新冠可能母嬰傳染，嚴(yán)重影響嬰兒健康
ERIN PRATER
2023-04-11
4月6日發(fā)表在《兒科學(xué)》上的一項研究表明，孕婦有可能將新冠病毒傳染給胎兒，破壞胎盤并導(dǎo)致大腦損傷。圖片來源：PHOTO ILLUSTRATION BY GETTY IMAGES
4月6日發(fā)表在《兒科學(xué)》（Pediatrics）上的一項研究表明，孕婦有可能將新冠病毒傳染給胎兒，破壞胎盤并導(dǎo)致大腦損傷。
邁阿密大學(xué)（University of Miami）研究人員記錄了兩例孕婦懷孕期間感染新冠后生產(chǎn)的病例。兩名嬰兒出生時病毒檢測結(jié)果均為陰性，但都出現(xiàn)了癲癇、發(fā)育延遲以及長大過程中頭部尺寸異常小的問題。
最終兩名嬰兒都夭折了。
邁阿密大學(xué)米勒醫(yī)學(xué)院的新生兒學(xué)家，也是該論文高級作者沙赫納茲·杜阿拉醫(yī)生告訴《財富》雜志，雖然這種結(jié)果很少見，不過懷孕或計劃備孕的人們都要認(rèn)識到新冠病毒給胎兒造成的風(fēng)險。
“多數(shù)處于育齡的年輕人對待新冠就像對待小病毒感染一樣，不想折騰接種疫苗或采取預(yù)防措施，”她說。
“他們認(rèn)為不會因此生病。事實并非如此。病毒會對嬰兒造成嚴(yán)重影響。”
醫(yī)療人員已經(jīng)發(fā)現(xiàn)，大約每千名嬰兒中就有兩三名出生時新冠病毒檢測呈陽性，其中一些記錄為死胎。可能還有很多嬰兒因母親懷孕期間感染新冠而神經(jīng)系統(tǒng)受影響。杜阿拉說，由于嬰兒出生時病毒檢測結(jié)果并非陽性，或者因為神經(jīng)系統(tǒng)問題尚未出現(xiàn)，醫(yī)生可能會忽略相關(guān)線索。
杜阿拉指出，在她和團(tuán)隊研究的病例里，病毒是在嬰兒組織中發(fā)現(xiàn)的，一般只有尸檢時才會檢測出，而且需要醫(yī)療人員刻意去查才會發(fā)現(xiàn)。
“可能還有其他類似病例沒得到承認(rèn)。”她說?！捌渌藭f，‘這不可能是新冠，因為嬰兒拭子檢測結(jié)果不是陽性?！苍S是研究不夠深入?！?/p>
杜阿拉希望該項新研究能提高家長和醫(yī)療人員的認(rèn)識。
有一點令人稍稍放心，即感染新冠的孕婦情況似乎有些特殊。其中一人2020年年中感染新冠后轉(zhuǎn)為重癥數(shù)周，另一人似乎在2021年年初懷孕期間感染了兩次，但從未出現(xiàn)癥狀。兩位母親接觸病毒時都在懷孕25周左右，都沒有接種疫苗。不過其他情況下可能也會導(dǎo)致類似的結(jié)果。杜阿拉說，這正是現(xiàn)在研究人員希望弄清的事。
關(guān)于新冠相關(guān)妊娠并發(fā)癥的建議
想告訴準(zhǔn)媽媽的是：“對祖父母、服用類固醇的人或免疫力低下的人采取同樣的預(yù)防措施，”她說。
考慮在孕前或孕早期接種新冠疫苗。
如果可以，盡量母乳喂養(yǎng)至少6個月，屆時嬰兒能接種第一劑新冠疫苗。如果母親對新冠有免疫力，可以通過母乳將抗體傳給嬰兒。
戴口罩等預(yù)防措施有助于降低懷孕期間感染新冠的風(fēng)險。
如果孕婦懷孕期間感染過新冠，她建議嬰兒父母及時告知兒科醫(yī)生，倘若嬰兒發(fā)育過程出現(xiàn)任何延遲，以及出現(xiàn)行為差異和聽力問題時也要告知。
“最關(guān)鍵的信息是，學(xué)界對這種病毒還不太了解——畢竟只研究了四年?！彼f。“但我們知道，（病毒）在特殊人群中癥狀也會特殊。”
“我們知道老年人的癥狀，會受到什么影響。嬰兒同樣面臨風(fēng)險，盡管我們還不知道風(fēng)險是否廣泛存在，或者妊娠期有沒有特定的風(fēng)險點，又或者（嬰兒）有沒有哪些情況導(dǎo)致更容易受影響，”她補充道。她還指出，目前尚未對嬰兒做基因檢測。
杜阿拉說，在這一點上，研究人員面臨的問題比答案多。但他們都確信一點：懷孕期間感染新冠是個問題。
杜阿拉指出：“也許只有少數(shù)人遇到，但肯定是個問題?！保ㄘ敻恢形木W(wǎng)）
譯者：梁宇
審校：夏林
