Effect of coronavirus on the infants of women delivering while infected

An important question for pediatricians during our current pandemic is if the novel coronavirus (SARS-CoV-2, Covid-19) has an effect on infants born to mothers who are infected. A recent study in the journal Pediatrics gives some information about this question.

The authors carried out a retrospective, observational study of 149 women who delivered infants while infected with the virus. The patients all delivered during the huge epidemic in New York City last spring. Included in the group were 3 sets of twins and 3 women who had stillbirths. The report is simple; it describes what happened to the mothers and their infants.

Forty percent of the mothers were asymptomatic. Approximately 15% of symptomatic mothers required some form of respiratory support, and 8% required intubation. Eighteen newborns (12%) were admitted to the ICU. Fifteen (10%) were born preterm, and 5 (3%) required mechanical ventilation. Symptomatic mothers had more premature deliveries (16% vs 3%, P = .02), and their newborns were more likely to require intensive care (19% vs 2%, P = .001) than asymptomatic mothers. One newborn tested positive for SARS-CoV-2, which was considered a case of horizontal postnatal transmission rather than vertical transmission from the mother.

We did not observe any distinct case of vertical transmission of SARS-CoV-2 from mothers to their newborns. However, we did observe significant perinatal morbidities among mothers with SARS-CoV-2 and their newborns. We also observed that neonates born to symptomatic mothers with SARS-CoV-2 were more likely to be born prematurely and also be admitted to the NICU than were infants born to asymptomatic mothers diagnosed during universal screening.

The bottom line to me is infants born to mothers symptomatic with Covid-19 have poorer outcomes. This is not particularly surprising, really, but it is good to have these data, which are the first thus far reported about neonatal risk with Covid-19.