COVID-19 and newborn health: systematic review

Abstract

Objective. To describe perinatal and neonatal outcomes in newborns exposed to SARS-CoV-2. Methods. A systematic review was conducted by searching PubMed Central, LILACS, and Google Scholar using the keywords ‘covid ’ AND ‘newborn’ OR ‘child’ OR ‘infant,’ on 18 March 2020, and again on 17 April 2020. One researcher conducted the search and extracted data on demographics, maternal outcomes, diagnostic tests, imaging, and neonatal outcomes. Results. Of 256 publications identified, 20 met inclusion criteria and comprised neonatal outcome data for 222 newborns whose mothers were suspected or confirmed to be SARS-CoV-2 positive perinatally (17 studies) or of newborns referred to hospital with infection/pneumonia (3 studies). Most (12 studies) were case-series reports; all were from China, except three (Australia, Iran, and Spain). Of the 222 newborns, 13 were reported as positive for SARS-CoV-2; most of the studies reported no or mild symptoms and no adverse perinatal outcomes. Two papers among those from newborns who tested positive reported moderate or severe clinical characteristics. Five studies using data on umbilical cord blood, placenta, and/or amniotic fluid reported no positive results. Nine studies reported radiographic imaging, including 5 with images of pneumonia, increased lung marking, thickened texture, or high-density nodular shadow. Minor, non-specific changes in biochemical variables were reported. Studies that tested breast milk reported negative SARS-CoV-2 results. Conclusions. Given the paucity of studies at this time, vertical transmission cannot be confirmed or denied. Current literature does not support abstaining from breastfeeding nor separating mothers and newborns. Further evidence and data collection networks, particularly in the Americas, are needed for establishing definitive guidelines and recommendations.

Breastfeeding during the COVID-19 pandemic – a literature review for clinical practice

“…In their Practice Advisory on the Novel Coronavirus 2019 (SARS-CoV-2), the American College of Obstetricians and Gynecologists (ACOG), state that infants born to mothers with confirmed COVID-19, should be considered persons under investigation (PUI), and as such should be isolated according to the Infection Prevention and Control Guidance for PUIs [54,55]. They further [18,38,40,[43][44][45].…”

Maternal and newborn care during the COVID-19 pandemic in Kenya: re-contextualising the community midwifery model

“…Recent reports from China [3,9] and the United States of America [10] showed that a majority of pregnant women that were positive for COVID-19 delivered via caesarean section because of foetal distress [11]. There is limited evidence concerning the possible maternal-foetal transmission and neonatal infection, and case reports have described COVID-19 in healthy newborns as a mild self-limiting disease [3,4,12].…”

Case report of a neonate with high viral SARSCoV-2 loads and long-term virus shedding

“…Compared to adults, children seem to be less affected by SARS-CoV-2 infection as they are usually asymptomatic or have mild symptoms [ [1] , [2] , [3] , [4] ]. However, little is known about disease severity in neonates, the need for treatment and their role in transmission of SARS-CoV-2 [ 5 ]. It is reported that children or neonates can have high viral loads, while remaining asymptomatic or having mild symptoms [ 6 , 7 ].…”