4月6日發(fā)表在《兒科學(xué)》（Pediatrics）上的一項研究表明，孕婦有可能將新冠病毒傳染給胎兒，破壞胎盤并導(dǎo)致大腦損傷。
邁阿密大學(xué)（University of Miami）研究人員記錄了兩例孕婦懷孕期間感染新冠后生產(chǎn)的病例。兩名嬰兒出生時病毒檢測結(jié)果均為陰性，但都出現(xiàn)了癲癇、發(fā)育延遲以及長大過程中頭部尺寸異常小的問題。
最終兩名嬰兒都夭折了。
邁阿密大學(xué)米勒醫(yī)學(xué)院的新生兒學(xué)家，也是該論文高級作者沙赫納茲·杜阿拉醫(yī)生告訴《財富》雜志，雖然這種結(jié)果很少見，不過懷孕或計劃備孕的人們都要認(rèn)識到新冠病毒給胎兒造成的風(fēng)險。
“多數(shù)處于育齡的年輕人對待新冠就像對待小病毒感染一樣，不想折騰接種疫苗或采取預(yù)防措施，”她說。
“他們認(rèn)為不會因此生病。事實并非如此。病毒會對嬰兒造成嚴(yán)重影響?！?/p>
醫(yī)療人員已經(jīng)發(fā)現(xiàn)，大約每千名嬰兒中就有兩三名出生時新冠病毒檢測呈陽性，其中一些記錄為死胎?？赡苓€有很多嬰兒因母親懷孕期間感染新冠而神經(jīng)系統(tǒng)受影響。杜阿拉說，由于嬰兒出生時病毒檢測結(jié)果并非陽性，或者因為神經(jīng)系統(tǒng)問題尚未出現(xiàn)，醫(yī)生可能會忽略相關(guān)線索。
杜阿拉指出，在她和團(tuán)隊研究的病例里，病毒是在嬰兒組織中發(fā)現(xiàn)的，一般只有尸檢時才會檢測出，而且需要醫(yī)療人員刻意去查才會發(fā)現(xiàn)。
“可能還有其他類似病例沒得到承認(rèn)。”她說?！捌渌藭f，‘這不可能是新冠，因為嬰兒拭子檢測結(jié)果不是陽性。’但也許是研究不夠深入?！?/p>
杜阿拉希望該項新研究能提高家長和醫(yī)療人員的認(rèn)識。
有一點令人稍稍放心，即感染新冠的孕婦情況似乎有些特殊。其中一人2020年年中感染新冠后轉(zhuǎn)為重癥數(shù)周，另一人似乎在2021年年初懷孕期間感染了兩次，但從未出現(xiàn)癥狀。兩位母親接觸病毒時都在懷孕25周左右，都沒有接種疫苗。不過其他情況下可能也會導(dǎo)致類似的結(jié)果。杜阿拉說，這正是現(xiàn)在研究人員希望弄清的事。
關(guān)于新冠相關(guān)妊娠并發(fā)癥的建議
想告訴準(zhǔn)媽媽的是：“對祖父母、服用類固醇的人或免疫力低下的人采取同樣的預(yù)防措施，”她說。
考慮在孕前或孕早期接種新冠疫苗。
如果可以，盡量母乳喂養(yǎng)至少6個月，屆時嬰兒能接種第一劑新冠疫苗。如果母親對新冠有免疫力，可以通過母乳將抗體傳給嬰兒。
戴口罩等預(yù)防措施有助于降低懷孕期間感染新冠的風(fēng)險。
如果孕婦懷孕期間感染過新冠，她建議嬰兒父母及時告知兒科醫(yī)生，倘若嬰兒發(fā)育過程出現(xiàn)任何延遲，以及出現(xiàn)行為差異和聽力問題時也要告知。
“最關(guān)鍵的信息是，學(xué)界對這種病毒還不太了解——畢竟只研究了四年?！彼f?！暗覀冎溃ú《荆┰谔厥馊巳褐邪Y狀也會特殊。”
“我們知道老年人的癥狀，會受到什么影響。嬰兒同樣面臨風(fēng)險，盡管我們還不知道風(fēng)險是否廣泛存在，或者妊娠期有沒有特定的風(fēng)險點，又或者（嬰兒）有沒有哪些情況導(dǎo)致更容易受影響，”她補充道。她還指出，目前尚未對嬰兒做基因檢測。
杜阿拉說，在這一點上，研究人員面臨的問題比答案多。但他們都確信一點：懷孕期間感染新冠是個問題。
杜阿拉指出：“也許只有少數(shù)人遇到，但肯定是個問題?！保ㄘ敻恢形木W(wǎng)）
譯者：梁宇
審校：夏林
COVID can travel from a pregnant mom to a fetus, breaching the placenta and causing brain damage, according to a study published Thursday in?Pediatrics.
