ARTICLE IN PRESS
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En e me ía
Clínica
xxx
(xxxx)
xxx---xxx
www.else ie .es/en e me iaclinica
BRIEF
ORIGINAL
ARTICLE
Managemen
o
labou ,
pue pe ium,
and
lac a ion
in
SARS-CoV-2
posi i e
women.
Mul icen ic
s udy
in
he
Valencian
Communi y夽
Ra ael
Vila-Candela,
Desi ée
Mena-Tudelab,∗,
Ana
Gómez-Seguíc,
Nie es
Asensio-Tomásc,
Agueda
Ce e a-Gaschb,
Yolanda
He aiz-Sole d
aDepa amen o
de
Obs e icia
y
Ginecología,
Hospi al
Uni e si a io
de
La
Ribe a,
Depa amen o
de
En e me ía,
Facul a
d’In e me ia
i
Podologia,
Uni e si a
de
València,
Valencia,
Spain
bUnidad
P e-Depa amen al
de
En e me ía,
Facul ad
de
Ciencias
de
la
Salud,
Uni e si a
Jaume
I,
Cas ellón,
Spain
cDepa amen o
de
Ginecología
y
Obs e icia,
Hospi al
Uni e si a io
y
Poli écnico
La
Fe,
Valencia,
Spain
dDepa amen o
de
Ginecología
y
Obs e icia,
Conso cio
Hospi al
Gene al
Uni e si a io
Valencia,
Depa amen o
de
En e me ía,
Facul a
d’In e me ia
i
Podologia,
Uni e si a
de
València,
Valencia,
Spain
Recei ed
7
Sep embe
2020;
accep ed
1
Janua y
2021
KEYWORDS
SARS-CoV-2;
COVID-19;
P egnancy;
Childbi h;
B eas eeding
Abs ac
Objec i e:
To
de e mine
he
ma e nal
and
pe ina al
impac
o
p egnan
women
wi h
SARS-CoV-2
posi i e
polyme ase
chain
eac ion
du ing
childbi h
and
pos
clinical
pe iod.
Me hod:
Obse a ional
desc ip i e,
e ospec i e,
and
mul icen e
s udy
ca ied
ou
h ough
he
e iew
o
clinical
eco ds
o
p egnan
women
admi ed
o
deli e y
om
1
Ma ch
o
30
June
2020.
Resul s:
Thi een
women
wi h
SARS-CoV-2
posi i e
polyme ase
chain
eac ion
we e
es ed.
The
p e alence
o
posi i e
cases
was
0.48%
o
he
o al
numbe
o
bi hs
a ended
du ing
he
s udy
pe iod.
None
o
he
mo he s
de eloped
complica ions
om
COVID-19
in ec ion,
no
did
hey
equi e
admission
o
he
In ensi e
Ca e
Uni .
O
he
bi hs,
15.4%
ended
in
caesa ean
sec ion,
7.7%
we e
p ema u e,
53.8%
o
he
newbo ns
we e
isola ed
om
hei
mo he s,
61.5%
had
la e
clamping
o
he
umbilical
co d
and
he
a e
o
exclusi e
b eas eeding
a
discha ge
was
76.9%.
All
he
newbo ns
we e
polyme ase
chain
eac ion-nega i e
o
COVID-19
and
had
no
pos pa um
complica ions.
DOI
o
o iginal
a icle:
h ps://doi.o g/10.1016/j.en cli.2021.01.006
夽Please
ci e
his
a icle
as:
Vila-Candel
R,
Mena-Tudela
D,
Gómez-Seguí
A,
Asensio-Tomás
N,
Ce e a-Gasch
A,
He aiz-Sole
Y.
Manejo
del
pa o,
el
pue pe io
y
la
lac ancia
en
muje es
posi i as
pa a
SARS-CoV-2.
Es udio
mul icén ico
en
la
Comunidad
Valenciana.
En e m
Clin.
2021.
h ps://doi.o g/10.1016/j.en cli.2021.01.006
∗Co esponding
au ho .
E-mail
add ess:
[email p o ec ed]
(D.
Mena-Tudela).
2445-1479/©
2021
Else ie
Espa˜
na,
S.L.U.
All
igh s
ese ed.
ENFCLE-1821;
No.
o
Pages
5
ARTICLE IN PRESS
+Model
R.
