Mama-Infant COVID-19 infection is less common

A New York City study found little evidence of vertical COVID-19 infection between cohorts of newborns whose mothers confirmed or suspected SARS-CoV-2 infection.

Cynthia Gamfibanerman, MD, of Columbia University Irving Medical, found that 95.7% of 101 neonates had no SARS-CoV-2 viral RNA detected in the nasopharyngeal polymerase chain reaction test and were overall in 2 neonates. The infection rate was 2%. New York City Center and colleagues.

Two infants with evidence of vertical transmission had uncertain tests and were infected with very low viral copy counts, suggesting that neither had symptoms of COVID-19. JAMA Pediatrics..

Gyamfi-Bannerman and colleagues found that about three-quarters of mothers lived with newborns, six infants were separated from severely ill mothers in the ICU, and 19 infants were admitted to the neonatal ICU without contact with their parents. Said.

“This study supports the benefits of room-in, establishment of breastfeeding, and delayed bathing for neonatal outcomes, separating SARS-CoV-2 positive mothers and their newborns and avoiding direct breastfeeding. It suggests that it may not be justified to prevent SARS-CoV-2. Communication. “

In American Academy of Pediatrics (AAP) Perinatal COVID-19 Registry, Data from more than 3,000 births suggest that approximately 2% of babies born to women who tested positive for SARS-CoV-2 near birth were positive within 96 hours of birth. doing.

Although case reports of newborns with severe SARS-CoV-2 infection have been documented, this and other studies confirm that most cases of infants are asymptomatic or minimally symptomatic. That’s what Dr. David W. Kimberlin of the University of Alabama at Birmingham commented. Karen M of the University of Pennsylvania, Philadelphia. Puopolo, MD, PhD, Ancillary editorial..

In this study, 67% of mothers were asymptomatic and routine tests only confirmed that they had SARS-CoV-2 viral RNA. Also, Kimberlin and Puopolo said only 55 of the 101 newborns were tested after discharge and only 6 infants were tested for SARS-CoV-2 after discharge.

“Therefore, the low risk of perinatal infection observed in this study should be seen in the context of the uncertain timing of many maternal infections,” they wrote. “More importantly, the very low risk of postnatal infection needs to be added to the context of maternal / neonatal physical separation and very careful infection control practices.”

In summary, the findings suggest that the steps taken to prevent mother-to-baby transmission in the early stages of the pandemic may have been overly conservative, Kimberlin and Puopolo said. It was.

The study collected data from mother-child pairs admitted to New York-Presbyterian Morgan Stanley Children’s Hospital and New York-Presbyterian Allen Hospital from March 13 to April 24. All babies underwent SARS-CoV-2 testing on the first day of life, and the majority underwent multiple tests within the next few days.

Overall, most women were asymptomatic or mildly ill (90%). The median maternal age was 28.5 years, and 36 women suffered from asthma, diabetes, chronic hypertension, or hypertensive disorders of pregnancy. In addition, 54 women had a BMI of over 30.

Newborns born to mothers with severe or severe COVID-19 were significantly more likely to be born about a week earlier than mothers with asymptomatic or mild COVID-19 infection (1.4 weeks difference). , 95% CI 0.3-2.3, P= 0.02), the incidence of hyperbilirubinemia requiring phototherapy was also high (5/9% difference, 95% CI 0.8-36.1, P= 0.04), the author reported.

One newborn with evidence of vertical transmission was born by vaginal delivery and was tested 3 days after birth after the mother began to show symptoms. The second newborn with evidence of vertical transmission was born by non-emergency caesarean section and the mother was asymptomatic.

The authors state that the findings were from the epicenter of the pandemic and may not be generalized to other communities, which is a limitation. They also added that most women were infected during the third semester of the study.