Investigating the association between severity of COVID-19 infection during pregnancy and neonatal outcomes

Dileep, Anita; ZainAlAbdin, Sham; AbuRuz, Salah

doi:10.1038/s41598-022-07093-8

Cited by 40 publications

(43 citation statements)

References 35 publications

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“…Increased risk of preterm delivery, lower birth weight, neonatal infection, and NICU admission were also reported in pregnant women with moderate to severe COVID-19 in U.A.E [26]. The neonates mainly presented with feeding difficulties (1.8%), respiratory distress (3.2%), and hyperbilirubinemia (4.04%) The fever and gastrointestinal symptoms were rare, similar to data from National Neonatology Forum, India, [24] not as common as reported in earlier studies [27].…”

Section: Discussionmentioning

confidence: 89%

Outcomes in neonates born to mothers with COVID-19 during the second wave in India

et al. 2022

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COVID-19 pandemic has affected all age groups globally including pregnant women and their neonates. The aim of the study was to understand outcomes in neonates of mothers with COVID-19 during the first and second waves of COVID-19 pandemic. A retrospective analysis of 2524 neonates born to SARS-CoV-2-infected mothers was conducted during the first wave (n = 1782) and second wave (n = 742) of the COVID-19 pandemic at five study sites of the PregCovid registry in Maharashtra, India. A significant difference was noted in preterm birth, which was higher in the second wave (15.0%, 111/742) compared to the first wave (7.8%, 139/1782) (P < 0.001). The proportion of neonates requiring NICU admission was significantly higher in the second wave (19.0%, 141/742) as compared to that in the first wave (14.8%, 264/1782) (P < 0.05). On comparing regional differences, significantly higher neonatal complications were reported from Mumbai metropolitan region (P < 0.05). During the second wave of COVID-19, birth asphyxia and prematurity were 3.8-and 2.1fold higher respectively (P < 0.001). Neonatal resuscitation at birth was significantly higher in second wave (3.4%, 25/742 vs 1.8%, 32/1782) (P < 0.05). The prevalence of SARS-CoV-2 infection in neonates was comparable (4.2% vs 4.6%) with no significant difference between the two waves.Conclusion: Higher incidence of adverse outcomes in neonates born to SARS-CoV-2-infected mothers in the second wave of COVID-19 as compared to the first wave. Trial registration: PregCovid study is registered with the Clinical Trial Registry of India (CTRI/2020/05/025423, Registered on 28/05/2020). What is Known:• The second wave of COVID-19 was more lethal to pregnant women than the first wave. Newborns are at risk of developing complications. What is New:• Birth asphyxia, prematurity, and neonatal resuscitation at birth were significantly higher in the second wave as compared to those in the first wave of the COVID-19 pandemic in India. Keywords Neonatal complications • NICU • SARS-CoV-2 • Second wave Abbreviations COVID-19 Coronavirus disease 2019 NICU Neonatal intensive care unit SARS-CoV-2 Severe acute respiratory syndrome coronavirus-2 * Rakesh Waghmare

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Section: Discussionmentioning

confidence: 89%

Outcomes in neonates born to mothers with COVID-19 during the second wave in India

et al. 2022

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“…However, research on infectious and immune outcomes within this age group has been limited, with the notable exception of research on fetal, perinatal, and neonatal transmission risks (e.g. 12 – 14 ). Beyond the neonatal period, infants may be at heighted risk of SARS-CoV-2 transmission from infected caregivers due to the frequency and intensity of close contact care and feeding ( 15 , 16 ), and may have higher risks of severe infection relative to older children due to less developed immune responses ( 6 , 17 , 18 ).…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 specific antibody trajectories in mothers and infants over two months following maternal infection

