Table 2.
Characteristics of neonates born from pregnant women with COVID-19 included in the systematic review
| Article title | Author | Study type | Country | Number of neonates | Neonatal maturity (= N) |
Neonatal clinical presentations (= N) |
Neonatal complications | Neonate test for nCoV-2019 | Apgar score | Neonatal outcome | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Result | Diagnostic method | ||||||||||
| Pregnant women with new coronavirus infection: clinical characteristics and placental pathological analysis of three cases | Chen et al. | Case study | China | 3 |
Mature infants (= 2) Premature with LBW (= 1) |
No remarkable clinical problem was reported | No complications were reported | Negative | Neonatal throat swab nucleic acid testing | Not reported | Healthy and discharged |
| Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia | Zhu et al. | Case study | China |
10 (2 twins) |
4 full terms, 6 premature (2 SGA AND 1 LGA) |
Respiratory distress (= 6), GI tract symptoms (= 4), Fever (= 2) Increased heart rate (= 1) Vomiting (= 1) |
Death (= 1)** DIC (= 1)** |
Negative | Neonatal throat swab nucleic acid testing |
5th min Apgar score: 10 (= 6) 9 (= 2) 8 (= 2) |
Cured (= 5) In hospital (= 4) Died (= 1) |
| Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records | Chen et al. | Case study | China | 9 | Full-term babies (= 5), birth at 36th week of gestational age (= 4*) | No remarkable clinical problem was reported | No complications were reported | Negative | Neonatal throat swab nucleic acid testing | All babies with 5th min Apgar score of 9 to 10 | None of the neonates needed special treatment |
| Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province | Zhang et al. | Case–control | China | 10 |
Full-term babies (= 9) Premature babies (= 1) |
3 neonate developed bacterial pneumonia | No complications were reported | Negative | Neonatal throat swab nucleic acid testing and imaging study | Not reported | None of the neonates needed special treatment. No neonatal death |
| Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy | Liu et al. | Case Study | China | 10 | Full-term babies (= 4), Premature babies (= 6) |
9 neonates survived with no remarkable clinical problem, 1 died due to ARDS and MODS |
1 neonate died due to MODS | Negative | Neonatal throat swab nucleic acid testing | 1st min Apgar score: 10 for all nine alive babies | 1 dead neonate because of MODS |
| Lack of Vertical transmission of severe acute respiratory syndrome Coronavirus 2, China | Li et al. | Case Report | China | 1 | Premature baby in 35th week of GA | No remarkable clinical problem was reported | No complications were reported | Negative | Neonatal throat swab nucleic acid testing | Not reported | Healthy and discharged |
| A case of 2019 Novel Coronavirus in a pregnant woman with preterm delivery | Wang et al. | Case report | China | 1 | Premature baby in 30th week of GA | No remarkable clinical problem was reported | No complications were reported | Negative | Neonatal throat swab nucleic acid testing | 5th min Apgar score: 10 | Healthy and discharged |
| A case report of neonatal COVID-19 infection in China | Wang et al. | Case report | China | 1 | Full-term baby | COVID-19 Pneumonia | No complications were reported | Positive | Neonatal throat swab nucleic acid testing (36th-hour birth) | 5th min Apgar score: 9 | Healthy and discharged |
| Perinatal transmission of COVID-19 associated SARS-CoV-2: should we worry? | Fan et al. | Case report | China | 2 |
Full-term neonate (= 1) 36th week and 5 days of GA (= 1) |
Mild neonatal pneumonia and lymphopenia (= 1) Low-grade Fever and diffuse haziness of lungs without patchy consolidation which cured with antibiotic |
No complications were reported | Negative | Neonatal throat swab nucleic acid testing | 5th min Apgar score: 10 | Healthy and discharged |
