326 - Newborns of Mothers Who Test Positive for SARS COV-2 On Admission for Delivery: Outcomes After Birth Hospitalization

Poster Number: 326
Publication Number: 326.439

Elena Aragona, Yale Children's Hospital, GUILFORD, CT, United States; Alexis L. Rodriguez, Yale-New Haven Children's Hospital, New Haven, CT, United States; Magna Dias, Yale School of Medicine, Bridgeport, CT, United States; Daniela Hochreiter, Yale School of Medicine, New Haven, CT, United States

Background: Literature suggests that newborns born to mothers with COVID-19 overall have good postpartum clinical courses. However, there are few large studies that follow clinical outcomes after the birth hospitalization in these newborns.

Objective: We sought to determine the clinical outcomes after the birth hospitalization, including Emergency Department visits and readmissions, in newborns born to mothers positive for SARS COV-2 at the time of delivery in a large health system with more than 10,000 annual deliveries.

Design/Methods: Retrospective chart review from March 30, 2020 through March 31, 2021 of newborns admitted to (and who remained in) the well newborn unit who were born to mothers who tested positive for SARS COV-2 upon admission for delivery. Study sites included the main tertiary care center and two affiliated community hospitals in Southern Connecticut. All sites followed American Academy of Pediatrics recommendations regarding separation (with subsequent rooming-in using infection prevention measures after July 2020). Primary outcomes included ED visits and admissions within 6 weeks of life that were captured within EPIC.
 

Results: 155 newborns were included in the study: 35% were white or Caucasian and 21% Black or African American; 55% were Hispanic or Latino; 30% were non-English speaking. 30% of couplets were separated for the birth hospitalization. 154 newborns were tested for SARS-COV-2 at 24 hours of life; none of the newborns tested positive. One newborn was readmitted within 6 weeks of birth (for hyperbilirubinemia associated with isoimmune hemolytic disease). 35 babies were seen in the ED within 6 weeks of birth: 25 of those for weight/bilirubin checks, 3 with URI symptoms, 1 BRUE, 1 fussiness, 1 rapid breathing, 1 conjunctivitis. There were 3 admits: 1 for hyperbilirubinemia and 1 for fever (at 5 weeks; infant found to be COVID19 positive and was discharged home after negative septic workup).  Conclusion(s): Our results add to the small body of literature that newborns of mothers positive for SARS-COV-2 at the time of delivery have excellent clinical outcomes. All infants tested negative for COVID-19 and utilization of healthcare after the birth hospitalization was related to other newborn issues, but not COVID-19. The findings also highlight a need for innovations to accommodate in person pediatrician follow up visits for these newborns and their mothers.