Prevalence of meconium-stained amniotic fluid in SARS COVID-19 positive pregnant mothers and its manifestations in newborns

Abstract

Background: This study is being conducted to find out whether coronavirus disease 2019 (COVID-19) is associated with an increased incidence of MSAF in COVID-positive pregnant women. Finding implications for operative delivery and perinatal outcome. The evidence will help in managing COVID-positive women in pregnancy. Methods: This prospective observational study was conducted from July 1, 2020 to October 20, 2020 at Rajarajeswari Medical College and Hospital, Bangalore. A total 38 newborns born to SARS-COVID-19 infected mothers were included. Data collected from pregnant women, patient records, birth registries, operating room/delivery room records and NICU registries. Results: The clinical characteristics of 38 mothers and their newborns were analyzed. The mode of delivery was normal vaginal delivery (NVD) in most (N=21) cases. All newborns tested negative for SARS-CoV-2. 18 babies required only routine newborn care, and 20 babies required neonatal intensive care unit (NICU) admission at birth for management of meconium-stained amniotic fluid (MSAF)(11pregnancies), prematurity (3 cases), dyspnea (6 cases), stage 2/3 hypoxic ischemic encephalopathy (HIE) (2 cases), and Jaundice (9 cases). 18 of 38 stable babies held mother's side and breastfeeding started, with no signs and symptoms attributed to SARS-CoV-2. Conclusions: In our study, the prevalence of MSAF is higher (28%) in COVID-19 Positive mothers, resulting in low APGAR scores and poor perinatal outcomes. Vigilant intrapartum care is recommended to reduce the risk of poor neonatal outcomes. No newborns developed signs and symptoms of SARS-CoV-2 infection during rooming-in, breastfeeding and during admissions at neonatal intensive care unit (NICU).