Impact of the novel coronavirus infection (COVID-19) experienced by pregnant women on the health of newborns

Background: Due to the high spread rate of SARS-CoV-2 and to the rapid increase in its incidence, including those among pregnant women, the novel coronavirus infection (COVID-19) has become a challenge in modern healthcare. Objective: To analyze the impact of the novel coronavirus infection experienced by pregnant women on the health of newborns in the early neonatal period. Materials and methods: A retrospective analysis was carried out of the birth records of 400 women who had experienced the novel coronavirus infection during pregnancy and the neonatal records of their newborns (n=500) who received health care in the clinical units of the V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia (Center), in July 2020 to July 2021. A comparison group consisted of randomly selected birth records of 495 pregnant women who had not been infected with COVID-19 and the neonatal records of their babies (n=500) born at the same Center at the same time. Results: The vast majority of women who had been infected with COVID-19 during pregnancy were found to have familial obstetric/gynecological and/or somatic histories. Among the factors aggravating pregnancy in the presence of COVID-19, chronic hypertension, hereditary thrombophilia, fat metabolism disorders, urogenital infections, and anemia are more common than those in the control group (p<0.05). This female group also tended to have miscarriage; however, no statistically significant differences could be detected (p=0.06). There were no statistically significant differences in the term and frequency of cesarean delivery in pregnant women in the study and control groups (p>0.05). Neonates born to women who had been infected with COVID-19 in the first trimester had its statistically significantly higher morbidity rates (p<0.05). The frequency of perinatal complications was higher in newborns whose mothers had experienced the novel coronavirus infection in the first trimester. Neonatal infants borns from women who had a new coronavirus infection in the third trimester, rhinitis and otitis media are statistically significantly more common in the early neonatal period. Among the factors leading to disruption of early neonatal adaptation of children whose mothers had a new coronavirus infection during pregnancy, the following were statistically significantly more common: infectious and inflammatory diseases (rhinitis, otitis media), hemorrhagic syndrome, and hypoglycemia (p<0.05). Neonates born to women who had been infected with COVID-19 in the first trimester were observed to have statistically significantly higher morbidity rates (p<0.05). The incidence of perinatal complications was higher in newborns whose mothers had experienced the novel coronavirus infection in the f irst trimester. Neonatal infants born to women who had the novel coronavirus infection in the third trimester were statistically significantly more commonly recorded to have rhinitis and otitis media in the early neonatal period. Among the factors leading to failure of early neonatal adaptation of babies whose mothers had the novel coronavirus infection during pregnancy, there were statistically significantly more often infectious and inflammatory diseases (rhinitis, otitis media), hemorrhagic syndrome, and hypoglycemia (p<0.05). Conclusion: The incidence of perinatal complications in babies born to women who had been infected with COVID- 19 depended on their gestational age and was higher than that in newborns whose mothers had experienced the novel coronavirus infection in the first trimester. At the same time, the incidence of infectious and inflammatory diseases proved to be higher in infants whose mothers had a coronavirus infection in the third trimester. Failure of early neonatal adaptation of babies born to women who had an infection caused by SARS- CoV-2 during pregnancy may be due to both infectious and non-infectious factors that complicate the course of pregnancy and childbirth.

COVID-19, SARS-CoV-2, newborns, infants, COVID-19, SARS-CoV-2, novel coronavirus infection, pregnancy, perinatal risk factors, early neonatal adaptation