Outcomes of Neonates Born to Mothers With Coronavirus Disease 2019 (COVID-19) — National Neonatology Forum (NNF) India COVID-19 Registry
Tóm tắt
Limited evidence exists on perinatal transmission and outcomes of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in neonates. To describe clinical outcomes and risk factors for transmission in neonates born to mothers with perinatal SARS-CoV-2 infection. Prospective cohort of suspected and confirmed SARS-CoV-2 infected neonates entered in National Neonatology Forum (NNF) of India registry. Neonates born to women with SARS-CoV-2 infection within two weeks before or two days after birth and neonates with SARS-CoV-2 infection. Incidence and risk factors of perinatal transmission. Among 1713 neonates, SARS-CoV-2 infection status was available for 1330 intramural and 104 extramural neonates. SARS-CoV-2 positivity was reported in 144 intramural and 39 extramural neonates. Perinatal transmission occurred in 106 (8%) and horizontal transmission in 21 (1.5%) intramural neonates. Neonates roomed-in with mother had higher transmission risk (RR1.16, 95% CI 1.1 to 2.4; P=0.01). No association was noted with the mode of delivery or type of feeding. The majority of neonates positive for SARS-CoV2 were asymptomatic. Intramural SARS-CoV-2 positive neonates were more likely to be symptomatic (RR 5, 95%CI 3.3 to 7.7; P<0.0001) and need resuscitation (RR 2, 95%CI 1.0 to 3.9; P=0.05) compared to SARS-CoV-2 negative neonates. Amongst symptomatic neonates, most morbidities were related to prematurity and perinatal events. Data from a large cohort suggests perinatal transmission of SARS-CoV-2 infection and increased morbidity in infected infants.
Tài liệu tham khảo
COVID19 India. Accessed 20 April, 2021. Available at https://www.mohfw.gov.in/
Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; 382:1708–720.
Fox NS, Melka S. COVID-19 in pregnant women: Case series from one large New York city obstetrical practice. Am J Perinatol. 2020;37:1002–04.
Raschetti R, Vivanti AJ, Vauloup-Fellous C, et al. Synthesis and systematic review of reported neonatal SARS-CoV-2 infections. Nature Communications. 2020;11: 5164.
Sheth S, Shah N, Bhandari V. Outcomes in COVID-19 positive neonates and possibility of viral vertical transmission: A narrative review. Am J Perinatol. 2020;37: 1208–16.
Blumberg DA, Underwood MA, Hedriana HL, et al. Vertical Transmission of SARS-CoV-2: What is the Optimal Definition?. Am J Perinatol. 2020;37:769–72.
Shah PS, Diambomba Y, Acharya G, et al. Classification system and case definition for SARS-CoV-2 infection in pregnant women, fetuses, and neonates. Acta Obstet Gynecol Scand. 2020;99:565–68.
Chawla D, Chirla D, Dalwai S, et al. Perinatal-Neonatal Management of COVID-19 Infection — Guidelines of the Federation of Obstetric and Gynaecological Societies of India (FOGSI), National Neonatology Forum of India (NNF), and Indian Academy of Pediatrics (IAP). Indian Pediatr. 2020;57:536–48.
Ministry of Health and Family Welfare. Guidelines for Management of COVID-19. Accessed January 05, 2021. Available at https://www.mohfw.gov.in
Dhir SK, Kumar J,Meena J, Kumar P. Clinical features and outcome of SARS-CoV-2 infection in neonates: A systematic review. J Trop Pediatr. 2020 Aug 28: fmaa059.
Gale C, Quigley MA, Placzek A, et al. Characteristics and outcomes of neonatal SARS-cov-2 infection in the UK: A prospective national cohort study using active surveillance. Lancet Child Adolesc Health. 2021;5:113–121.
Kotlyar AM, Grechukhina O, Chen A, et al. Vertical transmission of coronavirus disease 2019: A systematic review and meta-analysis. Am J Obstet Gynecol. 2021; 224: 35–53.
Walker KF, O’Donoghue K, Grace N, et al. Maternal transmission of SARS-COV-2 to the neonate, and possible routes for such transmission: A systematic review and critical analysis. BJOG. 2020;127:1324–36.
Nanavati R, Mascarenhas D, Goyal M, et al. A single-center observational study on clinical features and outcomes of 21 SARS-cov-2-infected neonates from India. Eur J Pediatr. 2021;1–12.
Anand P, Yadav A, Debata P, et al. Clinical profile, viral load, management and outcome of neonates born to COVID 19 positive mothers: A tertiary care centre experience from India. Eur J Pediatr. 2021;180:547–59.
Kumar J, Meena J, Yadav A, et al. SARS-CoV-2 detection in human milk: A systematic review. J Matern Fetal Neonatal Med. 2021 Feb 8;1–8.
Zhu F, Zozaya C, Zhou Q, et al. SARS-CoV-2 genome and antibodies in breastmilk: A systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2021 Feb 9; 0-F1-F8.
World Health Organization. Breastfeeding and COVID-19. Scientific Brief. 23 June 2020. Accessed December 25, 2020. Available at: https://www.who.int/opublications/i/item/WHO-2019-nCoV-Sci_Brief-Breasfeeding-2020.1
Salvatore CM, Han JY, Acker KP, et al. Neonatal management and outcomes during the COVID-19 pan-demic: an observation cohort study. Lancet Child Adolesc Health. 2020;4:721–27.
Sivanandan S, Chawla D, Kumar P, Deorari AK, National Neonatology Forum India. COVID-19 in neonates: A call for standardized testing. Indian Pediatr. 2020;57: 1166–71.
Nakra NA, Blumberg DA, Herrera-Guerra A, et al. Multi-System Inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection: Review of clinical presentation, hypothetical pathogenesis, and proposed management. Children (Basel). 2020;7:69.