Characteristics of Newborns Born to SARS-CoV-2-Positive Mothers: A Retrospective Cohort StudyFunding None.
Objective The novel virus known as severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has led to a terrifying pandemic. The range of illness severity among children is variable. This study aims to assess the characteristics of newborns born to SARS-CoV-2-positive women compared with those mothers who tested negative.
Study Design This was a retrospective cohort study performed at Brookdale Hospital Medical Center in New York City from March to May 2020. Electronic medical records of mother–baby dyads were reviewed.
Results Seventy-nine mothers tested for SARS-CoV-2 were included, out of which 18.98% of mothers tested SARS-CoV-2 positive. We found a significant association between symptoms and SARS-CoV-2 status. We observed a significant association between newborns of SARS-CoV-2 positive and SARS-CoV-2 negative mothers regarding skin-to-skin contact (p < 0.001). Both groups showed significant differences regarding isolation (p < 0.001). Interestingly, regarding SARS-CoV-2 infection in newborns, only one newborn tested SARS-CoV-2 positive and was unstable in the neonatal intensive care unit (NICU). With the multivariable logistic regression model, babies of SARS-CoV-2 positive mothers were three times as likely to have desaturations in comparison to newborns from negative mothers. Also, newborns of SARS-CoV-2-positive mothers were four times more likely to have poor feeding, compared with newborns of SARS-CoV-2-negative mothers. Finally, babies of SARS-CoV-2-positive mothers were ten times more likely to be symptomatic at the 2-week follow-up.
Conclusion SARS-CoV-2 has caused major morbidity and mortality worldwide. Neonates born to mothers with confirmed or suspected SARS-CoV-2 are most of the time asymptomatic. However, neonatal critical illness due to SARS-CoV-2 is still a possibility; thus, isolation precautions (such as avoiding skin-to-skin contact and direct breastfeeding) and vertical transmission should be studied thoroughly. In addition, testing these newborns by nasopharyngeal swab at least at 24 hours after birth and monitoring them for the development of symptoms for 14 days after birth is needed.
For SARS-CoV-2-positive mothers, reducing transmission of infection to newborns is crucial.
Newborns of SARS-CoV-2-positive mothers are usually asymptomatic and may not be easily infected.
Critical illness in the newborn may still happen, so monitoring is needed.
M.A.A.F., F.K., and R.M.K. designed the study. M.A.A.F. and F.C. collected the data and performed the data analysis. F.K. and R.M.K. revised the data analysis, edited the manuscript, and critically revised the final version. F.C. submitted the manuscript. All authors read and approved all the manuscript.
Received: 07 July 2020
Accepted: 30 July 2020
03 September 2020 (online)
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- 1 World Health Organization. Coronavirus disease 2019 (SARS-CoV-2). Situation Report-74. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200403-sitrep-74-covid-19-mp.pdf?sfvrsn=4e043d03_14 . Accessed August 6, 2020
- 2 Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species severe acute respiratory syndrome related coronavirus: classifying 2019-nCoV and naming it SARSCoV-2. Nat Microbiol 2020; 5: 536-544
- 3 Chen H, Guo J, Wang C. et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020; 395 (10226): 809-815
- 4 Alzamora MC, Paredes T, Caceres D, Webb CM, Valdez LM, La Rosa M. Severe COVID-19 during pregnancy and possible vertical transmission. Am J Perinatol 2020; 37 (08) 861-865
- 5 Centers for Disease Control and Prevention. Coronavirus disease 2019 in children—United States, February 12–April 2, 2020. Morbidity and Mortality Weekly Report 2020; 69 (14) 422-426
- 6 Chandrasekharan P, Vento M, Trevisanuto D. et al. Neonatal resuscitation and postresuscitation care of infants born to mothers with suspected or confirmed SARS-CoV-2 infection. Am J Perinatol 2020; 37 (08) 813-824
- 7 IBM-SPSS. Statistical Package for Social Science.Ver.21. Available at: https://www.ibm.com/support/pages/spss-statistics-210-available-download . Accessed August 6, 2020
- 8 World Health Organization. Breastfeeding and COVID-19. Available at: https://www.who.int/news-room/commentaries/detail/breastfeeding-and-covid-19 . Accessed August 6, 2020
- 9 Centers for Disease Control. Considerations for inpatient obstetric healthcare settings. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html . Accessed August 6, 2020
- 10 Chen Rong, Zhang Yuan, Huang Lei, Cheng Bi-heng, Xia Zhong-yuan, Meng Qing-tao. Safety and efficacy of different anesthetic regimens for parturients with SARS-CoV-2 undergoing cesarean delivery: a case series of 17 patients (in French). Can J Anaesth 2020; (e-pub ahead of print) DOI: 10.1007/s12630-020-01630-7.
- 11 Mullins E, Evans D, Viner RM, O'Brien P, Morris E. Coronavirus in pregnancy and delivery: rapid review. Ultrasound Obstet Gynecol 2020; 55 (05) 586-592