Infectious Diseases
Infectious Diseases 1
Prithvi M. Mohan, MD (she/her/hers)
Resident Physician
NewYork-Presbyterian Komansky Children’s Hospital
New York, New York, United States
In this observational cohort study, we identified all neonates born between 03/2020 and 10/2022, at 4 NewYork Presbyterian Hospitals in New York City (USA) to mothers positive for SARS-CoV-2 at delivery. Neonates were tested for SARS-CoV-2 via PCR at 24h, with recommended follow up for testing at 5-7 days (d), and 14 d of life. We recorded demographics, birth data, neonatal testing and follow up. Descriptive statistics were used for demographic (D) and clinical factors of interest (CFI). Categorical variables are represented as n (%) and continuous variables are represented as mean (M) with standard deviation (SD). Fisher’s exact test and one-way ANOVA were used to examine the association between D/CFI and COVID-19 wave. Seven COVID-19 waves were identified – Wave 1 (W1) (03-06/2020), Wave 2 (W2) (07/2020-06/2021), Wave 3 (W3) (Delta, 06-12/2021), and Waves 4 (W4) (combined 4 Omicron waves, 12/21-current).
Results:
A total of 1534 neonates born to mothers positive for SARS-CoV-2 were identified; 52% were male. 38% were White, 14% Black, 8.9% Asian, 39% declined to answer or unknown. 15% were Hispanic/Latino origin and 33.8% declined to answer or unknown. There was no statistical difference among the different waves for gestational age (GE), birth weight (BW), length (L) and head circumference (HC) with M GE 38.5 (SD 1.95), M BW 3228g (SD 552), M L 50.12 cm (SD 2.94) and M HC 34.04 cm (SD 1.82). There was a significant difference in the distribution of birth PCR result across the 4 COVID-19 waves (p < 0.001). 16 (1%) of all neonates were PCR positive at 24 hours of life, of which 14 (2.7%) were positive in W4, compared to 1 (0.3%) in W1, 1 (0.2%) in W2 and 0 (0%) in W3. When analyzing separately all the 7 Waves, the highest positive result at birth was during W5 with 5 (6.8%) newborns testing positive. Follow up at 5-7d and 14d decreased over time.
Conclusion(s):
Among Waves there was no statistically significant difference for standard birth variables (GE, BW, L, HC), however there was significant difference in distribution of positive PCR at birth across COVID-19 Waves, with highest transmissibility from mother to newborn in W4 (during the various Omicron variants). Follow up data collection was limited due to decreased parental fear of COVID-19 with subsequent lack of follow up.