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In Brief: COVID-19 and Maternal and Newborn Health

newborn baby

Two studies from Weill Cornell Medicine and NewYork-Presbyterian investigators suggest that maternal-to-child transmission of SARS-CoV-2 is rare; however, one study found that complications after birth occurred for some mothers infected with the virus. 

Small Study Suggests it May Be Safe for Mothers to Breastfeed and Have Babies in Room After Giving Birth With Simple Precautions Such as the Wearing of Face Masks and Hand/Breast Hygiene

A study published in The Lancet Child & Adolescent Health on July 23 reported that none of the 120 babies born to women infected with SARS-CoV-2 at three New York City hospitals tested positive or showed symptoms of the virus after a seven or 14 day follow-up. During their hospital stay, most of the newborns had been breastfed and roomed-in with their mothers. The study included 116 mothers who tested positive for the virus out of 1,481 who delivered at NewYork-Presbyterian/Weill Cornell Medical Center, NewYork-Presbyterian Lower Manhattan Hospital and NewYork-Presbyterian Queens from March 22 to May 17. The babies were kept in enclosed cribs six feet apart from their mothers, except during feeding. Mothers were required to wear surgical masks while handling their babies and followed frequent hand and breast washing procedures. Based on the results, the investigators advise that transmission of the virus is unlikely to occur at time of delivery and that breastfeeding or having newborns room-in is safe if parents wear masks and follow handwashing practices.

These are similar to recommendations from the World Health Organization, the Royal College of Obstetricians & Gynecologists and the Union of European Neonatal and Perinatal Societies; however, the Centers for Disease Control and the Prevention (CDC) and American Academy of Pediatrics in early April advised isolating newborns and restricting contact with their mothers for at least seven days from the time the women became symptomatic. The American Academy of Pediatrics updated its recommendations on July 23 and is now in line with the findings of the above reported study. Other studies have reported a small number of cases in China and in the United Kingdom of newborns testing positive for SARS-CoV-2.

Corresponding Author: Dr. Christine Salvatore

COVID-19 in Pregnancy is Associated with Increased Cesarean Delivery Rates and Postpartum Complications, but Otherwise Has Reassuring Maternal Outcomes

In a study published July 7 in the British Journal of Obstetrics & Gynecology, among 675 pregnant women admitted for delivery and universally tested for COVID-19, 10.4 percent were positive for SARS-CoV-2. Almost 80 percent of these women were asymptomatic at the time of hospital admission.

Cesarean deliveries were more common among women with COVID-19. However, there were no differences in the preterm birth rate between women with and without COVID-19 at the time of delivery. This represents a notable difference from the high preterm birth rate initially reported from Wuhan, China. Additionally, investigators reported no cases of mother-to-child transmission. However, infected mothers were more likely to have complications of thromboses, or blood clotting, in the placenta. The postpartum time period was noted to be a vulnerable time, with complications occurring among 13 percent of women, or approximately one in eight, with COVID-19, compared to 4.5 percent of women without the infection. There were no maternal deaths during the study period, and one woman out of the 71 infected was admitted to the intensive care unit, but did not require mechanical ventilation.

The data came from pregnant women admitted for delivery between March and April to NewYork-Presbyterian/Weill Cornell Medical Center, NewYork-Presbyterian Lower Manhattan Hospital and NewYork-Presbyterian Queens.

The authors note that the maternal outcomes are favorable, although women who tested positive for the virus may benefit from close outpatient monitoring and telehealth visits after they’ve left the hospital. They may also benefit from anticoagulants, or blood thinners, because of the risk of venous thromboembolic disease.

Corresponding author: Dr. Malavika Prabhu

 

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