Mothers with SARS-CoV-2 ‘unlikely’ to infect newborns while rooming-in
Infected mothers appear to be “unlikely” to spread SARS-CoV-2 to newborns while rooming-in, Italian researchers reported in JAMA Pediatrics.
Andrea Ronchi, MD, a neonatologist at the Policlinico of Milan, and colleagues studied 62 neonates born between March 19 and May 2 to 61 mothers with a SARS-CoV-2 infection, who were eligible for rooming-in with their mothers.
As of July, the AAP no longer recommends separating newborns from mothers with COVID-19, reversing advice that it gave early in the pandemic.
Of the 61 mothers included in the Italian study, SARS-CoV-2 was diagnosed in 44 (72%) before giving birth. Fourteen of the women (23%) were under investigation for SARS-CoV-2 infection at delivery, and three women (5%) were diagnosed between 2 and 5 days postpartum. Of the infected women, 34 (55%) were asymptomatic at diagnosis, and 43 women (70%) were asymptomatic at the time of delivery.
In all, 56 (90%) infants were born at term and six (10%) were late preterm. Of the 62 infants, 59 (95%) received breastmilk, including 45 (76%) who were exclusively breastfed. One infant (2%) was breastfed and simultaneously received expressed breast milk and 13 infants (22%) were breastfed and received formula.
Only one infant — who was born to a mother who required intensive care — was diagnosed with SARS-CoV-2 before being discharged (1.6%; 95% CI, 0%-8.7%), according to Ronchi and colleagues. The infant was born at 36 weeks’ gestational age and was admitted to the NICU on their fifth day of life. The infant was discharged to their father on the 18th day of life and was still positive. The infant received a negative test result from a nasopharyngeal swab test at their 30-day follow-up.
Of the remaining 61 infants, none tested positive for SARS-CoV-2 before being discharged, nor during their 30-day follow-up appointments.
In a related editorial, Infectious Diseases in Children Editorial Board Member David A. Kaufman, MD, and Karen M. Puopolo, MD, PhD, compared the results with a report on 120 infants born at a New York City hospital, who all tested negative for SARS-CoV-2. Nearly 80% of the infants were breastfed in the first week of life.
The outcome from the Italian study “is aligned with the changing findings of a perinatal COVID-19 case registry sponsored by the AAP Section on Neonatal Perinatal Medicine,” Kaufman and Puopolo wrote.
“The take-home message of Ronchi and colleagues is positive for perinatal clinicians and patients who wish to follow the recommended practice of mother-newborn rooming-in and who plan to breastfeed their infants during the current pandemic,” they wrote. “These findings are perhaps best viewed with our current understanding of how the virus is shed and when women are potentially infectious to their infants.”