Neonatal outcomes of maternal SARS-CoV-2 infection in the UK: a prospective cohort study using active surveillance

Ali, S. et al. (2023) Neonatal outcomes of maternal SARS-CoV-2 infection in the UK: a prospective cohort study using active surveillance. Pediatric Research, (doi: 10.1038/s41390-023-02527-z) (PMID:36899124) (PMCID:PMC10000338) (Early Online Publication)

Abstract

Background: Newborns may be affected by maternal SARS-CoV-2 infection during pregnancy. We aimed to describe the epidemiology, clinical course and short-term outcomes of babies admitted to a neonatal unit (NNU) following birth to a mother with confirmed SARS-CoV-2 infection within 7 days of birth. Methods: This is a UK prospective cohort study; all NHS NNUs, 1 March 2020 to 31 August 2020. Cases were identified via British Paediatric Surveillance Unit with linkage to national obstetric surveillance data. Reporting clinicians completed data forms. Population data were extracted from the National Neonatal Research Database. Results: A total of 111 NNU admissions (1.98 per 1000 of all NNU admissions) involved 2456 days of neonatal care (median 13 [IQR 5, 34] care days per admission). A total of 74 (67%) babies were preterm. In all, 76 (68%) received respiratory support; 30 were mechanically ventilated. Four term babies received therapeutic hypothermia for hypoxic ischaemic encephalopathy. Twenty-eight mothers received intensive care, with four dying of COVID-19. Eleven (10%) babies were SARS-CoV-2 positive. A total of 105 (95%) babies were discharged home; none of the three deaths before discharge was attributed to SARS-CoV-2. Conclusion: Babies born to mothers with SARS-CoV-2 infection around the time of birth accounted for a low proportion of total NNU admissions over the first 6 months of the UK pandemic. Neonatal SARS-CoV-2 was uncommon. Study registration: ISRCTN60033461; protocol available at http://www.npeu.ox.ac.uk/pru-mnhc/research-themes/theme-4/covid-19. Impact: Neonatal unit admissions of babies born to mothers with SARS-CoV-2 infection comprised only a small proportion of total neonatal admissions in the first 6 months of the pandemic. A high proportion of babies requiring neonatal admission who were born to mothers with confirmed SARS-CoV-2 infection were preterm and had neonatal SARS-CoV-2 infection and/or other conditions associated with long-term sequelae. Adverse neonatal conditions were more common in babies whose SARS-CoV-2-positive mothers required intensive care compared to those whose SARS-CoV-2-positive mothers who did not.

• Item Type: Articles
• Additional Information: The BPSU COVID-19 study is funded by the National Institute for Health Research (NIHR) Policy Research Programme, conducted through the Policy Research Unit in Maternal and Neonatal Health and Care, PR-PRU-1217-21202. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The UKOSS study was funded by the National Institute for Health Research HS&DR Programme (project number 11/46/12). M.K. is an NIHR Senior Investigator. The Maternal, Newborn and Infant Clinical Outcome Review Programme, delivered by MBRRACE-UK, is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). The Maternal, Newborn and Infant Clinical Outcome Review Programme is funded by NHS England, NHS Wales, the Health and Social Care division of the Scottish government, The Northern Ireland Department of Health, and the States of Jersey, Guernsey, and the Isle of Man.
• Status: Early Online Publication
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: MacTier, Dr Helen
• Authors: Ali, S., Mactier, H., Morelli, A., Hurd, M., Placzek, A., Knight, M., Ladhani, S. N., Draper, E. S., Sharkey, D., Doherty, C., Kurinczuk, J. J., Quigley, M. A., and Gale, C.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Pediatric Research
• Publisher: Springer Nature
• ISSN: 0031-3998
• ISSN (Online): 1530-0447
• Published Online: 10 March 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Pediatric Research 2023
• Publisher Policy: Reproduced under a Creative Commons License