| Clinical analysis of pregnant women with 2019 Novel Coronavirus pneumonia | Chen et al. | Case series | China | 5 | Full-term neonate (= 5) | Fetal tachycardia (= 1) | No complications were reported | Negative | Neonatal throat swab nucleic acid testing |
5th min Apgar score: 10 (= 5) |
Healthy |
| Possible vertical transmission of SARS-CoV-2 From an infected mother to her newborn | Dong et al. | Case report | China | 1 | 34 weeks and 5 days | Elevated IgM antibody*** | No complications were reported | Negative | Neonatal throat swab nucleic acid testing | 5th min Apgar score: 10 | Healthy and discharged |
|
Lung ultrasound and computed tomographic findings in a pregnant woman with COVID-19 |
Kalafat et al. | Case report | Turkey | 1 | 35 weeks and 3 days | No remarkable clinical problem was reported | No complications were reported | Negative | Neonatal throat swab nucleic acid testing | 5th min Apgar score: 9 | Healthy |
| Title: Coronavirus disease 2019 (COVID-19) during pregnancy: a case series | Liu et al. | Case series | China | 3 | Full-term neonates (= 3) | Chorioamnionitis and meconium aspiration syndrome (= 1) | No complications were reported | Negative | Neonatal throat swab nucleic acid testing | 5th min Apgar score: 9 (= 3) | Survived (= 3) |
| Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case–control study | Li et al. | Case–control | China | 17 |
Full-term (= 13) Premature (= 4) LBW (= 3) |
Intrauterine fetal distress (= 2) | No complications were reported | Negative |
Neonatal throat swab nucleic acid testing (= 3)**** |
5th min Apgar score: 10 (= 17) |
No death was reported |
| A pregnant woman with COVID-19 in Central America | Zambrano et al. | Case report |
United States, USA |
1 | 32 weeks of GA | No remarkable clinical problem was reported | No complications were reported | Negative | Neonatal throat swab nucleic acid testing | Not reported | No death was reported |
|
Pregnancy and Perinatal outcomes of women with Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis |
Liu et al. | Cross-sectional | China | 11 |
Full-term (= 8) Preterm delivery (= 3) |
No remarkable clinical problem was reported | No complications were reported | Negative | Not reported***** | 5th min Apgar score: 9 | No death was reported |
| Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-center, descriptive study | Yu et al. | Retrospective study | China | 7 |
Full-term (= 7) |
Mild shortness of breath (= 1) | Mild pulmonary infection in a neonate with positive COVID-19 test |
Negative (= 2) Positive (= 1)****** |
Neonatal throat swab nucleic acid testing |
5th min Apgar score: 9 -10 (= 7) |
No death was reported |
| Neonatal early-onset infection with SARS CoV-2 in 33 neonates born to mothers With COVID-19 in Wuhan, China | Zeng et al. | Cohort study | China | 33 |
Full-term (= 29) Preterm (= 4) |
Fever (= 2; both with positive COVID-19) Shortness of breath (= 4; 3 with negative COVID-19 and one positive) Cyanosis (= 3; 2 with negative COVID-19 and one with positive) Feeding intolerance (= 3; 2 with negative COVID-19 and one with positive) |
Asphyxia (= 2; one neonate with negative COVID-19 infection and one neonate with positive COVID-19 infection) Pneumonia (3; all 3 with positive COVID-19) Respiratory distress syndrome (4; 3 with negative COVID-19 and one positive) Requiring mechanical ventilation: 1 baby with COVID-19 positive |
Negative (= 30) Positive (= 3) |
Neonatal throat swab nucleic acid testing | Not reported******* | No death was reported |
| Mortality of a pregnant patient diagnosed with COVID-19: a case report with clinical, radiological, and histopathological findings | Karami et al. | Case report | Iran | 1 | Stillbirth | – | – | Not reported | Not reported | Apgar score:0 | Fetal death |
| Unlikely SARS-CoV-2 vertical transmission from mother to child: a case report | Peng et al. | Case report | China | 1 | Preterm | Mild respiratory distress | None | Negative | Neonatal throat and anal and swab and sputum and serum nucleic acid testing | 5th min Apgar score: 10 | Survived |
