A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society

Abstract

Limited data are available on pregnant women with COVID-19 and their neonates. We aimed to evaluate the epidemiological and clinical characteristics of newborns born to women infected with COVID-19. A multicenter cohort study was conducted among newborns born to mothers with COVID-19 in 34 neonatal intensive care units (NICUs) in Turkey. Pregnant women ( n = 125) who had a positive RT-PCR test and their newborns were enrolled. Cesarean section, prematurity, and low-birthweight infant rates were 71.2%, 26.4%, and 12.8%, respectively. Eight of 125 mothers (6.4%) were admitted to an intensive care unit for mechanical ventilation, among whom six died (4.8%). Majority of the newborns (86.4%) were followed in isolation rooms in the NICU. Four of 120 newborns (3.3%) had a positive RT-PCR test result. Although samples taken on the first day were negative, one neonate became positive on the second day and the other two on the fifth day. Sample from deep tracheal aspirate was positive on the first day in an intubated case. Conclusion : COVID-19 in pregnant women has important impacts on perinatal and neonatal outcomes. Maternal mortality, higher rates of preterm birth and cesarean section, suspected risk of vertical transmission, and low rate of breastfeeding show that family support should be a part of the care in the NICU. Trial registration : ClinicalTrials.gov identifier: NCT04401540 What is Known: • The common property of previous reports was the conclusions on maternal outcomes, rather than neonatal outcomes. • Published data showed similar outcomes between COVID-19 pregnant women and others. What is New: • Higher maternal mortality, higher rates of preterm birth and cesarean section, suspected risk of vertical transmission especially in a case with deep tracheal aspiration during the intubation, and the possible role of maternal disease severity on the outcomes are remarkable findings of this study. • In contrast to recommendation for breastfeeding, parents’ preference to formula and expressed breast milk due to anxiety and lack of information shows that family support should be a part of the care in the NICU.

Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers

“…Two studies exclusively evaluated the feeding plan of mothers infected with SARS-CoV-2 [ 39 , 43 ]. Firstly, a multicenter cohort study was conducted with 125 COVID-19-positive mothers in neonatal intensive care units in Turkey, whose data were collected by the neonatologist using the electronic case report form (eCFR).…”

“…Nonetheless, some mothers still opted for exclusive breastfeeding with caution ( n = 9, 7.2%). The study authors argued that the following reasons might have affected the rate of breastfeeding: isolation, the anxiety of parents and clinicians about the possibility of breast milk contamination and the health status of mothers [ 39 ].…”

Chronic Histiocytic Intervillositis With Trophoblast Necrosis Is a Risk Factor Associated With Placental Infection From Coronavirus Disease 2019 (COVID-19) and Intrauterine Maternal-Fetal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission in Live-Born and Stillborn Infants

“…7 The initial reports of pregnant women developing COVID-19 in Wuhan and surrounding areas in China indicated that no confirmed cases of vertical transmission were occurring, [8][9][10][11][12] although there were some cases that were suspicious. 13,14 However, as COVID-19 continued to extend throughout China and other parts of the world accompanied by increasing numbers of neonates testing positive for the virus in China and elsewhere, [15][16][17][18][19][20] the possibility of determining whether vertical transmission was occurring became of even greater importance. [21][22][23] Because vertical transmission can occur through intrauterine, intrapartum and postpartum mechanisms, the possibility that intrauterine transplacental transmission with SARS-CoV-2 was occurring in some cases was of particular interest.…”

Is There an Effect of Fetal Mesenchymal Stem Cells in the Mother–Fetus Dyad in COVID-19 Pregnancies and Vertical Transmission?

“…The majority of pregnant patients with COVID-19 infection present with a mild or asymptomatic course of the disease ( Ferrazzi et al, 2020 ). Some cases were hospitalized, and few needed intensive care unit admission or mechanical ventilation; some patients received oxygen support, whereas others were treated with antibiotics, antivirals, systemic corticosteroids, and other treatment combinations ( Breslin et al, 2020 ; Chen H. et al, 2020 ; Dashraath et al, 2020 ; Friedman et al, 2020 ; Hecht et al, 2020 ; Iqbal et al, 2020 ; Liu et al, 2020 ; Oncel et al, 2020 ; Savasi et al, 2020 ; Takemoto et al, 2020 ), while several clinical trials are ongoing to evaluate the choice of treatment in pregnant or breastfeeding COVID-19 patients ( Dashraath et al, 2020 ; Pastick et al, 2020 ). There have also been some case reports where neonates required mechanical ventilation post-COVID-19 pregnancies ( Alwardi et al, 2020 ; Amaral et al, 2020 ; Gale et al, 2020 ; Gregorio-Hernández et al, 2020 ; Kirtsman et al, 2020 ; Oncel et al, 2020 ; Savasi et al, 2020 ).…”