Impact of Perinatal Exposure to SARS-CoV-2 Infection on Early Health Outcomes among Infants Born from 2020 to 2021 in British Columbia, Canada

Lindsay L Richter; Matthew S P Ho; Qian Zhang; Jeffrey N Bone; Elodie Portales-Casamar; Connie L Yang; Ashley Roberts; Kristopher Kang; Emily Kieran; Carol Lam; Sarka Lisonkova; Joseph Y Ting

doi:10.1155/2023/9968774

Impact of Perinatal Exposure to SARS-CoV-2 Infection on Early Health Outcomes among Infants Born from 2020 to 2021 in British Columbia, Canada

Can J Infect Dis Med Microbiol. 2023 May 5:2023:9968774. doi: 10.1155/2023/9968774. eCollection 2023.

Authors

Lindsay L Richter¹, Matthew S P Ho², Qian Zhang³, Jeffrey N Bone^{3

4}, Elodie Portales-Casamar^{1

3}, Connie L Yang¹, Ashley Roberts¹, Kristopher Kang¹, Emily Kieran¹, Carol Lam^{1

5}, Sarka Lisonkova⁴, Joseph Y Ting^{1

2}

Affiliations

¹ Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
² Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
³ Research Informatics, BC Children's Hospital Research Institute, Vancouver, BC, Canada.
⁴ Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
⁵ Department of Pediatrics, University of Toronto, Toronto, ON, Canada.

Abstract

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has impacted healthcare services and outcomes. We aimed to investigate healthcare resource utilization and early health outcomes of infants born to mothers with perinatal SARS-CoV-2 infection.

Methods: The study included all infants born alive between February 1, 2020, and April 30, 2021, in British Columbia. We used linked provincial population-based databases including data on COVID-19 testing, birth, and health information for up to one year from birth. Perinatal COVID-19 exposure for infants was defined being born to mothers with a positive test for SARS-CoV-2 infection during pregnancy or at delivery. Cases of COVID-19-exposed infants were matched with up to four non-exposed infants by birth month, sex, birthplace, and gestational age in weeks. Outcomes included hospitalizations, emergency department visits, and in-/outpatient diagnoses. Outcomes were compared between groups using conditional logistic regression and linear mixed effects models including effect modification by maternal residence.

Results: Among 52,711 live births, 484 infants had perinatal exposure to SARS-CoV-2, an incidence rate of 9.18 per 1000 live births. Exposed infants (54.6% male) had a mean gestational age of 38.5 weeks, and 99% were born in hospital. Proportions of infants requiring at least one hospitalization (8.1% vs. 5.1%) and at least one emergency department visit (16.9% vs. 12.9%) were higher among the exposed vs. unexposed infants, respectively. Among infants from the urban area, those with exposure were more likely to have respiratory infectious diseases (odds ratio: 1.74; 95% confidence intervals: 1.07, 2.84), compared with those without exposure. Interpretation. In our cohort, infants born to mothers with SARS-CoV-2 infection have increased healthcare demands in their early infancy, which warrants further investigation.