Author:
Wang Yuanyuan,Chen Lian,Wu Tianchen,Shi Huifeng,Li Qin,Jiang Hai,Zheng Danni,Wang Xiaoli,Wei Yuan,Zhao Yangyu,Qiao Jie
Abstract
Abstract
Background
Evidence concerning the long-term impact of Covid-19 in pregnancy on mother’s psychological disorder and infant’s developmental delay is unknown.
Methods
This study is a longitudinal single-arm cohort study conducted in China between May 1 and July 31, 2020. Seventy-two pregnant patients with Covid-19 participated in follow-up surveys until 3 months after giving birth (57 cases) or having abortion (15 cases). We collected data from medical records regarding Covid-19, delivery or abortion, testing results of maternal and neonatal specimens, and questionnaires of quarantine, mother–baby separation, feeding, and measuring of mothers’ mental disorders and infants’ neurobehavioral disorders.
Results
All cases infected in the first trimester and 1/3 of cases infected in the second trimester had an abortion to terminate the pregnancy. 22.2% of pregnant patients were suffering from post-traumatic stress disorder or depression at 3 months after delivery or induced abortion. Among 57 live births, only one neonate was positive of nucleic acid testing for throat swab, but negative in repeated tests subsequently. The median duration of mother–baby separation was 35 days (interquartile range 16 to 52 days). After the termination of maternal quarantine, 49.1% of mothers chose to prolong the mother–baby separation (median 8 days; IQR 5 to 23 days). The breastfeeding rate was 8.8% at 1 week after birth, 19.3% at the age of 1 month, and 36.8% at the age of 3 months, respectively. The proportion of “monitoring” and “risk” in the social–emotional developmental domain at the age of 3 months was 22.7% and 63.6%, respectively. After the adjustment of preterm, neonatal sex, admitted to NICU, and the mother’s Covid-19 condition, the negative associations were significantly identified (p < 0.05) between mother–baby separation days and three developmental domains: communication, gross motor, and personal–social.
Conclusions
There is no definite evidence on vertical transmission of SARS-CoV-2. In addition to control infection risk, researchers and healthcare providers should pay more attention to maternal mental health and infant’s feeding, closeness with parents, and early development.
Funder
Chinese Academy of Engineering
National Natural Science Foundation of China
Peking University Health Science Center
Publisher
Springer Science and Business Media LLC
Reference39 articles.
1. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU).
https://coronavirus.jhu.edu/map.html
. Accessed 20 Oct 2020.
2. Ellington S, Strid P, Tong VT, Woodworth K, Galang RR, Zambrano LD, Nahabedian J, Anderson K, Gilboa SM. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status - United States, January 22-June 7, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):769–75.
3. Elshafeey F, Magdi R, Hindi N, Elshebiny M, Farrag N, Mahdy S, Sabbour M, Gebril S, Nasser M, Kamel M, et al. A systematic scoping review of COVID-19 during pregnancy and childbirth. Int J Gynaecol Obstet. 2020;150(1):47–52.
4. Chen L, Li Q, Zheng D, Jiang H, Wei Y, Zou L, Feng L, Xiong G, Sun G, Wang H, et al. Clinical characteristics of pregnant women with Covid-19 in Wuhan, China. N Engl J Med. 2020;382(25):e100.
5. Ashraf MA, Keshavarz P, Hosseinpour P, Erfani A, Roshanshad A, Pourdast A, Nowrouzi-Sohrabi P, Chaichian S, Poordast T. Coronavirus disease 2019 (COVID-19): a systematic review of pregnancy and the possibility of vertical transmission. J Reprod Infertil. 2020;21(3):157–68.