280 - Does maternal COVID-19 infection affect the outcome of their premature infants?

Poster Number: 280
Publication Number: 280.226

Mishref M. Abdelhamid, Michigan State University College of Human Medicine, East Lansing, MI, United States; Ranga Prasanth Thiruvenkataramani, Michigan State University College of Human Medicine, Lansing, MI, United States; Sara L. Hackett, Sparrow Hospital, Williamston, MI, United States; Tarek Mohamed, Michigan State University College of Human Medicine, East Lansing, MI, United States; Said Omar, Michigan State University College of Human Medicine and Medical Director of RNICU of Sparrow Hospital, East Lansing, MI, United States; Isoken N. Olomu, Michigan State University, Okemos, MI, United States; Cheryl Abernathy, Sparrow Medical Center, Davison, MI, United States

Background: The severity of COVID-19 infection in pregnant women ranges from mild to severe and the impact in newborn babies includes severe IUGR secondary to placental infarction, preterm labor, and symptomatic babies with suspected cytokine storm. The  effect on premature neonates born to COVID positive mothers remains unclear

Objective: To examine the effect of maternal COVID-19 infection in the outcome of their premature infants with GA < 35 weeks

Design/Methods: Sparrow hospital, Lansing, Michigan, is participating in the National Registry for Surveillance and epidemiology of Perinatal COVID-19 Infection (NPC-19), which included 252 centers to evaluate the outcome of mother/baby dyads after maternal COVID-19 infection. The study  was approved by the hospital IRB. Data for Sparrow hospital were collected for a 14 month-period from October 2020 to December 2021. The maternal and babies’ data, including premature babies admitted to the RNICU, will be summarized

Results: The total number of COVID positive and negative mothers and their babies are shown in Figure-1. The incidence of COVID positive mothers was 2.5%. Two COVID +ve mothers had intrauterine fetal demise. The incidence of babies born to COVID positive mothers and admitted to NICU was 4.1%. A total of 18 (7.5%) premature babies were born to COVID +ve mothers. Two premature babies had confirmed COVID +ve in their initial testing after admission. Both cases had multiple positive COVID swabs and presented with respiratory distress in the first week of life and became negative on DOL 11-13. There were neutrophilia and lymphopenia on admission and the lymphocytes recovered when the COVID swabs became negative (Figure-2). In contrast, babies born to COVID positive mothers who were COVID negative showed normal lymphocyte count (figure-3). In addition, one baby was born to a COVID +ve mother who was critically ill with severe hypoxic respiratory failure, he was tested -ve for COVID born at 26 weeks gestation and had severe hypoxic respiratory failure, persistent pulmonary hypertension, not responding to maximum support and died at the age of 9 days with suspected inflammatory and cytokine storm.Conclusion(s): The majority of babies born to COVID-19 positive mothers were not infected.  The 2 positive premature babies unlikely had any symptoms related to thei COVID-19 infection. More data should be collected regarding the impact of severely ill mothers  with COVID-19 infection at the time of delivery in the outcome of their babies and whether there is a passive transfer of cytokines and other inflammatory mediators from the sick mothers to their babies
Figure 1 (Demographics)
The Neutrophilic and Lymphocytic count in the reported cases (COVID +ve babies born to COVID +ve mothers