Abstract
Introduction: COVID-19 is the disease caused by the novel coronavirus SARS-CoV-2, responsible of the pandemic declared in March 2020 and still ongoing. COVID-19 affects all ages but presents less complications and fatalities in children. Neonatal infections have rarely been reported worldwide, and vertical transmission is uncertain. Methods: We conducted a prospective cohort study of all infants born to SARS-CoV-2-positive mothers admitted to 2 hospitals in South (Bari) and North (Varese) of Italy from April to December 2020. A molecular nasopharyngeal swab for SARS-CoV-2 using a reverse transcriptase polymerase chain reaction was made at birth for all enrolled newborns to evaluate vertical transmission of infection. We also evaluated postnatal transmission with a second nasopharyngeal swab made at 1 month of life and described maternal and neonatal clinical findings and short-term outcomes. Results: 176/179 (97%) newborns were SARS-CoV-2 negative at birth and 151/156 (97%) infants were still negative at 1 month of life. All newborns were asymptomatic. Seventy percent of newborns were breastfed during hospitalization. At 1 month of life, 76% of infants were breastfed. Conclusion: According to our results, vertical and perinatal infection is very rare. Breastfeeding does not increase the risk of COVID-19 and should be encouraged.
References
1.
Lu
R
, Zhao
X
, Li
J
, Niu
P
, Yang
B
, Wu
H
, Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding
. Lancet
. 2020
;395
(10224
):565
–74
. .2.
World Health Organization
. WHO announces COVID-19 outbreak a pandemic
. 2020 Mar
.3.
Williamson
EJ
, Walker
AJ
, Bhaskaran
K
, Bacon
S
, Bates
C
, Morton
CE
, Factors associated with COVID-19-related death using OpenSAFELY
. Nature
. 2020 Aug
;584
(7821
):430
–6
. .4.
Bialek
S
, Gierke
R
, Hughes
M
, McNamara
LA
, Pilishvili
T
, Skoff
T
. Coronavirus disease 2019 in children: United States, February 12–April 2, 2020
. MMWR Morb Mortal Wkly Rep
. 2020 Apr
;69
(14
):422
–6
. .5.
Xu
S
, Chen
M
, Weng
J
. COVID-19 and Kawasaki disease in children
. Pharmacol Res
. 2020
;159
:104951
.6.
Bellos
I
, Pandita
A
, Panza
R
. Maternal and perinatal outcomes in pregnant women infected by SARS-CoV-2: a meta-analysis
. Eur J Obstet Gynecol Reprod Biol
. 2021
;256
:194
–204
. .7.
Davanzo
R
, Moro
G
, Sandri
F
, Agosti
M
, Moretti
C
, Mosca
F
. Breastfeeding and coronavirus disease-2019: Ad interim indications of the Italian Society of Neonatology endorsed by the Union of European Neonatal & Perinatal Societies
. Matern Child Nutr
. 2020 Jul
;16
(3
):e13010
.8.
Aziz
K
, Lee
HC
, Escobedo
MB
, Hoover
AV
, Kamath-Rayne
BD
, Kapadia
VS
, Part 5: neonatal resuscitation – 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
. Circulation
. 2020 Oct
;142
(16_Suppl l_2
):S524
. .9.
Patanè
L
, Morotti
D
, Giunta
MR
, Sigismondi
C
, Piccoli
MG
, Frigerio
L
, Vertical transmission of coronavirus disease 2019: severe acute respiratory syndrome coronavirus 2 RNA on the fetal side of the placenta in pregnancies with coronavirus disease 2019–positive mothers and neonates at birth
. Am J Obstet Gynecol MFM
. 2020 Aug
;2
(3
):100145
.10.
Amaral
WND
, Moraes
CL
, Rodrigues
APDS
, Noll
M
, Arruda
JT
, Mendonça
CR
. Maternal coronavirus infections and neonates born to mothers with SARS-CoV-2: a systematic review
. Healthcare
. 2020 Nov
;8
(4
):511
.11.
Smith
V
, Seo
D
, Warty
R
, Payne
O
, Salih
M
, Chin
KL
, Maternal and neonatal outcomes associated with COVID-19 infection: a systematic review
. PLoS One
. 2020 Jun
;15
(6
):e0234187
. .12.
