American Journal of Obstetrics and Gynecology

Journal Information
ISSN / EISSN : 0002-9378 / 1097-6868
Current Publisher: Elsevier BV (10.1016)
Former Publisher: Ovid Technologies (Wolters Kluwer Health) (10.1097) , Elsevier BV (10.1067) , Elsevier BV (10.1053)
Total articles ≅ 85,605
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Latest articles in this journal

Erin K. Collier, Ram K. Parvataneni, Michelle A. Lowes, Haley B. Naik, Martin Okun, Vivian Y. Shi, Jennifer L. Hsiao
American Journal of Obstetrics and Gynecology, Volume 224, pp 54-61; doi:10.1016/j.ajog.2020.09.036

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Comment
Léo Pomar , Karin Nielsen-Saines, David Baud
American Journal of Obstetrics and Gynecology, Volume 224, pp 126-127; doi:10.1016/j.ajog.2020.09.003

Abstract:
We have read with great interest the systematic review and metaanalysis by Kotlyar and colleagues1Kotlyar A. Grechukhina O. Chen A. et al.Vertical transmission of COVID-19: a systematic review and meta-analysis.Am J Obstet Gynecol. 2020; ([Epub ahead of print])Google Scholar reporting a pooled proportion of 3.2% for vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The authors indicate the proportion of positive SARS-CoV-2 RNA testing in neonatal blood, urine, placental samples, and amniotic fluid, without considering the stability of viral RNA as a major limitation in the diagnosis of maternal-fetal transmission.
Jeannie C. Kelly , Nandini Raghuraman, Ebony B. Carter, Arvind Palanisamy, Molly J. Stout
American Journal of Obstetrics and Gynecology, Volume 224, pp 114-116; doi:10.1016/j.ajog.2020.09.023

Rebecca F. Hamm , Sarah Perelman, Eileen Y. Wang, Lisa D. Levine, Sindhu K. Srinivas
American Journal of Obstetrics and Gynecology, Volume 224, pp 84.e1-84.e7; doi:10.1016/j.ajog.2020.07.007

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Alexandra C. Sundermann , Digna R. Velez Edwards, James C. Slaughter, Pingsheng Wu, Sarah H. Jones, Eric S. Torstenson, Katherine E. Hartmann
American Journal of Obstetrics and Gynecology, Volume 224, pp 97.e1-97.e16; doi:10.1016/j.ajog.2020.07.012

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Scott A. Shainker, Beverly Coleman, Ilan E. Timor-Tritsch, Amarnath Bhide, Bryann Bromley, Alison G. Cahill, Manisha Gandhi, Jonathan L. Hecht, Katherine M. Johnson, Deborah Levine, et al.
American Journal of Obstetrics and Gynecology, Volume 224; doi:10.1016/j.ajog.2020.09.001

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Bonnie L. Bermas, Christina Chambers
American Journal of Obstetrics and Gynecology; doi:10.1016/j.ajog.2020.12.1218

Antonio Ragusa, Denise Rinaldo, Alessandro Svelato
American Journal of Obstetrics and Gynecology; doi:10.1016/j.ajog.2020.12.1216

Linn Woelber , Katharina Prieske, Christine Eulenburg, Leticia Oliveira-Ferrer, Nikolaus De Gregorio, Ruediger Klapdor, Matthias Kalder, Ioana Braicu, Sophie Fuerst, Maximilian Klar, et al.
American Journal of Obstetrics and Gynecology; doi:10.1016/j.ajog.2020.12.1220

Alexander Kotlyar , Olga Grechukhina, Alice Chen, Shota Popkhadze, Alyssa Grimshaw , Oded Tal, Hugh S. Taylor, Reshef Tal
American Journal of Obstetrics and Gynecology, Volume 224, pp 35-53.e3; doi:10.1016/j.ajog.2020.07.049

Abstract:
ObjectiveThis study aimed to conduct a systematic review of the current literature to determine estimates of vertical transmission of coronavirus disease 2019 based on early RNA detection of severe acute respiratory syndrome coronavirus 2 after birth from various neonatal or fetal sources and neonatal serology.Data SourcesEligible studies published until May 28, 2020, were retrieved from PubMed, EMBASE, medRxiv, and bioRxiv collection databases.Study Eligibility CriteriaThis systematic review included cohort studies, case series, and case reports of pregnant women who received a coronavirus disease 2019 diagnosis using severe acute respiratory syndrome coronavirus 2 viral RNA test and had reported data regarding the testing of neonates or fetuses for severe acute respiratory syndrome coronavirus 2 immediately after birth and within 48 hours of birth. A total of 30 eligible case reports describing 43 tested neonates and 38 cohort or case series studies describing 936 tested neonates were included.Study Appraisal and Synthesis MethodsThe methodological quality of all included studies was evaluated by a modified version of the Newcastle-Ottawa scale. Quantitative synthesis was performed on cohort or case series studies according to the neonatal biological specimen site to reach pooled proportions of vertical transmission.ResultsOur quantitative synthesis revealed that of 936 neonates from mothers with coronavirus disease 2019, 27 neonates had a positive result for severe acute respiratory syndrome coronavirus 2 viral RNA test using nasopharyngeal swab, indicating a pooled proportion of 3.2% (95% confidence interval, 2.2–4.3) for vertical transmission. Of note, the pooled proportion of severe acute respiratory syndrome coronavirus 2 positivity in neonates by nasopharyngeal swab in studies from China was 2.0% (8/397), which was similar to the pooled proportion of 2.7% (14/517) in studies from outside of China. Severe acute respiratory syndrome coronavirus 2 viral RNA testing in neonatal cord blood was positive in 2.9% of samples (1/34), 7.7% of placenta samples (2/26), 0% of amniotic fluid (0/51), 0% of urine samples (0/17), and 9.7% of fecal or rectal swabs (3/31). Neonatal serology was positive in 3 of 82 samples (3.7%) (based on the presence of immunoglobulin M).ConclusionVertical transmission of severe acute respiratory syndrome coronavirus 2 is possible and seems to occur in a minority of cases of maternal coronavirus disease 2019 infection in the third trimester. The rates of infection are similar to those of other pathogens that cause congenital infections. However, given the paucity of early trimester data, no assessment can yet be made regarding the rates of vertical transmission in early pregnancy and potential risk for consequent fetal morbidity and mortality.
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