et al. 2022

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Infants exposed to caregivers infected with SARS-CoV-2 may have heightened infection risks relative to older children due to their more intensive care and feeding needs. However, there has been limited research on COVID-19 outcomes in exposed infants beyond the neonatal period. Between June 2020 – March 2021, we conducted interviews and collected capillary dried blood spots from 46 SARS-CoV-2 infected mothers and their infants (aged 1-36 months) for up to two months following maternal infection onset (COVID+ group, 87% breastfeeding). Comparative data were also collected from 26 breastfeeding mothers with no known SARS-CoV-2 infection or exposures (breastfeeding control group), and 11 mothers who tested SARS-CoV-2 negative after experiencing symptoms or close contact exposure (COVID- group, 73% breastfeeding). Dried blood spots were assayed for anti-SARS-CoV-2 S-RBD IgG and IgA positivity and anti-SARS-CoV-2 S1 + S2 IgG concentrations. Within the COVID+ group, the mean probability of seropositivity among infant samples was lower than that of corresponding maternal samples (0.54 and 0.87, respectively, for IgG; 0.33 and 0.85, respectively, for IgA), with likelihood of infant infection positively associated with the number of maternal symptoms and other household infections reported. COVID+ mothers reported a lower incidence of COVID-19 symptoms among their infants as compared to themselves and other household adults, and infants had similar PCR positivity rates as other household children. No samples returned by COVID- mothers or their infants tested antibody positive. Among the breastfeeding control group, 44% of mothers but none of their infants tested antibody positive in at least one sample. Results support previous research demonstrating minimal risks to infants following maternal COVID-19 infection, including for breastfeeding infants.

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“…Our study is unique in that the predominant ethnicity of the mothers observed was Hispanic. Previous studies have noted the increased incidence of preterm births in infected mothers [ 26 , 27 , 28 , 29 ]. Our study shows no such risk, and we suggest that this may be explained by the fact that the majority of the infected mothers in our study did not suffer from severe symptoms or experience any major COVID-19 complications.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Neonates Born to SARS-CoV-2-Infected Mothers: Tertiary Care Experience at US–Mexico Border

et al. 2022

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Background: SARS-CoV-2 has affected millions of people around the world. There is a need for data on the effects of this infection on neonates admitted to neonatal intensive care (NICU) units born to infected mothers. Here, we decided to analyze neonates born to mothers who tested positive for SARS-CoV-2 and admitted to NICU compared with neonates who remained with their mothers. Methods: All pregnant mothers who tested positive for SARS-CoV-2 during pregnancy between 1 June 2020 and 30 June 2021, along with all neonates born to infected pregnant women, were included in this study. We then compared the neonates admitted to NICU with the neonates who remained with their mothers. Results: Eighty-eight neonates were born to eighty-eight SARS-CoV-2-positive mothers. Fifteen of these neonates were admitted to the NICU. The mothers of the neonates admitted to the NICU were more likely to have received prenatal care outside of the USA. In addition, the neonates admitted to the NICU were more likely to have needed significant resuscitation at birth. Respiratory distress was the most common reason for NICU admission. None of the NICU-admitted neonates were SARS-CoV-2-positive. There were no differences between the values of the complete blood counts, morbidities at discharge, lengths of hospitalization, or rates of readmission to hospital in the first month of life observed between the two groups. Conclusions: The vertical transmission of the SARS-CoV-2 infection remains rare; there was no difference in the hospital outcomes in the neonates of infected mothers. Unlike other studies, which show an increased tendency toward preterm birth in SARS-CoV-2-positive mothers, our study indicates no such association.

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Investigating the association between severity of COVID-19 infection during pregnancy and neonatal outcomes

Cited by 40 publications

References 35 publications

Outcomes in neonates born to mothers with COVID-19 during the second wave in India

Outcomes in neonates born to mothers with COVID-19 during the second wave in India

SARS-CoV-2 specific antibody trajectories in mothers and infants over two months following maternal infection

Outcome of Neonates Born to SARS-CoV-2-Infected Mothers: Tertiary Care Experience at US–Mexico Border

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