Vila-Candel,
D.
Mena-Tudela,
A.
Gómez-Seguí
e
al.
Conclusions:
Ve ical
ansmission
du ing
childbi h
in
newbo ns
o
COVID-19
posi i e
mo he s
has
no
been
epo ed.
Clinical
p ac ices
no
suppo ed
by
scien ific
e idence
we e
de ec ed
a
he
beginning
o
he
pandemic
and
adap ed
o
in e na ional
ecommenda ions
as
he
pandemic
e ol ed.
©
2021
Else ie
Espa˜
na,
S.L.U.
All
igh s
ese ed.
PALABRAS
CLAVE
SARS-CoV-2;
COVID-19;
Emba azo;
Pa o;
Lac ancia
ma e na
Manejo
del
pa o,
el
pue pe io
y
la
lac ancia
en
muje es
posi i as
pa a
SARS-CoV-2.
Es udio
mul icén ico
en
la
Comunidad
Valenciana
Resumen
Obje i o:
De e mina
las
epe cusiones
ma e nas
y
pe ina ales
de
las
ges an es
con
eacción
en
cadena
de
la
polime asa
posi i a
pa a
SARS-CoV-2
du an e
el
pa o
y
el
pue pe io
clínico.
Mé odo:
Es udio
obse acional
desc ip i o,
e ospec i o
y
mul icén ico
ealizado
median e
la
e isión
de
his o ias
clínicas
de
las
ges an es
ing esadas
po
pa o
desde
el
1
de
ma zo
has a
el
30
de
junio
de
2020.
Resul ados:
Se
analiza on
13
muje es
con
eacción
en
cadena
de
la
polime asa
posi i a
a
SARS-
CoV-2.
La
p e alencia
de
casos
posi i os
ue
del
0,48%
sob e
el
o al
de
pa os
a endidos
en
el
pe iodo
de
es udio.
Ninguna
de
las
mad es
desa olló
complicaciones
de i adas
de
la
in ección
po
COVID-19
ni
necesi ó
ing eso
en
la
Unidad
de
Cuidados
In ensi os.
El
15,4%
de
los
pa os
e minó
en
cesá ea,
el
7,7%
ue on
p ema u os,
el
53,8%
de
los
ecién
nacidos
ue on
aislados
de
su
mad e,
en
el
61,5%
se
ealizó
pinzamien o
a dío
del
co dón
umbilical
y
la
asa
de
lac ancia
ma e na
exclusi a
al
al a
ue
del
76,9%.
Todos
los
ecién
nacidos
ue on
nega i os
a
COVID-
19
median e
eacción
en
cadena
de
la
polime asa
y
no
u ie on
complicaciones
pos e io es
al
pa o.
Conclusiones:
No
ha
quedado
cons a ada
la
ansmisión
e ical
du an e
el
pa o
en
los
ecién
nacidos
de
mad es
posi i as
a
COVID-19.
Han
sido
de ec adas
p ác icas
clínicas
no
a aladas
po
la
e idencia
cien ífica
al
inicio
de
la
pandemia
que
han
ido
adap ándose
a
las
ecomendaciones
in e nacionales
a
medida
que
es a
e olucionaba.
©
2021
Else ie
Espa˜
na,
S.L.U.
Todos
los
de echos
ese ados.
Wha
is
known?
The
SARS-CoV-2
pandemic
has
a ec ed
ca e
du ing
ma e ni y,
di ec ly
influencing
a en ion
du ing
bi h
and
con ibu ing
o
in e en ions
which
a e
ha dly
suppo ed
by
scien ific
e idence,
such
as
sepa a ing
mo he s
om
hei
newly
bo n
baby.
Wha
does
his
pape
con ibu e?
Many
o
he
women
who
gi e
bi h
while
COVID-19
posi i e
emain
asymp oma ic,
and
aginal
bi h
does
no
cause
an
inc ease
in
he
e ical
ansmission
o
he
SARS-CoV-2
i us
o
new-bo n
babies.
Wi hin
he
con ex
o
his
pandemic
i
is
undamen al
o
espec
p ac ices
such
as
accompanying
women
du ing
bi h,
no
sepa a ing
mo he s
om
new-bo n
in an s
and
b eas eeding.
