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

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  1 , Kwee Ching See  1 , Kian Boon Law  2 , Nor Izwah Mohamed Kamarudin  1
Affiliations

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 et al. IJID Reg. 2022 Dec.

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.

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Further reading

    1. Department of Statistics Malaysia Department of Statistics Malaysia Official Portals; 2022. https://www.dosm.gov.my/v1/index.php?r=column/cone&menu_id=ZmVrN2FoYnBvZ.... [Accessed 3 September 2022].
    1. Ministry of Health Malaysia COVID-19 Management Guidelines in Malaysia; 2020. https://covid-19.moh.gov.my/garis-panduan/garis-panduan-kkm. [Accessed 1 March 2022].
    1. Ministry of Health Malaysia PRESS STATEMENT MINISTRY OF HEALTH MALAYSIA UPDATES ON THE CORONAVIRUS DISEASE 2019 (COVID-19) SITUATION IN MALAYSIA; 2020. https://covid-19.moh.gov.my/terkini/032020/situasi-terkini-16-mac-2020/5.... [Accessed 11 March 2022].
    1. National Institutes of Health, Malaysia Guidelines on COVID-19 Vaccination for pregnant and breastfeeding mothers; 2021. https://clinupcovid.mailerpage.com/resources/p6q9f2-guidelines-on-covid-.... [Accessed 1 September 2022].