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Perinatal aspects on the covid-19 pandemic: a practical resource for perinatal-neonatal specialists.

ABSTRACT: BACKGROUND:Little is known about the perinatal aspects of COVID-19. OBJECTIVE:To summarize available evidence and provide perinatologists/neonatologists with tools for managing their patients. METHODS:Analysis of available literature on COVID-19 using Medline and Google scholar. RESULTS:From scant data: vertical transmission from maternal infection during the third trimester probably does not occur or likely it occurs very rarely. Consequences of COVID-19 infection among women during early pregnancy remain unknown. We cannot conclude if pregnancy is a risk factor for more severe disease in women with COVID-19. Little is known about disease severity in neonates, and from very few samples, the presence of SARS-CoV-2 has not been documented in human milk. Links to websites of organizations with updated COVID-19 information are provided. Infographics summarize an approach to the pregnant woman or neonate with suspected or confirmed COVID-19. CONCLUSIONS:As the pandemic continues, more data will be available that could lead to changes in current knowledge and recommendations.

SUBMITTER: Mimouni F

PROVIDER: S-EPMC7147357 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Perinatal aspects on the covid-19 pandemic: a practical resource for perinatal-neonatal specialists.

Mimouni Francis F Lakshminrusimha Satyan S Pearlman Stephen A SA Raju Tonse T Gallagher Patrick G PG Mendlovic Joseph J

Journal of perinatology : official journal of the California Perinatal Association 20200410 5

<h4>Background</h4>Little is known about the perinatal aspects of COVID-19.<h4>Objective</h4>To summarize available evidence and provide perinatologists/neonatologists with tools for managing their patients.<h4>Methods</h4>Analysis of available literature on COVID-19 using Medline and Google scholar.<h4>Results</h4>From scant data: vertical transmission from maternal infection during the third trimester probably does not occur or likely it occurs very rarely. Consequences of COVID-19 infection a ...[more]

PMID: 32277162

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Project description:ImportanceThe incidence of mother-to-newborn SARS-CoV-2 transmission appears low and may be associated with biological and social factors. However, data are limited on the factors associated with neonatal clinical or viral testing outcomes.ObjectiveTo ascertain the percentage of neonates who were born to mothers with positive SARS-CoV-2 test results during the birth hospitalization, the clinical and sociodemographic factors associated with neonatal test result positivity, and the clinical and virological outcomes for newborns during hospitalization and 30 days after discharge.Design, setting, and participantsThis multicenter cohort study included 11 academic or community hospitals in Massachusetts and mother-neonate dyads whose delivery and discharge occurred between March 1, 2020, and July 31, 2020. Eligible dyads were identified at each participating hospital through local COVID-19 surveillance and infection control systems. Neonates were born to mothers with positive SARS-CoV-2 test results within 14 days before to 72 hours after delivery, and neonates were followed up for 30 days after birth hospital discharge.ExposuresHypothesized maternal risk factors in neonatal test result positivity included maternal COVID-19 symptoms, vaginal delivery, rooming-in practice, Black race or Hispanic ethnicity, and zip code-derived social vulnerability index. Delivery indicated by worsening maternal COVID-19 symptoms was hypothesized to increase the risk of adverse neonatal health outcomes.Main outcomes and measuresPrimary outcomes for neonates were (1) positive SARS-CoV-2 test results, (2) indicators of adverse health, and (3) clinical signs and viral testing. Test result positivity was defined as at least 1 positive result on a specimen obtained by nasopharyngeal swab using a polymerase chain reaction-based method. Clinical and testing data were obtained from electronic medical records of nonroutine health care visits within 30 days after hospital discharge.ResultsThe cohort included 255 neonates (mean [SD] gestational age at birth, 37.9 [2.6] weeks; 62 [24.3%] with low birth weight or preterm delivery) with 250 mothers (mean [SD] age, 30.4 [6.3] years; 121 [48.4%] were of Hispanic ethnicity). Of the 255 neonates who were born to mothers with SARS-CoV-2 infection, 225 (88.2%) were tested for SARS-CoV-2 and 5 (2.2%) had positive results during the birth hospitalization. High maternal social vulnerability was associated with higher likelihood of neonatal test result positivity (adjusted odds ratio, 4.95; 95% CI, 1.53-16.01; P = .008), adjusted for maternal COVID-19 symptoms, delivery mode, and rooming-in practice. Adverse outcomes during hospitalization were associated with preterm delivery indicated by worsening maternal COVID-19 symptoms. Of the 151 newborns with follow-up data, 28 had nonroutine clinical visits, 7 underwent SARS-CoV-2 testing, and 1 had a positive result.Conclusions and relevanceThe findings emphasize the importance of both biological and social factors in perinatal SARS-CoV-2 infection outcomes. Newborns exposed to SARS-CoV-2 were at risk for both direct and indirect adverse health outcomes, supporting efforts of ongoing surveillance of the virus and long-term follow-up.

Dataset Information

Perinatal aspects on the covid-19 pandemic: a practical resource for perinatal-neonatal specialists.

Publications

Perinatal aspects on the covid-19 pandemic: a practical resource for perinatal-neonatal specialists.

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