Clinical profiles of neonates born to mothers with COVID-19

Main Article Content

Ambili Susan Jacob
Mohammed MTP
Reetha Gopinath
Binoo Divakaran
Tariq Harris


Background The risk of congenital infections in neonates born to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected mothers and those breastfed by infected mothers remains largely unknown.

Objective To describe the outcomes and clinical features of neonates born to mothers infected with SARS-CoV-2 during pregnancy, to follow up neonates who were positive for SARS-CoV-2 at the time of delivery for a period of 1 month, and to identify potential risk factors associated with disease transmission.

Methods This prospective observational study on neonates born to SARS-CoV-2-infected mothers between June 2020 and January 2021 was carried out after getting written informed consent in a tertiary care government hospital (Government Medical college Kannur, North Kerala, India). The clinical and demographic characteristics of infected mothers were reviewed. Neonates were tested for SARS-CoV-2 infection within 24 hours of birth, with repeat testing on day 5 for those who were negative at birth.  The demographic and clinical characteristics as well as potential risk factors for disease transmission in these neonates were evaluated.

Results A total of 342 neonates (95.3%) were tested for SARS-CoV-2 infection at birth. Rooming-in and breastfeeding was practiced in 75% of at-risk neonates. Fifty neonates tested positive for SARS-CoV-2 infection at birth (14.3%); 293 neonates who tested negative at birth remained so on day 5, except one baby isolated with a caretaker who also tested positive, indicating postnatal infection. There was no statistically significant increased risk of infection in neonates born to SARS-CoV-2-positive mothers compared to those born to mothers who had already become negative at delivery. Mild symptoms were present in 8% of positive neonates. On one-month follow up, all neonates were well and gaining weight.

Conclusion Vertical transmission, in particular transplacental, may be possible in SARS-CoV-2-infected mothers. Maternal infection at the time of delivery is not a predictor for increased vertical transmission compared to mothers whose infections had resolved prior to delivery. Breastfeeding with appropriate hygiene measures is not a risk factor for horizontal transmission.

Article Details

How to Cite
Jacob A, MTP M, Gopinath R, Divakaran B, Harris T. Clinical profiles of neonates born to mothers with COVID-19. PI [Internet]. 20Sep.2021 [cited 8Dec.2021];61(5):277-2. Available from:
Author Biographies


Assistant Professor,Pediatrics


Professor and Head of Department,Pediatrics




Assistant Professor,Statistics,Department of Community Medicine


Senior Resident,Pediatrics

Received 2021-07-14
Accepted 2021-09-20
Published 2021-09-20


1. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395:809-15. DOI: 10.1016/S0140-6736(20)30360-3.
2. Chen ZM, Fu JF, Shu Q, Chen YH, Hua CZ, Li FB, et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr. 2020;16:240-6. DOI: 10.1007/s12519-020-00345-5.
3. Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiology of COVID-19 among children in China. Pediatrics Jun 2020; 145 (6) e20200702. DOI: 10.1542/peds.2020-0702.
4. Alzamora MC, Paredes T, Caceres D, Webb CM, Valdez LM, La Rosa M. Severe COVID-19 during pregnancy and possible vertical transmission. Am J Perinatol. 2020;37:861-5. DOI: 10.1055/s-0040-1710050.
5. Chawla D, Chirla D, Dalwai S, Deorari AK, Ganatra A, Gandhi A, et al. Perinatal-neonatal management of COVID-19 infection - Guidelines of the Federation of Obstetric and Gynecological Societies of India (FOGSI), National Neonatology Forum of India (NNF) and Indian Academy of Pediatrics (IAP). Indian Pediatrics. DOI: 10.1007/s13312-020-1852-4.
6. Kalamdani P, Kalathingal T, Manerkar S, Mondkar J. Clinical profile of SARS-CoV-2 infected neonates from a tertiary government hospital in Mumbai, India. Indian Pediatr. 2020;57:1143-6. DOI: 10.1007/s13312-020-2070-9.
7. Dhir SK, Kumar J, Meena J, Kumar P. Clinical features and outcome of SARS-CoV-2 infection in neonates: a systematic review. J Trop Pediatr. 2021;67:fmaa059. DOI: 10.1093/tropej/fmaa059.
8. Anand P, Yadav A, Debata P, Bachani S, Gupta N, Gera R. Clinical profile, viral load, management and outcome of neonates born to COVID 19 positive mothers: a tertiary care centre expe.rience from India. Eur J Pediatr. 2021;180:547-59. DOI: 10.1007/s00431-020-03800-7
9. Oncel MY, Akın IM, Kanburoglu MK, Tayman C, Coskun S, Narter F, et al. A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. Eur J Pediatr. 2021;180:733-42. DOI: 10.1007/s00431-020-03767-5.
10. Zamaniyan M, Ebadi A, Aghajanpoor S, Rahmani Z, Haghshenas M, Azizi S. Preterm delivery, maternal death, and vertical transmission in pregnant woman with COVID-19 infection. Prenat Diagn. 2020;40:1759-61. DOI: 10.1002/pd.5713.
11. Shah PS, Diambomba Y, Acharya G, Morris SK, Bitnun A. Classification system and case definition for SARS‐CoV‐2 infection in pregnant women, fetuses, and neonates. Acta Obstet Gynecol Scand. 2020;99:565–8. DOI: 10.1111/aogs.13870.
12. Kumar PS, Kumar B, Saha MM. Development of intrauterine growth restriction following COVID-19 infection in third trimester of pregnancy. J West Bengal Univ Health Sci. 2021;1:71-5.
13. World Health Organization. Coronavirus disease (COVID-19): Pregnancy and childbirth; 2 September 2020 [cited 2021 August 30]. Availablefrom: .
14. Panahi L, Amiri M, Pouy S. Risks of novel coronavirus disease (COVID-19) in pregnancy; a narrative review. Arch Acad Emerg Med. 2020;8:e34. PMID: 32232217.
15. Salvatore CM, Han JY, Acker KP, Tiwari P, Jin J, Brandler M, et al. Neonatal management and outcomes during the COVID-19 pandemic: an observation cohort study. Lancet Child Adolesc Health. 2020;4:721-7. DOI: 10.1016/S2352-4642(20)30235-2.