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

Yıl 2022, Cilt: 19 Sayı: 4, 1575 - 1584, 31.12.2022

Şevval Keskinkaya , Gülhan Samur

https://doi.org/10.38136/jgon.981795

Öz

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.

Anahtar Kelimeler

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

Öz

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.

Anahtar Kelimeler

COVID-19, pregnancy, eating habits, breast milk

Kaynakça

• Shojaaddini Ardakani T, Shojaaldini Ardakani H, Dafei M. The Effect of Stress Caused by the COVID-19 Pandemic on Pregnant Women's Dietetic and Clinical Outcomes. Journal of Midwifery and Reproductive Health. 2021;9(1):2636-8.
• Wang C-L, Liu Y-Y, Wu C-H, Wang C-Y, Wang C-H, Long C-Y. Impact of COVID-19 on Pregnancy. International Journal of Medical Sciences. 2021;18(3):763-7.
• Schwartz DA, Graham AL. Potential Maternal and Infant Outcomes from Coronavirus 2019-nCoV (SARS-CoV-2) Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections. Viruses. 2020;12(2):194.
• Zhang J, Zhang Y, Huo S, Ma Y, Ke Y, Wang P, et al. Emotional Eating in Pregnant Women during the COVID-19 Pandemic and Its Association with Dietary Intake and Gestational Weight Gain. Nutrients. 2020;12(8):2250.
• Dolin CD, Compher CC, Oh JK, Durnwald CP. Pregnant and hungry: Addressing food insecurity in pregnant women during the coronavirus disease 2019 (COVID-19) pandemic in the United States. Am J Obstet Gynecol MFM. 2021:100378.
• FAO, IFAD, UNICEF, WFP, WHO. In Brief to The State of Food Security and Nutrition in the World 20202020.
• Schanzenbach D, Pitts A. How much has food insecurity risen? Evidence from the Census Household Pulse Survey. Institute for Policy Research (IPR) Rapid Research Report Northwestern Institute for Policy Research Published June. 2020;10.
• Chen L, Li Q, Zheng D, Jiang H, Wei Y, Zou L, et al. Clinical Characteristics of Pregnant Women with Covid-19 in Wuhan, China. New England Journal of Medicine. 2020;382(25):e100.
• Juan J, Gil MM, Rong Z, Zhang Y, Yang H, Poon LC. Effect of coronavirus disease 2019 (COVID‐19) on maternal, perinatal and neonatal outcome: systematic review. Ultrasound in Obstetrics & Gynecology. 2020;56(1):15-27.
• Hughes BL, Miller E. Coronavirus (COVID-19) and Pregnancy: What Maternal-Fetal Medicine Subspecialists Need to Know 7.23. 20 (this is an update of the draft originally posted on 6.26. 2020).
• Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet. 2020;395(10226):809-15.
• Goyal M, Singh P, Melana N. Review of care and management of pregnant women during COVID-19 pandemic. Taiwan J Obstet Gynecol. 2020;59(6):791-4.
• Blumberg DA, Underwood MA, Hedriana HL, Lakshminrusimha S. Vertical transmission of SARS-CoV-2: what is the optimal definition? American journal of perinatology. 2020;37(8):769.
• Walker K, O'Donoghue K, Grace N, Dorling J, Comeau J, Li W, et al. Maternal transmission of SARS‐COV‐2 to the neonate, and possible routes for such transmission: a systematic review and critical analysis. BJOG: An International Journal of Obstetrics & Gynaecology. 2020;127(11):1324-36.
• Duran P, Berman S, Niermeyer S, Jaenisch T, Forster T, Gomez Ponce De Leon R, et al. COVID-19 and newborn health: systematic review. Revista Panamericana de Salud Pública. 2020;44:1.
• Pace RM, Williams JE, Järvinen KM, Belfort MB, Pace CDW, Lackey KA, et al. Characterization of SARS-CoV-2 RNA, Antibodies, and Neutralizing Capacity in Milk Produced by Women with COVID-19. mBio. 2021;12(1):e03192-20.
• Fitzgerald E, Hor K, Drake AJ. Maternal influences on fetal brain development: The role of nutrition, infection and stress, and the potential for intergenerational consequences. Early Hum Dev. 2020;150:105190.
• American Academy of Pediatrics (AAP). "FAQs: Management of Infants Born to Mothers with Suspected or Confirmed COVID-19". Erişim Tarihi: 15 Mayıs 2021. Available from: https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/faqs-management-of-infants-born-to-covid-19-mothers/.
