Clinico-epidemiological Characteristics and Short-term Outcomes of Neonates Born to COVID-19 Positive Mothers at a Tertiary Care Hospital in North Karnataka- A Retrospective Study

Introduction: Coronavirus Disease-2019 (COVID-19) infection in pregnant women can have important effects on the perinatal and neonatal outcomes. Multiple modes of transmission of infection from mother to the newborn have been suggested as also the increased risk of complications in COVID-19 infected neonates. Aim: To study the clinico-epidemiological characteristics and short-term outcomes of neonates born to mothers infected with COVID-19 in relation to maternal COVID-19 severity and co-morbidities and to compare the same between COVID-19 infected and non infected neonates. Materials and Methods: This was a retrospective study of 174 neonates born to COVID-19 positive mothers admitted and delivered from 1st August 2020 to 31st October 2020, at Belagavi Institute of Medical Sciences (BIMS), North Karnataka, India. Data was collected from medical records about the clinical and epidemiological characteristics of the mothers and their neonates, symptoms and severity of COVID-19 and their management and short-term outcomes. Pearson’s Chi-square or Fisher’s-exact test was used for statistical analysis. The p-value of less than 0.05 was considered statistically significant. Results: Out of 174, 18 (10.35%) neonates tested positive for COVID-19 by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). The rates of pre-maturity and low birth weight amongst all 174 neonates were 17.24% and 24.14%, respectively. There were no significant differences in demographic features, in the need for resuscitation and incidence of complications like prematurity, low birth weight, birth asphyxia, meconium aspiration syndrome, sepsis between COVID-19 infected and non infected neonates. However, an increased risk of Early Onset Sepsis (EOS) (OR– 2.21) in COVID-19 infected neonates. None of the COVID- 19 infected neonates required Continuous Positive Airway Pressure (CPAP) or mechanical ventilation and all were discharged subsequently. In this study there were 3(1.72%) deaths, all among COVID-19 non infected, neonates. Conclusion: The incidence of COVID-19 infection in neonates born to COVID-19 infected mothers in this study was 10.35%. Most of the infections in neonates were of less severity without a significantly increased need for respiratory support and without significant mortality.