PMID- 33044493
OWN - NLM
STAT- MEDLINE
DCOM- 20210211
LR  - 20210211
IS  - 2168-6211 (Electronic)
IS  - 2168-6203 (Print)
IS  - 2168-6203 (Linking)
VI  - 175
IP  - 2
DP  - 2021 Feb 1
TI  - Outcomes of Neonates Born to Mothers With Severe Acute Respiratory Syndrome 
      Coronavirus 2 Infection at a Large Medical Center in New York City.
PG  - 157-167
LID - 10.1001/jamapediatrics.2020.4298 [doi]
AB  - IMPORTANCE: Limited data on vertical and perinatal transmission of severe acute 
      respiratory syndrome coronavirus 2 (SARS-CoV-2) and health outcomes of neonates 
      born to mothers with symptomatic or asymptomatic coronavirus disease 2019 
      (COVID-19) are available. Studies are needed to inform evidence-based infection 
      prevention and control (IP&C) policies. OBJECTIVE: To describe the outcomes of 
      neonates born to mothers with perinatal SARS-CoV-2 infection and the IP&C 
      practices associated with these outcomes. DESIGN, SETTING, AND PARTICIPANTS: This 
      retrospective cohort analysis reviewed the medical records for maternal and 
      newborn data for all 101 neonates born to 100 mothers positive for or with 
      suspected SARS-CoV-2 infection from March 13 to April 24, 2020. Testing for 
      SARS-CoV-2 was performed using Cobas (Roche Diagnostics) or Xpert Xpress 
      (Cepheid) assays. Newborns were admitted to well-baby nurseries (WBNs) (82 
      infants) and neonatal intensive care units (NICUs) (19 infants) in 2 affiliate 
      hospitals at a large academic medical center in New York, New York. Newborns from 
      the WBNs roomed-in with their mothers, who were required to wear masks. Direct 
      breastfeeding after appropriate hygiene was encouraged. EXPOSURES: Perinatal 
      exposure to maternal asymptomatic/mild vs severe/critical COVID-19. MAIN OUTCOMES 
      AND MEASURES: The primary outcome was newborn SARS-CoV-2 testing results. 
      Maternal COVID-19 status was classified as asymptomatic/mildly symptomatic vs 
      severe/critical. Newborn characteristics and clinical courses were compared 
      across maternal COVID-19 severity. RESULTS: In total, 141 tests were obtained 
      from 101 newborns (54 girls [53.5%]) on 0 to 25 days of life (DOL-0 to DOL-25) 
      (median, DOL-1; interquartile range [IQR], DOL-1 to DOL-3). Two newborns had 
      indeterminate test results, indicative of low viral load (2.0%; 95% CI, 
      0.2%-7.0%); 1 newborn never underwent retesting but remained well on follow-up, 
      and the other had negative results on retesting. Maternal severe/critical 
      COVID-19 was associated with newborns born approximately 1 week earlier (median 
      gestational age, 37.9 [IQR, 37.1-38.4] vs 39.1 [IQR, 38.3-40.2] weeks; P = .02) 
      and at increased risk of requiring phototherapy (3 of 10 [30.0%] vs 6 of 91 
      [7.0%]; P = .04) compared with newborns of mothers with asymptomatic/mild 
      COVID-19. Fifty-five newborns were followed up in a new COVID-19 Newborn 
      Follow-up Clinic at DOL-3 to DOL-10 and remained well. Twenty of these newborns 
      plus 3 newborns followed up elsewhere had 32 nonroutine encounters documented at 
      DOL-3 to DOL-25, and none had evidence of SARS-CoV-2 infection, including 6 with 
      negative retesting results. CONCLUSIONS AND RELEVANCE: No clinical evidence of 
      vertical transmission was identified in 101 newborns of mothers positive for or 
      with suspected SARS-CoV-2 infection, despite most newborns rooming-in and direct 
      breastfeeding practices.
FAU - Dumitriu, Dani
AU  - Dumitriu D
AD  - Division of Child and Adolescent Health, Department of Pediatrics, Columbia 
      University Irving Medical Center, New York, New York.
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Developmental Neuroscience, Department of Psychiatry, Columbia 
      University Irving Medical Center, New York, New York.
AD  - Sackler Institute, Zuckerman Institute, and the Columbia Population Research 
      Center, Columbia University, New York, New York.
FAU - Emeruwa, Ukachi N
AU  - Emeruwa UN
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 
      Columbia University Irving Medical Center, New York, New York.
