Maternal and Newborn Hospital Outcomes of Perinatal SARS-CoV-2 Infection: A National Registry
Mark L. Hudak, Dustin D. Flannery, Kimberly Barnette, Trace Getzlaff, Shiva Gautam, Miren B. Dhudasia, Sagori Mukhopadhyay, Madeline R. Pfeifer, Sascha Ellington, Romeo R. Galang, Margaret Christine Snead, Kate R. Woodworth, Lauren B. Zapata, Karen M. Puopolo, Richard Hall, Dalton W. Janssen, Enrique Gomez, Hailey McNew, Christal Steen, Evguenia Cole, Brenda Graff, Suma A. Rao, Suganya Kathiravan, Christina Wade, Michel Mikhael, Ofelia Vargas-Shiraishi, Juliann Rosales, Pui Y. Lai, Rupal Patel, Loc Le, Sophia Jones, Gazelle Bahramianfard, Stacie Bennett, Michael W. Kuzniewicz, Allen Fischer, Eileen M. Walsh, Suyi Zhu, Brigid Acuna, Molly C. Easterlin, Manoj Biniwale, Lorayne Barton, Manoj Biniwale, Rangasamy Ramanathan, Liesbeth V. Maggiotto, Devang Patel, Fred Shum, Lisa Batistelli, Wang-Dar Sun, Hellen Rodriguez, Kenna Schnaar, Laurel Moyer, Sarah Lazar, Jordan Bui, Melanie Crabtree, Priya Jegatheesan, Angela Huang, Kamakshi Devarajan, Valerie Colorado, Edna Mancao, Renuka Kar, Maria Ransil, Cynthia C. Morton, Lavonne Sheng, Terry Zeilinger, Cherry Uy, Pam Aron-Johnson, Ericka Fernandez, Sarah Lazar, Jordan Bui, Melanie Crabtree, Sabrina I. Fossi, Arthur E. DʼHarlingue, Patricia Hagen, Rachel Pena, Michelle Feinberg, Laura Celvenger, Kelly Allen, Erica Wymore, Colleen Wheeler, Kelly Allen, Sadie Houin, Erin Jones, Kelly Allen, Alfonso Pantoja, Corrie J. Alonzo, Allie Wildenstein, Kelly Allen, Clyde J. Wright, Jessica Scott, Mary Jo Pugh, Sue Townsend, Lauren Beard, Wendy Barrett, Jeanne Zenge, Kathleen E. Hannan, Annmarie Golioto, Nancy Cyr, Sandra Motta, Jessie Mangs, Juliann Sheehan
Abstract
OBJECTIVES: The American Academy of Pediatrics National Registry for the Surveillance and Epidemiology of Perinatal coronavirus disease 2019 (COVID-19) (NPC-19) was developed to provide information on the effects of perinatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: National Registry for the Surveillance and Epidemiology of Perinatal COVID-19 participating centers entered maternal and newborn data for pregnant persons who tested positive for SARS-CoV-2 infection between 14 days before and 10 days after delivery. Incidence of and morbidities associated with maternal and newborn SARS-CoV-2 infection were assessed. RESULTS: From April 6, 2020 to March 19, 2021, 242 centers in the United States centers reported data for 7524 pregnant persons; at the time of delivery, 78.1% of these persons were asymptomatic, 18.2% were symptomatic but not hospitalized specifically for COVID-19, 3.4% were hospitalized for COVID-19 treatment, and 18 (0.2%) died in the hospital of COVID-related complications. Among 7648 newborns, 6486 (84.8%) were tested for SARS-CoV-2, and 144 (2.2%) were positive; the highest rate of newborn infection was observed when mothers first tested positive in the immediate postpartum period (17 of 125, 13.6%). No newborn deaths were attributable to SARS-CoV-2 infection. Overall, 15.6% of newborns were preterm: among tested newborns, 30.1% of polymerase chain reaction-positive and 16.2% of polymerase chain reaction-negative were born preterm (P < .001). Need for mechanical ventilation did not differ by newborn SARS-CoV-2 test result, but those with positive tests were more likely to be admitted to a NICU. CONCLUSIONS: Early in the pandemic, SARS-CoV-2 infection was acquired by newborns at variable rates and without apparent short-term effects. During a period that preceded widespread availability of vaccines, we observed higher than expected numbers of preterm births and maternal in-hospital deaths.