No abstract

Background Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk for severe illness compared with nonpregnant women. Data to assess risk factors for illness severity among pregnant women with COVID-19 are limited. This study aimed to determine risk factors associated with COVID-19 illness severity among pregnant women with SARS-CoV-2 infection. Methods Pregnant women with SARS-CoV-2 infection confirmed by molecular testing were reported during March 29, 2020–March 5, 2021 through the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). Criteria for illness severity (asymptomatic, mild, moderate-to-severe, or critical) were adapted from National Institutes of Health and World Health Organization criteria. Crude and adjusted risk ratios for moderate-to-severe or critical COVID-19 illness were calculated for selected demographic and clinical characteristics. Results Among 7,950 pregnant women with SARS-CoV-2 infection, moderate-to-severe or critical COVID-19 illness was associated with age 25 years and older, healthcare occupation, pre-pregnancy obesity, chronic lung disease, chronic hypertension, and pregestational diabetes mellitus. Risk of moderate-to-severe or critical illness increased with the number of underlying medical or pregnancy-related conditions. Conclusions Older age and having underlying medical conditions were associated with increased risk of moderate-to-severe or critical COVID-19 illness among pregnant women. This information might help pregnant women understand their risk for moderate-to-severe or critical COVID-19 illness and inform targeted public health messaging.

Background Multiple reports have described neonatal SARS‐CoV‐2 infection, including likely in utero transmission and early postnatal infection, but published estimates of neonatal infection range by geography and design type. Objectives To describe maternal, pregnancy and neonatal characteristics among neonates born to people with SARS‐CoV‐2 infection during pregnancy by neonatal SARS‐CoV‐2 testing results. Methods Using aggregated data from the Surveillance for Emerging Threats to Mothers and Babies Network (SET‐NET) describing infections from 20 January 2020 to 31 December 2020, we identified neonates who were (1) born to people who were SARS‐CoV‐2 positive by RT‐PCR at any time during their pregnancy, and (2) tested for SARS‐CoV‐2 by RT‐PCR during the birth hospitalisation. Results Among 28,771 neonates born to people with SARS‐CoV‐2 infection during pregnancy, 3816 (13%) underwent PCR testing and 138 neonates (3.6%) were PCR positive. Ninety‐four per cent of neonates testing positive were born to people with infection identified ≤14 days of delivery. Neonatal SARS‐CoV‐2 infection was more frequent among neonates born preterm (5.7%) compared to term (3.4%). Neonates testing positive were born to both symptomatic and asymptomatic pregnant people. Conclusions Jurisdictions reported SARS‐CoV‐2 RT‐PCR results for only 13% of neonates known to be born to people with SARS‐CoV‐2 infection during pregnancy. These results provide evidence of neonatal infection identified through multi‐state systematic surveillance data collection and describe characteristics of neonates with SARS‐CoV‐2 infection. While perinatal SARS‐CoV‐2 infection was uncommon among tested neonates born to people with SARS‐CoV‐2 infection during pregnancy, nearly all cases of tested neonatal infection occurred in pregnant people infected around the time of delivery and was more frequent among neonates born preterm. These findings support the recommendation for neonatal SARS‐CoV‐2 RT‐PCR testing, especially for people with acute infection around the time of delivery.

No abstract

Because hearing loss in children can result in developmental deficits, early detection and intervention are critical. This article identifies a constellation of maternal factors that predict loss to follow-up (LTF) at the point of rescreening—the first follow-up for babies who did not pass the hearing screening performed at birth—through New Jersey’s early hearing detection and intervention program. Maternal factors are critical to consider, as mothers are often the primary decision makers around children’s health care. All data were obtained from the state’s department of health and included babies born between June 2015 and June 2017. Logistic regression was used to predict LTF. Findings indicate that non-Hispanic Black mothers, younger mothers, mothers with previous live births, and mothers with obesity were more likely to be LTF. Hispanic mothers and those enrolled in the state’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program were less likely to be LTF. Mothers most at risk for LTF should be targeted for intervention to help children with hearing loss achieve the benefits from early intervention. Being a WIC recipient is a protective factor for LTF; therefore, elements of WIC could be used to reduce the state’s LTF rate.