Pregnant women have an impact on the baby?Nine common problems, one text clearly clarified

*How to manage the baby for medical professionals for reference?

Article | Li Yuelan

After "let go", maternal mothers and newborns, as one of the fragile people, also experienced a sudden trend of infection.Nowadays, a large part of the region has "Yang Kang", so the pregnant woman is Yang. What impact will it affect the baby, and how can the baby be born?Combined with the author’s work experience and the recent relevant authoritative documents, it has sorted out nine common problems for your reference.

1 Pregnant woman is Yang, does it affect the baby in the abdomen?

Maternal infection increases the risk of bad prognosis of the fetus and newborn.A British study showed that the premature birth rate of pregnant women with new crown pneumonia was 19%, which was significantly higher than the previous premature birth rate (7.8%).A Canadian study found that the risk of new crown virus infection with pregnant women in the intensive care unit of the severe illness increased significantly, and the premature birth rate increased significantly.A US research conclusion is similar to the above research.Maternal infection not only increases the risk of premature birth, but also increases the risk of death and newborn death.

In addition, due to the transfer of medical resources, pregnant women are worried about infection, so they fail to insist on regular health care, and will also increase the risk of bad pregnancy ending and newborn diseases.

Plan for the prevention and control management plan for newborn new -born coronary virus infection (third edition) pointed out that pregnant women infected with new coronary viruses may increase risks such as premature birth and fetal distress.

The obstetrics and neonatal departments in the hospital where the author are located, because of the increased increase in pregnant women who are infected with infection, and premature fetal membranes and premature births are more increasing than usual, which also confirms this.

Therefore, the pregnant woman is positive, and it is recommended to monitor high -risk pregnant women and fetal conditions, and make a plan for preparation and delivery preparation for prenatal management.In general, pregnant women do not have to panic. If they are obviously discomfort, fetal fetal movement is reduced, etc., you need to go to the doctor in time and do not carry it hard.

2 Is the baby born with a positive mother is also positive?

Due to the barrier of the placenta, the new coronal virus will not be transmitted vertically to the fetus. Newborns are mainly transmitted infection through the level of delivery and postpartum levels.

3 During the epidemic period, how risks of newborn babies to infection?

The risk of newborns infection is closely related to regional prevention and control strategies.From March to May 2022, during the popularity of Shanghai’s new crown virus Omicron, my country implemented a strict "dynamic clear zero" prevention and control policy.At that time, the number of infection cases was about 600,000, and 16 cases of infected newborn were treated in designated hospitals, all of which were caused by post -lifting contact infection cases.

During the above time, 156 new crown virus infection of the Shanghai Public Health Center gave a total of 158 newborn children. Due to effective isolation measures after birth, all infant 7 d kernel acid tests were negative after birth, and no cases of infection were seen.

A single center observation study in India shows that the risk of baby infection is related to the exposure of birth and after birth. Among the 221 new crown virus infected with pregnant women’s childbirth, 32 cases (14.5%) of the new crown virus test positiveThe infection rate of newborns was 17.4%(12/69), which was higher than those who were delivered from cesarean section (13.2%, 20/152).

The comparison of the two data shows that the infection of the newborn is closely related to the prevention and control policies in the region.It can be judged almost that under the current policy, the infection rate of newborns is much higher than Shanghai from March to May.In the past three years, the author’s department has not been treated in the past three years, and has not even been closely connected. However, after entering December 10, 8 cases of infection have been treated, which also illustrates this fact.

4 After the baby is born, is it separated from the mother separately?

If the newborn is generally good and the mother’s condition is stable, the mother and baby are in the same room, mainly observation.But the maternal infected with the diagnosis of the diseased N95 mask.Newborn with clinical symptoms or unstable vital signs, staying in a newborn isolation or transitional area hospitalization.

The incubation period of the Neo -Crown Virus Omikon mutation is about 3.42D. Therefore, 96h after life, the risk of infection of the new crown virus nucleic acid is still a negative newborn infection, which can be transferred to the general ward for treatment.

Prospective observation research shows that newborns and the mother of new crown pneumonia coexist in the same room, which will significantly increase the risk of new crown virus infection. Separation of mothers and infants can reduce the risk of horizontal transmission.Breastfeeding and intimacy of maternal and infants have adverse effects.

