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

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