Infant outcomes and maternal COVID-19 status at delivery

Abstract

Objectives To compare clinical characteristics and outcomes of infants born to COVID-19 to non COVID-19 mothers at delivery in a community hospital in Queens, New York. Methods Case-control study conducted March 15 to June 15, 2020. Cases were infants born to mothers with laboratory-confirmed COVID-19 infection at delivery. The infant of non COVID-19 mother born before and after each case were selected as controls. Results Of 695 deliveries, 62 (8.9%) infants were born to COVID-19 mothers; 124 controls were selected. Among cases, 18.3% were preterm compared to 8.1% in controls (p=0.04). In preterm cases, birth weight was not significantly different between groups. However, there was a significantly higher proportion of neonatal intensive care unit (NICU) admissions, need for respiratory support, suspected sepsis, hyperbilirubinemia, feeding intolerance and longer length of stay (LOS) in preterm cases. Among term cases, birth weight and adverse outcomes were not significantly different between cases and controls except for more feeding intolerance in cases. All infants born to COVID-19 mothers were COVID-19 negative at 24 and 48 h of life. No infants expired during birth hospitalization. Conclusions Significantly, more infants of COVID-19 mothers were premature compared to controls. Preterm cases were more likely to have adverse outcomes despite having similar birth weight and gestational age. These differences were not seen among full term infants. Health care providers should anticipate the need for NICU care when a COVID-19 mother presents in labor.

High rates of neonatal polycythemia and hyperbilirubinemia during the first phase of COVID-19 pandemic in Italy: a single-center experience

“…Hyperbilirubinemia is one of the neonatal outcomes commonly reported in the offspring of women with SARS-CoV-2 infection [2][3][4][5][6]. Since the increased rate of neonatal jaundice in our unit was recorded during the first phase of COVID-19 pandemic, it could be hypothesized that neonatal hyperbilirubinemia may be an indirect sign of Sars-CoV2 infection in pregnant women, even if not recognized because asymptomatic.…”

Impact of Perinatal Exposure to SARS-CoV-2 Infection on Early Health Outcomes among Infants Born from 2020 to 2021 in British Columbia, Canada

“…As vertical transmission of SARS-CoV-2 to infants had been known to be rare [26], most hospital policies on SARS-CoV-2 testing of infants were limited to symptomatic neonates. We believe that this limitation does not have any signifcant impact on the validity of our results because the positivity rate of infants born to mothers with SARS-CoV-2 infection during pregnancy was low as shown in previous cohort studies [5][6][7][8][9][10][11][12][13]. Even the largest cohort (with 255 neonates born to 250 mothers) in Massachusetts showed that the neonatal positivity rate (as measured by a SARS-CoV-2 test at 24 hours and 48 hours of life) was only 2.2% and for those positive infants, half of them were asymptomatic [5].…”

“…Te impact of perinatal exposure to SARS-CoV-2 infection on fetal development and subsequent infant health is not well understood. Several papers have studied the outcomes of neonates born to SARS-CoV-2-positive mothers from 2021 to 2022, including cohort studies from the United States [5][6][7][8][9][10], Italy [11], and Sweden [12]. Te results of these studies showed that the rate of perinatal infection among neonates as a result of maternal positivity for SARS-CoV-2 was approximately 2.2% [5].…”