A single center observation study in India showed that breastfeeding and the newborn infection rate of the mother and baby in the same room was 18.8%(31/165).To.

Therefore, personal suggestions, if the mother is positive, even if the general situation is good, in order to reduce the exposure, it is best to be taken care of by relatives. If the mother cannot insist on wearing the N95 mask, it is best to separate from the mother.Newborn with clinical symptoms need to be hospitalized.

5 What are the clinical manifestations after newborn infection?

The clinical manifestations of newborn infection may be similar to infants and young children.The symptoms of premature babies may be more hidden and need special attention.

(1) Suspected cases: Because the new crown virus is infectious, the crowd is generally susceptible.The mother is infected with the new coronal virus, or a newborn of the history of the new crown virus infection (including family members, caregivers, medical staff, and visitors). It is accompanied by clinical symptoms and should consider suspected infection cases.

(2) Confirmation of infection cases: Generally, the new coronary virus nucleic acid or antigen detection is performed by collecting respiratory specimens.For suspected cases, accompanied by or without clinical symptoms, if you have one of the original evidence of the following diseases, you can confirm the diagnosis:

① Real-time fluorescence RT-PCR detection new coronary virus nucleic acid positive; ② new coronary virus antigen detection positive.

6 How to judge the severity of newborns infection?

For newborns infected with new coronary virus, the disease evaluation is based on clinical symptoms, physical examination, laboratory examination, and other auxiliary examinations.

(1) Clinical symptoms include fever, feeding impsents, cough, shortness of breath and diarrhea.

(2) Severe cases can be manifested as respiratory failure, hyperglycemia, bone marrow suppression, and white blood cells.

(3) Referring to the severe manifestations of infants and young children, rare manifestations such as convulsions, acute encephalitis, laryngitis, myocarditis, and multi -system inflammation syndrome (mainly occurred in 4 to 6 weeks after infection), thrombosis and other rare manifestations.

7 How to treat newborns after infection?

Asymptomatic and light cases only need to be observed without special treatment.

(1) Clinical symptoms and support treatment, maintain internal environmental balance.

(2) For severe cases, dynamically evaluate organ function, and timely provide organic function support treatment, such as non -invasive ventilation, creative mechanical ventilation, kidney function substitution, and vitamin oxygen.

(3) Other treatments: such as glucocorticoids and other drugs, for severe cases, carefully choose according to the condition.It should be proposed that there is currently no effective anti -new coronal virus drug for newborns.

8 Under what circumstances, the baby can be discharged or lifted?

The child’s condition is stable, the signs of life is normal, such as stable respiratory, stable body temperature, feeding tolerance, etc., and the family can provide reasonable care, meet the standards of discharge, and can be discharged.

Responsible or home isolation, 2 consecutive (at least 24h) respiratory specimens collected by the new crown virus nucleic acid or antigen are negative and can be lifted.Or the symptoms have improved, and the normal body temperature exceeds 3D, it can also be considered to remove the isolation.

9 Is the positive mother breastfeeding the baby?

Breastfeeding should be advocated for new coronal virus infection with mothers, unless there is a taboos for breastfeeding.No evidence shows that the new coronal virus can be spread through breast milk.

In the feeding process, the mother needs to wear the N95 mask to do a good job of hand.The mother was tested twice negative (24h interval) by nucleic acid, or no fever exceeded 3D, and had no clinical symptoms. Direct breastfeeding, the risk of newborn infection was low.

If the bottle is fed after the pump milk, the mother should pay attention to hand hygiene during the pump milk and wear the N95 mask.If you are worried that breast milk contains viruses (from environmental pollution), you can consider Basal disinfection.

References: [1] Zhou Jianguo, Zhou Wenhao. Newborn new coronary virus infection prevention and control: evidence-based and experience [J]. China Magazine Magazine, 2022, 25 (12): 881-884. Doi: 10.3760/CMA.j.cn113903-2022101010-00883. [2] Chinese Contemporary Pediatric Magazine Editorial Committee Simultaneous Newborn New Coronary Virus Infection Prevention Management Plan Working Group.. Chinese contemporary pediatric magazine .2023, 25 (1): 1-4.Doi: 10.7499/J.ISSN.1008-8830.2212074.

Editor in charge: Xiang Yu

*"The medical community" strives to publish the professional and reliable content published, but does not commit a commitment to the accuracy of the content; please check or use it as a basis for decision -making.

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