Dumitriu
D
, Emeruwa
UN
, Hanft
E
, Liao
GV
, Ludwig
E
, Walzer
L
, Outcomes of neonates born to mothers with severe acute respiratory syndrome coronavirus 2 infection at a large medical center in New York city
. JAMA Pediatr
. 2021 Feb
;175
(2
):157
. .13.
Vardhelli
V
, Pandita
A
, Pillai
A
, Badatya
SK
. Perinatal COVID-19: review of current evidence and practical approach towards prevention and management
. Eur J Pediatr
. 2021 Apr
;180
(4
):1009
–31
. .14.
Donders
F
, Lonnée-Hoffmann
R
, Tsiakalos
A
, Mendling
W
, Martinez de Oliveira
J
, Judlin
P
, ISIDOG recommendations concerning COVID-19 and pregnancy
. Diagnostics
. 2020 Apr
;10
(4
):243
. .15.
Liu
H
, Wang
LL
, Zhao
SJ
, Kwak-Kim
J
, Mor
G
, Liao
AH
. Why are pregnant women susceptible to COVID-19? An immunological viewpoint
. J Reprod Immunol
. 2020 Jun
;139
:103122
. .16.
Debrabandere
ML
, Farabaugh
DC
, Giordano
C
. A review on mode of delivery during COVID-19 between December 2019 and April 2020
. Am J Perinatol
. 2021 Mar
;38
:332
–41
. .17.
Ministero della Salute. www.salute.gov.it. 2019 Sep 12.
18.
Yan
J
, Guo
J
, Fan
C
, Juan
J
, Yu
X
, Li
J
, Coronavirus disease 2019 in pregnant women: a report based on 116 cases
. Am J Obstet Gynecol
. 2020 Jul
;223
(1
):111.e1
–e14
. .19.
World Health Organization (WHO)
. Clinical management of severe acuterespiratory infection (SARI) when COVID-19 disease is suspected
. Interimguidance
; 2020 March 13
. Available from: https://apps.who.int/iris/bitstream/handle/10665/331446/WHO-2019-nCoV-clinical-2020.4-eng.pdf.20.
Center of Disease Control (CDC)
. Pregnancy & breastfeeding information about Coronavirus disease 2019
. Page last reviewed: 2020 April 3
. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extraprecautions/pregnancybreastfeeding.html.21.
Puopolo
KM
, Kimberlin
DW
. American academy of pediatrics committee on fetus and newborn, section on neonatal perinatal medicine, and committee on infectious diseases
. Initial guidance: management of infants born to mothers with COVID-19
; 2020 Apr 2
. Available from: https://downloads.aap.org/AAP/PDF/COVID%2019%20Initial%20Newborn%20Guidance.pdf.).22.
Hand
IL
, Noble
L
. COVID-19 and breastfeeding: what’s the risk?
J Perinatol Off J Calif Perinat Assoc
. 2020 Oct
;40
(10
):1459
–61
.23.
Schlaudecker
EP
, Steinhoff
MC
, Omer
SB
, McNeal
MM
, Roy
E
, Arifeen
SE
, IgA and neutralizing antibodies to influenza a virus in human milk: a randomized trial of antenatal influenza immunization
. PLoS One
. 2013
;8
(8
):e70867
. .24.
Salvatori
G
, De Rose
DU
, Concato
C
, Alario
D
, Olivini
N
, Dotta
A
, Managing COVID-19-positive maternal–infant dyads: an Italian experience
. Breastfeed Med
. 2020 May
;15
(5
):347
–8
.25.
World Health Organization
. Available from: www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-aon-covid-19-pregnancy-and-childbirth. 2020.26.
Salvatore
CM
, Han
JY
, Acker
KP
, Tiwari
P
, Jin
J
, Brandler
M
, Neonatal management and outcomes during the COVID-19 pandemic: an observation cohort study
. Lancet Child Adolesc Health
. 2020 Oct
;4
(10
):721
–7
. .27.
American Academy of Pediatrics
. FAQs: management of infants born to mothers with suspected or confirmed COVID-19
. Available from: https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/faqs-management-of-infants-born-to-covid-19-mothers. Accessed 2020 Aug 4.© 2021 S. Karger AG, Basel
2021
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