ROSSANA PULCINELI VIEIRA FRANCISCO

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Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina - Líder

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Autor e Coautores FMUSP-HC Normalizados: MARIA AUGUSTA BENTO CICARONI GIBELLI × search.filters.applied.f.dateIssued: 2022 × Revista / Livro: Clinics ×

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  • article 6 Citação(ões) na Scopus
    Impact of SARS-CoV-2 on pregnancy and neonatal outcomes: An open prospective study of pregnant women in Brazil
    (2022) GOMEZ, Ursula Trovato; FRANCISCO, Rossana Pulcineli Vieira; BAPTISTA, Fernanda Spadotto; GIBELLI, Maria Augusta B. C.; IBIDI, Silvia Maria; CARVALHO, Werther Brunow de; PAGANOTI, Cristiane de Freitas; SABINO, Ester Cerdeira; SILVA, Lea Campos de Oliveira da; JAENISCH, Thomas; MAYAUD, Philippe; BRIZOT, Maria de Lourdes
    Objectives: To determine the incidence and risk of adverse obstetric and neonatal outcomes according to SARSCoV-2 infection severity in pregnant women. Method: Open prospective study of pregnant women tested for SARS-CoV-2 by serological and molecular assays during pregnancy or delivery in two hospitals in Sao Paulo, Brazil from April 12, 2020, to February 28, 2021. Five groups were considered for analysis: C0, negative COVID-19 results and no COVID-19 symptoms; C1, positive COVID-19 results, and no symptoms; C2, positive COVID-19 results with mild symptoms; C3, positive COVID-19 results with moderate symptoms; and C4, positive COVID-19 results with severe symptoms. The association between obstetric and neonatal outcomes and COVID-19 severity was determined using multivariate analysis. Results: 734 eligible pregnant women were enrolled as follows: C0 (n = 357), C1 (n = 127), C2 (n = 174), C3 (n = 37), and C4 (n = 39). The following pregnancy and neonatal outcomes were associated with severe COVID19: oligohydramnios (adjusted Odds Ratio [aOR] = 6.18; 95% CI 1.87-20.39), fetal distress (aOR = 4.01; 95% Confidence Interval [CI] 1.84-8.75), preterm birth (aOR = 5.51; 95% CI 1.47-20.61), longer hospital stay (aOR = 1.66; 95% CI 1.36-2.02), and admission to the neonatal intensive care unit (aOR = 19.36; 95% CI, 5.8663.99). All maternal (n = 6, 15.4%, p < 0.001) and neonatal (n = 5, 12.5%, p < 0.001) deaths and most fetal deaths (n = 4, 9.8%, p < 0.001) occurred in C4 group. Moderate COVID-19 was associated with oligohydramnios (aOR = 6.23; 95% CI 1.93-20.13) , preterm birth (aOR = 3.60; 95% CI 1.45-9.27). Mild COVID-19 was asso-ciated with oligohydramnios (aOR = 3.77; 95% CI 1.56-9.07). Conclusion: Adverse pregnancy and neonatal outcomes were associated with maternal symptomatic COVID-19 sta-tus , risk increased with disease severity.
  • article 1 Citação(ões) na Scopus
    Clinical characteristics and evolution of 71 neonates born to mothers with COVID-19 at a tertiary center in Brazil
    (2022) DUARTE, Bruna de Paula; KREBS, Vera Lucia Jornada; CALIL, Valdenise Martins Laurindo Tuma; CARVALHO, Werther Brunow de; GIBELLI, Maria Augusta Bento Cicaroni; FRANCISCO, Rossana Pulcineli Vieira
    Introduction: Limited data are available on pregnant women with COVID-19 and their neonates.Objective: This study aimed to describe clinical characteristics and evolution from birth to discharge of a retrospec-tive cohort of 71 neonates, with one set of twins, born to women with COVID-19 diagnosed at the end of preg-nancy. The authors included all newborns admitted into a neonatal unit of a tertiary hospital in Brazil, between March 2020 and March 2021, whose unvaccinated mothers had COVID-19 symptoms and RT-PCR (Real-Time Polymerase Chain Reaction) for SARS-CoV-2 positive within fourteen days prior to delivery. Newborns to mothers with COVID-19 symptoms and negative tests for SARS-CoV-2 were excluded. Results: The main route of birth delivery was cesarean, corresponding to 60 pregnant women (84.5%). The fore-most indications for cesarean were pregnant with critical disease (24.6%) and acute fetal distress (20.3%). The mean birth weight was 2452 g (865-3870 g) and the mean gestational age was 345/7 weeks (25-40 weeks). There were 45 premature newborns (63.3%), of which 21 newborns (29.5%) were less than 32 weeks of gestational age. RT-PCR for SARS-CoV-2 on oropharyngeal swabs was positive in 2 newborns (2.8%) and negative in the other 69 newborns (97.2%). Most newborns (51.4%) needed respiratory support. Therapeutic interventions dur-ing hospitalization were inotropic drugs (9.9%), antibiotics (22.8%), parenteral nutrition (26.8%), and photother-apy (46.5%).Conclusion: Maternal COVID-19 diagnosticated close to delivery has an impact on the first days of neonatal life.