BACKGROUND AND PURPOSE:

• Flaherman et al. (Clinical Infectious Diseases, 2020) report early findings from the nationwide PRegnancy CoronavIrus Outcomes RegIsTrY (PRIORITY)

METHODS:

• Prospective cohort study (March 22 to June 22)
• Setting
  • 100 hospitals across the US
• Participants
  • ≥13 years who are pregnant or 6 weeks postpartum
  • Suspected or confirmed COVID-19
• Study design
  • Data collection by phone, email or text
    • At the time of enrollment | After birth | 6 to 8 weeks after delivery
  • Infant medical records were also obtained
  • Outcomes between infants whose mothers tested positive for the virus and those whose mothers tested negative were compared

RESULTS:

• Total of 283 infants
  • Mothers tested positive: 179 infants
    • Symptomatic mothers: 81.6%
  • Mothers tested negative: 84 infants
    • Symptomatic mothers: 63.1%
• 17% of infants were admitted to the NICU | No differences between mothers testing positive vs negative were found for the following
  • Breathing difficulties: 11%
  • Apnea: 1.6%
• Mothers who tested positive within 0 to 14 days of delivery vs those who tested positive >14 days were
  • More likely to delivery prematurely (p=0.0009)
    • Positive maternal test 0 to 14 days: 37.5 weeks mean GA at delivery
    • Positive maternal test >14 days:  39 weeks mean GA at delivery
  • More likely to be admitted to the NICU (p=0.04)
    • Positive maternal test 0 to 14 days prior to delivery: 26.0% NICU admission
    • Positive maternal test >14 weeks prior to delivery:  12.2% NICU admission 39 weeks
• Birth defects
  • Positive maternal test: 2 infants with multiple anomalies
  • Negative maternal test: 1 infant with multiple anomalies
• Through 6 to 8 weeks of age
  • No pneumonia or lower respiratory tract infections were reported
  • 2 infants born to positive mothers also tested positive (1.1%)
• No infants were re-hospitalization

CONCLUSION:

• In the US PRIORITY registry, adverse outcomes (preterm birth, NICU admission, respiratory disease) in infants did not differ between mothers who tested positive vs those who tested negative
• Overall, infants had minimal symptoms with a SARS-CoV-2 incidence rate of approximately 1%

The authors state

Overall, PRIORITY’s initial findings regarding infant health are reassuring

Further investigation with longer follow up periods and larger sample sizes will be needed to make a definitive determination of the risk of vertical transmission

Learn More – Primary Sources:

Infant Outcomes Following Maternal Infection with SARS-CoV-2: First Report from the PRIORITY Study

Related ObG Topics:

Neonatal Infection: COVID-19 and Risk for Vertical Transmission

AAP Recommendations: L&D Guidance and Management of Infants Born to COVID-19 Positive Mothers

COVID-19 Case Series: Pregnancy and Infant Outcomes

Infants Born to Mothers with COVID-19 Have Detectable Levels of Antibodies