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COVID-19 and Women’s Health

101 Infants Born to Mothers with COVID-19: No Evidence of Vertical Transmission

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BACKGROUND AND PURPOSE:

  • Dumitriu et al. (JAMA Pediatrics, 2020) described the outcomes of neonates born to mothers with perinatal SARS-CoV-2 infection

METHODS:

  • Retrospective cohort analysis (March 13 to April 24, 2020)
  • Setting
    • New York City
  • Participants
    • Neonates born to mothers with confirmed or suspected SARS-CoV-2
  • Exposures
    • Perinatal exposure to maternal asymptomatic/mild COVID-19
    • Perinatal exposure to maternal severe/critical COVID-19
  • Study design
    • Newborns were admitted to well-baby nurseries unless NICU setting required
    • Newborns admitted to well-baby nurseries roomed-in | Mothers were required to wear masks
    • Direct breastfeeding after appropriate hygiene was encouraged
  • Primary outcome
    • Newborn SARS-CoV-2 testing results
  • Secondary outcomes
    • Follow-up at COVID-19 Newborn Follow-up Clinic and nonroutine encounters (telehealth, emergency department, hospitalizations, or clinic) through April 27

RESULTS:

  • 101 newborns born to 100 mothers
    • Well-baby nursery admission: 82
    • NICU admission: 19 for standard indications
  • 6 mothers required ICU care | 76 mothers roomed in with their newborns
  • Number of newborn tests performed: 141
    • All newborns had a test done at 0 days of life
    • 70 newborns had only a single test
  • Compared to maternal asymptomatic/mild COVID-19, maternal severe/critical COVID-19 exposure was associated with
    • Earlier delivery (P=0.02)
      • Severe COVID-19: median gestational age 37.9 weeks (IQR 37.1 to 38.4)
      • Mild COVID-19: 39.1 (IQR 38.3 to 40.2)
    • Increased risk for phototherapy (P=0.04)
      • Severe COVID-19: 30.0%
      • Mild COVID-19: 7.0%
  • 55 newborns underwent follow-up
    • 23 newborns had nonroutine encounters between 3 and 25 days of life
    • No evidence of SARS-CoV-2 infection was identified

CONCLUSION:

  • Even with a high percentage of women rooming-in and breastfeeding, there was no documented cases of vertical transmission among 101 neonates of mothers with COVID-19

The authors conclude that

This study endorses the benefits of rooming-in, establishing breastfeeding, and delaying bathing on newborn outcomes and suggests that separating mothers positive for SARS-CoV-2 and their newborns and avoiding direct breastfeeding may not be warranted to prevent SARS-CoV-2 transmission

Learn More – Primary Sources:

Outcomes of Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection at a Large Medical Center in New York City

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Related ObG Topics:

A Possible Case of SARS-CoV-2 Vertical Transmission
Neonatal Infection: COVID-19 and Risk for Vertical Transmission
Vertical Transmission in Pregnancies with Confirmed COVID-19

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