Maternal SARS-COV-2 enfeksiyonunun neonatal antropometrik ölçümler ve morbiditeler üzerine etkilerinin araştırılması
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
T.C. Maltepe Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: COVID-19 (2019 Yeni Koronavirüs Hastalığı); 2019 yılı sonunda Çin’in Wuhan kentinden dünyaya yayılan, birçok insana bulaşan ve ölümcül bir pandemi olarak tanımlanmıştır. COVID-19 salgını dünya genelinde yayılmaya devam ederken, hastalığın etkileri ve riskleri üzerine araştırmalar halen devam etmektedir. Enfeksiyonun gebelik sürecine etkisi hakkında araştırmaların sınırlı olması ve yenidoğanlar üzerindeki etkileri konusunda yeterli verinin olmaması endişe yaratmaktadır. Bu çalışmanın amacı, gebelik sırasında COVID-19 enfeksiyonu geçirmiş olmanın neonatal antropometrik ölçümler, neonatal morbiditeler ve yenidoğan yoğun bakıma yatış oranları üzerine etkisinin araştırılmasıdır. Yöntem: Çalışmamıza Ocak 2020-Aralık 2022 tarihleri arasında Maltepe Üniversitesi Tıp Fakültesi Hastanesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı’nda doğan toplam 655 yenidoğan dahil edildi. Çalışma grubunu, annelerinde gebelik dönemi içerisinde PCR ile COVID-19 pozitifliği teyit edilmiş 48 yenidoğan ve kontrol grubunu ise anneleri gebeliği süresince SARS-COV-2 enfeksiyonu geçirmemiş 607 yenidoğan oluşturdu. Anne ve yenidoğan dosyaları; anne gravidası, annede COVID-19 pozitifliği saptanan trimester, doğum şekli, yenidoğanın doğum ağırlığı, boyu, baş çevresi, cinsiyeti, doğum haftası, yenidoğan yoğun bakım ihtiyacı varlığı, yatış tanıları, yatış süresi, term/preterm olma durumu, solunum desteği ihtiyacı, solunum desteği yöntemi açısından retrospektif olarak incelendi. Bulgular: Çalışmaya dahil edilen toplam 655 yenidoğanın 607’sinin (%92.7) annesi gebelik döneminde COVID-19 enfeksiyonu geçirmemiş olup 48 (%7,3) yenidoğanın annesinde gebelik döneminde qRT-PCR (kantitatif revers transkripsyon polimeraz zincir reaksiyonu) testi pozitifliği saptandığı izlendi. Gebelik döneminde COVID-19 enfeksiyonu geçirmiş annelerdendoğanbebeklerin%12,5’u (n:6) NSD ile, %87,5’u (n:42) C/S ile; gebelik döneminde bu enfeksiyonu geçirmemiş annelerden doğan bebeklerin %11,7 ’si (n:71) NSD ile, %88,3’ü (n:536) C/S ile doğmuşlardı. gruplararasında doğum şekli açısından istatistiksel bir fark saptanmadı(p=0.868). Gebelik döneminde COVID-19 enfeksiyonu geçirmiş annelerin bebeklerinin preterm doğum oranı %20,8 (n:10) iken, term doğan bebeklerin oranı %79,2 (n:38) idi. Gebelik döneminde COVID-19 enfeksiyonu geçirmemiş annelerin bebeklerinin ise preterm doğum oranı %23,4 (n:142), term bebek doğum oranı %76,6 (n:465) saptandı. Gruplararasında preterm doğma oranı açısından istatistiksel bir fark saptanmadı(p=0.686). Gruplar arasında doğum haftaları karşılaştırıldığında da aralarında istatistiksel olarak anlamlı bir fark saptanmadı (p=0.577). Tüm doğan bebeklerin doğum kilosu ortalamaları karşılaştırıldığında gebelik döneminde COVID-19 enfeksiyonu geçirmiş annelerden doğan bebeklerin ortalama doğum ağırlığı 3014gr +-713 iken, gebelik döneminde COVID-19 enfeksiyonu geçirmemiş annelerden doğan bebeklerin ortalama doğum ağırlığı 3040gr +- 613 idi. Gruplar arasında doğum ağırlığı açısından istatistiksel