Desfechos clínicos em recém-nascidos de mulheres grávidas com COVID-19: revisão integrativa

Ximenes, Iara Bezerra da Silva; Leal, Cassiano Richel Ferreira; Batista, Odinéia Maria Amorim; Moura, Maria Eliete Batista; Madeira, Maria Zélia de Araújo; Valle, Andreia Rodrigues Moura da Costa; Prates, Pedro Emílio Gomes; Sousa, Álvaro Francisco Lopes de; Andrade, Denise de

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REVIEW • Rev. Bras. Enferm. 77 (Suppl 1) • 2024 • https://doi.org/10.1590/0034-7167-2023-0400 copiar

Desfechos clínicos em recém-nascidos de mulheres grávidas com COVID-19: revisão integrativa

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivos:

analisar desfechos clínicos em recém-nascidos de mulheres grávidas com COVID-19. Métodos: revisão integrativa realizada no PubMed, Web of Knowledge, SCOPUS, CINHAL; foram obtidos 2.111 estudos, e 8 artigos compuseram a amostra final. Resultados: os desfechos clínicos em neonatos de mulheres grávidas positivas para COVID-19 foram classificados de acordo com as seguintes categorias: a) contaminação por COVID-19, relatada em 62,5% dos estudos; b) alta hospitalar devido à melhora, mencionada em 37,5% dos artigos; c) óbito, representando casos raros em 25% da amostra. A complicação gestacional mais prevalente foi prematuridade, mencionada em 75% dos estudos. Essa complicação foi observada devido a casos de ruptura prematura de membranas e descolamento de placenta. Conclusões: apesar do conhecimento do comportamento assintomático e levemente sintomático em neonatos, é importante continuar a busca por novos dados clínicos, pois esse público apresenta reações incertas à infecção por SARS-CoV-2.

Descritores:
Recém-Nascidos; Desfechos; COVID-19; Grávidas; Enfermagem

Reason for exclusion	Quantitative excluded (n=2301)
Wrong population	981
Wrong phenomenon or wrong intervention	711
Wrong context	485
Wrong type of study	102
Search and extraction not allowed	10
Not available in electronic format	12

