Six-Month Outcomes of Infants Born to People With SARS-CoV-2 in Pregnancy

Gosdin, Lucas; Wallace, Bailey; Lanzieri, Tatiana M.; Olsen, Emily O’Malley; Lewis, Elizabeth; Chang, Daniel; Khuwaja, Salma; Chicchelly, Sarah; Ojo, Kristen D.; Lush, Mamie; Heitner, Daniel; Longcore, Nicole D.; Delgado-López, Camille; Humphries, Brian K.; Sizemore, Lindsey; Mbotha, Deborah; Hall, Aron J.; Ellington, Sascha; Gilboa, Suzanne M.; Tong, Van T.; Woodworth, Kate R.

doi:10.1542/peds.2022-059009

Cited by 6 publications

(9 citation statements)

References 24 publications

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“…Of these, 1491 were discharged to another facility, discharged to hospice, or deceased within a day of birth; these newborns were included for analysis without imputing a higher-level nursery. For the remaining 6165 newborns, we backfilled Level III or higher care when [1] they were born ≤35 weeks' gestation (1876/6165) or [2] had a billing record that indicated likely ICU-level care (e.g., caffeine, surfactant, total parenteral nutrition, furosemide, lorazepam, nitric oxide, umbilical catheter) (4289/ 6165).…”

Section: Measures and Outcomesmentioning

confidence: 99%

“…While Coronavirus disease 2019 (COVID-19) in newborns is uncommon, studies have reported 0.4-3.6% of infants born to mothers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy test positive during the birth hospitalization or within 14 days of birth, depending on methodology, population, and period of the study [1][2][3]. Findings from the period when wild-type SARS-CoV-2 virus was predominant (March-December 2020) showed that late preterm and term newborns (≥34 gestational weeks) with COVID-19 had an increased risk of neonatal intensive care unit (ICU) admission and early preterm newborns (<34 gestational weeks) with COVID-19 had an increased risk of invasive ventilation support [4].…”

Section: Introductionmentioning

confidence: 99%

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Critical care among newborns with and without a COVID-19 diagnosis, May 2020–February 2022

et al. 2023

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Objective To assess COVID-19 association with newborn critical care outcomes, including nursery level of care and ventilation, during three time periods: Pre-delta (May 2020–June 2021), Delta (July–November 2021), and Omicron (December 2021–February 2022). Study design In a retrospective cohort of newborns born May 2020–February 2022 using the Premier Healthcare Database, we classified COVID-19 status and critical care using International Classification of Diseases 10th Revision and Current Procedural Terminology codes, laboratory data, and billing records and assessed for variation during three time periods. Results Of 1,388,712 newborns, 0.06% had COVID-19 during the birth hospitalization (Pre-delta period: 0.03%; Delta: 0.07%; Omicron: 0.21%). Among newborns with COVID-19, the risks for admission to a higher-level nursery and for invasive or non-invasive ventilation were lower in the Omicron period compared to Pre-delta and Delta periods. Conclusion From May 2020–February 2022, COVID-19 in newborns was rare and cases were less severe during the period of Omicron predominance.

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Section: Measures and Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Critical care among newborns with and without a COVID-19 diagnosis, May 2020–February 2022

et al. 2023

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“…Preliminary studies during the first few months of the pandemic noted decreases in breastfeeding and EBF from pre-pandemic rates [12]. Similarly, patients with cases of SARS-CoV-2 diagnosed less than two weeks prior to delivery in 2020 were found to be less likely to initiate breastfeeding at all [15]. Given the uncertainties toward the impact of COVID-19 on newborns during this period, these findings may be attributed to safety concerns at the beginning of the pandemic.…”