bir fark saptanmadı (p=0.330) . Tüm doğan bebeklerin doğum boy ortalamaları karşılaştırıldığında gebelik döneminde COVID-19 enfeksiyonu geçirmiş annelerden doğan bebeklerin ortalama doğum boyları 48.3 +- 4.2 cm iken, gebelik döneminde COVID-19 enfeksiyonu geçirmemiş annelerden doğan bebeklerin doğum boy ortalamaları 48.9 +- 3.4cm idi. Gruplar arasında doğum boyları açısından istatistiksel bir fark saptanmadı (p=0.211). Gebelik döneminde COVID-19 enfeksiyonu geçirmiş annelerden doğan bebeklerin doğum baş çevreleri ortalamaları 33.9 +-2.8 cm iken, gebelik döneminde COVID-19 enfeksiyonu geçirmemiş annelerden doğan bebeklerin doğum baş çevreleri ortalamaları 34.1 +-2.87 cm idi. Gruplar arasında doğum baş çevresi ortalamaları karşılaştırıldığında aralarında istatistiksel olarak anlamlı bir farklılık saptanmadı (p=0.841). Gebelik döneminde COVID-19 enfeksiyonu geçirmiş annelerden doğan bebeklerin %18,8’i (n:9) 2500 gr altında iken gebelik döneminde COVID-19 enfeksiyonu geçirmemiş annelerin bebeklerinin düşük doğum ağırlıklı doğma oranı %16,1 (98) idi. Gruplar arasında düşük doğum ağırlığı ile doğma oranı açısından istatistiksel bir fark saptanmadı (p=0.638). Gebelik döneminde COVID-19 enfeksiyonu geçirmiş annelerden doğan bebeklerin (n=48) yenidoğan yoğun bakıma yatış oranı %41,7(n:20)iken,gebelikdöneminde COVID-19 enfeksiyonu geçirmemiş annelerden doğan bebeklerin (n=607) yoğun bakıma yatış oranı %29,8 (n:184) saptandı. Her ne kadar gebelik döneminde COVID-19 enfeksiyonu geçirmiş anne bebeklerinin yoğun bakıma yatış oranı COVID-19enfeksiyonu geçirmemiş anne bebeklerinden fazla olsa da her iki grup arasında istatistiksel açıdan anlamlı bir farklılık saptanmadı (p=0.087). Yenidoğan yoğun bakıma yatış tanıları incelendiğinde, gebelik döneminde COVID-19 enfeksiyonu geçirmiş anne bebeklerinin %30’unun (n:6) TTN, % 35’inin (n=7) prematürite, % 25’inin sepsis (n=5) ve % 25’inin (n=5) RDS tanıları ile yatırıldığı gözlendi. Bu oranlar gebelik döneminde COVID-19 enfeksiyonu geçirmemiş anne bebeklerinde sırasıyla %48.4 (n:89), %38 (n:70), %39,7(n:73) ve %16,8 (n:31) olarak izlendi. Her iki grup yoğun bakıma yatış tanıları açısından karşılaştırıldığında istatistik açıdan herhangi bir fark saptanmadı (sırasıyla p=0.2, p=0.2, p=0.2, p=0.364) Sonuç: Gebeliğinde COVID-19 enfeksiyonu geçirmiş olan anne bebekleri, gebeliğinde bu enfeksiyonu geçirmemiş anne bebeklerine göre doğum sırasındaki antropometrik ölçümler, doğum haftaları, düşük doğum ağırlıklı olarak doğmaları, yenidoğan yoğun bakım ihtiyacı olması karşılaştırıldığında her iki grup arasında istatistik açıdan herhangi bir fark saptanmadı. Çalışmamızdan elde ettiğimiz veriler ışığında gebelik döneminde COVID-19 enfeksiyonu geçirmiş olmanın, yenidoğanın doğum sırasındaki antropometrik ölçümleri, prematüre doğum riski ve yoğun bakıma yatış oranları açısından bir fark yaratmaması bu enfeksiyonu geçiren anneler için güven verici olabilir. Ancak bu konuda daha net bir sonuca varmak için daha fazla sayıda bebeği içeren çalışmaların verilerine de ihtiyaç vardır. Gebeliğinde COVID-19 enfeksiyonu geçirmiş anne bebeklerinin daha yakın izlenmesi ve takip edilmesi ilerleyen yaşlarda gelişebilecek olası morbiditeler açısından akılda tutulmalıdır.
