Maternal Coronavirus Disease 2019 Test Positivity and Neonatal Intensive Care Unit Outcomes for Infants Born Extremely Preterm
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To describe the neonatal intensive care unit outcomes of infants born extremely preterm to mothers who test positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy. STUDY DESIGN: Prospective study (March 1, 2020-April 30, 2023) at 16 Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers of inborn infants (birth weight 401-1000 g and/or gestational age <29 weeks) born to mothers tested for SARS-CoV-2 during pregnancy. Frequency of maternal SARS-CoV-2 detection, vertical transmission rate, and association of maternal SARS-CoV-2 positivity during pregnancy with infant outcomes were determined. RESULTS: During the 38-month study, 4548 extremely preterm infants were born to 4072 mothers tested for SARS-CoV-2 during pregnancy. Overall, 7% (297/4072) of mothers had a positive SARS-CoV-2 test; 1% (2/181) of tested infants were positive at age <72 hours. The majority of outcomes (eg, bronchopulmonary dysplasia and retinopathy of prematurity) did not differ between infants of test-positive vs test-negative mothers. Infants of test-positive mothers were more likely to be diagnosed with necrotizing enterocolitis (NEC) than those of test-negative mothers (14% vs 11%; P = .03). In adjusted analyses, infants born to test-positive mothers were more likely to develop NEC (risk ratio [RR] 1.40; 95% CI, 1.03-1.89; P = .03) or the combined outcome of death within 12 hours of age or NEC (RR 1.33; 95% CI, 1.09-1.62; P < .01) but not death within 12 hours of age (RR 1.22, 95% CI, 0.92-1.62; P = .16) or before discharge (RR 0.83, 95% CI, 0.55-1.26; P = .38). CONCLUSIONS: Among infants <29 weeks' gestation, vertical transmission of SARS-CoV-2 was infrequent. Maternal SARS-CoV-2 positivity was associated with NEC but not with other infant outcomes or mortality. TRIAL REGISTRATION: ClinicalTrials.gov ID. Generic Database: NCT00063063. https://clinicaltrials.gov/study/NCT00063063.
Source: The Journal of Pediatrics
Authors: Emily A. Messick, Shampa Saha, Jonathan L. Slaughter, Matthew J. Kielt, Kristen L. Benninger, Edward F. Bell, Barbara J. Stoll, Karen M. Puopolo, Sagori Mukhopadhyay, Dustin D. Flannery, Myra H. Wyckoff, C. Michael Cotten, Ravi M. Patel, Abbot R. Laptook, Cathy Grisby, Abhik Das, Michele C. Walsh, Pablo J. Sánchez
Institutions: Nationwide Children's Hospital, The Ohio State University, RTI International, University of Iowa, Emory University, University of Pennsylvania, Children's Hospital of Philadelphia, The University of Texas Southwestern Medical Center, Duke University, Children's Healthcare of Atlanta, Brown University, Cincinnati Children's Hospital Medical Center, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,570
Funders: Children's Hospital of Philadelphia, University of Pennsylvania, University of Rochester, National Institutes of Health, Medical Center, University of Rochester, National Institute of Child Health and Human Development, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: NICHD Cooperative Multicenter Neonatal Research Network, Rochester-Buffalo Neonatal Research Group, NICHD Cooperative Multicenter Neonatal Research Network, Indiana Clinical and Translational Sciences Institute, Duke CTSA (Composite), Clinical Center for NICHD/Neonatal Research Network, Spectrum Stanford Center for clinical and Translational Research and Education, NICHD Neonatal Research Network (NRN), NICHD Cooperative Multicenter Neonatal Research Network, UNM HSC Clinical and Translational Science Center, NICHD Cooperative Multicenter Neonatal Research Network, NICHD Cooperative Multicenter Neonatal Research Network, One Center, Two States, Multicenter Network of Neonatal Intensive Care Units, North Carolina Translational & Clinical Sciences Institute (NC TraCS), Cooperative Multicenter Neonatal Research Network - UAB, Cooperative Multicenter Network of Neonatal Intensive Care Units, NICHD Cooperative Multicenter Neonatal Research Network, Center for Clinical and Translational Science and Training, Neonatal Research Network Data Coordinating Center (DCC), Atlanta Clinical and Translational Science Institute (ACTSI) Renewal, The University of Rochester's Clinical and Translational Science Institute, Eunice Kennedy Shriver NICHD Cooperative Multicenter Neonatal Research Network, NICHD Cooperative Multicenter Neonatal Research Network, University of Iowa Clinical and Translational Science Program, NICHD Neonatal Research Network, Multicenter Network of Neonatal Intensive Care Units-University of Texas at Houston (UT Houston) Clinical Center, Rochester-Buffalo Neonatal Research Group, University of Utah Center for Clinical and Translational Science-UL1, Data Ctr for the Cooperative Neonatal Research Network, Eunice Kennedy Shriver NICHD Cooperative Multicenter Neonatal Research Network, NICHD Neonatal Research Network Clinical Center UAB, NICHD Cooperative Multicenter Neonatal Research Network - Utah Center, Neonatal Research Network Data Coordinating Center (DCC) 2023-2028, NICHD Neonatal Research Network -- Cincinnati Clinical Center, Childrens' of Mississippi Neonatal Research Group, NICHD Neonatal Research Network - Stanford University, NICHD Neonatal Research Network Clinical Center - Case Western Reserve University, NICHD Neonatal Research Network, Eunice Kennedy Shriver NICHD Cooperative Multicenter Neonatal ResearchNetwork, Clinical Center for NICHD/Neonatal Research Network, NICHD COPPERATIVE MULTICENTER NEONATAL RESEARCH NETWORK, NICHD Cooperative Multicenter Neonatal Research Network, North Carolina Clinical Center
OpenAlex ID: W4414575096