SARS-CoV-2 emerged in China in December 2019, creating a massive public health concern. Although previous studies have identified SARS-CoV-2 in pregnant women, the possibility of transmission to newborns remains uncertain. Herein, we investigated SARS-CoV-2 infection and risk factors among parturients and newborns. This was a cross-sectional study carried out with 3633 parturients from Luanda, Angola, between January and April 2021, with an age ranging from 13 to 48 years. SARS-CoV-2 infection of the parturients was further confirmed with RT-PCR after COVID-19 Ag Rapid Testing. About 0.4% of parturients tested positive on the day of delivery. Surprisingly, parturients from urbanized areas (OR: 0.18, p = 0.025) had a low chance of infection. None of the newborns tested positive in the first 24 h after birth, while one (9.1%, 1/10) of the newborns tested positive with pharyngeal swabs seven days after birth. However, whether the case was due to vertical transmission from mother to child remains to be confirmed. The mother’s residence, education level, antenatal follow-up, and delivery category were related to SARS-CoV-2 transmission (p < 0.05). Our findings showed a relatively low SARS-CoV-2 infection from parturients to newborns, regardless of the severity of the maternal disease. Furthermore, these findings are an early assessment of COVID-19 cases in late pregnancy, which could indicate the need for intensive management of SARS-CoV-2 infection among parturients in Angola. Further studies are needed on the consequences of SARS-CoV-2 among pregnant women and neonates from Angola.
A cross-sectional study was carried out with 3633 parturients from Lucrécia Paim maternity, located in Luanda, the capital city of Angola, between January and April 2021. Lucrécia Paim maternity is a public health unit and reference center for providing health care to pregnant women and newborns from all provinces of Angola. The study was reviewed and approved by the national ethics committee of the Ministry of Health of Angola (approval no. 35/2020) and by the general director of Lucrécia Paim maternity (approval no. 840/GDG/MLP/2020). In addition, informed consent was presented to participants where they, their parent or legal guardian, freely accepted to participate in the study and follow the newborn. All data used in the analyses were coded and restricted access was given only to the research team in order to anonymize the personal data of the studied participants. A structured questionnaire prepared by the research team was used to collect sociodemographic, epidemiological, and clinical data before proceeding with the test to detect SARS-CoV-2 infection. After, a nasopharyngeal smear sample was collected from all participants before labor began. The collected samples were used for the screening of the SARS-CoV-2 antigen using a COVID-19 Ag Rapid Test Device kit (Panbio, Seoul, Korea, Abbott) [14]. The entire technical procedure and interpretation of the results were carried out according to the instructions provided by the manufacturer [14]. This test allows for rapid in vitro diagnostics for the qualitative detection of the SARS-CoV-2 antigen. The research team worked with the health unit’s clinical staff to guarantee clinical assistance in case of any positive results for SARS-CoV-2. The parturients who tested negative had normal care according to the maternity’s protocol. On the other hand, parturients who tested positive for SARS-CoV-2 were isolated in a section established for the management of pregnant women infected with SARS-CoV-2 in the Lucrecia Paim maternity unit. Newborns of mothers positive for SARS-CoV-2 were also screened for SARS-CoV-2 infection in the first 24 h of life, repeating the test after seven days. In addition, a new sample was collected from all reactive participants and sent to the SARS-CoV-2 testing reference center of the Angolan Ministry of Health to perform real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2 nucleic acid of nasopharyngeal swabs in order to confirm SARS-CoV-2 infection. Statistical analysis was performed using SPSS version 25 (IBM SPSS Statistics, Armonk, NY, USA). Frequencies and percentages were part of the descriptive analysis. The normally distributed data are presented as mean and standard deviation (SD). The variables were categorized, and the chi-square (X2) and logistic regression tests were applied to verify the relationship between the categorical variables. In addition, the odds ratio (OR) and 95% confidence intervals (CIs) were calculated to determine the strength and direction of relationships. All reported p-values are two-tailed and were deemed statistically significant when p < 0.05.
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