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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2023.tde-16112023-123459
Document
Author
Full name
Bruna de Paula Duarte
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2023
Supervisor
Committee
Krebs, Vera Lúcia Jornada (President)
Diniz, Edna Maria de Albuquerque
Pimenta, Marina de Souza
Zacharias, Romy Schmidt Brock
Title in Portuguese
Evolução clínica de recém-nascidos de mães com COVID-19 no momento do parto em hospital terciário no Brasil
Keywords in Portuguese
Brasil
COVID-19
Neonatologia
Recém-nascido
Abstract in Portuguese
INTRODUÇÃO: Dados limitados estão disponíveis em gestantes com COVID-19 e seus neonatos. OBJETIVO: Este estudo teve como objetivo descrever as características clínicas e a evolução do nascimento até a alta de recém-nascidos de mulheres com COVID-19 diagnosticado no final da gravidez. MÉTODOS: Trata-se de uma coorte retrospectiva de 71 recém-nascidos. Foram incluídos todos os recém-nascidos admitidos em uma unidade neonatal de um hospital terciário no Brasil, entre março de 2020 e março de 2021, cujas mães não vacinadas tiveram sintomas de COVID-19 e RT-PCR (Real-Time Polymerase Chain Reaction) para SARS-CoV-2 positivo até quatorze dias antes do parto. Recém-nascidos de mães com sintomas de COVID-19 e teste negativo para SARS-CoV-2 foram excluídos da amostra. RESULTADOS: A principal via de parto das gestantes foi a cesárea (84,5%), cujas principais indicações foram: gravidade da doença materna (COVID-19 crítica, em 24,6% das gestantes) e sofrimento fetal agudo (20,3%). O peso médio ao nascer foi de 2452 gramas (mínimo=580 g, máximo=3870 g) e a idade gestacional média foi de 34 semanas e 5 dias (mínimo=25 semanas, máximo=40 semanas). Houve 45 (63,3%) recémnascidos pré-termo, dos quais 21 (29,5%) tinham idade gestacional inferior a 32 semanas. O RT-PCR para SARS-CoV-2 através de swab de orofaringe foi positivo em dois (2,8%) recém-nascidos e negativo em 69 (97,2%). A maioria dos recém-nascidos (51,4%) recebeu suporte respiratório. Outras intervenções terapêuticas durante a hospitalização foram inotrópicos (9,9%), antibióticos (22,8%), nutrição parenteral (26,8%) e fototerapia (46,5%). CONCLUSÕES: A morbidade de 71 RN de mães não vacinadas com diagnóstico de COVID-19 próximo ao momento do parto foi elevada, bem como as taxas de prematuridade e de baixo peso ao nascer. Houve necessidade frequente de cuidados intensivos, com taxa de mortalidade de 2,8%. A positividade do teste RT-PCR para SARS-CoV-2 em swab de orofaringe no RN foi baixa
Title in English
Clinical characteristics and evolution of 71 neonates born to mothers with COVID-19 at a tertiary center in Brazil
Keywords in English
Brazil
COVID-19
Infant
Neonatology
Abstract in English
INTRODUCTION: Limited data is available on pregnant women with COVID-19 and their neonates. This study aims to describe the clinical characteristics and evolution of neonates born to women diagnosed with COVID-19 near the time of delivery. METHODS: This is a retrospective cohort study of 71 newborns. The authors included all newborns admitted to a neonatal unit of a tertiary hospital in Brazil between March 2020 and March 2021, whose unvaccinated mothers had COVID-19 symptoms and RT-PCR (Real-Time Polymerase Chain Reaction) within fourteen days prior to delivery. Newborns born to mothers with COVID-19 symptoms and negative tests for SARS-CoV-2 were excluded. RESULTS: The main route of delivery was cesarean, corresponding to 60 pregnant women (84.5%). The foremost indications for cesarean were critical maternal disease (24.6%) and acute fetal distress (20.3%). The mean birth weight was 2452 g (minimum=580, maximum=3870 g), and the mean gestational age was 34 weeks and 4 days (minimum= 25 weeks, maximum=40 weeks). There were 45 premature newborns (63.3%), of which 21 (29.5%) had a gestational age of less than 32 weeks. RT-PCR for SARS-CoV-2 on oropharyngeal swabs was positive in 2 newborns (2.8%) and negative in the other 69 newborns (97.2%). Most newborns (51.4%) required respiratory support. Therapeutic interventions during hospitalization included inotropic drugs (9.9%), antibiotics (22.8%), parenteral nutrition (26.8%), and phototherapy (46.5%). CONCLUSIONS: The morbidity of 71 newborn to non-vaccinates mothers diagnosed with COVID-19 near the time of delivery was high, as well as the rates of prematurity and low birth weight. There was a frequent need for intensive care, with a mortality rate of 2.8%. The positivity of the RT-PCR test for SARS-CoV-2 in oropharyngeal swab samples from newborns was low
 
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Publishing Date
2023-11-23
 
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