Impact of COVID-19 infection on neonatal birth outcomes

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.