• Sankaran D, Nakra N, Cheema R, Blumberg D, Lakshminrusimha S. Perinatal SARS-CoV-2 Infection and Neonatal COVID-19: A 2021 Update. NeoReviews. 2021;22(5):e284-e95.
• Liguoro I, Pilotto C, Bonanni M, Ferrari ME, Pusiol A, Nocerino A, et al. SARS-COV-2 infection in children and newborns: a systematic review. Eur J Pediatr. 2020;179(7):1029-46.
• Biviá-Roig G, La Rosa VL, Gómez-Tébar M, Serrano-Raya L, Amer-Cuenca JJ, Caruso S, et al. Analysis of the Impact of the Confinement Resulting from COVID-19 on the Lifestyle and Psychological Wellbeing of Spanish Pregnant Women: An Internet-Based Cross-Sectional Survey. International Journal of Environmental Research and Public Health. 2020;17(16):5933.
• Matvienko-Sikar K, Pope J, Cremin A, Carr H, Leitao S, Olander EK, et al. Differences in levels of stress, social support, health behaviours, and stress-reduction strategies for women pregnant before and during the COVID-19 pandemic, and based on phases of pandemic restrictions, in Ireland. Women Birth. 2020.
• Hoffman MC, Freedman R, Law AJ, Clark AM, Hunter SK. Maternal nutrients and effects of gestational COVID-19 infection on fetal brain development. Clin Nutr ESPEN. 2021;43:1-8.
• Hunter SK, Hoffman MC, D'Alessandro A, Noonan K, Wyrwa A, Freedman R, et al. Male fetus susceptibility to maternal inflammation: C-reactive protein and brain development. Psychological Medicine. 2021;51(3):450-9.
• Ersoy N, Yardımcı H. COVID-19’UN ÇOCUKLUK ÇAĞINDA YETERSİZ BESLENMEYE ETKİSİ. FARKLI BOYUTLARIYLA SAĞLIK. 2020:1.
• Benjamin-Neelon SE, Allen C, Neelon B. Household Food Security and Infant Adiposity. Pediatrics. 2020;146(3):e20193725.
• Amini S, Mohseni H, Kalantar M, Amani R. Nutrition in Caring for Pregnant Women During the COVID-19 Pandemic in Low-Income Countries. Nutrition Today. 2021;56(2):80-4.
• Vazquez-Vazquez A, Dib S, Rougeaux E, Wells JC, Fewtrell MS. The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study. Appetite. 2021;156:104985.
• Alam S, Bhuiyan FR, Emon TH, Hasan M. Prospects of nutritional interventions in the care of COVID-19 patients. Heliyon. 2021;7(2):e06285.
• De Faria Coelho-Ravagnani C, Corgosinho FC, Sanches FLFZ, Prado CMM, Laviano A, Mota JF. Dietary recommendations during the COVID-19 pandemic. Nutrition Reviews. 2021;79(4):382-93.
• Dörnemann J, Burzio C, Ronsse A, Sprecher A, De Clerck H, Van Herp M, et al. First newborn baby to receive experimental therapies survives Ebola virus disease. The Journal of infectious diseases. 2017;215(2):171-4.
• Benski C, Di Filippo D, Taraschi G, Reich MR. Guidelines for Pregnancy Management During the COVID-19 Pandemic: A Public Health Conundrum. International Journal of Environmental Research and Public Health. 2020;17(21):8277.
• Chen D, Yang H, Cao Y, Cheng W, Duan T, Fan C, et al. Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (COVID‐19) infection. International Journal of Gynecology & Obstetrics. 2020;149(2):130-6.
• Centers for Disease Control and Prevention (CDC). "Breastfeeding and Caring for Newborns". Erişim tarihi: 25 Mayıs 2021. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html.
• World Health Organization (WHO). Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected: interim guidance, 13 March 2020. World Health Organization.
• American Academy of Pediatrics (AAP). "Breastfeeding guidance post hospital discharge for mothers or infants with suspected or confirmed SARS-Co V-2 infection". Erişim Tarihi: 25 Mayıs 2021. Available from: https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/breastfeeding-guidance-post-hospital-discharge/ 2020.
• Marinelli KA, Lawrence RM. Safe Handling of Containers of Expressed Human Milk in all Settings During the SARS-CoV-2 (COVID-19) Pandemic. Journal of Human Lactation. 2020;36(3):498-501.