In oduc ion
The
disease
caused
by
SARS-CoV-2
is
now
a
wo ldwide
medical
eme gency.1SARS-CoV-2
may
cause
se e e
disease,
abo e
all
in
olde
indi iduals
wi h
concomi an
diseases,
al hough
he
whole
popula ion
is
suscep ible
o
in ec ion.2
Expe ience
wi h
known
i al
in ec ions
du ing
p egnancy
shows
an
inc ease
in
ma e nal
complica ions,
including
spon aneous
abo ions,
p ema u e
memb ane
up u e
and
p ema u i y.2In
pa icula ,
p e ious
ou b eaks
o
o he
ypes
o
co ona i us
showed
ha
p egnan
women
who
we e
in ec ed
may
su e
se e e
complica ions
such
as
acu e
es-
pi a o y
synd ome,
anxie y
synd ome
and
mul iple
o gan
ailu e.3I
is
well-known
ha
i al
pneumonia,
especially
when
i
is
accompanied
by
como bidi ies
(such
as
ca dio as-
cula
p oblems
and
ch onic
espi a o y
p oblems
o
obesi y)
may
significan ly
inc ease
ma e nal
and
neona al
mo bidi y.2
Gi en
he
unce ain
p ognosis
o
p egnan
women
a ec ed
by
SARS-CoV-2
in
he
fi s
mon hs
o
he
pandemic,
many
conce ns
a ose
ega ding
he
clinical
managemen
o
such
a
sensi i e
g oup
o
pa ien s.3The
main
aim
o
his
s udy
was
he e o e
o
de e mine
he
ma e nal
and
pe ina-
al
epe cussions
du ing
bi h
and
he
clinical
pue pe ium
in
p egnan
mo he s
in ec ed
by
SARS-CoV-2
in
he
Valencian
2
ARTICLE IN PRESS
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En e me ía
Clínica
xxx
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xxx---xxx
Communi y.
The
seconda y
objec i es
we e
o
de e mine
he
exis ence
o
absence
o
e ical
ansmission,
and
o
desc ibe
he
ma e nal
ca e
gi en
du ing
he
epidemic
and
he
ype
o
lac a ion
implemen ed.
Me hod
This
desc ip i e,
obse a ional,
e ospec i e
and
mul i-
cen e
s udy
was
unde aken
in
5
public
hospi als
in
he
Valencian
Communi y
(Hospi al
Uni e si a io
de
La
Ribe a,
Hospi al
Lluis
Alcanyis,
Hospi al
de
On inyen ,
Hospi al
Gen-
e al
de
Valencia
and
Hospi al
Uni e si a i
i
Poli ècnic
La
Fe).
The
a ge
popula ion
we e
women
who
ga e
bi h
in
hese
hospi als.
The
inclusion
c i e ia
we e:
a
posi i e
poly-
me ase
chain
eac ion
(PCR)
de e mina ion
o
SARS-CoV-2,
a
new-bo n
in an
wi h
a
posi i e
PCR
de e mina ion
o
SARS-CoV-2
and
a
single
p egnancy.
P egnan
women
wi h
a
posi i e
PCR
admi ed
o
a
medical
o
su gical
eason
o he
han
bi h
we e
excluded.
All
o
he
posi i e
cases
seen
du ing
he
da a
ga he ing
pe iod
we e
included.
Pa icipan
da a
we e
ob ained
om
he
elec onic
eg-
is ies
o
hei
clinical
his o ies
om
1
Ma ch
o
30
June
2020.
Sociodemog aphic,
obs e ic
and
clinical
a iables
we e
eco ded,
oge he
wi h
hose
in
connec ion
wi h
lac-
a ion.
Quan i a i e
a iables
we e
exp essed
as
an
a e age
wi h
s anda d
de ia ion
o
hei
median
and
in e qua ile
ange,
depending
on
hei
na u e.
Quali a i e
a iables
we e
exp essed
as
pe cen ages
and
absolu e
equencies.
S a is-
ical
analysis
was
pe o med
using
IBM®SPSS® .22
so wa e.
This
s udy
was
app o ed
by
he
Resea ch
E hics
Commi -
ee
o
he
Resea ch
Commission
o
Hospi al
Uni e si a io
de
La
Ribe a
(Regis a ion
numbe :
HULR2020
27),
as
well
as
by
he
o he
hospi als.
