日本新生児成育医学会雑誌　35(2)：298-303；2023　

日本新生児成育医学会雑誌　第35巻　第2号　149 ～ 154頁（2023年）

受付日：2022．12．08

受理日：2023．05．01

COVID-19 肺炎罹患母体から垂直感染をきたした早産児の1 例

A Case of a Preterm Infant with Vertical Transmission from a Mother with Severe Acute Respiratory Syndrome Coronavirus 2（ SARS-CoV-2） Pneumonia

日本赤十字社愛知医療センター名古屋第二病院　新生児科

Department of Neonatalogy, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital

山田崇春・上田健太郎・野村幸伸・廣岡孝子・田中太平

Takaharu YAMADA，Kentaro UEDA，Yukinobu NOMURA，Takako HIROOKA，Taihei TANAKA

Key Words：COVID-19，SARS-CoV-2vertical transmission，loop-mediated isothermal amplification，personal protective equipment

新型コロナウイルス感染症（coronavirus disease 2019：COVID-19）の母親から出生した児への垂直感染は稀だ と報告されている。今回我々は，COVID-19 肺炎罹患母体から垂直感染をきたした早産児の1 例を経験した。症例 は在胎33 週6 日，体重2,022g で出生した女児。分娩9 日前に母体は発症，その後肺炎を合併し母体治療のために 緊急帝王切開で出生となった。分娩前の母体の血液，尿，膣分泌物，便および羊水の新型コロナウイルス（severe acute respiratory syndrome coronavirus 2：SARS-CoV-2）核酸増幅検査（Loop-Mediated Isothermal Amplification： LAMP 法）はいずれも陽性であった。児の鼻咽頭SARS-CoV-2 核酸増幅検査（LAMP 法）は，入院時陽性で あったが日齢2 以降は陰性，再び日齢9 に陽性となり日齢21 および24 に2 回陰性を確認し感染隔離を解除した。 便のみ日齢2 から退院時までLAMP 法で陽性が続いた。児の血液および尿もLAMP 法で陽性となり，生後1 か月 のSARS-CoV-2 IgM およびIgG 陽性であったことから垂直感染と診断した。

Vertical transmission of severe acute respiratory syndrome coronavirus 2（ SARS-CoV-2） from mother to infant is considered rare. We report a case of a preterm infant with vertical transmission from a mother with SARS-CoV-2 pneumonia. A female infant was born at 33 weeks and 6 days of gestation and weighing 2022 g. Her mother had developed SARSCoV- 2 infection 9 days before delivery, which was complicated by pneumonia, and the infant was born by emergency cesarean section for maternal indication. A series of SARS-CoV-2 nucleic acid amplification tests（ loop-mediated isothermal amplification；LAMP） from mother’s nasopharynx, serum, urine, vaginal secretions, anal swab, and amniotic fluid were positive before delivery. The result of nasopharyngeal SARS-CoV-2 LAMP test of her was positive at birth, but negative at 2nd day of age. It became positive again at 9th day of age, and then negative twice at 21st and 24th day of age, and the quarantine period was lifted. Only the stool remained positive by LAMP throughout the period from 2nd day of age to 32nd day of age. The infant’s serum and urine were also positive by LAMP at 4th, 6th, and 9th day of age and were positive for SARS-CoV-2 IgM and IgG at 32nd day of age, leading to the diagnosis of vertical transmission.