Impact of COVID-19 Infection on Neonatal Birth Outcomes

Abstract

Introduction: There is limited data on newborns born to mothers with COVID-19 infection. This multicenter cohort study aimed to investigate the clinical characteristics and outcomes of neonates born to mothers with and without COVID-19 infection to fill a gap in the literature review. Methods: The medical records of all neonates in Isfahan, Iran, between October 2020 and March 2021, were retrospectively reviewed. Results: Among the 600 neonates in this study, 255 (42.5) were in the infected group and 345 (57.5) were assigned to the control group as they were born to non-infected mothers. In the infected group, sepsis, fever and pneumothorax were detected in 3 (1.2), 3 (1.2) and 4 (1.6) neonates, respectively, compared with no case in the control group. In the infected group, neonatal respiratory distress (NRDS) (32, 12.5) was significantly higher than the control group (27, 10.6). Asphyxia in the infected group was 22(6.4), compared with 19 (5.5), in the control group. Preterm labor (PTL) (55, 21.65), premature rupture of membranes (PROMs) (24, 9.4) and intra-uterine growth retardation (IUGR) (15, 5.9) were significantly higher in women with COVID-19 (45, 13.0, 4, 1.2 and 7, 2.0, respectively). Low birth weight (LBW) accounted for 42 (16.5) neonates in the infected group and 25 (7.2) in the control group (p < 0.05). Of the 255 neonates born to infected mothers, 38 (14.9) were admitted to the Neonatal Intensive Care Unit (NICU), compared with 31 out of 345 (9.0) in the control group (p < 0.05). RT-PCR test results were positive in two newborns (0.8), one of whom died of necrotizing enterocolitis. Conclusion: As a result of maternal COVID-19 infections, neonates experienced higher rates of sepsis, fever, pneumothorax, asphyxia and NRDS in addition to PTL, PROMs, IUGR, and LBW.