Clinical outcome in newborns of perinatally COVID-19 infected women

Abstract

Objective

Maternal COVID-19 infection during pregnancy has been associated with adverse neonatal outcomes, such as prematurity and neonatal morbidity. Those adverse events are mainly attributed to maternal factors, rather than to the neonatal infection itself. Our aim is to add our experience and present the neonatal outcome of neonates born to mothers with perinatal SARS-CoV-2 infection.

Methods

This is a prospective case-control study with data from two Academic Tertiary Referral Hospitals in Greece. Electronic records of all births from SARS-CoV-2 positive mothers between March 2020 and April 2021 were analyzed. Demographic data, the severity of maternal COVID-19 disease, gestational age (GA), mode of delivery, birth weight (BW), need for resuscitation and/or supplemental oxygen and duration of hospitalization were recorded. A comparison with 2:1 matched neonates according to sex, GA, and BW born to SARS-CoV-2 negative mothers during the same period was performed. Chi-square and Mann–Whitney U test were used for categorical and non-categorical variables respectively.

Results

A total of eighty-one neonates were born to SARS-CoV-2 positive mothers during this period. Forty-three percent of pregnant mothers were asymptomatic. Median GA and median BW were 38 weeks (Interquantile range (IQR): 36–39 weeks) and 2940 gr (IQR: 2560–3340 gr) respectively. Prematurity was observed in 24.7% of the cases. Only 2 (2.4%) neonates were PCR positive after delivery. SARS-CoV-2 positive women were more likely to undergo Cesarean section. APGAR score at 5 min and the need for resuscitation did not differ between the two groups. In comparison with the control group, neonates born to SARS-CoV-2 positive mothers presented with gastrointestinal symptoms (53.6% vs 5.1%, p-value= <.001) and hospitalization was longer, mostly due to maternal factors.

Conclusion

In our study neonatal positivity was limited and no vertical transmission was noted. Neonatal outcomes were comparable to the control group. However, the presence of gastrointestinal symptoms in neonates born to PCR-positive women compared to controls needs further investigation.

Keywords:

• COVID-19
• neonates
• pregnancy
• perinatal infection
• SARS-CoV-2

Acknowledgments

The authors thank Dr Anastasia Konstantinidou, 1st Department of Pathology, Unit of Perinatal Pathology, National and Kapodistrian University of Athens, Greece, for her work on placental histopathology in a sub-group of our cohort and Dr George Antonogeorgos, School of Health Science & Education, Harokopio University, who provided statistical assistance.

Disclosure statement

No potential conflict of interest was reported by the author(s)..

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.