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  • Review Article
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Management of neonates with maternal prenatal coronavirus infection and influencing factors

Pediatric Research volume 95, pages 436–444 (2024)Cite this article

Abstract

The coronavirus disease 2019 (COVID-19) in pregnancy causes adverse outcomes for both the mother and the fetus. Neonates are at risk of vertical transmission and in-utero infection. Additionally, intensive care unit (ICU) admission and impairment in the organ systems of the mother are associated with neonatal outcomes, including impaired intrauterine growth, prematurity, and neonatal ICU admission. The management of neonates born from infected mothers has changed over the progress of the pandemic. At the beginning of the pandemic, cesarean section, immediate separation of mother-infant dyads, isolation of neonates, and avoiding of skin-to-skin contact, breast milk, and breastfeeding were the main practices to reduce vertical and horizontal transmission risk in the era of insufficient knowledge. The effects of antenatal steroids and delayed cord clamping on COVID-19 were also not known. As the pandemic progressed, data showed that prenatal, delivery room, and postnatal care of neonates can be performed as pre-pandemic practices. Variants and vaccines that affect clinical course and outcomes have emerged during the pandemic. The severity of the disease and the timing of infection in pregnancy also influence maternal and neonatal outcomes. The knowledge and lessons from COVID-19 will be helpful for the next pandemic if it happens.

Impact

  • Prenatal infection with COVID-19 is associated with adverse maternal and neonatal outcomes.

  • Our review includes the management of neonates with prenatal COVID-19 infection exposure, maternal-fetal, delivery room, and postnatal care of neonates, clinical features, treatment of neonates, and influencing factors such as variants, vaccination, severity of maternal disease, and timing of infection during pregnancy.

  • There is a growing body of data and evidence about the COVID-19 pandemic. The knowledge and lessons from the pandemic will be helpful for the next pandemic if it happens.

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Fig. 1: Factors influencing neonates with prenatal COVID-19 exposure.
Fig. 2: Flowchart of management of pregnant women with confirmed or suspected COVID-19 and her newborn.

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Authors and Affiliations

  1. University of Health Sciences Turkey; Etlik Zubeyde Hanim Women’s Health Teaching and Research Hospital, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye

    Istemi Han Celik

  2. Ankara Yildirim Beyazit University; Ankara Bilkent City Hospital, Department of Pediatrics, Pediatric Infectious Diseases Unit, Ankara, Türkiye

    Aslinur Ozkaya Parlakay

  3. University of Health Sciences Turkey, Ankara Bilkent City Hospital, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye

    Fuat Emre Canpolat

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  1. Istemi Han Celik
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I.H.C. contributed to conception and design, acquisition of data, and analysis and interpretation of data; drafting the article and revising it critically for important intellectual content, manuscript preparation. A.O.P contributed to acquisition and interpretation of data and assisted in the manuscript preparation. F.E.C. contributed to conception and design, acquisition of data, and analysis and interpretation of data; drafting the article and revising it critically for important intellectual content and assisted in the manuscript preparation. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Celik, I.H., Ozkaya Parlakay, A. & Canpolat, F.E. Management of neonates with maternal prenatal coronavirus infection and influencing factors. Pediatr Res 95, 436–444 (2024). https://doi.org/10.1038/s41390-023-02855-0

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