Perinatal aspects of early neonatal period disorders in children with COVID-19 transmitted by the mother during pregnancy

Abstract

SARS-CoV-2 infection during pregnancy can potentially affect the health of the fetus and newborn through various mechanisms: increased rates of preterm birth, placental infection that can disrupt placental-fetal exchange, and through transmission of the virus in utero, during childbirth or after birth.

Purpose - to determine the characteristics of the state of newborns and the neonatal period, depending on the severity of the mother’s illness with COVID-19.

Materials and methods. Under observation were 14 newborns (group 1), whose mothers were ill with severe COVID-19 and needed intensive care in the department of anesthesiology and intensive care, and 46 children from mothers with moderate COVID-19, who were treated in the infectious diseases and obstetrics department (group 2).

Results. In mothers with COVID-19, especially when the disease is severe, the fetus is exposed to direct and indirect negative effects of a viral infection, which is confirmed by signs of placental insufficiency in the vast majority of pregnant women (71.4%) and its clinical manifestations in the form of distress and fetal growth retardation (50.0% and 35.7%, respectively), placental dysfunction was confirmed pathohistologically. Dangerous for the fetus are oligohydramnios in 50.0% of women up to ahydramnios (14.3%), preeclampsia (14.3%), caesarean section (57.1%), premature rupture of fruit membranes (14.3%) and preterm birth (28.0%). 42.9% of children are born in a state of asphyxia, with 14.3% having severe asphyxia, 35.7% of children were born weighing less than 2500 g. A positive test for COVID-19 was observed in 7.1% of newborns. 21.4% of children were diagnosed with pneumonia, 35.7% had respiratory distress syndrome. Children from mothers with COVID-19 have a high incidence of maladaptation syndromes (64.3%). In addition to RDS, there was a high incidence of neurological disorders (57.1%) in the form of a syndrome of depression, gastrointestinal syndrome (50.0%), thermoregulation disorders (42.9%), and 35.7% had hypoglycemic and hemorrhagic syndromes. Necrotizing enterocolitis was diagnosed in children with pneumonia on the 5-7^th day of life.

Conclusions. Disorders in children from mothers with COVID-19 at birth and a high incidence of maladjustment syndromes, the risk of health and cognitive impairment in the future necessitate further scientific research, active follow-up of this new cohort of children and the development of prevention and rehabilitation measures.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.