Effect of maternal SARS-COV-2 infection on neonatal anthropometric measurements and morbidities

Introduction and Objective: COVID-19 (2019 Novel Coronavirus Disease) was defined as a deadly pandemic that spread from the city of Wuhan, China, to many people and spread to the world at the end of 2019. As the COVID-19 epidemic continues to spread around the world, research on the effects and risks of the disease is still ongoing. The limited research on the effect of infection on the pregnancy process and the lack of sufficient data on the effects on newborns raise concerns. The aim of this study is to investigate the effects of having a COVID 19 infection during pregnancy on neonatal anthropometric measurements, neonatal morbidities and neonatal intensive care admission rates. Method: A total of 655 newborns born in Maltepe University Medical Faculty Hospital, Department of Pediatrics between January 2020 and December 2022 were included in our study. The study group consisted of 48 newborns whose mothers were confirmed to be positive for COVID-19 by PCR during pregnancy, and the control group consisted of 607 newborns whose mothers did not have SARS-COV-2 infection during pregnancy. Mother and newborn files; maternal gravida, trimester, type of delivery, birth weight, height, head circumference of the newborn, gender, week of birth, presence of need for neonatal intensive care, hospitalization diagnoses, length of hospitalization, being term/preterm, the need for respiratory support and method of respiratory support were analyzed retrospectively. Results: Of the 655 newborns included in the study, 607 (92.7%) mothers did not have COVID-19 infection during pregnancy, and qRT-PCR (quantitative reverse transcription polymerase chain reaction) test positivity was detected in the mothers of 48 (7.3%) newborns during pregnancy. Of these babies born to mothers who had COVID-19 infection during pregnancy, 12.5% (n: 6) were born by NSD, 87.5% (n: 42) by C/S; 11.7% (n:71) of the babies born to mothers who did not have this infection during pregnancy were born by NSD, and 88.3% (n:536) by C/S. There was no statistical difference between the groups in terms of delivery type (p=0.868). While the rate of preterm birth of the babies of mothers who had COVID-19 infection during pregnancy was 20.8% (n:10), the rate of babies born at term was 79.2% (n:38). The rate of preterm birth was 23.4% (n:142) and the rate of term baby delivery was 76.6% (n:465) in babies of mothers who did not have COVID-19 infection during pregnancy. There was no statistical difference between the groups in terms of being born preterm (p=0.686). When the weeks of birth were compared between the groups, there was also no statistically significant difference between groups (p=0.577). When the average birth weight of all newborns was compared, the average birth weight of babies born to mothers who had COVID-19 infection during pregnancy was 3014gr +-713, while the average birth weight of babies born to mothers who did not have COVID-19 infection during pregnancy was 3040gr +-613. There was no statistical difference between the groups in terms of birth weight (p=0.330). When the average birth lengths of all newborns were compared, the average birth length of babies born to mothers who have had COVID-19 infection during pregnancy was 48.3 +- 4.2 cm, while in those born to mothers who have not had COVID-19 infection during pregnancy it was 48.9 +- 3.4cm. There was no statistical difference between the groups in terms of birth length (p=0.211). While the mean birth head circumference of babies born to mothers who had COVID-19 infection during pregnancy was 33.9 +-2.8 cm, the mean birth head circumferences of babies born to mothers who did not have COVID-19 infection during pregnancy was 34.1 +-2.87 cm. When the mean birth head circumferences between the groups were compared, no statistically significant difference was found between them (p=0.841).While 18.8% (n:9) of babies born to mothers who had COVID-19 infection during pregnancy were under 2500 g, the rate of being born < 2500 gr in babies of mothers who did not have COVID-19 infection during pregnancy was 16.1% (98). There was no statistical difference between the groups in terms of low birth weight (p=0.638). While the rate of hospitalization in neonatal intensive care unit (n=48) of babies born to mothers who had COVID-19 infection during pregnancy was 41.7% (n:20), thisrate was 29.8% (n:184) in babies born to mothers who did not have COVID-19 infection during pregnancy (n=607). Although the rate of hospitalization in the intensive care unit in babies of mothers who had COVID-19 infection during pregnancy was higher than the babies of mothers who did not have COVID-19 infection, no statistically significant difference was found between the two groups (p=0.087). When the diagnoses of neonatal intensive care hospitalization were examined, 30% (n:6) were TTN, 35% (n=7) were prematurity, 25% (n=5) were sepsis and 25% (n=5) were RDS. These rates were 48.4% (n:89), 38% (n:70), 39.7% (n:73) and 16.8% (n:31), respectively in babies of mothers who did not have COVID-19 infection during pregnancy. When the two groups were compared in terms of admission diagnosis to the intensive care unit, no statistical difference was found (p=0.2, p=0.2, p=0.2, p=0.364, respectively). Conclusion: There was no statistical difference when the anthropometric measurements, weeks of birth, being born with low birth weight, and need for neonatal intensive care were compared between babies of mothers who had COVID-19 infection during pregnancy and those whose mothers did not have this infection during pregnancy. In the light of the data we obtained from our study, the fact that having a COVID-19 infection during pregnancy does not make a difference in terms of the anthropometric measurements of the newborn at the time of delivery, the risk of premature birth and the rates of admission to the intensive care unit may be reassuring for the mothers who had this infection during pregnancy. However, data from studies involving larger numbers of infants are also needed to reach a more definite conclusion on this issue. Closer monitoring and follow-up of the babies of mothers who had COVID-19 infection during pregnancy should be kept in mind in terms of possible morbidities that may develop in later ages. Key words: SARS-COV-2, COVID-19, pregnancy, newborn, anthropometric measurements, morbidity