Archives of Disease in Childhood - Fetal and Neonatal Edition | 2021
Neonatal outcome following maternal infection with SARS-CoV-2 in Germany: COVID-19-Related Obstetric and Neonatal Outcome Study (CRONOS)
Abstract
SARSCoV-2 infections in pregnant women and the consequences for their offspring are summarised in various reviews, 2 but data on the impact of time of SARSCoV-2 infection during pregnancy on neonatal morbidity are still inconclusive. 4 CRONOS (COVID-19Related Obstetric and Neonatal Outcome Study) is a prospective German registry enrolling pregnant women with confirmed SARSCoV-2 infection during their pregnancy. SARSCoV-2 infection is defined as detection of viral RNA by PCR testing or detection of maternal SARSCoV-2 antibodies. Neonatal infection is defined as detection of viral RNA by PCR testing of a nasopharyngeal/oropharyngeal or rectal swab. For the present analysis, time of maternal infection was categorised into ‘early’ or ‘late’ if women tested positive for SARSCoV-2 more or less than 2 weeks prior to delivery, respectively. Data obtained between 3 April and 27 November 2020 were analysed, using 74 hospitals (73 German and 1 Austrian) comprising approximately 20% of German births. Within the study period 435 newborns were entered into the registry, 4 (0.9%) of which were stillbirths. From the 431 live births, 261 (60.6%) were born to mothers with a late SARSCoV-2 infection and 163 (37.8%) were born to mothers with an early infection. In 7 (1.6%) cases time of SARSCoV-2 detection was unclear (table 1). We found no significant difference in neonatal outcome with regard to time of maternal infection (table 2). There was no decrease in birth weight or increase in congenital malformations in infants of mothers with early infection. Neither the rate of caesarean section (37.4% vs 37.9%, n.s.) nor the rate of prematurity (14.9% vs 10.4%, n.s.) differed between the two groups. Prevalence of neonatal intensive care unit (NICU) admission (15.4% vs 12.5%, n.s.) or need for ventilatory support (58.8% vs 41.2%, p=0.07) was not affected by time of maternal SARSCoV-2 infection. Thus, recent maternal SARSCoV-2 seems not to increase the risk of neonatal pulmonary Table 1 Maternal characteristics by time of positive SARSCoV-2 infection (n=7 with undetermined time of diagnosis)