Resul s
Thi een
women
and
hei
new-bo n
in an s
we e
included.
Respec ing
he
dis ibu ion
o
he
hospi als,
38.5%
(n
=
5)
we e
ea ed
in
La
Fe,
30.8%
(n
=
4)
in
La
Ribe a,
15.4%
(n
=
2)
in
he
Hospi al
Gene al
de
Valencia,
7.7%
(n
=
1)
in
Hospi al
Lluis
Alcanyis
and
7.7%
(n
=
1)
in
Hospi al
de
On inyen .
The
p e alence
o
posi i e
cases
amoun ed
o
0.48%
o
he
o al
numbe
o
bi hs
seen
du ing
he
s udy
pe iod.
The
a e age
age
o
he
women
was
35.31
±
4.2
yea s.
Almos
one
hi d
o
he
in ec ed
p egnan
women
we e
fi s -
ime
mo he s
(30.8%,
n
=
4),
wi hou
any
p e ious
ma e nal
disease
(92.3%,
n
=
12),
ges a ional
disease
(84.6%,
n
=
11)
o
oe al
disease
(84.6%,
n
=
11)
(Table
1).
53.8%
(n
=
7)
o
he
bi hs
commenced
spon aneously.
In
16.6%
(n
=
1)
bi h
he
cause
o
induc ion
was
a ibu ed
o
SARS-CoV-2
in ec ion.
76.9%
(n
=
10)
o
he
bi hs
we e
eu ocic
and
15.4%
(n
=
2)
e -
mina ed
in
caesa ean
sec ion.
The
causes
o
he
la e
we e
he
isk
o
losing
oe al
well-being
and
knowledge
o
he
posi i e
esul
o
he
COVID-19
es
in
a
case
o
p ema u e
memb ane
up u e
(>18
h)
wi h
a
p e ious
caesa ean.
The e
was
one
case
o
pos -pa um
haemo hage
(7.7%).
None
o
he
women
we e
admi ed
o
he
In ensi e
Ca e
Uni
a e
gi ing
bi h,
and
no
did
hey
show
any
symp oms
du ing
he
same
(Table
2).
Table
1
Sociodemog aphic
and
obs e ic
cha ac e is ics
o
he
sample
(n
=
13).
n
%
Coun y
o
o igin
Cen al
and
Sou h
Ame ica
1
7.7
Spain
12
92.3
Educa ional
le el
Qualified
3
23.1
Deg ee
3
23.1
P ima y
school 4
30.8
Seconda y
school/second
le el
(Baccalau ea e)
3
23.1
Occupa ion
Wage
ea ne
10
76.9
Unemployed
2
15.4
Business
woman/p o essional 1
7.7
Heal hca e
pe sonnel
No
10
76.9
Yes 3
23.1
Bi hs
Mul iple
9
69.2
Fi s - ime
mo he 4
30.8
P e ious
ma e nal
disease
Hypo hy oidism
1
7.7
None
12
92.3
Disease
du ing
p egnancy
Ges a ional
diabe es
1
7.7
Hypo hy oidism
1
7.7
None
11
84.6
Foe al
disease
None
11
84.6
Club oo
1
7.7
SGA
1
7.7
SGA:
small
o
ges a ional
age.
Nine y- wo
poin
h ee
pe cen
(n
=
12)
o
he
new-bo n
in an s
we e
bo n
a
e m,
wi h
an
a e age
ges a ional
age
o
38.6
±
1.5
weeks.
The
Apga
es
a e
1
min
and
a
5
min
ga e
a
median
o
10
(in e qua ile
ange
9---10)
poin s.
The
umbilical
co d
was
clamped
la e
in
61.5%
(n
=
8)
o
cases,
and
in
46.2%
(n
=
6)
cases
skin
o
skin
con ac
was
made.
Be o e
bi h
he
desi e
o
b eas eed
was
o al,
al hough
a e
lea ning
o
he
posi i e
COVID-19
esul ,
23.1%
(n
=
3)
decided
no
o
do
so.
53.8%
(n
=
7)
o
he
new-bo n
babies
we e
sepa a ed
om
hei
mo he s
and
admi ed
o
he
neona al
In ensi e
Ca e
Uni
as
an
isola ion
measu e,
a e
which
no
complica ion
was
iden ified
du -
ing
admission
(median
admission
2
days,
in e qua ile
ange
1---3).