Title	Year/ country	Design/ Participants	Outcomes
Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia(¹⁹19 Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr. 2020;9(1):1-9. https://doi.org/10.21037%2Ftp.2020.02.06 https://doi.org/10.21037%2Ftp.2020.02.06... )	2020 China	Retrospective study 10 neonates	Perinatal COVID-19 infection can harm newborns, leading to fetal distress, prematurity, respiratory issues, thrombocytopenia, and death. No evidence of vertical transmission was found.
Clinical characteristics of 19 neonates born to mothers with COVID-19(²⁰20 Liu W, Wang J, Li W, Zhou Z, Liu S, Rong Z. Clinical characteristics of 19 neonates born to mothers with COVID-19. Front Med. 2020;14(2):193-8. https://doi.org/10.1007%2Fs11684-020-0772-y https://doi.org/10.1007%2Fs11684-020-077... )	2020 China	Cohort study n = 19 neonates	Neonates showed no clinical, radiological, or hematological evidence of COVID-19, and no vertical transmission occurred during the third trimester.
Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study(²¹21 Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K, et al. Maternal and neonatal outcomes of pregnant women with Coronavirus Disease 2019 (COVID-19) Pneumonia: a case-control study. Clin Infect Dis. 2020;71(16):2035-41. https://doi.org/10.1093/cid/ciaa352 https://doi.org/10.1093/cid/ciaa352... )	2020 China	Cohort study n = 17 neonates	Newborns did not contract COVID-19 or experience serious complications or respiratory failure during hospitalization.
Neonatal Early-Onset Infection with SARS-CoV-2 in 33 Neonates Born to Mothers with COVID-19 in Wuhan, China(²²22 Zeng L, Xia S, Yuan W. Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China. JAMA Pediatr. 2020;174(7):722-5. https://doi.org/10.1001/jamapediatrics.2020.0878 https://doi.org/10.1001/jamapediatrics.2... )	2020 China	Cohort study n = 33 neonates	Neonatal symptoms in COVID-19-exposed or at-risk infants were mild, with favorable outcomes. Vertical transmission couldn’t be ruled out despite negative test results.
Vaginal delivery in SARS-CoV-2 infected pregnant women in Northern Italy: a retrospective analysis(²³23 Ferrazzi E, Frigerio L, Savasi S, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116-21. https://doi.org/10.1111/1471-0528.16278 https://doi.org/10.1111/1471-0528.16278... )	2020 Italy	Retrospective multicenter study n = 42 neonates	Some neonates tested positive for COVID-19, possibly due to postpartum contamination, suggesting low intrapartum transmission risk during vaginal delivery.
Clinical profile, viral load, management and outcome of neonates born to COVID 19 positive mothers: a tertiary care centre experience from India(²⁴24 Anand P, Yadav A, Debata P, Bachani S, Gupta N, Gera R. Clinical profile, viral load, management and outcome of neonates born to COVID 19 positive mothers: a tertiary care centre experience from India. Eur J Pediatr. 2021;180(2):547-59. https://doi.org/10.1007/s00431-020-03800-7 https://doi.org/10.1007/s00431-020-03800... )	2020 India	Cohort study n = 65 neonates	Seven out of 65 tested neonates had mild COVID-19, and maternal viral load did not correlate with newborn severity.
A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society(²⁵25 Oncel M, Akin I, Kanburoglu M, Tayman C, Coskun S, Narter F, et al. A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. Eur J Pediatr. 2021;180(3):733-42. https://doi.org/10.1007/s00431-020-03767-5 https://doi.org/10.1007/s00431-020-03767... )	2020 Turkey	Multicenter cohort n = 125 neonates	Four out of 120 newborns tested positive for COVID-19, indicating significant impacts on perinatal and neonatal outcomes, including prematurity, cesarean section, suspected vertical transmission, and low breastfeeding rates.
Clinical outcomes of maternal and neonate with COVID-19 infection-Multicenter study in Saudi Arabia(²⁶26 Al-Matary A, Almatari F, Al-Matary M, Al-Dhaefi A, Alqahtani M, Alhulaimi E, et al. Clinical outcomes of maternal and neonate with COVID-19 infection; multicenter study in Saudi Arabia. J Infect Public Health. 2021;14(6):702-8. https://doi.org/10.1016/j.jiph.2021.03.013 https://doi.org/10.1016/j.jiph.2021.03.0... )	2021 Saudi Arabia	Retrospective cohort study n = 200 neonates	Most neonates had normal laboratory results, with few requiring NICU admission or respiratory support, and no cases of COVID-19 or evidence of vertical transmission.
Clinical outcomes of COVID-19 positive mothers and their newborns - a retrospective study(²⁷27 Silva D, Afonso A, Silva A, Silva A, Póvoas A. Clinical outcomes of COVID-19 positive mothers and their newborns: a retrospective study. Pediatr Oncall J. 2022;20(4):127-31. https://doi.org/10.7199/ped.oncall.2023.46 https://doi.org/10.7199/ped.oncall.2023.... )	2022 Portugal	Retrospective cohort study n = 52 neonates	The study covered 865 deliveries, with few infants testing positive for SARS-CoV-2, and no fatal outcomes were observed, indicating unlikely perinatal or postnatal transmission.
Clinical outcomes and antibody transfer in a cohort of infants with in utero or perinatal exposure to SARS-CoV-2 (Coronascope Study)(²⁸28 Carrasco Colom J, Manzanares À, Gómez A, Escribano I, Esquivel E, Pérez-Rivilla A, et al. Clinical outcomes and antibody transfer in a cohort of infants with in utero or perinatal exposure to SARS-CoV-2 (Coronascope Study). Eur J Pediatr. 2023;182:4647-54 https://doi.org/10.1007/s00431-023-05147-1 https://doi.org/10.1007/s00431-023-05147... )	Espanha 2022	Observational prospective study n = 95 neonates	Infants born to mothers with COVID-19 had normal neurological and auditory development, and most exhibited typical development in their first year of life, with only some showing positive serological results.
Shortand mid-term multidisciplinary outcomes of newborns exposed to SARS-CoV-2 in utero or during the perinatal period: preliminary findings(²⁹29 Buonsenso D, Costa S, Giordano L, Priolo F, Colonna A, Morini S. Short-and mid-term multidisciplinary outcomes of newborns exposed to SARS-CoV-2 in utero or during the perinatal period: preliminary findings. Eur J Pediatr. 2022;181:1507-20. https://doi.org/10.1007/s00431-021-04319-1 https://doi.org/10.1007/s00431-021-04319... )	Italy, 2022	Prospective study N: 199 newborns.	The study encompassed various assessments, most newborns had normal growth and neurological development, and some showed potential effects of SARS-CoV-2 exposure. Overall, positive results were observed, except for some ophthalmological findings in a subset of cases

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[1] Autor Correspondente: Pedro Emílio Gomes Prates, E-mail: pedropratesmoreno@usp.br