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Management and Early Outcomes of Neonates Born to Women with SARS-CoV-2 in 16 U.S. Hospitals
Journal article   Open access   Peer reviewed

Management and Early Outcomes of Neonates Born to Women with SARS-CoV-2 in 16 U.S. Hospitals

Jayme L Congdon, Laura R Kair, Valerie J Flaherman, Kelly E Wood, Mary Ann LoFrumento, Eberechi Nwaobasi-Iwuh, Carrie A Phillipi and Better Outcomes through Research for Newborns (BORN) Network
American journal of perinatology, Vol.38(6), pp.622-631
05/2021
DOI: 10.1055/s-0041-1726036
PMCID: PMC8191701
PMID: 33723834
url
https://escholarship.org/content/qt9682b31b/qt9682b31b.pdfView
Open Access

Abstract

There is a paucity of evidence to guide the clinical care of late preterm and term neonates born to women with perinatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The objective of this case series is to describe early neonatal outcomes and inpatient management in U.S. hospitals. We solicited cases of mother-infant dyads affected by novel coronavirus disease 2019 (COVID-19) from the Better Outcomes through Research for Newborns (BORN) Network members. Using a structured case template, participating sites contributed deidentified, retrospective birth hospitalization data for neonates ≥35 weeks of gestation at birth with mothers who tested positive for SARS-CoV-2 before delivery. We describe demographic and clinical characteristics, clinical management, and neonatal outcomes. Sixteen U.S. hospitals contributed 70 cases. Birth hospitalizations were uncomplicated for 66 (94%) neonates in which 4 (6%) required admission to a neonatal intensive care unit. None required evaluation or treatment for infection, and all who were tested for SARS-CoV-2 were negative (  = 57). Half of the dyads were colocated (  = 34) and 40% directly breastfed (  = 28). Outpatient follow-up data were available for 13 neonates, all of whom remained asymptomatic. In this multisite case series of 70 neonates born to women with SARS-CoV-2 infection, clinical outcomes were overall good, and there were no documented neonatal SARS-CoV-2 infections. Clinical management was largely inconsistent with contemporaneous U.S. COVID-19 guidelines for nursery care, suggesting concerns about the acceptability and feasibility of those recommendations. Longitudinal studies are urgently needed to assess the benefits and harms of current practices to inform evidence-based clinical care and aid shared decision-making. · Birth hospitalizations were uncomplicated for late preterm and term infants with maternal COVID-19.. · Nursery management of dyads affected by COVID-19 varied between hospitals.. · Adherence to contemporaneous U.S. clinical guidelines for nursery care was low.. · Breastfeeding rates were lower for dyads roomed separately than those who were colocated..
 Adult Breast Feeding - methods Breast Feeding - statistics & numerical data COVID-19 - epidemiology COVID-19 - therapy Female Gestational Age Guideline Adherence Health Services Needs and Demand Hospitalization - statistics & numerical data Humans Infant, Newborn Infant, Premature Intensive Care Units, Neonatal - statistics & numerical data Male Practice Guidelines as Topic Pregnancy Pregnancy Complications, Infectious - epidemiology Pregnancy Complications, Infectious - therapy Pregnancy Complications, Infectious - virology Pregnancy Outcome - epidemiology Premature Birth - epidemiology Term Birth United States - epidemiology

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