All
o
he
new-bo n
in an s
we e
ound
o
be
nega-
i e
in
PCR
o
SARS-CoV-2.
A
e es
was
pe o med
in
23.1%
(n
=
3)
o
cases
24
h
and
48
h
a e
admission,
and
hese
es s
we e
nega i e.
69.2%
(n
=
9)
o
hei
pa ne s
accompanied
he
women
du ing
bi h
(Table
2).
Discussion
The
clinical
cha ac e is ics
o
his
se ies
o
women
we e
sim-
ila
o
hose
epo ed
in
o he
publica ions.4The
scien ific
li e a u e
shows
ha
p egnancy
does
no
inc ease
he
p ob-
3
ARTICLE IN PRESS
+Model
R.
Vila-Candel,
D.
Mena-Tudela,
A.
Gómez-Seguí
e
al.
Table
2
Cha ac e is ics
and
ca e
du ing
bi h
and
he
pue -
pe ium
(n
=
13).
n
%
Bi h
Spon aneous
7
53.8
Induced
6
46.2
Cause
o
induc ion
PMR
>
18
h4
66.7
Ges a ional
diabe es 1
16.7
COVID-19+
1
16.6
Complica ion
du ing
dila ion
Asymp oma ic
12
92.3
CTGR
al e a ion
1
7.7
End
o
bi h
Caesa ean
2
15.4
Eu ocic
10
76.9
Ins umen al
1
7.7
Complica ion
du ing
pue pe ium
Asymp oma ic
12
92.3
Pue pe al
haemo hage
1
7.7
Mo he
admi ed
o
ICU
No
13
100.0
Was
he
new-bo n
in an
sepa a ed
om
he
mo he ?
No
6
46.2
Yes
7
53.8
Reason
o
sepa a ion
Mo he
COVID-19+
7
53.8
No
applicable
6
46.2
De e mina ion
o
mo he ’s
PCR
An epa um
12
92.3
Pos pa um
1
7.7
Resul
o
ma e nal
PCR+
An epa um
4
30.8
In apa um
3
23.1
Pos pa um
6
46.2
De e mina ion
o
new-bo n
in an
PCR
Day
o
bi h
13
100.0
Resul
o
new-bo n
in an
PCR
Nega i e
13
100.0
Posi i e
0
0.0
Accompanied
du ing
bi h
No
4
30.8
Yes
9
69.2
Companion
Nobody
4
30.8
Pa ne 9
69.2
La e
clamping
No
5
38.5
Yes
8
61.5
Ea ly
con ac
No
7
53.8
Yes,
wi h
he
mo he
bu
in
he
oom
2
15.4
Yes,
in
he
deli e y
oom
4
30.8
Desi e
o
b eas eed
be o e
bi h
Yes
13
100.0
Table
2
(Con inued)
n
%
Type
o
lac a ion
a e
bi h
A ificial
lac a ion
due
o
mo he ’s
decision
3
23.1
B eas eeding
10
76.9
PCR:
polyme ase
chain
eac ion;
PMR:
p ema u e
memb ane
up u e;
CTGR:
ca dio ocog aphy
eco ding;
ICU:
in ensi e
ca e
uni .
abili y
o
complica ions
associa ed
wi h
COVID-19,
al hough
some
ha e
been
desc ibed.2
Due
o
he
cu en
pandemic
and
he
h ea
o
new
wa es
caused
by
SARS-CoV-2,
i
is
necessa y
o
ha e
clinical
da a
which
aid
clinical
decision-making.
This
scena io
and
he
swi
modifica ion
and
adap a ion
o
wo king
ou ine
in
ma e ni y
ca e
ac oss
Eu ope5has
mean
ha
conce n
has
inc eased
abou
ensu ing
sa e
ca e
o
p egnan
women,
some imes
leading
o
medical
in e en ions
ha
we e
no
p ope ly
jus ified.5These
ac o s
may
ha e
a ec ed
compli-
ance
wi h
ca e
quali y
indica o s,
gi ing
ise
o
si ua ions
ha
may
ha e
been
classified
wi hin
he
con ex
o
obs e -
ic
iolence,
al hough
hey
we e
masked
by
he
s uc u al
and
medical
con ex
a ising
om
SARS-CoV-2.6
Rega ding
he
ma e nal
ca e
and
igh
o
COVID-19
posi i e
women,
se e al
impo an
poin s
o
conce n
exis :
being
accompanied
du ing
bi h,
skin- o-skin
con ac ,
no
sepa a ing
mo he s
om
hei
new-bo n
baby
and
b eas eeding.5Al hough
he
ecommenda ions
o
he
Min-
is y
o
Heal h
suppo
he
implemen a ion
o
all
4
elemen s,
i
seems
ha
clinical
p ac ice
di e ed.
