Since the beginning of the COVID-19 pandemic, there have been major concerns about how to protect the most vulnerable, especially newborns. In previous pandemics, newborns and adolescents were with one increased risk of illness and death. This likely impacted COVID-19 policies in hospitals and healthcare systems.
A recently published global survey found that last year, as a precautionary measure, newborns were separated from their mothers in half of the world’s countries if the mother tested positive for COVID-19. Separation of a baby from its mother at birth can have negative consequences for the health of mother and child. This has to be weighed against the possible benefits of separation.
Even more than a year after the pandemic began, results for babies born to mothers with COVID-19 are largely unknown and not reported, putting a heavy burden on families and healthcare providers.
With this in mind, my colleagues and I – in collaboration with the Swedish Health Department – tried to find a better understanding the potential risks to babies whose mothers tested positive for coronavirus during pregnancy or childbirth.
We were able to do this because during the pandemic in Sweden, separation of mothers and babies at birth was only practiced if both were not healthy and breastfeeding was allowed if strict hygiene practices were followed.
Analysis of the annual data
Our study looked at daily reports to three Swedish registries: the National Quality Register for Pregnancy, the National Quality Register for Newborn Care and the Register for Communicable Diseases. Cross-referencing made it possible to monitor and report results for babies during both the first and second waves of COVID-19.
Overall, we recorded the results of 92% of all babies born in Sweden between March 11, 2020 and January 31, 2021. This corresponded to nearly 90,000 births, making it one of the largest datasets on the subject. We found that 2,323 babies were born to mothers who tested positive for COVID-19 during pregnancy, with 642 mothers (28%) testing positive at delivery time.
All babies born to mothers who tested positive were themselves tested between 12 and 24 hours after birth. For babies admitted to a neonatal unit, the COVID-19 tests were repeated 48 and 96 hours after birth. Only 21 babies (0.9%) tested positive for COVID-19, most with no symptoms. Some babies were treated as COVID-19 for other reasons.
However, babies born to mothers with COVID-19 were more likely to enter newborn care and have difficulty breathing. However, this can be explained by the higher number of premature births in the COVID-19 group than in the comparison group. We found no direct association between maternal infection and neonatal respiratory infection or pneumonia.
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That is, our study adds to the evidence that women who test positive for COVID-19 are at increased risk of premature birth. In our study, 8.8% of women who were COVID positive during pregnancy gave birth to premature births compared to 5.5% of women who were COVID negative.
We also found that COVID-19 was not associated with child death in the mother. Seven infants born to mothers who had COVID-19 died from non-COVID-19 related reasons, with none of these infants tested positive for the disease. There was also no difference in the death rate of babies born to mothers who were COVID positive and COVID negative during pregnancy.
No need to separate
Our study therefore supports the recommendation that babies born to women who tested positive for COVID-19 during pregnancy or delivery do not need to be routinely separated from their mothers at birth. Babies are They are very unlikely to be infected or have any illness as a result of her mother having or had COVID-19.
Our research also showed that breastfeeding appears to be safe: 94% of women in the COVID-19 group were breastfeeding their babies on discharge from the hospital, and 99% of their infants tested negative. The small number of infected infants showed no signs of infection.
While not all countries are like Sweden – there are population differences, as well as country-specific differences when it comes to health care and COVID-19 – our work should reassure pregnant women in other countries (and their families) that coronavirus infection during pregnancy is at low risk .