Association between maternal coronavirus disease 2019 and transient tachypnea of the newborn: a single-center study

Abstract

Background: Limited clinical reports have investigated the effects of maternal coronavirus disease 2019 (COVID-19) on fetuses and neonates.Purpose: This retrospective study aimed to assess the impact of maternal COVID-19 on neonates during the perinatal period, including neonatal clinical outcomes, versus the outcomes of neonates of mothers without COVID-19.Methods: Neonates born to COVID-19-infected mothers at the National Health Insurance Service Ilsan Hospital between February 2021 and March 2022 were included. Those with gestational age (GA) ≥35+0 weeks who were born within 2 weeks of the maternal infection were matched 1:2 with a control group based on GA. The main outcomes were respiratory diseases, including transient tachypnea of the newborn (TTN), respiratory distress syndrome, meconium aspiration syndrome, the need for respiratory support, and length of hospital stay. Uni- and multivariate logistic regression analyses were performed and adjusted for relevant covariates, including maternal age, obstetric complications (hypertension and gestational diabetes), delivery mode, birth weight, sex, and small-for-gestational-age status.Results: The case group comprised 103 neonates (mean GA, 38.5±1.3 weeks; mean birth weight, 3,121±397 g), while the control group included 206 neonates (mean GA, 38.4±1.2 weeks; mean birth weight, 3088±428 g). In the case and control groups, the proportion of cesarean sections was 91% and 40%, respectively, while the proportion of male infants was 56% and 47%, respectively. After adjusting for covariates, the case group had a higher risk of TTN (adjusted odd ratio [AOR], 3.69; 95% confidence interval [CI], 1.69–8.07), noninvasive respiratory ventilator use (AOR, 2.28; 95% CI, 1.05–4.97), and oxygen support (AOR, 4.83; 95% CI, 1.46–15.95).Conclusion: Newborns born to COVID-19-infected mothers are at increased risk of TTN and may require respiratory support. Close monitoring of respiratory symptoms is crucial in neonates.

Maternal and neonatal COVID-19 – the pandemic experience in a tertiary maternity unit in Romania – unicentric, prospective study

“…Only 14 infants delivered by SARS-CoV-2 positive mothers were born prematurely. Therefore, the rate of prematurity was lower in mothers diagnosed with COVID-16 (6.42%) as compared to the prematurity rate during the study period (7.42%) and different from the rates reported by other authors: 7.4-26.8% [14,20,21,37,43,[55][56][57]. A lower rate (4.54%) was reported by a recent study performed during Omicron variant dominance [51].…”

“…Increased morbidity and mortality in pregnant women and newborns is recognized for many years with viral infections during pregnancy, therefore, even at the beginning of the pandemic both pregnant women and newborns were considered at high risk for SARS-CoV-2 infection and its complications. Soon after pandemic onset, reports coming first from China and thereafter from all over the world described adverse outcomes of COVID-19 during pregnancy: increased rates of prematurity, stillbirth, fetal death, intrauterine growth restriction (IUGR), fetal distress, maternal respiratory failure (with increased need for oxygen, respiratory support, and intensive care unit admission), preeclampsia, C-section delivery, and maternal and neonatal death as compared to non-exposed pregnancies [16][17][18][19][20][21][22][23][24]. Studies also reported an even more complicated course of COVID-19 in pregnancies complicated with lung, cardiovascular, renal, and liver conditions, high blood pressure, diabetes, obesity, anti-phospholipidic syndrome, and thrombophilia [9,25].…”

“…More than 40% of the neonatal infections are asymptomatic or present with mild symptoms, and less than 15% of the newborns reported have moderate/severe symptoms (respiratory distress syndrome, lethargy, feeding difficulties, vomiting, diarrhea, hemodynamic or temperature instability) [3,14,29]. But even in SARS-CoV-2 negative RT-PCR neonates delivered by mother RT-PCR positive mothers an increased risk for fetal distress, small for gestational age, low birth weight (LBW), prematurity, respiratory distress syndrome (transient tachypnea of the newborn, need for oxygen and/or respiratory support), temperature instability, hyper bilirubinemia, gastrointestinal and cardiovascular dysfunctions, neonatal intensive care unit admission and increased hos p ita lization length were reported [20,21,30].…”

Impacts of maternal COVID-19 during pregnancy on neonatal health and epidemiology

“…This study [ 4 ] compared the clinical outcomes between newborns born to mothers with COVID-19 who tested negative and those born to noninfected mothers (control group). The two groups were compared by matching gestational age at birth, and errors in the study results were reduced by regression analysis and controlling for other factors that may affect neonatal outcomes, including cesarean section.…”

“…A significantly higher risk of transient tachypnea in the newborn, noninvasive ventilation use, and supplemental oxygen requirement were noted among neonates born to mothers with COVID-19. The authors emphasized the importance of closely monitoring respiratory symptoms in neonates born to COVID-19-infected mothers [ 4 ]. A Swedish study also reported that maternal SARS-CoV-2 infection during pregnancy was significantly associated with increased risk of respiratory disorders and other neonatal health issues [ 5 ].…”