Tình hình bệnh tật của trẻ sơ sinh được sinh ra từ bà mẹ nhiễm Covid-19 tại Bệnh viện Đa khoa Đức Giang

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Tác giả: Thị Huệ Chu, Thị Tường Vi Đinh, Trung Phong Nguyễn, Thị Loan Phan, Thị Thu Nga Vũ

Ngôn ngữ: vie

Ký hiệu phân loại: 362.1962414 Physical illness

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 123-131

Bộ sưu tập: Metadata

ID: 498967

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Mô tả tình hình bệnh tật của trẻ sơ sinh được sinh ra từ bà mẹ nhiễm COVID-19 tại bệnh viện đa khoa Đức Giang và tìm hiểu một số yếu tố liên quan giữa bệnh lý của trẻ sơ sinh với những bà mẹ này. Phương pháp nghiên cứu: Nghiên cứu hồi cứu, tiến cứu mô tả hàng loạt trẻ sinh ra từ bà mẹ nhiễm COVID-19 và mẹ của những trẻ này từ 01/09/2021- 31/3/2022. Kết quả: Có 113 trẻ (3 cặp song thai) và 110 bà mẹ đưa vào nghiên cứu. Tuổi mẹ trung bình là 29,33 ± 5,48. Có 56,4% bà mẹ tiêm vắc xin COVID-19. Có 14,5% bà mẹ mắc COVID-19 mức độ nặng-nguy kịch. Tỷ lệ trẻ nam 54,9%. Tỷ lệ trẻ đẻ non là 12,4%. Tỷ lệ trẻ có cân nặng ≥ 2500 gram là 92,9%. Cân nặng trung bình 3238,05 ± 550,21 gram và tuổi thai trung bình 37,96 ± 2,03 tuần. Sinh mổ là 74,3%, trong đó mổ do COVID-19 là 14,2%. Tỷ lệ hồi sức tại phòng sinh là 6,2%. Có 0,9% trẻ PCR COVID-19 dương tính. Có 96,4% ra viện. Các bệnh lý bao gồm nhiễm khuẩn sơ sinh sớm (26,5%), suy hô hấp (21,2%), vàng da tăng bilirubin tự do (16,8%). Nguyên nhân gây suy hô hấp sau sinh là ngạt (6,2%), cơn ngưng thở ở trẻ đẻ non (4,4%) và cơn thở nhanh thoáng qua (3,5%). Mẹ nhiễm COVID-19 nặng-nguy kịch thì tỷ lệ con đẻ non, hỗ trợ hô hấp khi sinh, chiếu đèn vàng da, nhiễm khuẩn sơ sinh sớm cao hơn (p<
0,001). Sau khi phân tích hồi quy đa biến, còn 1 yếu tố độc lập đó là mẹ nhiễm COVID-19 mức độ nặng-nguy kịch thì con sinh ra có nguy cơ phải hỗ trợ hô hấp khi sinh cao gấp 20 lần, p<
0,01. Mẹ có dùng thuốc chống đông trước sinh thì tỷ lệ con rối loạn đông máu cao hơn (p<
0,001). Kết luận: Nhiễm khuẩn sơ sinh sớm chiếm tỷ lệ cao nhất, sau đó là suy hô hấp. Mẹ nhiễm COVID-19 mức độ nặng-nguy kịch thì con có nguy cơ cao phải hỗ trợ hô hấp khi sinh. Mẹ có dùng thuốc chống đông trước sinh thì tỷ lệ con rối loạn đông máu cao hơn.To describe disease characteristics of neonates born to mothers with COVID-19 at Duc Giang general hospital and find some relative factors between neonates and these mothers. Methods: This study was retrospective and prospective description and case series in neonates born to mothers with COVID-19 from September 1st 2021 to March 31st 2022. Results: A total of 113 neonates (three twins) and 110 mothers were enrolled in the study. The mean maternal age was 29.33 ± 5.48. There were 56.4% of mothers vaccinated against COVID-19. There were 14,5% of mothers with severe-critical COVID-19. The rate of male was 54.9%. The rate of premature neonates was 12.4%. The neonates with the birth weight ≥ 2500 grams was 92.9%. These neonates had a mean birth weight of 3238.05 ± 550.21 grams and a mean gestational weight of 37.96 ± 2.03 weeks. Caesarean section was 74.3%, of which caesarean section due to COVID-19 was 14.2%. The rate of resuscitation in the delivery room was 6.2%. A neonate tested positive for COVID-19 (0.9%). There were 96.4% discharged. Diseases included early onset neonatal sepsis (6.5%), respiratory failure (21.2%), jaundice (16.8%). Causes of respiratory failure after birth were asphyxia (6.2%), apnea of prematurity (4.4%), transient tachypnea (3.5%). Neonates whose mothers with severe-critical COVID-19 had higher rates of premature births, respiratory support at birth, and phototherapy for jaundice and early onset neonatal sepsis than those whose mothers with mild- moderate (p<
0,001). After multivariate regression analysis, there is an independent factor that is the neonates whose mothers with severe-critical COVID-19 has a 20 times higher risk of requiring respiratory support at birth (p<
0,01). Neonates whose mothers used anticoagulants before giving birth had a higher rate of blood clotting disorders than mothers did not. Neaonates with early onset neonatal sepsis accounted for the highest rate, followed by respiratory failure. Neonates whose mothers with severe-critical COVID-19 has higher risk of requiring respiratory support at birth. Neonates whose mothers used anticoagulants before giving birth had a higher rate of blood clotting disorders than those whose mothers did not.

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