Neonatal COVID-19 in French Guiana, a Case-Control study.

Abstract

BackgroundThis study aims to assess the risk of transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS COV-2) to newborns in the context of breastfeeding practice as part of routine care.MethodsIn this prospective study, we identified neonates born between May 14th and August 31st, 2020, to mothers who tested positive for SARS-CoV-2 at the time of delivery. From the cohort of 974 deliveries, we performed a nested case-control study. ResultsDuring the study period, 133 (13.7%) were positive by RT‐PCR for SARS‐CoV‐2. Among the 35 pregnant women with symptomatic COVID-19 (26.3%), cough was the most common symptom, occurring in half of the cases. Among them, 3 developed fever as other symptoms during hospitalization and 4 have progressed to critical pneumonia requiring transfer to intensive care unit. Among the neonates born from mothers with positive RT‐PCR for SARS‐CoV‐2, 32 were tested for SARS-COV-2 at 48 hours-7 days. Of them, 3 asymptomatic neonates tested positive. There were no significant differences in fetal distress, meconium-stained amniotic fluid, preterm birth, and neonatal asphyxia between the two groups Most infants were breastfed at birth, regardless of their mothers' COVID-19 status. In COVID-19-positive pregnant women admitted to intensive care unit, the proportion of preterm births ( OR=12.5 [1.7-90.5]), fetal death in utero (OR=25.9 [2.2-305]) and admission in neonatal intensive care unit admission (OR=13.4 [3.0-60]), appeared higher than the controls. No maternal deaths were recorded.ConclusionsOur data suggest that under breastfeeding conditions with rigorous hygiene precautions and parental education, the risk of vertical transmission of the SARS-COV-2 virus is unlikely.