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Association between maternal SARS-CoV-2 infection & clinical outcomes in infants: A multicentric retrospective cohort
Rupsa Banerjee1, Pijush Kanti Khan1, Bidhan Goswami2
1Department of Health Systems and Implementation Research, International Institute of Health Management Research, New Delhi, India.
Insights
Maternal COVID-19 infection increases stillbirth risk and newborn intensive care unit admissions. Infant development milestones were unaffected in low- and middle-income countries.
Area of Science:
- Perinatal health
- Infectious disease epidemiology
- Child development
Background:
- Limited data exists on COVID-19's impact on perinatal outcomes and infant development in low- and middle-income countries.
- Understanding these effects is crucial for maternal and child health strategies.
Purpose of the Study:
- To investigate the impact of maternal COVID-19 infection during pregnancy on neonatal outcomes.
- To assess the effect on infant development up to one year of age.
Main Methods:
- Retrospective cohort study comparing pregnant women with and without COVID-19 exposure.
- Data collected via hospital records and maternal interviews.
- Propensity score matching used to minimize selection bias.
Main Results:
- Maternal SARS-CoV-2 infection was linked to increased stillbirth risk (aOR 2.63) and higher admission rates to the special newborn care unit (SNCU) (aOR 2.57).
- Infants born to mothers with COVID-19 had a significantly higher risk of illness (RR 4.23).
- Developmental milestone attainment by age one was similar between exposed and unexposed infant cohorts.
Conclusions:
- COVID-19 in pregnancy elevates the risk of stillbirth and necessitates increased SNCU admissions for newborns.
- No significant differences were observed in the age of developmental milestone achievement between infants of mothers with and without COVID-19.
Abstract:
Background & objectives The effects of COVID-19 on neonatal and perinatal outcomes and infant development in low- and middle-income countries have not been well studied. Our study aimed to explore the effect of maternal COVID-19 infection on pregnancy, neonatal outcomes, and development of infants. Methods We conducted a retrospective cohort study on women exposed to and not exposed to COVID-19 during pregnancy and their infants (exposed and comparison cohort, respectively). Data were collected through hospital records and interview of mothers. Outcomes included stillbirth, preterm birth, low birth weight, admission to special newborn care unit (SNCU) and attainment of age-appropriate developmental milestones till one year of age. We conducted propensity score matching analysis to address any selection bias. Results Exposure to SARS-CoV-2 was associated with a higher risk of stillbirths [adjusted odds ratio (aOR) 2.63; 95% confidence interval (CI) 1.39, 4.96] and admission to SNCU (aOR 2.57; 95% CI 1.85, 3.58) after adjusting for pregnancy and birth-related covariates. Risk of illness among babies born to COVID-positive mothers was higher [relative risk (RR) 4.23; 95% CI 3.14, 5.69; P<0.001]. Age of attainment of developmental milestones were similar between both cohorts. Interpretation & conclusions Women who contracted COVID-19 in pregnancy were at higher risk of stillbirths, and their babies were more likely to be admitted to the SNCU as compared to their COVID-negative counterparts. There were no clinically meaningful differences between babies of both cohorts in the age at which developmental milestones were attained.
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