691 - Treatment of Mothers with Symptomatic SARS-CoV-2 infection Does Not Affect the Need for Resuscitative Efforts at Delivery in Full-Term Infants
Saturday, April 29, 2023
3:30 PM – 6:00 PM ET
Poster Number: 691 Publication Number: 691.233
Shetal Shah, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, NY, United States; Trace Getzlaff, University of Florida College of Medicine, Jacksonville, FL, United States; Shiva Gautam, University of Florida, Jacksonville, FL, United States; Kimberly S. Barnette, UFJPI, 32209, FL, United States; Mark L.. Hudak, University of Florida Colllege of Medicine - Jacksonville, Jacksonville, FL, United States
Professor of Pediatrics Maria Fareri Children's Hospital at Westchester Medical Center Valhalla, New York, United States
Background: SARS-CoV-2 infection during pregnancy increases the risk of maternal hospitalization & mortality. Treatment of mothers with symptomatic SARS-CoV-2 infection (COVID-19) improves maternal outcomes. Yet, the role of treatment of maternal COVID-19 on newborn resuscitative interventions is unclear. Objective: To compare the spectrum of resuscitative interventions employed for full term (>37-<41 weeks) infants born to symptomatic mothers with/without benefit of SARS-CoV-2-specific treatment. Design/Methods: The American Academy of Pediatrics Section on Neonatal Perinatal Medicine COVID Registry contains paired data on mothers (with an initial positive SARS-CoV-2 test between 14 days before to 3 days after delivery) & their infant(s). We selected mothers who presented in anticipation of delivery who manifested active SARS-CoV-2 symptoms (e.g., fever, respiratory signs or symptoms, myalgia or anosmia) or who were admitted to the hospital for treatment of COVID.Treatment was defined as maternal receipt of SARS-CoV-2 antiviral or steroid therapy for lung disease prior to delivery.Resuscitative interventions included: need for supplemental oxygen, positive pressure ventilation (PPV) or any resuscitation (any O2, PPV, intubation, chest compressions, epinephrine or volume expansion) at delivery. We used multiple logistic regression analysis to explore associations between the 3 resuscitative interventions & maternal SARS-CoV-2- treatment, adjusting for factors that may have independently influenced the need for resuscitation such as gestational age, race, ethnicity, mode of delivery, maternal receipt of betamethasone & preeclampsia. Results: Of 10,368 mothers captured in the Registry, 2,317 met eligibility criteria for analysis and of these 235 received SARS-CoV-2-specific treatment. In adjusted analysis, infants whose symptomatic mothers received SARS-CoV-2-specific treatment had equivalent odds of delivering an infant who received supplemental oxygen (OR 1.27, CI 0.73-2.04), PPV (OR 1.08, CI 0.65-1.80), and any resuscitation (OR 1.03, CI 0.64-1.67) compared to symptomatic mothers who were untreated.
Conclusion(s): After adjusting for other risk factors for neonatal resuscitation, the likelihood of neonatal resuscitation was not independently affected by maternal SARS-CoV-2-specific drug therapy. We conclude that due to very low rates of prenatal vertical transmission of SARS-CoV-2 to the fetus, the need for newborn resuscitation in infants born to mothers with symptomatic SARS-CoV-2 is driven by maternal & fetal factors and is not reduced by maternal SARS-CoV-2-specific drug therapy.
