Limited data are available on pregnant women with COVID-19 and their neonates. We aimed to evaluate the epidemiological and clinical characteristics of newborns born to women infected with COVID-19. A multicenter cohort study was conducted among newborns born to mothers with COVID-19 in 34 neonatal intensive care units (NICUs) in Turkey. Pregnant women (
n
= 125) who had a positive RT-PCR test and their newborns were enrolled. Cesarean section, prematurity, and low-birthweight infant rates were 71.2%, 26.4%, and 12.8%, respectively. Eight of 125 mothers (6.4%) were admitted to an intensive care unit for mechanical ventilation, among whom six died (4.8%). Majority of the newborns (86.4%) were followed in isolation rooms in the NICU. Four of 120 newborns (3.3%) had a positive RT-PCR test result. Although samples taken on the first day were negative, one neonate became positive on the second day and the other two on the fifth day. Sample from deep tracheal aspirate was positive on the first day in an intubated case.
Conclusion
: COVID-19 in pregnant women has important impacts on perinatal and neonatal outcomes. Maternal mortality, higher rates of preterm birth and cesarean section, suspected risk of vertical transmission, and low rate of breastfeeding show that family support should be a part of the care in the NICU.
Trial registration
:
ClinicalTrials.gov
identifier: NCT04401540
What is Known:
• The common property of previous reports was the conclusions on maternal outcomes, rather than neonatal outcomes.
• Published data showed similar outcomes between COVID-19 pregnant women and others.
What is New:
• Higher maternal mortality, higher rates of preterm birth and cesarean section, suspected risk of vertical transmission especially in a case with deep tracheal aspiration during the intubation, and the possible role of maternal disease severity on the outcomes are remarkable findings of this study.
• In contrast to recommendation for breastfeeding, parents’ preference to formula and expressed breast milk due to anxiety and lack of information shows that family support should be a part of the care in the NICU.
Introduction
Neonatal sepsis (NS) is a common systemic disease that causes morbidity and mortality in newborns. But there is no ideal biomarker that can be used in the early diagnosis of NS. In recent studies, platelet width to lymphocyte ratio (PLR) have been reported to play a critical role in the inflammatory process. In this study, we aimed to contribute to the research about whether or not PLR can be used in the early diagnosis of NS.
Methods
This retrospective cohort study was conducted among the newborns whose born in İzmir Buca Maternity and Pediatric Hospital between March 2015-February 2016. During these twelve months, 611 neonates with EOS were admitted to our neonatal intensive care unit. One hundred and forty-nine neonates with suspected EOS, 67 neonates with proven EOS and 92 healty neonates were enrolled in the study.
Results
Platelet width lymphocyte (LPR) values of the groups were calculated 56.5 ± 17.8 vs 62.4± 14.9 vs 15.3 ± 2.1 respectively. PLR values of suspected or proven EOS group was significantly higher than the control group. PLR has AUC 0.89 to 0.93, cutoff value of 39.5 to 57.7, sensitivity of 88.9% to 91.3% and specifity of 94.7% to 97.6%, positive predictive value of 94.3% to 97.4%, and negative predictive value of 88.6% to 91.8% in suspected and proven sepsis diagnosis.
Conclusion
Based on our results suggest that PLR can be used as a biomarker predictive of EOS.
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