Introduction and Objective: COVID-19 (2019 Novel Coronavirus Disease) was defined as a deadly pandemic that spread from the city of Wuhan, China, to many people and spread to the world at the end of 2019. As the COVID-19 epidemic continues to spread around the world, research on the effects and risks of the disease is still ongoing. The limited research on the effect of infection on the pregnancy process and the lack of sufficient data on the effects on newborns raise concerns. The aim of this study is to investigate the effects of having a COVID- 19 infection during pregnancy on neonatal anthropometric measurements, neonatal morbidities and neonatal intensive care admission rates. Method: A total of 655 newborns born in Maltepe University Medical Faculty Hospital, Department of Pediatrics between January 2020 and December 2022 were included in our study. The study group consisted of 48 newborns whose mothers were confirmed to be positive for COVID-19 by PCR during pregnancy, and the control group consisted of 607 newborns whose mothers did not have SARS-COV-2 infection during pregnancy. Mother and newborn files; maternal gravida, trimester, type of delivery, birth weight, height, head circumference of the newborn, gender, week of birth, presence of need for neonatal intensive care, hospitalization diagnoses, length of hospitalization, being term/preterm, the need for respiratory support and method of respiratory support were analyzed retrospectively. Results: Of the 655 newborns included in the study, 607 (92.7%) mothers did not have COVID-19 infection during pregnancy, and qRT-PCR (quantitative reverse transcription polymerase chain reaction) test positivity was detected in the mothers of 48 (7.3%) newborns during pregnancy. Of these babies born to mothers who had COVID-19 infection during pregnancy, 12.5% (n: 6) were born by NSD, 87.5% (n: 42) by C/S; 11.7% (n:71) of the babies born to mothers who did not have this infection during pregnancy were born by NSD, and 88.3% (n:536) by C/S. There was no statistical difference between the groups in terms of delivery type (p=0.868). While the rate of preterm birth of the babies of mothers who had COVID-19 infection during pregnancy was 20.8% (n:10), the rate of babies born at term was 79.2% (n:38). The rate of preterm birth was 23.4% (n:142) and the rate of term baby delivery was 76.6% (n:465) in babies of mothers who did not have COVID-19 infection during pregnancy. There was no statistical difference between the groups in terms of being born preterm (p=0.686). When the weeks of birth were compared between the groups, there was also no statistically significant difference between groups (p=0.577). When the average birth weight of all newborns was compared, the average birth weight of babies born to mothers who had COVID-19 infection during pregnancy was 3014gr +-713, while the average birth weight of babies born to mothers who did not have COVID-19 infection during pregnancy was 3040gr +-613. There was no statistical difference between the groups in terms of birth weight (p=0.330). When the average birth lengths of all newborns were compared, the average birth length of babies born to mothers who have had COVID-19 infection during pregnancy was 48.3 +- 4.2 cm, while in those born to mothers who have not had COVID-19 infection during pregnancy it was 48.9 +- 3.4cm. There was no statistical difference between the groups in terms of birth length (p=0.211). While the mean birth head circumference of babies born to mothers who had COVID-19 infection during pregnancy was 33.9 +-2.8 cm, the mean birth head circumferences of babies born to mothers who did not have COVID-19 infection during pregnancy was 34.1 +-2.87 cm. When the mean birth head circumferences between the groups were compared, no statistically significant difference was found between them (p=0.841). While 18.8% (n:9) of babies born to mothers who had COVID-19 infection during pregnancy were under 2500 g, the rate of being born < 2500 gr in babies of mothers who did not have COVID-19 infection during pregnancy was 16.1% (98). There was no statistical difference between the groups in terms of low birth weight (p=0.638). While the rate of hospitalization in neonatal intensive care unit (n=48) of babies born to mothers who had COVID-19 infection during pregnancy was 41.7% (n:20), this rate was 29.8% (n:184) in babies