Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Trends in COVID-19 diagnoses and outcomes in infants hospitalized in the neonatal intensive care unit

Journal of Perinatology volume 44, pages 35–39 (2024)Cite this article

Subjects

Abstract

Objective

Characterize the prevalence of coronavirus disease 2019 (COVID-19) diagnosis among mothers with infants hospitalized in 294 neonatal intensive care units (NICUs), and demographics and outcomes of infants with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure in utero.

Study design

Cohort study of infants discharged from NICUs 01/2020–09/2021. We defined groups based on infant diagnosis, infant testing, and maternal SARS-CoV-2 infection status. We compared demographics, clinical characteristics, and outcomes.

Results

Of 150,924 infants, 94% had no COVID-related diagnosis or test; 247 (0.2%) infants tested positive for COVID-19 and were more likely to require mechanical ventilation. Infants with unknown maternal status and negative testing were more commonly premature, outborn, and had longer hospitalizations.

Conclusion

In this large cohort of hospitalized infants, most had no known exposure to COVID-19. Adverse outcomes and mortality were rare. Further studies are needed to evaluate the long-term effects of COVID-19 in this population.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Maternal and Infant COVID-19 Trends.

Similar content being viewed by others

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Centers for Disease Control and Prevention. COVID Data Tracker. [Updated 2023 March 7] https://covid.cdc.gov/covid-data-tracker/#datatracker-home. Accessed 8 March 2023.

  2. Lopez L 3rd, Hart LH 3rd, Katz MH. Racial and ethnic health disparities related to COVID-19. JAMA. 2021;325:719–20.

    Article  CAS  PubMed  Google Scholar 

  3. Jamieson DJ, Rasmussen SA. An update on COVID-19 and pregnancy. Am J Obstet Gynecol. 2022;226:177–86.

    Article  CAS  PubMed  Google Scholar 

  4. Walter K. COVID-19 and pregnancy. JAMA. 2022;327:790.

    Article  CAS  PubMed  Google Scholar 

  5. Sankaran D, Nakra N, Cheema R, Blumberg D, Lakshminrusimha S. Perinatal SARS-CoV-2 infection and neonatal COVID-19: a 2021 update. Neoreviews. 2021;22:e284–95.

    Article  PubMed  Google Scholar 

  6. Di Toro F, Gjoka M, Di Lorenzo G, De Santo D, De Seta F, Maso G, et al. Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis. Clin Microbiol Infect. 2021;27:36–46.

    Article  PubMed  Google Scholar 

  7. Villar J, Ariff S, Gunier RB, Thiruvengadam R, Rauch S, Kholin A, et al. Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection: the INTERCOVID multinational cohort study. JAMA Pediatr. 2021;175:817–26.

    Article  PubMed  Google Scholar 

  8. Abu-Raya B. Vaccination of pregnant women against COVID-19. Neoreviews. 2021;22:e570–3.

    Article  PubMed  Google Scholar 

  9. Angelidou A, Sullivan K, Melvin PR, Shui JE, Goldfarb IT, Bartolome R, et al. Association of maternal perinatal SARS-CoV-2 infection with neonatal outcomes during the COVID-19 pandemic in Massachusetts. JAMA Netw Open. 2021;4:e217523.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Spitzer AR, Ellsbury DL, Handler D, Clark RH. The Pediatrix BabySteps Data Warehouse and the Pediatrix QualitySteps improvement project system–tools for "meaningful use" in continuous quality improvement. Clin Perinatol. 2010;37:49–70.

    Article  PubMed  Google Scholar 

  11. Athiraman NK, Patience A, Onwuneme C, Zalewski S, Skeath T. Impact of COVID-19 on maternity and neonatal services—three year-on-year review data from the North East of England. Acta Paediatr. 2022;111:1039–41.

    Article  CAS  PubMed  Google Scholar 

  12. Devin J, Marano R, Mikhael M, Feaster W, Sanger T, Ehwerhemuepha L. Epidemiology of neonatal COVID-19 in the United States. Pediatrics. 2022;150:e2022056297.

    Article  PubMed  Google Scholar 

  13. Smith V, Seo D, Warty R, Payne O, Salih M, Chin KL, et al. Maternal and neonatal outcomes associated with COVID-19 infection: a systematic review. PLoS One. 2020;15:e0234187.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Hudak ML, Flannery DD, Barnette K, Getzlaff T, Gautam S, Dhudasia MB, et al. Maternal and newborn hospital outcomes of perinatal SARS-CoV-2 infection: a national registry. Pediatrics. 2023;151:e2022059595.