Researchers with the University of Miami documented the cases of two infants born to mothers who had COVID during pregnancy. Both infants tested negative for the virus at birth, but experienced seizures, delays in developmental milestones, and a head size that became disproportionately small with time.
Both infants eventually died.
While such outcomes are rare, those who are pregnant or planning to become pregnant need to be cognizant of the risks COVID poses to fetuses, Dr. Shahnaz Duara, a neonatologist at the University of Miami’s Miller School of Medicine and senior author on the paper, tells Fortune.
“Most young people who are child-producing age treat COVID as if it’s going to be a little viral infection, and they don’t want to bother with getting vaccinated or taking precautions,” she says.
“They’re thinking it’s not going to make them sick. And it doesn’t. But it can have a big impact on the baby.”
Medical professionals were already aware that roughly two or three babies out of every thousand are born COVID-positive, with some reports of stillbirth among them. It’s possible that additional babies whose mothers had COVID while pregnant have been born neurologically impacted. Doctors may not have connected the dots because the babies didn’t test positive for the virus at birth, Duara says, or because the neurological issues have yet to surface.
In the cases Duara and his team studied, the virus was discovered in infants’ tissue–a finding that would generally only occur at autopsy, and only if health professionals were looking for it, she notes.
“There may have been other cases like this that have gone unrecognized,” she says. “Others would have said, ‘This can’t be COVID; the babies didn’t swab positive.’ But maybe [the babies] didn’t get studied to the extent we studied” these babies.
Duara hopes the new research raises awareness among parents and medical professionals alike.
Reassuringly, the mothers’ cases appear unusual. One was incredibly sick with COVID for weeks during mid-2020, and the other appears to have been infected twice during her pregnancy during early 2021, but never had symptoms. Both mothers were around 25 weeks of gestation when exposed to the virus, and neither were vaccinated. But other patterns could lead to similar outcomes. That’s what researchers are trying to figure out now, Duara says.
Advice about COVID-related pregnancy complications
His message to moms-to-be: “Use the same precautions you would for your grandparents, for those on steroids or who are immunocompromised,” she says.
Consider getting the COVID vaccine ahead of getting pregnant, or early in your pregnancy.
If you’re able, breastfeed your child at least until 6 months of age, when they’re eligible for their first COVID vaccine. If a mother has immunity to COVID, she can transfer antibodies to her baby via breast milk.
Other precautions, including masking, can help reduce the risk of becoming infected with COVID while pregnant.
When it comes to babies whose mothers had COVID during pregnancy, she recommends parents tell their pediatrician, and report any delays in developmental milestones, as well as behavioral differences and hearing issues.
“The message really is that we don’t know much about this virus yet–we’ve only been at it for four years,” she says. “But we know that in special populations, [the virus] behaves in special ways.”
“We know about the elderly, what it does to them. Babies are also at risk, though we don’t know yet if that risk is across the board, or if there are specific points in gestation that are at risk, or something in [infants’] own data that makes them more vulnerable,” she adds, noting that genetic testing has not yet been performed on infants.
At this point, researchers have more questions than answers, Duara says. But they know one thing: COVID in pregnancy is a problem.
Notes Duara: “Perhaps it’s only a problem for a handful of people, but it’s a problem.”
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