Abstract
This observational study done during April-December 2020 at a tertiary-care hospital in Haryana (India) enrolled 152 SARS-CoV-2-exposed neonates. Among them, 150 neonates had perinatal SARS-CoV-2 exposure and 2 neonates had late postnatal exposure. Stable infant-mother dyads were roomed-in with precautions to support breastfeeding. Nasopharyngeal swabs collected from neonates were tested for SARS-CoV-2 by reverse transcriptase-polymerase chain reaction (RT-PCR) test. There was a high incidence of prematurity (23%), low birth weight (31%), intrauterine fetal distress (16%), perinatal asphyxia (6%), admission to neonatal intensive care unit (24%), and mortality (1.3%) among neonates with perinatal SARS-CoV-2 exposure. In this sub-group, 20 neonates tested positive for SARS-CoV-2 in nasopharyngeal swab sample(s). A recent official publication by the World Health Organization emphasizes that the perinatal SARS-CoV-2-exposed neonates found RT-PCR positive once in upper respiratory (non-sterile) sample must document viral persistence in another non-sterile sample for confirmation of mother-to-child virus transmission. With this approach, only one neonate was confirmed intrapartum transmission. A telephonic follow-up in discharged neonates at 1 month of age or 1 month postexposure recorded them all to be asymptomatic and doing well.Conclusion: Neonates with perinatal SARS-CoV-2 exposure constitute a high-risk group and it is not uncommon to get a positive RT-PCR report in upper respiratory sample(s) from these babies. Majority of them do not demonstrate viral persistence. Clinical outcomes are favorable in breastfed infants roomed-in with their asymptomatic-mild symptomatic SARS-CoV-2-infected mothers following appropriate safety protocols. What is Known: •Neonates with perinatal exposure suffer a high burden of morbidities and mortality. •Still, an uncertainty exists about rooming-in and breastfeeding among neonates born to SARS-CoV-2 positive mothers. What is New: •With the policy of mother-infant rooming-in and supporting breastfeeding, none of the neonate suffered clinical illness compatible with postnatal SARS-CoV-2 transmission and infection. •Around 13% perinatal exposed neonates demonstrated SARS-CoV-2 RNA in nasopharyngeal swab samples but the majority of them did not demonstrate viral persistence.
Keywords: Breastfeeding; COVID-19; Mother-to-child transmission; Outcome; Rooming-in; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2, Breastfeeding, outcome, Mother-to-child transmission, Rooming-in, 【초록키워드】 SARS-CoV-2, Mortality, intensive care, hospital, India, Infection, Transmission, virus transmission, RT-PCR, Infant, Nasopharyngeal swab, SARS-CoV-2 transmission, Neonate, Neonates, Asymptomatic, symptomatic, clinical, morbidity, viral persistence, age, SARS-CoV-2 RNA, Follow-up, Swab, incidence, Precaution, Admission, mother, positive RT-PCR, protocols, distress, Neonatal, Support, World Health Organization, positive, nasopharyngeal swab sample, approach, upper respiratory, STABLE, enrolled, tested, collected, majority, demonstrated, suffered, discharged, recorded, fetal, 【제목키워드】 risk, Clinical outcome, SARS-CoV-2 transmission, Neonate, mother, benefit, provided,