To Evaluate the Clinical Profile of Neonates Born to COVID Positive Mothers during Pandemic at GIMS Hospital, Kalaburagi

ABSTRACT

Background: The incidence of mother-to-newborn Covid 19 transmission is low. However, data are limited on the factors associated with neonatal clinical or viral testing outcomes. This study aims at evaluation of clinical profile of neonates born to COVID positive mothers. Objective: To determine the number of neonates from 01 April 2020 to 30 August 2021 with lab confirmed COVID-19 infection born to Covid 19 positive mothers. To assess the clinical features of neonates born to Covid 19 positive mothers. Methods & Materials Study design: Retrospective cohort study Study period 01 April 2020 to 30 August 2021 Study Place Gulbarga institute of medical science kalaburagi, Karnataka India. Conclusions: Perinatal covid 19 infection may have adverse effects on newborns causing problems such as fetal distress, premature labour, Hyperbilirubinemia, respiratory distress, oxygen requirement, sepsis, birth asphyxia and even death. However vertical transmission of Covid 19 is yet to be confirmed Aims and objectives: To determine the number of neonates from 01 April 2020 to 30 August 2021with RTPCR confirmed COVID-19 infection born to Covid 19 positive mothers. To assess the clinical features of newborns born to Covid 19 positive mothers. Inclusion criteria All neonates born to Covid 19 positive mothers METHODS: Manual medical records of mother and baby were reviewed. Data on maternal demographic factors (age, residence, socioeconomic status), co morbidities, symptoms of COVID 19, Data on newborn demographic factors (gestational age, sex, birth weight, mode of delivery, Apgar score) were collected . All neonates born to covid 19 positive mother were reviewed for clinical and lab data till time of discharge. Clinical data such as respiratory distress, oxygen desaturation, poor feeding, apnea, seizures, tachycardia, fever, hypothermia, jaundice in those neonates was reviewed. Associated morbid factors such as Birth asphyxia, prematurity, relative sepsis were analysed. Lab data such as TLC, CRP, Sr Ferritin, Sr LDH, D-Dimer, Procalcitonin, RTPCR analysis of nasopharyngeal and throat swab of neonates born to covid positive mothers were reviewed. Chest x ray was reviewed. Those having clinical symptoms/ signs were admitted in NICU. Asymptomatic hemodynamically stable Covid19 negative neonates were isolated on mother side. Sample size 200 neonates born to covid19 positive mothers. Sample size was determined based on the incidence of covid19 positive rates of neonates born to covid positive mothers, using formula 4PQ/L2. Results: Among these 200 pregnant women with confirmed Covid 19 infection, fever and cough were the common symptoms noted. Of the newborns born to these mothers, 92 were male neonates and 108 were female neonates, 153 were full-term neonates and 32 were born premature;15 were small-for-gestational-age (SGA) neonates. Clinically, the initial presentations in the neonates were respiratory distress(n=5) and failure to breathe at birth(n=4), but other presentations such as fever(n=1), poor feeding(n=3),rapid heart rate(n=4), hyperbilirubinaemia (n=5) abnormal Xray(n=3) and oxygen requirement(n=4) were also observed. All neonates were improved and discharged. Nasopharyngeal and throat swab specimens were collected from these neonates 2to3days after birth for Covid 19 RT-PCR tests, out of which 02 neonates showed positive results. One COVID-19 positive baby presented with failure to breathe at birth was treated with antiviral and antibiotics. The other baby also had similar presentation was treated with antiviral and oxygen. Both neonates improved and discharged.