Clinical profile of neonates delivered from mothers with confirmed COVID-19 infection: An experience from a Tertiary Perinatal Care Center in Dubai, UAE

Abstract

Background: The Coronavirus disease 2019 (COVID-19) outbreak is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 1 On January 30, 2020, the World Health Organization (WHO) declared the outbreak, as a Public Health Emergency of international concern and later on upgraded the outbreak on 11 March 2020, to a Pandemic. Neonates are a special population who might have different level of risks and susceptibilities to the virus. The risk of in-utero (vertical transmission) transmission of SARS-CoV-2 is anticipated to be low. The risk of perinatal transmission, especially during breastfeeding and the neonate’s risk of developing COVID-19 during the perinatal period are also unknown. Until date, the knowledge is limited on whether rooming-in the neonate with mother (if she is SARS-COV-2 positive) after delivery is a safe practice. Methods: This is a retrospective observational study, which is conducted at the Neonatal Intensive Care Unit (NICU) and post-natal wards of Latifa Women and Children Hospital (LWCH), Dubai, United Arab Emirates (UAE). We conducted this study aiming to evaluate and follow up neonates born to SARS-COV-2 positive mothers. In addition, to find out any potential risk factors associated with transmission of infection and elucidate best infection control and management practices. Maternal and neonatal data were collected retrospectively from our electronic medical records. Testing for neonates for SARS-COV-2 infection was done by real time reverse transcriptase Polymerase Chain Reaction (rtPCR) performed on nasopharyngeal swab samples. Samples are collected at birth (or as soon as possible) and 24-48 hours after the first sample; in case of any positive result, subsequent samples collected after 5-7days (at 24 hours interval), until two consecutive samples were negative. Universal COVID-19 screening for pregnant women presented for delivery was adopted. Results: st 2020 and th 2020, a total of 92 pregnant women were admitted to our hospital and diagnosed positive for SARS- COv-2 infection. Out of which, 35 mothers and their 36 neonates (one was twin delivery) were included for analysis. Two (5.5%) neonates were confirmed positive for SARS-COV-2 infection and one had inconclusive report. All neonates were stable and asymptomatic, and their subsequent rtPCR tests were negative. All the neonates (including the positive cases) were roomed-in together with their mother and exclusive breast-feeding was given unless not feasible. These practices did not increase the risk of neonatal SARS-COV-2 infection. All neonates were discharge home in good condition. Neonates were clinic follow up (outpatient clinic or telephonic) and were found to be in healthy condition. Conclusion: our current study, we found out that transmission rate of SARS-COV-2 from mother to child is minimal if proper identification of infections and proper education to and adherence to infection control practice is ensured. If possible, mother and baby should be in a single room and exclusive breast-feeding practice could be feasible without any additional risk of transmission of SARS-COV-2 infection to the neonates.