| Severe COVID-19 during pregnancy and possible vertical transmission | Alzamora et al. | Case report | The United States, USA | 1 | Preterm |
Mild respiratory distress And sporadic cough |
Intubation because of mother’s sedation | Positive |
Neonatal throat swab nucleic acid testing (16 h after delivery) |
5th min Apgar score: 8 | No death was reported |
| Preterm delivery in a pregnant woman with critical COVID-19 pneumonia and vertical transmission | Zamanian et al. | Case report | Iran | 1 | Preterm | Fever | None | Positive | Neonatal throat swab nucleic acid testing | 5th min Apgar score: 9 | Survived |
| Vaginal delivery report of a healthy neonate born to a convalescent mother with COVID-19 | Xiong et al. | Case report | China | 1 | Full-term | No remarkable clinical problem was reported | None | Negative | Neonatal throat and anal swab nucleic acid testing | 5th min Apgar score: 10 | Healthy and discharged |
| Association of COVID-19 infection with pregnancy outcomes in healthcare workers and general women | Khan et al. | Case series | China | 17 |
Full-term (= 14) Preterm (= 3) |
Neonatal pneumonia (= 5) 2 case of COVID-19 which one of them developed pneumonia |
No serious complications were reported |
Negative (= 15) Positive (= 2) |
Neonatal throat and anal swab nucleic acid testing | 5th min Apgar score: 9–10 | No case of death was reported |
| Impact of COVID-19 infection on pregnancy outcomes and the risk of maternal-to- neonatal intrapartum transmission of COVID-19 during natural birth | Khan et al. | Case report | China | 3 |
Full-term (= 2) Preterm (= 1) |
No remarkable clinical problem was reported | None | Negative (= 3) | Neonatal throat and anal swab nucleic acid testing | 5th min Apgar score: 9–10 | No case of death was reported |
| Clinical characteristics of 19 neonates born to mothers with COVID-19 | Liu et al. | Retrospective study | China | 19 |
Full-term (= 17) Preterm (= 2) |
No remarkable clinical problem was reported | None | Negative (= 19) | Neonatal throat and anal swab nucleic acid testing | 5th min Apgar score: 9 | No case of death was reported |
| COVID-19 infection among asymptomatic and symptomatic pregnant women: Two weeks of confirmed presentations to an affiliated pair of New York City hospitals | Breslin et al. | Cohort study |
The United States, USA |
18 |
Full-term (= 17) Premature (= 1) |
Respiratory distress (= 1) One patient with congenital disease |
None | Negative (= 18; including one intermediate result which considers as negative because of low detection) | Neonatal throat and anal swab nucleic acid testing | 5th min Apgar score: 9–10 | All healthy and discharged |
| Clinical features and outcomes of pregnant women suspected of Coronavirus Disease 2019 | Yang et al. | Case–control | China | 20******** | Mean ± SD GA: 38.2 ± 2.3 | Fever (= 1 from COVID-19 positive mother) | None | Negative | Neonatal throat and anal swab nucleic acid testing | Not reported | No case of death was reported |
| Asymptomatic COVID-19 in a pregnant woman with typical chest CT manifestation: a case report | Renbin et al. | Case report | China | 1 | Full-term | No remarkable clinical problem was reported | None | Negative | Neonatal throat swab nucleic acid testing | Not reported | Healthy and discharged |
| Chest CT findings in a pregnant patient with 2019 Novel Coronavirus Disease | Liao et al. | Case report | China | 1 | Preterm | No remarkable clinical problem was reported | None | Negative | Neonatal throat and anal swab nucleic acid testing | Not reported | No case of death was reported |
| Infants born to mothers with a new Coronavirus (COVID-19) | Chen et al. | Case report | China | 4 | Full-term (= 4) | No remarkable clinical problem was reported | None |
Negative (= 4) |
