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Gutiérrez-Vélez A, Merino-Hernández A, Chamorro IP, Luna MS, Huerta-Aragonés J. Necrotizing enterocolitis after intravenous immunoglobulin administration and exchange transfusion in a newborn with hemolytic disease due to anti-c. An Pediatr (Engl Ed) 2022; 97:427-429. [PMID: 36344387 DOI: 10.1016/j.anpede.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/25/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Ana Gutiérrez-Vélez
- Unidad de Neonatología, Servicio de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | | | - Isabel Pescador Chamorro
- Unidad de Neonatología, Servicio de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Manuel Sánchez Luna
- Unidad de Neonatología, Servicio de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Jorge Huerta-Aragonés
- Unidad de Oncohematología, Servicio de Pediatría, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
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Solís-García G, Gutiérrez-Vélez A, Pescador Chamorro I, Zamora-Flores E, Vigil-Vázquez S, Rodríguez-Corrales E, Sánchez-Luna M. Epidemiology, management and risk of SARS-CoV-2 transmission in a cohort of newborns born to mothers diagnosed with COVID-19 infection. An Pediatr (Barc) 2021; 94:173-178. [PMID: 33521167 PMCID: PMC7834971 DOI: 10.1016/j.anpede.2020.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/12/2020] [Indexed: 12/04/2022] Open
Abstract
Introduction The impact of maternal SARS-CoV-2 infection and its risk of vertical transmission is still not well known. Recommendations from scientific societies seek to provide safety for newborns without compromising the benefits of early contact. The aim of the study is to describe characteristics and evolution of newborns born to mothers with SARS-CoV-2 infection, as well as the implemented measures following recommendations from the Sociedad Española de Neonatología. Methods Observational, prospective and single-center cohort study. A specific circuit was designed for mothers with SARS-CoV-2 infection and their newborns. Epidemiological and clinical data were collected. PCR were performed in newborns at delivery and at 14 days of age. Results 73 mothers and 75 newborns were included in the study. 95.9% of maternal infections were diagnosed during the third trimester of pregnancy, 43.8% were asymptomatic. Median gestational age was 38 weeks (IQR: 37–40), 25.9% of newborns required admission to Neonatology. Skin-to-skin mother care was performed in 68% of newborns, 80% received exclusive maternal or donated breast milk during hospital stay. No positive PCR results were observed in newborns at delivery, one case of positive PCR was observed in an asymptomatic neonate at 14 days of age. Conclusions Risk of SARS-CoV-2 transmission is low when complying to the recommendations issued by Sociedad Española de Neonatología, allowing rooming-in and promoting breastfeeding.
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Affiliation(s)
- Gonzalo Solís-García
- Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ana Gutiérrez-Vélez
- Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Elena Zamora-Flores
- Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Sara Vigil-Vázquez
- Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Manuel Sánchez-Luna
- Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Solís-García G, Gutiérrez-Vélez A, Pescador Chamorro I, Zamora-Flores E, Vigil-Vázquez S, Rodríguez-Corrales E, Sánchez-Luna M. [Epidemiology, management and risk of SARS-CoV-2 transmission in a cohort of newborns born to mothers diagnosed with COVID-19 infection]. An Pediatr (Barc) 2020; 94:173-178. [PMID: 33431332 PMCID: PMC7833088 DOI: 10.1016/j.anpedi.2020.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/03/2020] [Accepted: 12/12/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The impact of maternal SARS-CoV-2 infection and its risk of vertical transmission is still not well known. Recommendations from scientific societies seek to provide safety for newborns without compromising the benefits of early contact. The aim of the study is to describe characteristics and evolution of newborns born to mothers with SARS-CoV-2 infection, as well as the implemented measures following recommendations from the Sociedad Española de Neonatología. METHODS Observational, prospective and single-center cohort study. A specific circuit was designed for mothers with SARS-CoV-2 infection and their newborns. Epidemiological and clinical data were collected. PCR were performed in newborns at delivery and at 14 days of age. RESULTS 73 mothers and 75 newborns were included in the study. 95.9% of maternal infections were diagnosed during the third trimester of pregnancy, 43.8% were asymptomatic. Median gestational age was 38 weeks (IQR: 37-40), 25.9% of newborns required admission to Neonatology. Skin-to-skin mother care was performed in 68% of newborns, 80% received exclusive maternal or donated breast milk during hospital stay. No positive PCR results were observed in newborns at delivery, one case of positive PCR was observed in an asymptomatic neonate at 14 days of age. CONCLUSIONS Risk of SARS-CoV-2 transmission is low when complying to the recommendations issued by Sociedad Española de Neonatología, allowing rooming-in and promoting breastfeeding.
