Study to know the Perinatal Transmission of SARS CoV-2 and Outcome of Newborns born to Covid-19 positive Mother in a L3 Centre in Barabanki District of Uttar Pradesh
Background: Due to limited data on perinatal and vertical transmission, outcomes of SARS-CoV-2 infection in neonates, appropriate management and the neonate’s risk of developing COVID-19 during the perinatal period are unknown. Therefore, we aimed to know best practices regarding infection control in mother–newborn and identify potential risk factors associated with perinatal transmission.
Objective: To describe clinical outcomes and risk factors for transmission in neonates born to mothers with perinatal SARS CoV-2 infection and practices associated with these outcomes.
Material and Methods: This retrospective cross sectional study was conducted in a L3 Covid Centre at Mayo Institute of Medical Sciences in Barabanki District of Uttar Pradesh. This study includes all newborns born to SARS-COV-2 positive in first and second wave of COVID-19 from March 2020 to June 2021. Infection control practices included in the data collection were disposition of the neonate at delivery either allowed to room in with mother or admitted to a dedicated isolation room, feeding method (direct breastfeeding or expressed breast milk or formula feed). Maternal nasopharyngeal swab specimens were tested for SARS-CoV-2 at the Central Microbiology Laboratory of Mayo Institute of Medical Sciences, Barabanki. A minimum of two nasopharyngeal swab specimen was obtained from each newborn and tested for SARS-CoV-2 using the RTPCR tests. First test was done within 48 hours of birth and second tests was done for each newborn in between day 5-7 day of birth.
Results: There were 53 deliveries in our institute to mothers who were tested positive for SARS-CoV-2. Among all positive mothers, 6 (11.3%) were asymptomatic and 47 (88.6%) were symptomatic. Most common symptom in positive mother is fever 37 (69.8%) followed by cough & sore throat 26 (49.0%), GI symptoms and diarrhea 25 (47.1%), anosmia 19 (35.8%), headache 19 (35.8%) dyspnea & shortness of breath 10 (18.8%). Maternal outcome was very good and all the mothers were discharged. Of the 53 neonates, born to covid positive mother 29 (54.7%) were male, 24 (45.2%) were female. There were 53 live births out of these 39 (73.5%) newborns were born by cesarean section and 14 (26.4%) were through normal vaginal delivery. 20 (37.7%) neonates were admitted to the neonatal intensive care unit (NICU) in view of birth and neonatal complications and 10 (18.8%) received routine care in neonatal nursery. 23 newborns were handed directly to mother to be roomed in with proper protective equipments, mask and hand hygiene. A total of 48 (90.5%) newborns tested negative and only 5 (9.4%) tested positive. All neonates had a repeat RTPCR at 5–7 days of life and all were negative. All newborns after discharge from hospital were referred to outpatient clinic. 41 (77.3%) were lost to follow-up and 12 (22.6%) patients were adhered to follow up visits and tele-consultation.
Conclusion: No clinical evidence of vertical transmission was identified in 53 newborns of mothers positive for SARS-CoV-2 infection if correct hygiene precautions are undertaken and that rooming in and breastfeeding are safe procedures when paired with effective parental education of infant protective strategies. Our study also provides important data on neonatal infection, clinical features, and outcomes in neonates born to SARS-CoV-2 positive mother.
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