    Article  PubMed  Google Scholar 

  15. Buonsenso D, Costa S, Giordano L, Priolo F, Colonna AT, Morini S, et al. Short- and mid-term multidisciplinary outcomes of newborns exposed to SARS-CoV-2 in utero or during the perinatal period: preliminary findings. Eur J Pediatr. 2022;181:1507–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Raman R, Patel KJ, Ranjan K. COVID-19: unmasking emerging SARS-CoV-2 variants, vaccines and therapeutic strategies. Biomolecules. 2021;11:993.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This work was supported by Duke Clinical Research Institute’s R25 Summer Training in Academic Research (STAR) Program (grant #5R25HD076475-09). This work was also funded by a COVID-19 Supplement (3U24TR001608-05S2), in part by the Duke University-Vanderbilt University Medical Center Trial Innovation Center (U24TR001608), and by the Vanderbilt University Medical Center Recruitment Innovation Center (U24TR001579), which is part of the National Center for Advancing Translational Sciences (NCATS) Trial Innovation Network. This work is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Duke University, Durham, NC, USA

    Elizabeth B. Heyward, P. Brian Smith, Daniel K. Benjamin Jr, Kanecia O. Zimmerman & Rachel G. Greenberg

  2. Pediatrix Center for Research, Education, Quality, and Safety, Sunrise, FL, USA

    Reese H. Clark & Kaashif A. Ahmad

  3. Duke Clinical Research Institute, Durham, NC, USA

    P. Brian Smith, Daniel K. Benjamin Jr, Kanecia O. Zimmerman, Hannah Won, Rachel Ssengonzi, Avi Belbase, Courage O. Ndalama, Jennifer An, Ogugua Nwaezeigwe & Rachel G. Greenberg

  4. Pediatrix Neonatology of San Antonio, San Antonio, TX, USA

    Kaashif A. Ahmad

  5. Pediatrix Neonatology of Houston, Houston, TX, USA

    Kaashif A. Ahmad

  6. Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Courtney K. Blackwell

Authors
  1. Elizabeth B. Heyward
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Reese H. Clark
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Brian Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniel K. Benjamin Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kanecia O. Zimmerman
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kaashif A. Ahmad
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Courtney K. Blackwell
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hannah Won
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Rachel Ssengonzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Avi Belbase
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Courage O. Ndalama
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Jennifer An
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Ogugua Nwaezeigwe
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Rachel G. Greenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

EBH conceptualized and designed the study, and contributed to the data interpretation, the drafting of the initial manuscript, and reviewing and revising the manuscript. RHC contributed to the data interpretation and the critical revision of the manuscript for important intellectual content. PBS contributed to the data interpretation and the critical revision of the manuscript for important intellectual content. DKB contributed to the data interpretation and the critical revision of the manuscript for important intellectual content. KOZ contributed to the data interpretation and the critical revision of the manuscript for important intellectual content. KAA contributed to the data interpretation and the critical revision of the manuscript for important intellectual content. CKB contributed to the data interpretation and the critical revision of the manuscript for important intellectual content. HW contributed to the data interpretation and the manuscript drafting. RS contributed to the data interpretation and the manuscript drafting. AB contributed to the data interpretation and the manuscript drafting. CON contributed to the data interpretation and the manuscript drafting. JA contributed to the data interpretation and the manuscript drafting. ON contributed to the data interpretation and the manuscript drafting. RGG contributed to the conception and design of the study, supervised the drafting of the manuscript, interpreted the data analyses, and reviewed and revised the manuscript. RGGreenberg had full access to all the data and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Rachel G. Greenberg.

Ethics declarations

Competing interests

RGG has received support from industry for research services (https://dcri.org/about-us/conflict-of-interest/). The authors have no other conflicts of interest relevant to this article to disclose.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

High school or college student affiliated with the Duke Clinical Research Institute’s R25 Summer Training in Academic Research (STAR) Program: Hannah Won, Rachel Ssengonzi, Avi Belbase, Courage O. Ndalama, Jennifer An, Ogugua Nwaezeigwe.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Heyward, E.B., Clark, R.H., Smith, P.B. et al. Trends in COVID-19 diagnoses and outcomes in infants hospitalized in the neonatal intensive care unit. J Perinatol 44, 35–39 (2024). https://doi.org/10.1038/s41372-023-01725-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41372-023-01725-1

Search

Advanced search

Quick links