Outcomes of Neonates Born to Mothers with Coronavirus Disease 2019 (COVID-19) - National Neonatology Forum (NNF) India COVID-19 Registry

BACKGROUND: Limited evidence exists on perinatal transmission and outcomes of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in neonates OBJECTIVE: To describe clinical outcomes and risk factors for transmission in neonates born to mothers with perinatal SARS-CoV-2 infection DESIGN: Prospective cohort of suspected and confirmed SARS-CoV-2 infected neonates entered in National Neonatology Forum (NNF) of India registry SUBJECTS: Neonates born to women with SARS-CoV-2 infection within two weeks before or two days after birth and neonates with SARS-CoV-2 infection OUTCOMES: Incidence and risk factors of perinatal transmission RESULT: Among 1713 neonates, SARS-CoV-2 infection status was available for 1330 intramural and 104 extramural neonates SARS-CoV-2 positivity was reported in 144 intramural and 39 extramural neonates Perinatal transmission occurred in 106 (8%) and horizontal transmission in 21 (1 5%) intramural neonates Neonates roomed-in with mother had higher transmission risk (RR1 16, 95%CI 1 1 to 2 4;P=0 01) No association was noted with the mode of delivery or type of feeding The majority of neonates positive for SARS-CoV2 were asymptomatic Intramural SARS-CoV-2 positive neonates were more likely to be symptomatic (RR 5, 95%CI 3 3 to 7 7;P<0 0001) and need resuscitation (RR 2, 95%CI 1 0 to 3 9;P=0 05) compared to SARS-CoV-2 negative neonates Amongst symptomatic neonates, most morbidities were related to prematurity and perinatal events CONCLUSION: Data from a large cohort suggests perinatal transmission of SARS-CoV-2 infection and increased morbidity in infected infants