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Updated: Nov 2, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Newborns at risk of Covid-19 - lessons from the last year
Malika D Shah1,2, Ola Didrik Saugstad2,3
1Prentice Newborn Nursery, Northwestern Memorial Hospital, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
Insights
SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) in pregnant women, though rarely transmitted vertically, increases risks for premature birth and neonatal complications. However, recommended newborn care practices like skin-to-skin contact and breastfeeding remain safe with precautions.
Area of Science:
- Maternal-fetal medicine
- Neonatal care
- Infectious diseases
Background:
- Over a year into the SARS-CoV-2 pandemic, understanding of its impact on pregnant women, fetuses, and newborns has grown.
- Guidelines for managing newborns during the pandemic, such as those from the American Academy of Pediatrics (AAP) and World Health Organization (WHO), have converged.
Purpose of the Study:
- To summarize current knowledge on mother-to-fetus/newborn transmission of SARS-CoV-2.
- To outline evidence-based recommendations for neonatal care in the context of maternal SARS-CoV-2 infection.
Main Methods:
- Review of accumulated knowledge and existing guidelines on SARS-CoV-2 and pregnancy.
- Synthesis of data regarding vertical and horizontal transmission routes.
- Analysis of the impact of maternal SARS-CoV-2 status on neonatal outcomes and care practices.
Main Results:
- Vertical and horizontal SARS-CoV-2 transmission from mother to newborn are rare.
- Maternal SARS-CoV-2 positivity is linked to increased risks of preterm birth, neonatal mortality, and morbidity.
- Antibodies from infected or vaccinated mothers are present in breast milk and cross the placenta, potentially protecting newborns.
Conclusions:
- Maternal SARS-CoV-2 status should not alter standard delivery modes or cord clamping.
- Skin-to-skin contact, rooming-in, and breastfeeding are encouraged for newborns, with appropriate hygiene measures.
- Maternal antibodies offer potential protection to newborns against SARS-CoV-2.
Abstract:
After more than 1 year of the SARS-CoV-2 pandemic, a great deal of knowledge on how this virus affects pregnant women, the fetus and the newborn has accumulated. The gap between different guidelines how to handle newborn infants during this pandemic has been minimized, and the American Academy of Pediatrics (AAP)'s recommendations are now more in accordance with those of the World Health Organization (WHO). In this article we summarize present knowledge regarding transmission from mother to the fetus/newborn. Although both vertical and horizontal transmission are rare, SARS-CoV-2 positivity is associated with an increased risk of premature delivery and higher neonatal mortality and morbidity. Mode of delivery and cord clamping routines should not be affected by the mother's SARS-CoV-2 status. Skin to skin contact, rooming in and breastfeeding are recommended with necessary hygiene precautions. Antibodies of infected or vaccinated women seem to cross both the placenta and into breast milk and likely provide protection for the newborn.
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