Outcome of Neonates Born to COVID-19 Positive Mothers at a Tertiary Centre: A Retrospective Cohort Study

Abstract

Introduction: In the context of the COVID-19 pandemic, studies on perinatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection play an essential role in the understanding of the disease which in turn is necessary for optimal management of affected neonates. Aim and Objective: To determine the clinical outcomes in neonates born to mothers with SARS-CoV-2 infection and to identify possible risk factors in perinatal transmission. Materials and Methods: This was a retrospective cohort study performed at level-3 teaching Neonatal Intensive Care Unit (NICU) in South India. Medical records of all mothers who delivered in the COVID-19 facility and neonates born to COVID-19 confirmed mothers from April 15, 2020, to September 15, 2021, were collected and analyzed. Results: Of 15,720 deliveries, 556 mothers who tested positive for COVID-19 delivered 563 babies (7 twins), of which 6.3% were positive for SARS-CoV-2. Out of 563 babies, 14.5% were preterm and 95% were asymptomatic. Among COVID-19 positive mothers, cesarean was the most common mode of delivery (73.5% and 88% in COVID-19 positive and negative neonates respectively; P value = .01) and most of the babies were roomed-in (85.2% in COVID-19 positive and 94.6% in COVID-19 negative neonates; P value = .02). COVID-19 positive neonates had significantly high probability of pneumonia ( P value = .003), sepsis ( P value = .03), septic shock ( P value = .01), and abnormal CXR ( P value = .01). There was no significant difference in the mortality rate. Conclusion: COVID-19 positive status of the mother is not associated with increased risk of preterm birth, neonatal admission, morbidity, or mortality. The risk of transmission was not found to be associated with direct breastfeeding or rooming-in.