born to mothers who did not have COVID-19 infection during pregnancy (n=607). Although the rate of hospitalization in the intensive care unit in babies of mothers who had COVID-19 infection during pregnancy was higher than the babies of mothers who did not have COVID-19 infection, no statistically significant difference was found between the two groups (p=0.087). When the diagnoses of neonatal intensive care hospitalization were examined, 30% (n:6) were TTN, 35% (n=7) were prematurity, 25% (n=5) were sepsis and 25% (n=5) were RDS. These rates were 48.4% (n:89), 38% (n:70), 39.7% (n:73) and 16.8% (n:31), respectively in babies of mothers who did not have COVID-19 infection during pregnancy. When the two groups were compared in terms of admission diagnosis to the intensive care unit, no statistical difference was found (p=0.2, p=0.2, p=0.2, p=0.364, respectively). Conclusion: There was no statistical difference when the anthropometric measurements, weeks of birth, being born with low birth weight, and need for neonatal intensive care were compared between babies of mothers who had COVID-19 infection during pregnancy and those whose mothers did not have this infection during pregnancy. In the light of the data we obtained from our study, the fact that having a COVID-19 infection during pregnancy does not make a difference in terms of the anthropometric measurements of the newborn at the time of delivery, the risk of premature birth and the rates of admission to the intensive care unit may be reassuring for the mothers who had this infection during pregnancy. However, data from studies involving larger numbers of infants are also needed to reach a more definite conclusion on this issue. Closer monitoring and follow-up of the babies of mothers who had COVID-19 infection during pregnancy should be kept in mind in terms of possible morbidities that may develop in later ages.
Introduction and Objective: COVID-19 (2019 Novel Coronavirus Disease) was defined as a deadly pandemic that spread from the city of Wuhan, China, to many people and spread to the world at the end of 2019. As the COVID-19 epidemic continues to spread around the world, research on the effects and risks of the disease is still ongoing. The limited research on the effect of infection on the pregnancy process and the lack of sufficient data on the effects on newborns raise concerns. The aim of this study is to investigate the effects of having a COVID- 19 infection during pregnancy on neonatal anthropometric measurements, neonatal morbidities and neonatal intensive care admission rates. Method: A total of 655 newborns born in Maltepe University Medical Faculty Hospital, Department of Pediatrics between January 2020 and December 2022 were included in our study. The study group consisted of 48 newborns whose mothers were confirmed to be positive for COVID-19 by PCR during pregnancy, and the control group consisted of 607 newborns whose mothers did not have SARS-COV-2 infection during pregnancy. Mother and newborn files; maternal gravida, trimester, type of delivery, birth weight, height, head circumference of the newborn, gender, week of birth, presence of need for neonatal intensive care, hospitalization diagnoses, length of hospitalization, being term/preterm, the need for respiratory support and method of respiratory support were analyzed retrospectively. Results: Of the 655 newborns included in the study, 607 (92.7%) mothers did not have COVID-19 infection during pregnancy, and qRT-PCR (quantitative reverse transcription polymerase chain reaction) test positivity was detected in the mothers of 48 (7.3%) newborns during pregnancy. Of these babies born to mothers who had COVID-19 infection during pregnancy, 12.5% (n: 6) were born by NSD, 87.5% (n: 42) by C/S; 11.7% (n:71) of the babies born to mothers who did not have this infection during pregnancy were born by NSD, and 88.3% (n:536) by C/S. There was no statistical difference between the groups in terms of delivery type (p=0.868). While the rate of preterm birth of the babies of mothers who had COVID-19 infection during pregnancy was 20.8% (n:10), the rate of babies born at term was 79.2% (n:38). The rate of preterm birth was 23.4% (n:142) and the rate of term baby delivery was 76.6% (n:465) in babies of mothers who did not have COVID-19 infection during pregnancy. There was no statistical difference