This
s udy
shows
a
ce ain
deg ee
o
a iabili y
espec ing
being
accompanied
du ing
bi h.
This
p ac ice
is
no
solely
go e ned
by
a
igh ,
as
i
is
also
associa ed
wi h
inc eased
sa e y
and
well-being
o
women
du ing
bi h.7Mo emen s
by
midwi es’
collec i es
in
he
Valencian
Communi y
may
ha e
influenced
he
change
o
a i ude
o
his
aspec .8
Ve ical
in ec ion
o
he
new-bo n
in an s
was
uled
ou
in
he
sample.
Con ac
be ween
mo he s
and
hei
new-bo n
in an s
was
main ained
in
his
s udy,
gi en
i s
p emise
o
no
causing
ha m.2,9 Mo eo e ,
sepa a ing
a
mo he
om
he
heal hy
new-bo n
child
in
a
heal hca e
sys em
unde
s ess
leads
o
inc eased
wo kload
o
he
sys em
and
he
p o es-
sionals
in ol ed,
who
ha e
wo ked
abo e
hei
capaci ies
du ing
he
whole
du a ion
o
he
pandemic.
No
s udies
we e
ound
ha
o e
da a
on
he
la e
clamp-
ing
o
he
umbilical
co d
du ing
he
pandemic.
Ne e heless,
he
high
gene al
pe cen age
o
caesa ean
sec ions,
sys em-
a ic
sepa a ions
and
s ic
measu es
o
isola ion
may
ha e
led
o
he
abandonmen
o
his
p ac ice.2The
consequences
o
ce ain
clinical
ac ions
due
o
he
pandemic
in
e ms
o
he
heal h
o
new-bo n
in an s
ha e
ye
o
be
de e mined.
These
ac ions
include
ea ly
clamping
o
he
umbilical
co d,
isola ing
new-bo n
babies
om
hei
mo he
o
p e e ence
o
bo le
eeding.
This
s udy
seems
o
indica e
a
ce ain
deg ee
o
ejec-
ion
o
b eas eeding
in
women
who
know
hey
a e
COVID-19
posi i e.
The
causes
o
his
ejec ion
may
include
ea
o
in ec ing
hei
baby,2al hough
he
s ic
measu es
o
p e-
4
ARTICLE IN PRESS
+Model
En e me ía
Clínica
xxx
(xxxx)
xxx---xxx
en
he
ho izon al
ansmission
o
he
i us
may
also
ha e
had
an
influence.
The e
we e
many
ecommenda ions
o
discou age
o
o bid
b eas eeding
du ing
he
fi s
wa e
o
SARS-CoV-2.2,10 Di e en
scien ific
socie ies
ha e
g adually
adap ed
o
modified
hei
p o ocols
o
ac ion
du ing
he
pandemic.
The
la es
e sions
o
hese
p o ocols
exp ess
he
ad isabili y
o
non-sepa a ion,
skin- o-skin
con ac
and
he
encou agemen
o
b eas eeding.
Limi a ions
Al hough
his
s udy
cen es
on
a
small
g oup
o
women,
i
is
impo an
o
unde line
ha
Eu opean
Union
coun ies
ha e
epo ed
changes
in
how
p egnan
women
and
hei
ami-
lies
a e
ea ed.5In
he
majo i y
o
cases
e ospec i e
da a
ga he ing
is
influenced
by
he
lack
o
eco ds.
In
his
case,
gi en
he
excep ional
na u e
o
he
cases
ea ed
in
each
one
o
he
hospi als,
i
was
comple e
and
exhaus i e.
