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Short-term outcomes of infants born to mothers with SARS-CoV-2 infection
Michael A Moffat1, Almaz S Dessie2, Kathryn O'Leary1
1Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA.
Insights
Infants born to mothers with SARS-CoV-2 (COVID-19) showed low rates of significant illness. This suggests minimal risk of severe COVID-19 in newborns, regardless of maternal symptoms or adherence to personal protective equipment (PPE).
Area of Science:
- Neonatal care
- Infectious disease transmission
- Maternal-fetal health
Background:
- The transmission rate of SARS-CoV-2 from mothers to infants during the peri- and post-natal periods requires further investigation.
- Understanding COVID-19 risks for newborns is crucial for clinical management and public health guidance.
Purpose of the Study:
- To determine the incidence of clinically significant COVID-19 disease in infants within one month of birth.
- To compare disease development rates in infants born to symptomatic versus asymptomatic SARS-CoV-2 positive mothers.
Main Methods:
- A retrospective cohort study was conducted at a single center, including infants born to SARS-CoV-2 positive mothers.
- Infants were monitored via phone follow-up and medical record review for symptoms and healthcare encounters post-discharge.
- Maternal adherence to personal protective equipment (PPE) was also assessed.
Main Results:
- No infants tested positive for SARS-CoV-2 prior to discharge.
- Among infants with follow-up, 31 exhibited symptoms concerning for SARS-CoV-2 infection or Multisystem Inflammatory Syndrome in Children (MIS-C), with 19 seeking medical care.
- Two infants were hospitalized for fever but tested negative for SARS-CoV-2; 65% of mothers reported consistent PPE use.
Conclusions:
- Infants born to mothers with SARS-CoV-2, whether symptomatic or asymptomatic, are unlikely to develop severe COVID-19 in the peri- and post-natal periods.
- The study supports the safety of rooming-in for infants born to asymptomatic mothers and highlights the importance of continued monitoring.
Objective:
The rate of transmission of SARS-CoV-2 from mothers to infants in the peri- and post-natal period remains an area of ongoing investigation. This study aims to determine rates of development of clinically significant COVID-19 disease within 1 month among infants born to symptomatic and asymptomatic SARS-CoV-2 positive mothers.
Materials And Methods:
This was a single-center, retrospective cohort study of all infants born to SARS-CoV-2 positive mothers who were admitted to the Well Baby Nursery (WBN) at New York University Langone Hospital-Brooklyn from 23 March-23 September 2020. Infants born to asymptomatic mothers were allowed to room-in, while infants born to mothers with symptoms of SARS-CoV-2 were isolated and discharged home to an alternate primary caregiver. A phone follow-up program contacted mothers at 2 weeks and 1 month post discharge to inquire about newborn symptoms, maternal symptoms, personal protective equipment (PPE) usage, and any presentations to care. Medical records were also reviewed for clinic and hospital visits to determine if exposed infants developed any symptoms following discharge.
Results:
Of 1903 deliveries during the study period, 131 mothers (21 symptomatic, 110 asymptomatic) tested positive for SARS-CoV-2 and had infants admitted to the WBN. 57 infants (21 born to symptomatic mothers, 36 born to asymptomatic mothers) were tested prior to discharge, and none were positive. 121 of 133 infants had at least 1 follow up call in the study period. Of these, 31 had symptoms potentially concerning for SARS-CoV-2 infection or Multisystem Inflammatory Syndrome in Children, and 19 presented to medical care for these symptoms. 4 infants had SARS- CoV-2 testing after discharge, and none were positive. 2 infants were admitted to the hospital for fever but neither had a positive SARS-CoV-2 result. 65% of mothers reported always adhering to PPE recommendations.
Conclusion:
Our results suggest that infants born both to symptomatic and asymptomatic mothers are unlikely to develop clinically significant COVID-19 disease in the peri- and post-natal periods.
