COVID–19 Pandemisinin Maternal, Perinatal ve Neonatal Sonuçları ile Beslenme Durumu ve Davranışları Üzerindeki Etkisi

Abstract

İlk kez Çin’in Wuhan kentinde ortaya çıkan COVID-19, kısa süre içinde yayılarak pandemiye dönmüştür. Gebeler ve yenidoğanlar bu süreçte savunmasız gruplar arasında yer almaktadırlar. Ancak virüsün gebelik ve emzirme dönemindeki etkisine ilişkin sınırlı sayıda yüksek kanıt düzeyine sahip çalışma bulunmaktadır. Çalışmalarda bu sürecin gebeleri psikolojik açıdan olumsuz etkilediği, besin güvencesizliğinin arttığı ve bunların da dolaylı yoldan kadınların beslenme alışkanlıklarını etkileyebileceği belirtilmektedir. Pandeminin bebek üzerindeki etkileri düşünüldüğünde ise virüsün fetal dönemdeki etkileri tam olarak netleşmese de enfeksiyona maruziyet, maternal yetersiz beslenme veya maternal obezitenin fetüs üzerinde olumsuz etkilerinin bulunduğu bilinmektedir. COVID-19 sürecinde gebelik ve emzirme dönemindeki kadınların beslenmesine yönelik ek bir öneri bulunmasa da, bağışıklık sistemini güçlendirici besinlerin olduğu yeterli ve dengeli bir beslenme düzeninin sağlanması gerektiği belirtilmektedir. Anneden bebeğe virüs geçişi araştırıldığında ise vertikal değil horizontal yol aracılığıyla bulaş olduğunu gösteren çalışmalar mevcuttur. Çalışmalarda enfekte annelerin sütünde virüs tespit edilmemiştir, aksine, virüse karşı koruyu antikorların sayısında artış gözlenmiştir. Bu doğrultuda Dünya Sağlık Örgütü, Amerikan Pediatri Akademisi, Hastalık Kontrol ve Önleme Merkezleri gibi kuruluşlar tarafından gerekli hijyen koşullarının sağlanması şartıyla bebeğin anne sütüyle beslenmesinin önemi belirtilmiştir. Bu derlemede, COVID-19’un maternal, perinatal ve neonatal sonuçları ile beslenme durumu ve davranışları üzerindeki etkisinin yanı sıra anne sütü uygulamaları ile ilgili kılavuzlar incelenmiştir.

Keywords

• COVID-19
• gebelik
• beslenme alışkanlıkları
• anne sütü

The Effect of the COVID-19 Pandemic on Maternal, Perinatal and Neonatal Outcomes and Nutritional Status and Behaviors

Abstract

COVID-19, which first appeared in Wuhan, China, soon spread and turned into a pandemic. Pregnant women and newborns are among the vulnerable groups in this process. However, there are limited studies with high level of evidence regarding the effect of the virus during pregnancy and lactation. Studies have shown that this process affects pregnant women negatively, food insecurity increases, and these may indirectly affect women's eating habits. Considering the effects of the pandemic on the baby, although the effects of the virus in the fetal period are not fully clarified, it is known that exposure to infection, maternal malnutrition or maternal obesity have negative effects on the fetus. Although there is no additional recommendation for the nutrition of women during pregnancy and lactation during the COVID-19 process, it is stated that an adequate and balanced diet should be provided with nutrients that strengthen the immune system. When the virus transmission from mother to baby is investigated, there are studies showing that it is transmitted through the horizontal route, not the vertical route. The studies did not detect the virus in the milk of infected mothers, on the contrary, an increase in the number of protective antibodies against the virus was observed. Therefore, the importance of feeding the baby with breast milk provided that the necessary hygiene conditions are met by organizations such as the World Health Organization, The American Academy of Pediatrics, and Centers for Disease Control and Prevention have stated. In this review, the effects of COVID-19 on maternal, perinatal and neonatal outcomes, nutritional status and behaviors, as well as guidelines for breast milk practices were examined.

Keywords

• COVID-19
• pregnancy
• eating habits
• breast milk

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