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. 2021 Feb;180(2):547-559.
doi: 10.1007/s00431-020-03800-7. Epub 2020 Sep 10.

Clinical profile, viral load, management and outcome of neonates born to COVID 19 positive mothers: a tertiary care centre experience from India

Pratima Anand  1 , Anita Yadav  1 , Pradeep Debata  2 , Sumitra Bachani  3 , Nitesh Gupta  4 , Rani Gera  1
Affiliations

Clinical profile, viral load, management and outcome of neonates born to COVID 19 positive mothers: a tertiary care centre experience from India

Pratima Anand et al. Eur J Pediatr. 2021 Feb.

Abstract

Despite rapidly evolving knowledge about COVID 19 infection, routes of perinatal COVID 19 transmission and viral load in mother neonate dyad remain uncertain. Data were analysed to describe the clinicodemographic profile and viral load in neonates born to COVID 19 positive mothers. Of 2947 deliveries, 69 mothers were COVID 19 positive (2.3%), with 1 abortion, 2 macerated stillbirths and 2 fresh stillbirths as pregnancy outcomes. Of 65 tested neonates, 10.7% (7) were confirmed COVID 19 positive by RTPCR (reverse transcriptase-polymerase chain reaction). Viral load (cycle threshold, Ct of E, RDRp) in neonates was comparable with the Ct reported from adults; however, neonates had milder clinical manifestations. All 7 neonates who tested positive for COVID 19 were subsequently discharged. Six of the 7 neonates were asymptomatic and 1 neonate needed respiratory support (indication being prematurity) which resolved after 48 h. Maternal and neonatal comparison of Ct of E and RdRp gene was statistically non-significant (25.97 vs 19.68, p = 0.34 and 26.5 vs 25.0, p = 0.84). Viral loads of mothers with COVID 19 positive neonates compared with mothers with COVID 19 negative neonates for E and RdRp gene were also statistically non-significant (25 vs 27.19, p = 0.63 and 19.6 vs 27.6, p = 0.08). The majority (93%) of neonates tested later than 48 h (roomed in with mother and breastfed) tested negative.Conclusion: The study supports milder manifestation in COVID 19 positive neonates. Risk of transmission from COVID 19 positive mother to neonate by rooming-in and breastfeeding is low. In this study on a limited number of neonates, maternal viral load was not found to be associated with the positivity status or severity of the illness of neonate. What is Known: • Neonates born to COVID 19 positive mothers are at risk of COVID 19 infection. What is New: • Risk of transmission of COVID 19 from mother to neonate, with rooming-in and breastfeeding, appears low. • In this study on a limited number of neonates, maternal viral load of COVID 19 (E and RdRp cycle thresholds) was not associated with severity of illness or COVID 19 positivity in neonates.

Keywords: COVID 19; Clinical profile; Neonates; Viral load.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Maternal and neonatal viral load of COVID 19 (cycle thresholds of E, RdRp and ORF-1b-nsp14 based assay). a E gene cycle thresholds in maternal neonatal dyads in COVID positive neonates. b RdRp gene cycle thresholds in maternal neonatal dyads in COVID positive neonates. c E gene cycle thresholds in COVID mothers whose neonates were negative. d RdRp gene cycle thresholds in COVID positive mothers whose neonates were negative
Fig. 2
Fig. 2
Clinical profile of mothers and neonates positive for COVID 19
See this image and copyright information in PMC

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