between the groups in terms of being born preterm (p=0.686). When the weeks of birth were compared between the groups, there was also no statistically significant difference between groups (p=0.577). When the average birth weight of all newborns was compared, the average birth weight of babies born to mothers who had COVID-19 infection during pregnancy was 3014gr +-713, while the average birth weight of babies born to mothers who did not have COVID-19 infection during pregnancy was 3040gr +-613. There was no statistical difference between the groups in terms of birth weight (p=0.330). When the average birth lengths of all newborns were compared, the average birth length of babies born to mothers who have had COVID-19 infection during pregnancy was 48.3 +- 4.2 cm, while in those born to mothers who have not had COVID-19 infection during pregnancy it was 48.9 +- 3.4cm. There was no statistical difference between the groups in terms of birth length (p=0.211). While the mean birth head circumference of babies born to mothers who had COVID-19 infection during pregnancy was 33.9 +-2.8 cm, the mean birth head circumferences of babies born to mothers who did not have COVID-19 infection during pregnancy was 34.1 +-2.87 cm. When the mean birth head circumferences between the groups were compared, no statistically significant difference was found between them (p=0.841). While 18.8% (n:9) of babies born to mothers who had COVID-19 infection during pregnancy were under 2500 g, the rate of being born < 2500 gr in babies of mothers who did not have COVID-19 infection during pregnancy was 16.1% (98). There was no statistical difference between the groups in terms of low birth weight (p=0.638). While the rate of hospitalization in neonatal intensive care unit (n=48) of babies born to mothers who had COVID-19 infection during pregnancy was 41.7% (n:20), this rate was 29.8% (n:184) in babies born to mothers who did not have COVID-19 infection during pregnancy (n=607). Although the rate of hospitalization in the intensive care unit in babies of mothers who had COVID-19 infection during pregnancy was higher than the babies of mothers who did not have COVID-19 infection, no statistically significant difference was found between the two groups (p=0.087). When the diagnoses of neonatal intensive care hospitalization were examined, 30% (n:6) were TTN, 35% (n=7) were prematurity, 25% (n=5) were sepsis and 25% (n=5) were RDS. These rates were 48.4% (n:89), 38% (n:70), 39.7% (n:73) and 16.8% (n:31), respectively in babies of mothers who did not have COVID-19 infection during pregnancy. When the two groups were compared in terms of admission diagnosis to the intensive care unit, no statistical difference was found (p=0.2, p=0.2, p=0.2, p=0.364, respectively). Conclusion: There was no statistical difference when the anthropometric measurements, weeks of birth, being born with low birth weight, and need for neonatal intensive care were compared between babies of mothers who had COVID-19 infection during pregnancy and those whose mothers did not have this infection during pregnancy. In the light of the data we obtained from our study, the fact that having a COVID-19 infection during pregnancy does not make a difference in terms of the anthropometric measurements of the newborn at the time of delivery, the risk of premature birth and the rates of admission to the intensive care unit may be reassuring for the mothers who had this infection during pregnancy. However, data from studies involving larger numbers of infants are also needed to reach a more definite conclusion on this issue. Closer monitoring and follow-up of the babies of mothers who had COVID-19 infection during pregnancy should be kept in mind in terms of possible morbidities that may develop in later ages.
Açıklama
Anahtar Kelimeler
SARS-COV-2, COVID-19, Gebelik, Yenidoğan, Antropometrik ölçümler, Morbidite, SARS-COV-2, COVID-19, Pregnancy, Newborn, Anthropometric measurements, Morbidity
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Sak Güler, S. (2023). Maternal SARS-COV-2 enfeksiyonunun neonatal antropometrik ölçümler ve morbiditeler üzerine etkilerinin araştırılması / Effect of maternal SARS-COV-2 infection on neonatalan thropometric measurements and morbidities (Yayımlanmamış Tıpta Uzmanlık Tezi). Maltepe Üniversitesi, Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.