Awa e-
ness
o
he
posi i e
PCR
esul
o
he
mo he
may
a ec
he
esul s,
abo e
all
in
he
managemen
o
he
new-bo n
in an
du ing
he
fi s
mon hs
(Ma ch
and
Ap il)
o
he
pandemic,
as
his
may
ha e
led
o
inc eased
es ic ions.
All
o
he
women
analysed
we e
asymp oma ic
and
had
no
complica ions.
No
e ical
ansmission
o
he
new-bo n
in an s
o
SARS-CoV-2
posi i e
mo he s
was
de ec ed
in
his
s udy.
Du ing
he
fi s
mon hs
o
he
pandemic,
he
lack
o
a ailable
scien ific
e idence
on
SARS-CoV-2
had
a
nega i e
e ec
on
bi h,
pue pe ium
and
b eas eeding
managemen
in
he
COVID-19
posi i e
women,
as
hey
we e
sepa a ed
om
hei
new-bo n
babies.
This
a ec ed
ea ly
skin- o-skin
con ac
and
educed
beneficial
p ac ices
such
as
la e
clamp-
ing
o
he
umbilical
co d
and
b eas eeding.
Conflic
o
in e es s
The
au ho s
ha e
no
conflic
o
in e es s
o
decla e.
Acknowledgemen s
We
would
like
o
hank
Víc o
Manuel
González-Cho dá
and
F ancisco
Ja ie
So iano-Vidal
o
all
hei
help
and
aluable
con ibu ions
o
his
wo k.
We
would
also
like
o
hank
all
o
he
obs e ic
and
paedia ic
s a
who
ook
pa
in
ca ing
o
he
cases,
o
hei
wo k
and
dedica ion.
Re e ences
1.
Wo ld
Heal h
O ganiza ion.
WHO
Di ec o -Gene al’s
opening
ema ks
a
he
media
b iefing
on
COVID-19-11
Ma ch
2020.
Gene a:
WHO;
2020.
A ailable
a :
h ps://www.who.in /dg/
speeches/de ail/who-di ec o -gene al-s-opening- ema ks-a -
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S ump e
FM,
Ti zmann
A,
Schneide
MO,
S elzl
P,
Kehl
S,
Fasching
PA,
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SARS-CoV-2
in ec ion
in
p egnancy
---
a
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cu en
li e a u e
and
possible
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ma e nal
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Gebu shil e
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2020;80:380---90,
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3.
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Mascio
D,
Khalil
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Saccone
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G,
Buca
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h p://dx.doi.o g/10.1016/j.ajogm .2020.100107.
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19,
hei
newbo n
in an s,
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ma e nal- e al
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o
SARS-CoV-2:
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A ch
Pa hol
Lab
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h p://dx.doi.o g/10.5858/a pa.2020-0901-SA.
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K,
Tu ienzo
CF,
Kweekel
L,
Gooda zi
B,
B igan e
L,
Simon
A,
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al.
The
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pan-
demic
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ma e ni y
ca e
in
Eu ope.
Midwi e y.
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h p://dx.doi.o g/10.1016/j.midw.2020.102779.
6.
Sadle
M,
Lei a
G,
Olza
I.
COVID-19
as
a
isk
ac o
o
obs e -
ic
iolence.
Sex
Rep od
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h p://dx.doi.o g/10.1080/26410397.2020.1785379.
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Minis e io
de
Sanidad
y
Polí ica
Social.
Guía
de
P ác ica
Clínica
sob e
la
A ención
al
Pa o
No mal.
Vi o ia-Gas eiz:
Se icio
Cen al
de
Publicaciones
del
Gobie no
Vasco;
2010.
A ailable
a :
h ps://po al.guiasalud.es/wp-con en /uploads/2018/12/
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472
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No mal
Os eba
compl.pd
[accessed
10.12.20].
8.
La
sanidad
alenciana
ecula
y
pe mi i á
a
las
emba azadas
es a
acompa˜
nadas
du an e
el
pa o.
20
Minu os
[In e -
ne ].
8
Ap il
2020.
A ailable
a :
h ps://www.20minu os.es/
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10.12.20].
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S uebe
A.
Should
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om
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wi h
COVID-19?
Fi s ,
do
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B eas eed
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h p://dx.doi.o g/10.1089/b m.2020.29153.ams.
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Run-Qian
L,
Hao-Ran
W,
Hao-Ran
C,
Ya-Bin
L,
Yang
G,
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al.
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5
