8% Neonates acquired infection from perinatal transmission: PGI Chandigarh Study

The corresponding author of the study Prof Praveen Kumar, Head, Division of Neonatology, Department of Paediatrics, PGI, Chandigarh, with the title ‘Outcomes of neonates born to others with Covid-19’ has highlighted that 8% per cent Covid positive new-borns acquired infection most commonly in the first 72 hours after birth, showed the data from a large cohort of neonates. The findings confirm perinatal transmission of SARS-CoV-2 and suggest increased morbidity in infected infants.

Study initiated in April, 2020

The data was composed from 20 hospitals voluntarily enrolled in the National Neonatology Forum (NNF) Covid-19 registry, which was initiated in April, 2020. Neonates born to women with SARS-CoV-2 infection within two weeks prior to or two days after delivery and neonates with confirmed SARS-CoV-2 infection within 28 days of life were eligible for enrolment in the study.

Among 1,330 tested new-borns, 143 (10.8%) were Covid positive. Of these, 68 (5.1%) tested positive on Day 1. Among the Covid-19 infected new-borns, 106 (8%) were positive within 72 hours (perinatal transmission) and 21 (1.5%) beyond 72 hours (horizontal transmission) of birth.

Horizontal transmission was considered in a neonate with negative Covid-19 within the first 72 hours, who subsequently tested positive any time after 72 hours of birth irrespective of the mother’s Covid-19 status.

The study found out that 5.1% new-borns who tested positive on Day 1 may have acquired the infection within the uterus or during labour and delivery or childbirth. Those newborns, who tested positive on Day 2 or 3 after birth, may also have been infected due to intrauterine transmission but could have acquired the infection after birth from mother, other family members or healthcare providers.

In study cohort, 21% (30/143) of Covid-positive newborns were symptomatic and the most common symptoms included respiratory distress and sepsis-like features. These Covid-infected newborns were five times more likely to be symptomatic and twice more likely to need resuscitation, need NICU admission, have abnormal chest X-rays and need respiratory support.

The prematurity rate of 20.7% in this cohort was significant, which, according to researchers, raises concerns about the possibility of increased risk of premature labour in Covid-positive pregnant women.

The study also found a marginally higher incidence of infection in newborns who were roomed-in with mother. However, there was no association found with breastfeeding.

What is Perinatal transmission

According to the study, perinatal transmission is  apositive RT-PCR test in a new-born in the first 72 hours after birth. This includes the transmission within uterus (intrauterine) and during the act of birth (intrapartum).

 

Excerpts from The Tribune, Chandigarh edition 16th June.

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