Table 3.
Clinical and demographic characteristics of neonates born to mothers with SARS-CoV-2 infection
| Neonates with positive SARS-CoV-2 PCR testing n=61 |
Neonates without positive SARS-CoV-2 testing n=1269 |
All neonates n=1330 |
|
|---|---|---|---|
| Maternal critical illness, n/total (%) | 10/31 (32) | 101/802 (13) | 121/973 (12) |
| Gestational age in completed weeks, median (IQR) | 35 (31-38) n=38 |
38 (36-39) n=554 |
38 (36-39) n=592 |
| Preterm, n/total (%) | 22/40 (55) | 281/1056 (27) | 339/1273 (27) |
| Birth weight in grams, median (IQR) | 2520 (1808-3184) n=34 |
3110 (2675-3400) n=431 |
3110 (2600-3380) n=465 |
| Male sex, n/total (%) | 21/35 (60) | 226/398 (57) | 250/439 (57) |
| Caesarean delivery, n/total (%) | 31/45 (69) | 671/1164 (58) | 714/1230 (58) |
| APGAR score at 1 minute, median (IQR) | 8 (5-9) n=25 |
8 (8-9) n=365 |
8 (8-9) n=435 |
| APGAR score at 5 minutes, median (IQR) | 9 (8-9) n=26 |
9 (9-10) n=408 |
9 (9-10) n=479 |
| Neonatal asphyxia, n (%) | 2/46 (4) | 15/1023 (1) | 17/1070 (2) |
| Separation from mother after delivery, n/total (%) | 34/40 (85) | 375/559 (67) | 415/611 (68) |
| Breastfed, n/total (%) | 4/31 (13) | 184/575 (32) | 199/627 (32) |
| NICU admission, n/total (%) | 39/43 (91) | 296/932 (32) | 343/997 (34) |
| Fever, n/total (%) | 9/32 (28) | 8/511 (2) | 18/554 (32) |
| Respiratory distress, n/total (%) | 35/51 (69) | 91/535 (17) | 126/590 (21) |
| Abnormal chest imaging, n (%) | 21/26 (81) | 22/39 (56) | 43/65 (66) |
| Need for PPV, n/total (%) | 11/38 (29) | 34/837 (4) | 45/885 (5) |
| Need for mechanical ventilation, n/total (%) | 14/50 (28) | 30/864 (3) | 44/918 (5) |
| GI symptoms, n/total (%) | 8/29 (28) | 16/481 (3) | 25/527 (5) |
| DIC, n/total (%) | 1/44 (2) | 3/836 (0) | 4/888 (0) |
| Lymphopenia, n/total (%) | 4/17 (24) | 8/190 (4) | 12/207 (6) |
| Thrombocytopenia, n/total (%) | 5/17 (29) | 16/170 (9) | 21/187 (11) |
| Elevated aminotransferases, n/total (%) | 8/16 (50) | 84/160 (53) | 92/176 (52) |
| Neonatal death, n (%) | 1/55 (2) | 13/1131 (1) | 14/1167 (1) |
notes. Clinical and demographic characteristics of neonatal with perinatal COVID exposure. Studies not reporting neonatal outcomes were excluded. Neonates without positive SARS-CoV-2 PCR testing include neonates with negative testing and neonates in whom testing was not performed or reported. Not all variables of interest were reported for all neonates; denominators reported for individual variables as appropriate. Breastfeeding was defined as direct breastfeeding; use of expressed breast milk only was not considered breastfeeding. Neonates described as asymptomatic were presumed to not have clinical symptoms (fever, respiratory distress, GI symptoms, asphyxia) or have required PPV or mechanical ventilation. PPV includes non-invasive modalities including CPAP, SiPAP, and NIPPV. GI symptoms include abdominal distention, feeding intolerance, vomiting, and diarrhea. Lymphopenia was defined as a lymphocyte count <1,500/mm3. Thrombocytopenia was defined as a platelet count <150,000/mm3. Aminotransferases were considered elevated if either aspartate aminotransferase or alanine aminotransferase was >40 U/L. Abbreviations: APGAR – Appearance, Pulse, Grimace, Activity, and Respiration score ; CPAP – continuous positive airway pressure; DIC – disseminated intravascular coagulation; GI – gastrointestinal; IQR – interquartile range; NICU – neonatal intensive care unit; NIPPV - noninvasive positive pressure ventilation; PCR – polymerase chain reaction; PPV – positive pressure ventilation; SARS-CoV-2 – severe acute respiratory syndrome coronavirus 2; SiPAP – synchronized intermittent positive airway pressure.