OBJECTIVES: The American Academy of Pediatrics National Registry for the Surveillance and Epidemiology of Perinatal coronavirus disease 2019 (COVID-19) (NPC-19) was developed to provide information on the effects of perinatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: National Registry for the Surveillance and Epidemiology of Perinatal COVID-19 participating centers entered maternal and newborn data for pregnant persons who tested positive for SARS-CoV-2 infection between 14 days before and 10 days after delivery. Incidence of and morbidities associated with maternal and newborn SARS-CoV-2 infection were assessed. RESULTS: From April 6, 2020 to March 19, 2021, 242 centers in the United States centers reported data for 7524 pregnant persons; at the time of delivery, 78.1% of these persons were asymptomatic, 18.2% were symptomatic but not hospitalized specifically for COVID-19, 3.4% were hospitalized for COVID-19 treatment, and 18 (0.2%) died in the hospital of COVID-related complications. Among 7648 newborns, 6486 (84.8%) were tested for SARS-CoV-2, and 144 (2.2%) were positive; the highest rate of newborn infection was observed when mothers first tested positive in the immediate postpartum period (17 of 125, 13.6%). No newborn deaths were attributable to SARS-CoV-2 infection. Overall, 15.6% of newborns were preterm: among tested newborns, 30.1% of polymerase chain reaction-positive and 16.2% of polymerase chain reaction-negative were born preterm (P < .001). Need for mechanical ventilation did not differ by newborn SARS-CoV-2 test result, but those with positive tests were more likely to be admitted to a NICU. CONCLUSIONS: Early in the pandemic, SARS-CoV-2 infection was acquired by newborns at variable rates and without apparent short-term effects. During a period that preceded widespread availability of vaccines, we observed higher than expected numbers of preterm births and maternal in-hospital deaths.

Objective Adipocytokines are markers of fetal metabolism, but their association with childhood growth is unclear. This study examined associations of neonatal adipocytokines with longitudinal childhood adiposity measures in a prospective cohort of pregnant women and their children. Methods We measured leptin and adiponectin concentrations at delivery and children’s body mass index (BMI) z-scores between ages 4 weeks and 8 years. We estimated differences in BMI z-scores and rates of BMI z-score change by leptin (N = 257) and adiponectin (N = 271) terciles. Results Children in the middle (mean difference: 0.2; 95% CI: −0.1, 0.4) and highest (0.4; 95% CI: 0.1, 0.6) leptin terciles had greater BMI z-scores than children in the lowest tercile. Associations were null after adjustment for birthweight z-score. Children in the lowest adiponectin tercile had greater gains in BMI z-score (change per year: 0.10; 95% CI: 0.08, 0.13) than children in the middle (0.07; 95% CI: 0.04, 0.09) and highest terciles (0.04; 95% CI: −0.01, 0.05) (adiponectin x age interaction P < 0.001). Conclusions Lower adiponectin levels were associated with increased rates of BMI gains in the first 8 years of life. While leptin was positively associated with BMI, this association may be confounded by birthweight.

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Despite known associations with reduced birthweight, gestational serum perfluoroalkyl substances concentrations were not associated with neonatal adipocytokine concentrations. Further exploration of pathways of perfluoroalkyl substances associated changes in birthweight may help identify biomarkers that could be used to identify at-risk populations and develop interventions.