including one stillbirth. Between test-positive and test-negative groups, the rates of SGA, preterm delivery, duration between maternal symptom onset and delivery, and perinatal complication were not significantly different; but the rate of symptomatic after birth reached significant difference (62.5% vs 20.5%, p = 0.008).

Conclusions

Most neonates born to infected mothers had favorable outcomes. Although direct evidences of intrauterine infection were scarce, the risk of intrauterine infection should be considered based on a positive test in 8.8% of the neonates. Symptomatic neonates born to infected mothers should receive tests for SARS-CoV-2 to initiate appropriate treatment and quarantine. Further studies are warranted to assess the outcomes of COVID-19 in neonates.

中文翻译：

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母亲患有冠状病毒病-2019年的新生儿的临床特征：对105例新生儿的系统评价

背景

尽管严重急性呼吸系统综合症（SARS）冠状病毒2（SARS-CoV-2）引起的新型冠状病毒病（COVID-19）对成人和儿童健康的许多方面的影响日益受到认可，但其对新生儿的影响受感染的母亲仍不清楚。我们进行了这项研究，以调查COVID-19母亲所生的新生儿的结局。

方法

我们搜索了从开始到2020年3月31日的医学数据库，以系统回顾性分析COVID-19的母亲所生的新生儿的结局。使用随机效应回归模型汇总数据。主要和次要结局分别是新生儿临床结局和感染状况。

结果

确定了14项研究，涉及105例符合研究标准的新生儿。早产儿和小胎龄儿（SGA）的发生率分别为25（23.8％）和10（11.2％）。在接受测试的91名新生儿中，有8名（8.8％）的SARS-CoV-2核酸或抗体阳性。此外，有28名（26.7％）的新生儿有症状，两名测试阴性的新生儿死亡，包括一名死胎。在测试阳性和测试阴性组之间，SGA的发生率，早产，产妇症状发作和分娩之间的持续时间以及围产期并发症没有显着差异。但出生后症状发生率差异显着（62.5％vs 20.5％，p  = 0.008）。

结论

受感染的母亲所生的大多数新生儿的预后良好。尽管缺乏宫内感染的直接证据，但应基于8.8％的新生儿的阳性试验考虑宫内感染的风险。有感染症状的母亲所生的有症状新生儿应接受SARS-CoV-2检验，以开始适当的治疗和隔离。有必要做进一步的研究来评估新生儿COVID-19的结果。