Characteristics and outcome of infants born to mothers with SARS-CoV-2 infection during the first three waves of COVID-19 pandemic in northern Iran: A prospective cross-sectional study

Roya Farhadi; Vajiheh Ghaffari; Shahrokh Mehrpisheh; Mahmood Moosazadeh; Mohammadreza Haghshenas; Aghdas Ebadi

doi:10.1016/j.amsu.2022.103839

Characteristics and outcome of infants born to mothers with SARS-CoV-2 infection during the first three waves of COVID-19 pandemic in northern Iran: A prospective cross-sectional study

Ann Med Surg (Lond). 2022 Jun:78:103839. doi: 10.1016/j.amsu.2022.103839. Epub 2022 May 23.

Authors

Roya Farhadi¹, Vajiheh Ghaffari¹, Shahrokh Mehrpisheh¹, Mahmood Moosazadeh², Mohammadreza Haghshenas³, Aghdas Ebadi⁴

Affiliations

¹ Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
² Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
³ Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
⁴ Department of Obstetrics and Gynecology, Mazandaran University of Medical Sciences, Sari, Iran.

Abstract

Background: Despite the rapid increase in knowledge about coronavirus disease 2019 (COVID-19), there is limited data on vertical transmission, viral loads in mother-neonate pairs, and health outcomes. We aimed to describe the characteristics, viral loads, and short-and mid-term outcomes of neonates born to mothers with confirmed COVID-19 infection in northern Iran.

Materials and methods: In a cross-sectional study, we prospectively collected and analyzed the clinical features, reverse transcription-polymerase chain reaction (RT-PCR) results, viral loads, and outcomes of 60 neonates delivered by 58 SARS-CoV-2 infected pregnant women in maternity hospitals of Mazandaran University of Medical Sciences (northern Iran) during first three waves of the pandemic from March 1 to December 31, 2020. We assessed neonates' short and mid-term outcomes up to 24 months after the pandemic. We also described the timing of mother-to-infant transmission based on the classification presented by the World Health Organization.

Results: Of the 17767 deliveries, 58 mothers had confirmed and probable COVID-19 infection. Twenty (33.3%) neonates were positive for SARS-CoV-2, two of whom had possible in utero transmission. Twenty-five (41.2%) neonates were preterm, most of whom were born during the first and second waves in which mothers were critically ill. 19 (31.7%) patients needed resuscitation in the delivery room. 34 (56.7%) neonates were isolated in the neonatal intensive care unit. We observed a significant relationship between the maternal and neonatal viral load (correlation coefficient = 0.983, P = 0.00). No neonatal death was observed and all babies had a good outcome.

Conclusions: The results showed that vertical transmission of SARS-CoV-2 is possible but rare. Regional factors and severity of mother's disease may influence the clinical course of neonates. With increasing experience, proper observance of health precautions, and rapid development of evidence-based response systems for regional and global disasters, the transmission rate of SARS-CoV-2 from mother to newborn is reduced.

Keywords: COVID-19; COVID-19, Coronavirus Disease 2019; ICU, Intensive Care Unit; NICU, Neonatal Intensive Care Unit; Newborn; Outcome assessment; RT-PCR, Reverse Transcription – Polymerase Chain Reaction; SARS-CoV-2, Severe Acute Respiratory Syndrome Corona-Virus 2; Sars-cov-2; Viral load.