Neonatal throat and anal swab nucleic acid testing | Not reported | No case of death was reported |
| Anesthetic management for emergent cesarean delivery in a parturient with recent diagnosis of Coronavirus Disease 2019 (COVID-19): a case report | Song et al. | Case report | China | 1 | Preterm | No remarkable clinical problem was reported | None | Negative | Neonatal throat swab nucleic acid testing | 5th min Apgar score: 9 | Healthy and discharged |
| Clinical characteristics and risk assessment of newborns born to mothers with COVID-19 | Yang et al. | Case series | China | 7 |
Full-term (= 3) Preterm (= 4) |
Mild respiratory distress syndrome (= 2) Vomiting and hypoglycemia (= 1) |
None |
Negative (performed for 6 neonates) |
Neonatal throat swab nucleic acid testing | 5th min Apgar score: 9–10 | No case of death was reported |
| COVID-19 in pregnancy: early lessons | Breslin et al. | Case series |
The United States, USA |
2 | Full-term (= 2) | No remarkable clinical problem was reported | None |
Negative (performed for one neonate) |
Neonatal throat swab nucleic acid testing | Not reported | No case of death was reported |
|
Antibodies in Infants Born to mothers with COVID-19 Pneumonia |
Zeng et al. | Case study | China | 6 | Not reported | No remarkable clinical problem was reported********* | None | Negative (= 6) | Neonatal throat and serum swab nucleic acid testing | Not reported | No case of death was reported |
| Novel Coronavirus infection in newborn babies under 28 days in China | Zhang et al. | Case series | China | 2 | Full-term (= 2) | Shortness of breath (= 1) | None | Positive | Neonatal throat swab nucleic acid testing | Not reported | No case of death was reported |
| Clinical characteristics of pregnant women with Covid-19 in Wuhan, China | Chen et al. | Retrospective study | China |
70 (2 set of twins) |
Full-term (= 56) Preterm (14) |
No remarkable clinical problem was reported | None | Negativeϕ | Neonatal throat swab nucleic acid testing | 5th min Apgar score: 8-9ϕ | No case of death was reported |
| Total results | Total number of neonates: 302 |
Full-term (= 210/276) Premature (= 65/276) stillbirth (= 1) |
DIC (= 2) MODS (= 1) |
Negatives (= 208) And positive (= 11) |
Survived (= 299) died (= 3) |
||||||
MODS Multiple organ dysfunction syndrome, ARDS Acute respiratory distress syndrome, DIC Disseminated intravascular coagulation, GA gestational age, SGA Small for gestational age, LGA Large for gestational age, LBW low birth weight, C-Section Cesarean section
We considered GA < 37 weeks as preterm delivery
*One complicated with pre-eclampsia, one with history of 2 stillbirth, one with history of 2 previous c-sections and irregular contractures, and one with premature rupture of membranes
**One neonate in which first symptom was increased heart rate developed refractory shock and gastric bleeding which lead to death, another neonate with shortness of breath and moaning and later with DIC that cured
***SARS-CoV-2 IgG level: 140.32 AU/mL and IgM level: 45.83 AU/mL 2 h after birth and also 16 days after birth repeated test revealed IgG level of 69.94 AU/mL and IgM level of 11.75 AU/mL
****The specimens collected from three neonates whom delivered by cesarean section
*****The study claimed that no COVID-19 infection was represented in neonates but did not clarified by which method -clinical or nucleic acid testing-
******Specimens collected from three neonates and positive sample was collected 36 h after birth
*******Except one of infected neonates with confirmed COVID-19 infection born with need of resuscitation and Apgar score of 3, 4, 5 in 1, 5 and 10 min
********The total number of neonates were 57 and 20 neonates tested for COVID-19 but study did not clarify how many neonates belong to the case group
*********2 neonates had elevated serum IgM levels
ϕNasopharyngeal swab was taken from 8 neonates
ϕϕApgar score was measured for 66 neonates