Characteristics of Newborns Born to SARS-CoV-2-Positive Mothers: A Retrospective Cohort Study

Abstract

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. Key Points

SARS-CoV-2 testing and clinical outcomes in a Texas tertiary care center labor and delivery unit

“…Farghaly and colleagues found that neonates born to mothers with laboratory-confirmed SARS-CoV-2 infection were more likely to have a cesarean delivery, lower APGAR scores, and a lower birthweight compared to neonates born to mothers without SARS-CoV-2 infection. 5 In our study, the birthweight of neonates born to mothers with laboratory-confirmed SARS-CoV-2 infection was 2.83 kg, and approximately 70% of these neonates were delivered via cesarean section.…”

A Comprehensive Analysis of Maternal and Newborn Disease and Related Control for COVID-19

“…In a large American cohort, perinatal COVID-19 infection was estimated at 2.6% [108]. Most studies, however, report an infrequency of neonatal SARS-CoV-2 infection at birth or thereafter despite maternal infection of varying severity [1-3, 13, 16, 19, 20, 188,191,193,196,197,213,222,228,[237][238][239][240][241][242][243][244]. The latter has also been evident despite some newborn exposure to maternal breastfeeding [82,118,127,136,241].…”

“…In India, newborn infections were mild and selflimited [258]. The latter studies are contrasted to the report from Farghaly et al who found that newborns of COVID-19 infected mothers were more likely to have desaturations, have poor feeding, and be symptomatic during the first 2 weeks of post-natal follow-up [237]. Virus can be potentially found in both respiratory secretions and stool [260].…”

COVID-19 impact on perinatal care: risk factors, clinical manifestation and prophylaxis. Polish experts’ opinion for December 2020

“…On the other hand, a less liberal approach for neonatal care is proposed by authors of the study by Farghaly et al [22], in which their analysis showed significant association between symptoms and SARS-CoV-2 status regarding skin-to-skin contact (p < 0.001). Both studied groups showed significant differences regarding isolation patterns (p < 0.001).…”