Background
Chorioamnionitis (CA) affects up to 3.9% of all deliveries worldwide and is one of the leading causes of early-onset neonatal sepsis. Fever≥380C is an essential criterion for the diagnosis of clinical CA. Obstetricians frequently take the maternal risk factors into consideration, and many mothers are treated as CA even with peak intrapartum temperature (PIT) between 37.60C to 37.90C if they have other clinical signs and risk factors.
Aim
To estimate the prevalence of confirmed chorioamnionitis and adverse neonatal outcomes among those mothers with PIT below 380C.
Materials and methods
Retrospective chart review among mothers delivered at Al-Wakra Hospital, Qatar, between1stJanuary2016 to 31stDecember 2019 with a clinical suspicion of CA.
Results
Among 21,471 mothers, 442 were suspected of having CA (2.06%, 95% CI 1.88 to 2.26%). After exclusions, 415 were included in the study, 203(48.9%) mothers had PIT between 37.6-37.90C. There was no significant difference in the rate of confirmed CA between the low (<380C) and higher (≥380C) temperature groups (25.4%Vs.31.3%, OR0.75, 95%CI0.46-1.25 , p.262). More patients in the low-temperature group received paracetamol for PIT between 37.6 to 37.9 0C, while it was less frequently used for such milder elevation in higher temperature group (88.2%Vs.38.9%, OR11.69, 95% CI 6.46-2.15, p <.001).
Conclusion
The incidence of suspected clinical CA in our institution was within the international rates. Although nearly half of the mothers with suspected clinical CA had peak temperature below the recommended diagnostic criteria, the rate of confirmed CA and neonatal outcome was not significantly different from those with PIT≥380C. Early antipyretic use might have affected further elevation of temperature.
Background: Pregnant women are typically vulnerable to infectious diseases due to exaggerated disease manifestations and detrimental effects on their obstetric and neonatal outcomes. Previous studies have demonstrated that pregnant women with COVID-19 had similar clinical manifestations as nonpregnant women. However, there is not enough knowledge about the outcomes of neonates born to infected women although it has been reported that maternal pneumonia results in unfavorable obstetrical outcomes, including the premature rupture of membranes (PROM), intrauterine fetal demise (IUFD), intrauterine growth restriction (IUGR), and neonatal death. This retrospective study analyzes the clinical characteristics of all women with confirmed COVID-19 infection who gave birth in AWH, Qatar, as well as the possible adverse neonatal outcomes associated with maternal COVID-19 infection.
Objective: To identify adverse neonatal outcomes in mothers with confirmed COVID-19 infection during the last two weeks of a viable pregnancy.
Methods: This retrospective study included newborn babies born to mothers diagnosed with COVID-19 infection between 1 April 2021 and 23 May 2021 at AWH, Hamad Medical Corporation.
Data: Clinical characteristics, investigation results, and course of treatment were gathered from medical records for both mothers and babies.
Results: Out of 108 babies born to COVID-19-infected mothers, 47 (43.5%) were identified with adverse neonatal outcomes. Prematurity (28.7%), low birth weight (26%), respiratory distress (33.3%), and neonatal depression (8.3%) were the most commonly associated outcomes. Eight out of 108 babies (7.4%) tested positive for COVID-19, with 4.6% incidence of vertical transmission and 2.8% transient viremia. Using logistic regression analysis, maternal pneumonia and CT values were found to be statistically significant factors for premature delivery but were not significantly associated with neonatal infection. However, maternal ferritin levels significantly predicted neonatal positive PCR results.
Conclusion: Our data support the possibility of the intrauterine transmission of SARS-CoV-2 even in asymptomatic women. Studies with a larger number of subjects are recommended for identifying the biological mechanisms involved.
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