Characteristics and outcomes of SARS-CoV-2 positivity in neonates born to mothers with COVID-19 in Klang Valley, Malaysia: a retrospective observational study

Sok Bee Lim; Kwee Ching See; Kian Boon Law; Nor Izwah Mohamed Kamarudin

doi:10.1016/j.ijregi.2022.10.001

Characteristics and outcomes of SARS-CoV-2 positivity in neonates born to mothers with COVID-19 in Klang Valley, Malaysia: a retrospective observational study

IJID Reg. 2022 Dec:5:146-153. doi: 10.1016/j.ijregi.2022.10.001. Epub 2022 Oct 7.

Authors

Sok Bee Lim¹, Kwee Ching See¹, Kian Boon Law², Nor Izwah Mohamed Kamarudin¹

Affiliations

¹ Pediatric Department, Sungai Buloh Hospital, Ministry of Health Malaysia, Selangor, Malaysia.
² Digital Health Research and Innovation Unit, Institute for Clinical Research, Ministry of Health Malaysia, Selangor, Malaysia.

Abstract

Objective: The aim of this study was to analyze the clinical characteristics of neonates born to mothers with coronavirus disease 2019 (COVID-19), along with the incidence and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) positivity in Klang Valley, Malaysia.

Methods: The clinical records of all neonates born to mothers with COVID-19 who were admitted to Sungai Buloh Hospital, Selangor, Malaysia from October 1, 2020 to September 30, 2021 were reviewed retrospectively. Data collected included demographic details and the incidence, risk factors, and clinical outcomes of neonates with SARS-CoV-2 positivity.

Results: A total of 766 neonates from 753 mothers with COVID-19 were included. Overall, 23 (3%) neonates tested positive by nasopharyngeal swab SARS-CoV-2 PCR taken within the first 8 days of life. There were three (0.4%) confirmed and four (0.5%) probable neonatal infections acquired intrapartum, seven (0.9%) confirmed neonatal infections acquired postpartum, and nine (1.2%) cases that did not fit within the classification. The rate of preterm delivery was 25% among all neonates born to mothers with COVID-19 and 39.1% among SARS-CoV-2-positive neonates. Of the SARS-CoV-2-positive neonates, 43.5% required ventilatory support. Factors identified to have a significant association with neonate SARS-CoV-2 positivity included maternal antepartum hemorrhage (odds ratio (OR) 7.33, P = 0.014), place of delivery in a non-designated COVID-19 center (OR 7.64, P < 0.001), exposure to the mother post-delivery (OR 4.13, P = 0.014), and a higher 5-minute Apgar score (score 6-10; OR 0.20, P = 0.0037).

Conclusions: This study identified a risk of SARS-CoV-2 transmission from mothers with COVID-19 to their offspring, with infection acquired predominantly postpartum. A higher incidence of preterm delivery and ventilatory support were observed among SARS-CoV-2-positive neonates.

Keywords: Neonate born to mother, with COVID-19; SARSCoV-2 positivity in newborn; Vertical transmission of COVID-19.