Obstetric, Neonatal Outcomes and Histopathological Changes in COVID-positive Pregnancies in a South Indian Population

Abstract

Introduction: COVID-19 might be transmitted vertically from mother to fetus and causes clinically significant infection. Limited evidence about the in utero infectivity of the COVID-19 virus and early positive neonatal testing is present. Aims and objectives: To determine the incidence of vertical transmission in COVID-positive pregnancies was the primary objective and to correlate the maternal demographic details and neonatal outcomes to maternal COVID-19 infection. Materials and methods: This was a cross-sectional study done during the SARS-CoV-2 pandemic over 6 months, in a tertiary care center, in south India. Neonates whose mothers were tested positive for COVID-19 infection by real-time polymerase chain reaction (RT-PCR) were included (who were tested by RT-PCR after 24 hours of life). Maternal and neonatal data were collected from their case charts. Results: In total, 82 pregnant women were diagnosed to be COVID-19 positive by the RT-PCR or rapid antigen test (RAT). The mean gestational age of the study population was 37.91 ± 2.08 weeks. In total, 58 (70.7%) of the women were detected to be COVID-positive by the RT-PCR test. In total, 45 (54.9%) women were primigravidae. In total, 75 (91.5%) women had mild COVID infections. During the study period of 1/7/2020–31/1/2021, there were 983 mothers and 112 (11.3%) tested positive for COVID-19 infection. There were 39 (47.6%) boys and 43 (52.4%) girl babies. Out of 82 COVID-19 exposed neonates, 4 (4.8%) of the neonates were tested positive for COVID-19 infection. All babies were discharged home. About 89% of neonates were breastfed at discharge and 92% of the total were breastfeeding at 3 months of age. Conclusion: The incidence of vertical transmission in COVID-positive pregnancies in a South Indian population during the COVID-19 pandemic appears to be low (3.6%). COVID-19 status will not affect the breastfeeding rates at discharge and follow-up.