From: https://www.contagionlive.com/news/whats-the-risk-for-babies-born-to-mothers-with-coronavirus
By Rachel Lutz
In a small cohort of pregnant women with coronavirus in Wuhan, 9% of infants had early-onset coronavirus, according to a research letter published in JAMA Pediatrics.
Researchers in Wuhan, China, studied 33 babies born to mothers with coronavirus to determine if there was any early-onset infection in the newborns. As the number of coronavirus infections increases worldwide, the number of pregnant women and children with coronavirus is also rising. Prior to this study, only 19 babies born to infected mothers had been investigated in other studies.
Wuhan was the original epicenter of the outbreak. Researchers recruited infants born to infected mothers at Wuhan Children's Hospital between January and February 2020. They collected demographic, epidemiological, and clinical data from the medical records system. Additionally, coronavirus testing was performed using PCR tests on nasopharyngeal and anal swab samples.
Researchers found that the group of 33 babies born to mothers with coronavirus included 3 babies with coronavirus. The most common symptom was difficulty breathing, which was found in 4 of the 33 babies, although X-ray findings were not specific, the study authors said. There were no reported deaths.
The study authors went on to describe the conditions of each of the three infants: The first baby was born via cesarean section after 40 weeks of gestation. The authors wrote that the decision to perform a cesarean was made due to meconium-stained amniotic fluid and confirmed maternal COVID-19 pneumonia. On the second day of life, the infant became lethargic and feverish, although physical examination results were unremarkable. The baby was transferred to the intensive care unit, where a chest X-ray revealed pneumonia. Other laboratory tests were normal, except for procalcitonin, the authors added. The baby underwent nasopharyngeal and anal swab tests for coronavirus and tested positive on days 2 and 4 of life, but negative on day 6.
The second baby was born after 40 weeks and 4 days of gestation, also by cesarean section due to maternal COVID-19 pneumonia. The child, a boy, exhibited lethargy, vomiting, and fever, although physical examination results were unremarkable. Laboratory tests showed leukocytosis, lymphopenia, and an elevated creatine kinase-MB fraction, according to researchers, and a chest X-ray also showed pneumonia. Like the first baby, nasopharyngeal and anal swabs were positive for coronavirus on days 2 and 4 of life, but negative on day 6.
The third baby was born after 31 weeks and 2 days of gestation via cesarean section due to fetal distress and maternal pneumonia confirmed as COVID-19, the study authors reported, adding that resuscitation was required. After 1, 5, and 10 minutes from birth, the baby's Apgar scores were 3, 4, and 10, respectively. A chest X-ray showed neonatal respiratory distress syndrome and pneumonia, but both resolved by day 14 of life. The baby was treated with non-invasive ventilation and caffeine, the study authors reported. Antibiotics were used to treat the baby for suspected sepsis, with a positive Enterobacter blood culture, leukocytosis, thrombocytopenia, and coagulopathy. Nasopharyngeal and anal swabs for coronavirus were positive in the infant on days 2 and 4 of life, but negative on day 7.
“Because strict infection control and prevention procedures were in place during delivery, it is likely that the sources of SARS-CoV-2 in the upper respiratory tracts of newborns were maternal,” the study authors wrote. “Although two recent studies have shown no clinical findings or investigations suggestive of COVID-19 in newborns of infected mothers, and all samples, including amniotic fluid, umbilical cord blood, and breast milk, were negative for SARS-CoV-2, mother-to-child vertical transmission cannot be ruled out in the current cohort. Therefore, it is crucial to screen pregnant women and implement strict infection control measures, quarantine infected mothers, and closely monitor newborns at risk for COVID-19.”
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