Background COVID-19 infection during pregnancy was reported to cause adverse outcomes. Such knowledge stands low quality evidence due to lack of internal controls and inferential statistics. Objectives To assess impact of COVID-19 in pregnancy on fetal and neonatal outcomes. Study Design Prospective analytical cohort study (July 2020 to March 2021). Setting Level III NICU of teaching hospital in India. Participants COVID positive mothers (exposed = 239) each matched with 2 women delivered consecutively by same mode without COVID (unexposed = 478) and enrolled at admission during delivery. Procedure Maternal demographic, comorbidities, and obstetric characteristics; fetal growth, pregnancy complications, and neonatal details of 242 and 482 neonates born to exposed and unexposed mothers respectively were analyzed. Infants were followed until neonatal period. Outcomes Incidence of prematurity was primary outcome. Secondary outcomes were incidence of abortions, IUD, stillbirth, neonatal mortality, neonatal resuscitation at birth, SFD, NICU admission, neonatal morbidities, length of hospitalization, in-hospital mortality, infant positivity rate for SARS COV-2. Results Incidence of prematurity was not significantly different between mothers with and without COVID-19 infection [42(17.3%) vs 94(19.3%), IRR (95%CI) 1.04(0.83,1.31), P = .833]. Neonatal mortality, adverse fetal outcomes, PROM, fetal distress, SGA, neonatal resuscitation, NICU admission did not differ significantly between groups. Gestational hypertension was associated with COVID-19 infection [14(5.9%) vs 11(2.3%), (p=0.014)]. Infant swab positivity was 7%. Swab positivity and neonatal symptoms were associated significantly (10/17(58.8%) vs 7/17(41.1%), P = .0001). Conclusion Asymptomatic COVID-19 infection during pregnancy does not increase adverse fetal and neonatal outcomes. COVID positive neonates become symptomatic and hence need monitoring in health-care facility.

Microvillus inclusion disease is a rare autosomal recessive disorder of intestinal epithelium causing intractable secretary diarrhea in the first two months of life and about 140 cases have been reported worldwide till now. Here authors report 2 cases of Microvillus inclusion disease (MVID) diagnosed in neonates by electron microscopy study of small intestinal biopsy.

Background: Single application of chlorhexidine soon after birth reduces skin colonization. The benefit is not sustained after 72 h and multiple repeated cleansing is suggested. Such interventions especially in preterm infants need evaluation. Objective: To evaluate efficacy and safety of multiple whole-body cleansing with aqueous 0.5% chlorhexidine during first week in preterm infants. Study Design: Randomized controlled trial with superiority design and triple blinding. Setting: Level-III neonatal intensive care unit of teaching hospital in India. Participants: A total of 120 hemodynamically stable preterm (28-34 weeks) infants without encephalopathy weighing ≥ 1,000 g admitted within 6 h of life. Intervention: Following stratified randomization (28-31 weeks n = 31; 32-34 weeks n = 89), 59 and 61 infants were cleansed with identically looking aqueous 0.5% chlorhexidine wipes and placebo (sterile-water wipes) respectively at 0, 48, and 96 h after recruitment and followed up until neonatal period. Outcomes: Primary outcome was skin colonization rate on day 7. Secondary outcomes include neonatal mortality, incidence of sepsis, adverse skin reactions, and hypothermic episodes and colony counts during first week. Results: We used intention to treat analysis. After multiple cleansings, skin colonization on day 7 with chlorhexidine was 50.9% (28/55) and sterile water was 92.8% (52/56). Risk reduction with chlorhexidine cleansing was 45% compared with sterile water (relative risk = 0.55; 95% confidence interval [CI]: 0.42,0.72). Absolute risk reduction = 41.95% (95% CI: 27.1, 56.78) and number needed to treat = 2.4 persons (95% CI: 1.8, 3.7). Neonatal mortality (10.1% vs 16.3%, P = .539), sepsis (10.1% vs 19.6%, P = .229) was not significant. None had adverse skin reactions. Temperature loss after wet cleansing was not different between chlorhexidine and water. Conclusion: Multiple whole-body cleansing with aqueous 0.5% chlorhexidine at 48 h interval during first week of life reduces skin colonization in preterm infants.