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Affiliation(s)
- Gonzalo Solís-García
- Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Ana Gutiérrez-Vélez
- Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | | | - Elena Zamora-Flores
- Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Sara Vigil-Vázquez
- Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | | | - Manuel Sánchez-Luna
- Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, España
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Fernández Colomer B, Sánchez-Luna M, de Alba Romero C, Alarcón A, Baña Souto A, Camba Longueira F, Cernada M, Galve Pradell Z, González López M, López Herrera MC, Ribes Bautista C, Sánchez García L, Zamora Flores E, Pellicer A, Alonso Díaz C, Herraiz Perea C, Romero Ramírez DS, de Las Cuevas Terán I, Pescador Chamorro I, Fernández Trisac JL, Arruza Gómez L, Cardo Fernández LM, García García MJ, Nicolás López M, Hortelano López M, Riaza Gómez M, Hernández González N, González Sánchez R, Zambudio Sert S, Larrosa Capacés S, Matías Del Pozo V. Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain. Front Pediatr 2020; 8:580584. [PMID: 33194912 PMCID: PMC7644848 DOI: 10.3389/fped.2020.580584] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/09/2020] [Indexed: 12/18/2022] Open
Abstract
Objective: Coronavirus disease 2019 (COVID-19) cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to increase worldwide. Although some data from pediatric series are available, more evidence is required, especially in neonates, a group with specific characteristics that deserve special attention. This study aimed to describe general and clinical characteristics, management, and treatment of postnatal-acquired (community and nosocomial/hospital-acquired) COVID-19 neonatal cases in Spain. Methods: This was a national prospective epidemiological study that included cases from a National Registry supported by the Spanish Society of Neonatology. Neonates with postnatal SARS-CoV-2 infection were included in this study. General data and infection-related information (mode and source of transmission, age at diagnosis, clinical manifestations, need for hospitalization, admission unit, treatment administered, and complementary studies performed, hospital stay associated with the infection) were collected. Results: A total of 40 cases, 26 community-acquired and 14 nosocomial were registered. Ten were preterm newborns (2 community-acquired and 8 nosocomial COVID-19 cases). Mothers (in both groups) and healthcare workers (in nosocomial cases) were the main source of infection. Hospital admission was required in 22 community-acquired cases [18 admitted to the neonatal intermediate care unit (NIMCU) and 4 to the neonatal intensive care unit (NICU)]. Among nosocomial COVID-19 cases (n = 14), previously admitted for other reasons, 4 were admitted to the NIMCU and 10 to the NICU. Ten asymptomatic patients were registered (5 in each group). In the remaining cases, clinical manifestations were generally mild in both groups, including upper respiratory airways infection, febrile syndrome or acute gastroenteritis with good overall health. In both groups, most severe cases occurred in preterm neonates or neonates with concomitant pathologies. Most of the cases did not require respiratory support. Hydroxychloroquine was administered to 4 patients in the community-acquired group and to 2 patients in the nosocomial group. Follow-up after hospital discharge was performed in most patients. Conclusions: This is the largest series of COVID-19 neonatal cases in Spain published to date. Although clinical manifestations were generally mild, prevention, treatment, and management in this group are essential.
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Affiliation(s)
| | - Manuel Sánchez-Luna
- Neonatology Department, Complutense University, Madrid, Spain.,Division of Neonatology, Gregorio Marañón University Hospital, Madrid, Spain
| | | | - Ana Alarcón
- Department of Neonatology, Sant Joan de Déu University Hospital, Barcelona, Spain
| | - Ana Baña Souto
- Department of Neonatology, Clinical Hospital de Santiago, Santiago de Compostela, Spain
| | | | - María Cernada
- Division of Neonatology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | | | - María González López
- Department of Neonatology, Regional de Málaga University Hospital, Málaga, Spain
| | | | | | | | - Elena Zamora Flores
- Division of Neonatology, Gregorio Marañón University Hospital, Madrid, Spain
| | - Adelina Pellicer
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
| | - Clara Alonso Díaz
- Department of Neonatology, 12 de Octubre University Hospital, Madrid, Spain
| | | | | | | | | | | | - Luis Arruza Gómez
- Department of Neonatology, Clinical Hospital San Carlos, Madrid, Spain
| | | | | | - Marta Nicolás López
- Department of Neonatology, Germans Trias i Pujol University Hospital, Badalona, Spain
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Zeballos Sarrato G, Sánchez Luna M, Zeballos Sarrato S, Pérez Pérez A, Pescador Chamorro I, Bellón Cano JM. New Strategies of Pulmonary Protection of Preterm Infants in the Delivery Room with the Respiratory Function Monitoring. Am J Perinatol 2019; 36:1368-1376. [PMID: 30620944 DOI: 10.1055/s-0038-1676828] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To investigate if the use of a visible respiratory function monitor (RFM) to use lower tidal volumes (Vts) during positive pressure ventilation (PPV) in the delivery room (DR) reduces the need of surfactant administration and invasive mechanical ventilation during the first 72 hours after birth of preterm infants <32 weeks' gestational age (GA). STUDY DESIGN Infants <32 weeks' GA (n = 106) requiring noninvasive PPV were monitored with a RFM at birth and randomized to visible (n = 54) or masked (n = 52) display on RFM. Pulmonary data were recorded during the first 10 minutes after birth. Secondary analysis stratified patients by GA (<28, 28-29+6, or ≥30 weeks). RESULTS Median expiratory Vts during inflations were greater in the masked group (7 mL/kg) than in the visible group (5.8 mL/kg; p = 0.001) same as peak inflation pressure (PIP) administered (21.5 vs. 19.7 cmH2O; p < 0.001). Consequently, minute volumes were greater in the masked group (256 vs. 214 mL/kg/min; p < 0.001), with no differences in respiratory rate. These differences were higher in those <30 weeks' GA. There was no difference in the need of surfactant administration or intubation during the first 72 hours of age. CONCLUSION Using a RFM in the DR prevents the use of large Vt and PIP during respiratory support inflations, mostly in the more immature newborn infants, but with no other short-term benefits.
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Affiliation(s)
| | - Manuel Sánchez Luna
- Division of Neonatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Alba Pérez Pérez
- Division of Neonatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Jose María Bellón Cano
- Division of Neonatology, Department of Statistics Institute for Health Research, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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