FAU - Hanft, Erin
AU  - Hanft E
AD  - Division of Neonatology, Department of Pediatrics, Columbia University Irving 
      Medical Center, New York, New York.
FAU - Liao, Grace V
AU  - Liao GV
AD  - Division of Neonatology, Department of Pediatrics, Columbia University Irving 
      Medical Center, New York, New York.
FAU - Ludwig, Elizabeth
AU  - Ludwig E
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Department of Obstetrics and Gynecology, Columbia University Irving Medical 
      Center, New York, New York.
FAU - Walzer, Lauren
AU  - Walzer L
AD  - Division of Child and Adolescent Health, Department of Pediatrics, Columbia 
      University Irving Medical Center, New York, New York.
AD  - NewYork-Presbyterian Hospital, New York, New York.
FAU - Arditi, Brittany
AU  - Arditi B
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 
      Columbia University Irving Medical Center, New York, New York.
FAU - Saslaw, Minna
AU  - Saslaw M
AD  - Division of Child and Adolescent Health, Department of Pediatrics, Columbia 
      University Irving Medical Center, New York, New York.
AD  - NewYork-Presbyterian Hospital, New York, New York.
FAU - Andrikopoulou, Maria
AU  - Andrikopoulou M
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 
      Columbia University Irving Medical Center, New York, New York.
FAU - Scripps, Tessa
AU  - Scripps T
AD  - Division of Child and Adolescent Health, Department of Pediatrics, Columbia 
      University Irving Medical Center, New York, New York.
AD  - NewYork-Presbyterian Hospital, New York, New York.
FAU - Baptiste, Caitlin
AU  - Baptiste C
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 
      Columbia University Irving Medical Center, New York, New York.
FAU - Khan, Adrita
AU  - Khan A
AD  - Division of Child and Adolescent Health, Department of Pediatrics, Columbia 
      University Irving Medical Center, New York, New York.
AD  - NewYork-Presbyterian Hospital, New York, New York.
FAU - Breslin, Noelle
AU  - Breslin N
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 
      Columbia University Irving Medical Center, New York, New York.
FAU - Rubenstein, David
AU  - Rubenstein D
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Neonatology, Department of Pediatrics, Columbia University Irving 
      Medical Center, New York, New York.
FAU - Simpson, Lynn L
AU  - Simpson LL
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 
      Columbia University Irving Medical Center, New York, New York.
FAU - Kyle, Margaret H
AU  - Kyle MH
AD  - Division of Developmental Neuroscience, Department of Psychiatry, Columbia 
      University Irving Medical Center, New York, New York.
FAU - Friedman, Alexander M
AU  - Friedman AM
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 
      Columbia University Irving Medical Center, New York, New York.
FAU - Hirsch, Daniel S
AU  - Hirsch DS
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Neonatology, Department of Pediatrics, Columbia University Irving 
      Medical Center, New York, New York.
FAU - Miller, Russell S
AU  - Miller RS
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 
      Columbia University Irving Medical Center, New York, New York.
FAU - Fernandez, Cristina R
AU  - Fernandez CR
AD  - Division of Child and Adolescent Health, Department of Pediatrics, Columbia 
      University Irving Medical Center, New York, New York.
AD  - NewYork-Presbyterian Hospital, New York, New York.
FAU - Fuchs, Karin M
AU  - Fuchs KM
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 
      Columbia University Irving Medical Center, New York, New York.
FAU - Keown, M Kathleen
AU  - Keown MK
AD  - Division of Child and Adolescent Health, Department of Pediatrics, Columbia 
      University Irving Medical Center, New York, New York.
AD  - NewYork-Presbyterian Hospital, New York, New York.
FAU - Glassman, Melissa E
AU  - Glassman ME
AD  - Division of Child and Adolescent Health, Department of Pediatrics, Columbia 
      University Irving Medical Center, New York, New York.
AD  - NewYork-Presbyterian Hospital, New York, New York.
FAU - Stephens, Ashley
AU  - Stephens A
AD  - Division of Child and Adolescent Health, Department of Pediatrics, Columbia 
      University Irving Medical Center, New York, New York.
AD  - NewYork-Presbyterian Hospital, New York, New York.
FAU - Gupta, Archana
AU  - Gupta A
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Neonatology, Department of Pediatrics, Columbia University Irving 
      Medical Center, New York, New York.
