COVID-19, maternal, and neonatal outcomes: National Mother-Child Cohort (NMCC) of K-COV-N cohort in South Korea

Abstract

Throughout the COVID-19 pandemic, pregnant women have been classified as a vulnerable population. However, the evidence on the effect of infection during pregnancy on maternal and neonatal outcomes is still uncertain, and related research comprising a large population of pregnant women in Asian countries is limited. We constructed a national cohort including mothers and children (369,887 pairs) registered in the Prevention Agency-COVID-19-National Health Insurance Service (COV-N), from January 1, 2020 to March 31, 2022. We performed propensity score matchings and generalized estimation equation models to estimate the effect of COVID-19 on maternal and neonatal outcomes. In summary, we found little evidence of the effect of COVID-19 infection during pregnancy on maternal and neonatal outcomes; however, a relationship between COVID-19 infection in the second trimester and postpartum hemorrhages was discovered (Odds ratio (OR) of Delta period: 2.26, 95% Confidence intervals (CI): 1.26, 4.05). In addition, neonatal intensive care unit (NICU) admissions increased due to COVID-19 infection (pre-Delta period: 2.31, 95% CI: 1.31, 4.10; Delta period: 1.99, 95% CI: 1.47, 2.69; Omicron period: 2.36, 95% CI: 1.75, 3.18). Based on the national retrospective cohort study data, this study investigated the effects of COVID-19 infection on maternal and neonatal outcomes in Korea from the pre-Delta to the initial Omicron epidemic periods. Our evidence suggests that the timely and successful policies of the government and academia in response to COVID-19 infections in newborns in Korea may cause an increase in NICU admissions, but nonetheless, they prevent adverse maternal and neonatal outcomes simultaneously.

Association between the COVID-19 pandemic and childhood development aged 30 to 36 months in South Korea, based on the National health screening program for infants and children database

“…The questions in each domain are scored from 0 to 3 points. Based on the sum of the total score in each domain, the K-DST results were classified into four levels, namely “need for follow-up,” “recommendation for further evaluation,” “peer level,” and “fast level.” The outcome of interest was suspected neurodevelopmental delay, characterized by the results of “need for follow-up” or “recommendation for further evaluation” in each K-DST domain at 30–36 months of age [ 29 ]. If any of the six domains showed suspected neurodevelopmental delay, the “any domain” was defined as a suspected neurodevelopmental delay.…”

“…By comparing the risk of developmental delay among these strata, we aimed to gain a more nuanced understanding of the potential role of SES in this context. We visualized the difference in adjusted ORs using the ‘ggplot2’ function in the R package in supplementary figure S2 and S3 [ 29 ]. A two-sided P < 0.05 was considered statistically significant.…”

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

“…Currently, limited data with small sample sizes are available regarding the risk of perinatal infection and neonatal outcomes of infants born to COVID-19 infected mothers in Korea [ 1 , 13 , 14 ]. A recent Korean National Mother-Child Cohort study on neonatal outcomes discovered a possible association of COVID-19 mothers with increased NICU admission [ 15 ]. However, this association is not clear since the isolation policy may have affected admission.…”

“…1,13,14) A recent Korean National Mother-Child Cohort study on neonatal outcomes discovered a possible association of COVID-19 mothers with increased NICU admission. 15) However, this association is not clear since the isolation policy may have affected admission. Moreover, the detailed clinical respiratory outcome was not presented in the data.…”