Section: Discussionmentioning

confidence: 96%

Exclusive Breastfeeding in the Bronx—Successes and Shortcomings

2023

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Objective: Despite efforts to encourage breastfeeding, exclusive breastfeeding (EBF) rates in the Bronx remain suboptimal. Hospital restrictions and uncertainty surrounding the side effects of COVID-19 greatly impacted the mother-infant dyad during the postpartum hospitalization. Preliminary studies found an initial decrease in EBF, but lasting effects remain unknown. This study aimed to investigate the effect of the COVID-19 pandemic on birth hospitalization EBF rates among a high-risk urban patient population. Study Design: A retrospective chart review was conducted on all newborns admitted to the newborn nursery at an urban medical center between 2019 and 2021. Patients were separated into pre-pandemic and pandemic cohorts. Patient demographics, maternal comorbidities, length of stay, feeding method, and newborn characteristics, including status as high risk for hypoglycemia, were collected. EBF was defined as receiving only mother’s milk during the birth hospitalization. Descriptive statistics and bivariate analysis were used to examine the data. Results: 630 pre-pandemic and 643 pandemic newborns were included. The cohorts did not differ in baseline maternal characteristics. Pre-pandemic newborns were less likely to be high risk (23.3% vs. 29.4%, p= 0.01), more likely to see the hospital lactation consultant (53.2% vs. 24.0%, p< 0.001), and had a longer average length of stay (63.4 vs. 54.5 hours, p< 0.001). Most infants in both cohorts received some breastmilk during the hospitalization (97.6% vs. 94.6%, NS). There was no difference in EBF between cohorts among all newborns (9.5% vs. 11.4%, p= 0.29), or among non-high-risk newborns (12.2% vs. 15.0%, p=0.22). Conclusion: EBF rates in the Bronx, NY did not change during the pandemic period, despite an increase in high-risk newborns. Further investigation into the effect of lactation consultation, maternal race, ethnicity, and primary language should be further explored to understand the implications of healthcare disparities on the mother-infant dyad.

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“…SET‐NET constitutes an adaptable mother–infant surveillance network, with general variables consistent across conditions, as well as modular data elements that allow for expansion to novel conditions (Woodworth et al, 2021). Most recently, SET‐NET data were used to describe SARS‐CoV‐2 testing patterns and positivity rates among neonates born to pregnant persons with SARS‐CoV‐2 infection during pregnancy, as well as infant outcomes through 6 months of age (Olsen et al, 2022; Gosdin et al, in press). During 2022–2023, CDC will fund five jurisdictions (Iowa, Minnesota, New Jersey, New York, and Utah) to pilot cCMV surveillance through SET‐NET.…”

Section: Discussionmentioning

confidence: 99%

Congenital cytomegalovirus surveillance in the United States

Raines

Heitman

Leung

et al. 2022

Birth Defects Research

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Background Congenital cytomegalovirus (cCMV) is not a nationally notifiable condition, and little is known about how U.S. health departments (HDs) currently conduct cCMV surveillance. Methods We surveyed U.S. HDs that conduct cCMV surveillance or screening activities identified through a web‐based assessment. Meetings were held with each HD to enhance our understanding of survey responses. Results Ten states are systematically collecting cCMV case data to track cCMV cases during early infancy and to provide resources and services to families. Cases are ascertained using cCMV diagnostic codes, reported diagnosis, or laboratory results. Data elements collected for each case include demographics (all 10 states), clinical signs (8 states), laboratory data (4 states), treatment (4 states), and long‐term outcomes (1 state). Annual number of cases reported by HDs ranged from 3 to 47 cases/year in seven states, which was much lower than the expected number of cCMV cases. All 10 HDs have the ability to analyze data collected and four disseminate findings. Major challenges of surveillance reported by HDs were lack of standardized case definitions, personnel constraints, and limited funding. Conclusions A comprehensive account of cCMV disease burden is severely limited by low case ascertainment and paucity of data on long‐term outcomes. A standardized public health case definition for cCMV would improve consistency in measuring disease prevalence across jurisdictions and over time. Surveillance for cCMV has the potential to increase disease awareness and inform strategies to prevent cCMV‐associated disabilities.

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Six-Month Outcomes of Infants Born to People With SARS-CoV-2 in Pregnancy

Cited by 6 publications

References 24 publications

Critical care among newborns with and without a COVID-19 diagnosis, May 2020–February 2022

Critical care among newborns with and without a COVID-19 diagnosis, May 2020–February 2022

Exclusive Breastfeeding in the Bronx—Successes and Shortcomings

Congenital cytomegalovirus surveillance in the United States

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