Outcomes of Preterm Infants Admitted to Canadian NICUs Before and During the SARS-COV Pandemic

To better elucidate the impact of the SARS-COV pandemic on neonatal outcomes, we compared the health outcomes of infants born preterm requiring care in a Canadian NICU before and during the SARS-COV pandemic.

Using a retrospective cohort study, infants born between 23 and 32 weeks gestation who were admitted to tertiary Canadian NICUs before and during the pandemic were included. A total of 7280 infants were in the pre-pandemic cohort (admitted 1 April 2018-31 December 2019), and 7088 infants were in the pandemic cohort (admitted 1 April 2020-31 December 2021). The primary outcomes included major morbidity or mortality rates. Care strategies and treatments were compared across the two periods. The relative risk (RR) for the pandemic period, compared to the pre-pandemic period, was calculated using a Poisson regression model, adjusted for identified risk factors.

There were no significant differences in infant characteristics between the pre-pandemic and pandemic cohorts. The risk of mortality or major morbidity was comparable before and during the pandemic (37% pre-pandemic, 36% pandemic; RR = 1.01, 95% CI 0.92, 1.01). Individual risks for morbidity and mortality did not differ significantly between periods. There was a clinically significant decline in the receipt of the mothers' own milk exclusively at discharge during the pandemic (45% before and 37% during; RR 0.85, 95% CI 0.68, 1.06).

There were no significant differences in major morbidity or mortality rates in preterm infants between pre-pandemic and pandemic cohorts in Canadian NICUs.