FAU - Sultan, Sally
AU  - Sultan S
AD  - Division of Child and Adolescent Health, Department of Pediatrics, Columbia 
      University Irving Medical Center, New York, New York.
AD  - NewYork-Presbyterian Hospital, New York, New York.
FAU - Sibblies, Caroline
AU  - Sibblies C
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Neonatology, Department of Pediatrics, Columbia University Irving 
      Medical Center, New York, New York.
FAU - Whittier, Susan
AU  - Whittier S
AD  - Department of Pathology and Cell Biology, Columbia University Irving Medical 
      Center, New York, New York.
FAU - Abreu, Wanda
AU  - Abreu W
AD  - Division of Child and Adolescent Health, Department of Pediatrics, Columbia 
      University Irving Medical Center, New York, New York.
AD  - NewYork-Presbyterian Hospital, New York, New York.
FAU - Akita, Francis
AU  - Akita F
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Neonatology, Department of Pediatrics, Columbia University Irving 
      Medical Center, New York, New York.
FAU - Penn, Anna
AU  - Penn A
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Neonatology, Department of Pediatrics, Columbia University Irving 
      Medical Center, New York, New York.
FAU - D'Alton, Mary E
AU  - D'Alton ME
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Department of Obstetrics and Gynecology, Columbia University Irving Medical 
      Center, New York, New York.
FAU - Orange, Jordan S
AU  - Orange JS
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Department of Pediatrics, Columbia University Irving Medical Center, New York, 
      New York.
FAU - Goffman, Dena
AU  - Goffman D
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 
      Columbia University Irving Medical Center, New York, New York.
AD  - Department of Obstetrics and Gynecology, Columbia University Irving Medical 
      Center, New York, New York.
FAU - Saiman, Lisa
AU  - Saiman L
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Pediatric Infectious Diseases, Department of Pediatrics, Columbia 
      University Irving Medical Center, New York, New York.
FAU - Stockwell, Melissa S
AU  - Stockwell MS
AD  - Division of Child and Adolescent Health, Department of Pediatrics, Columbia 
      University Irving Medical Center, New York, New York.
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Department of Population and Family Health, Mailman School of Public Health, 
      Columbia University Irving Medical Center, New York, New York.
FAU - Gyamfi-Bannerman, Cynthia
AU  - Gyamfi-Bannerman C
AD  - NewYork-Presbyterian Hospital, New York, New York.
AD  - Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 
      Columbia University Irving Medical Center, New York, New York.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - JAMA Pediatr
JT  - JAMA pediatrics
JID - 101589544
SB  - IM
CIN - JAMA Pediatr. 2021 Feb 1;175(2):129-130. PMID: 33044485
MH  - COVID-19/epidemiology/*transmission
MH  - COVID-19 Testing/*statistics & numerical data
MH  - Female
MH  - Humans
MH  - Infant, Newborn
MH  - Infectious Disease Transmission, Vertical/*statistics & numerical data
MH  - Male
MH  - New York City
MH  - Outcome Assessment, Health Care
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious/*epidemiology
MH  - Pregnancy Outcome/*epidemiology
MH  - Retrospective Studies
MH  - SARS-CoV-2/isolation & purification
MH  - Young Adult
PMC - PMC7551222
COIS- Conflict of Interest Disclosures: Dr Miller reported receiving personal fees from 
      UpToDate and Medicolegal for consulting work outside the submitted work. Dr 
      D'Alton reported a paid advisory board member for Merck for Mothers, Merck & Co, 
      outside the submitted work. Dr Orange reported receiving stock options for 
      service on the advisory board of GigaGen outside the submitted work. Dr 
      Gyamfi-Bannerman reported receiving grants from the Eunice Kennedy Shriver 
      National Institute of Child Health and Human Development outside the submitted 
      work. No other disclosures were reported.
EDAT- 2020/10/13 06:00
MHDA- 2021/02/12 06:00
PMCR- 2021/10/12
CRDT- 2020/10/12 12:11
PHST- 2020/10/13 06:00 [pubmed]
PHST- 2021/02/12 06:00 [medline]
PHST- 2020/10/12 12:11 [entrez]
PHST- 2021/10/12 00:00 [pmc-release]
AID - 2771636 [pii]
AID - poi200070 [pii]
AID - 10.1001/jamapediatrics.2020.4298 [doi]
PST - ppublish
SO  - JAMA Pediatr. 2021 Feb 1;175(2):157-167. doi: 10.1001/jamapediatrics.2020.4298.