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Infectious Diseases

Updated 01 October 2020

Reassuring research shows that infants do well, even when born to mothers who have Covid-19

Previously, little was understood about what happens when infants are born to mothers who test positive for SARS-CoV-2. But new research has shed light on this question.

  • Previously, the impact of Covid-19 on pregnant women, and infants, was poorly understood
  • Even though some babies are born testing positive for SARS-CoV-2, they show few adverse outcomes
  • New research has reached a positive and assuring conclusion

When Covid-19 started to spread, experts were not sure about the outcomes for pregnant women and infants.

A previous study discussed on Health24 advised that mothers who contracted Covid-19 should continue to breastfeed their infants as the benefits of breastfeeding outweigh the risk of Covid-19.

Now, a new study from researchers at the University of California, San Francisco, suggests that even when babies are born to mothers infected with SARS-Cov-2, they do well in the six to eight weeks after birth, and that there are few adverse effects. This was the case even though there were more neonatal intensive care unit (NICU) admissions of mothers who had Covid-19 up to two weeks before delivery.

No effect on infants’ respiratory tract

The study, a pre-publication accepted by Clinical Infectious Diseases, investigated 263 infants and found that adverse outcomes, whether they were preterm birth, NICU admission or prevalence of respiratory disease, did not differ between those born to mothers with the virus and those who tested negative.

In this research, 179 of the mothers tested positive for SARS-CoV-2 and 83 tested negative.

Out of the 263 infants, 44 were admitted to NICU, but not for pneumonia or lower respiratory infection.

A low 1.1% of infants who were born to SARS-CoV-2 positive mothers also tested positive – and even though the infants tested positive, they showed no adverse symptoms.

Two infants born to mothers who tested positive in the third trimester had birth defects with multiple congenital anomalies.

"The babies are doing well, and that's wonderful," said lead author Valerie J. Flaherman, MD, MPH, associate professor of paediatrics and of epidemiology and biostatistics at UCSF in a news release. "When coronavirus first hit, there were so many strange and unfortunate issues tied to it, but there was almost no information on how Covid-19 impacts pregnant women and their newborns. We didn't know what to expect for the babies, so this is good news."

What about pregnancy and the immune system?

While it’s well recorded that pregnant women’s immune systems can make them more susceptible to severe outcomes resulting from influenza viruses, leading to hospitalisation, stillbirth or miscarriage, it was not well-known how SARS-Cov-2 affected pregnant women.

Some research has reported that mothers infected with Covid-19 are at higher risk of giving birth pre-term and that the virus can be passed on to the infant, but there was no current data available on how SARS-CoV-2 affects an infant during the first stages of their lives.

"Overall, the initial findings regarding infant health are reassuring, but it's important to note that the majority of these births were from third-trimester infections," said senior author Dr Stephanie L. Gaw, PhD, assistant professor of obstetrics, gynaecology and reproductive sciences at UCSF. "The outcomes from our complete cohort will give the full picture of risks throughout pregnancy."

Although there were some study limitations, the findings can help inform guidelines and policies for the care of infants during the pandemic.

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