Newly published research led by the Pediatrix Medical Group and the Duke Clinical Research Institute’s Rachel Greenberg, MD, MB, MHS assessed the impact of COVID-19 on pregnant women and infants admitted to the neonatal intensive care unit (NICU). It is believed to be the largest study evaluating the prevalence of COVID-19 within a diverse neonatal population and associated hospital outcomes.
Among a cohort of more than 150,000 hospitalized infants discharged from nearly 300 neonatal intensive care units, most had no known exposure to COVID-19.
While researchers have learned more about the impact of COVID-19 on mothers and infants over the course of the pandemic, little was previously known about the prevalence and trends of COVID-19 exposures and diagnoses within the NICU. “Trends in COVID-19 diagnoses and outcomes in infants hospitalized in the neonatal intensive care unit,” published in the Journal of Perinatology in July, enhances the depth of knowledge of how COVID-19 affected hospitalized infants in the NICU.
“Our study showed that while COVID-19 exposures occurred in hospitalized infants consistent with countrywide trends, few infants in the NICU tested positive for COVID-19,” Greenberg said. “Infants who did test positive for COVID-19 had similar outcomes to other infants hospitalized in the NICU other than slightly longer hospital stay.”
The cohort study was conducted using the Pediatrix BabySteps Clinical Data Warehouse, and included all infants discharged between January 2020 and September 2021. A total of 150,924 were discharged from 294 NICUs. Of the infants that tested positive for COVID-19, 112 (45%) had mothers that were also COVID positive. A total of 4,157 (3%) infants were in the “infant COVID negative, maternal COVID positive” group. Among the mothers with a documented positive COVID-19 test, the rate of infant positivity was 2.6%. Overall, 142,585 (95%) infants had no reported COVID-related diagnosis or test.
This data suggests that COVID-19 did not affect babies in the NICU to the same extent as mothers, though more studies are needed to follow-up with the patients who had COVID-19 exposures to assess their future neurodevelopmental outcomes.
“Being able to monitor what is happening in our neonatal intensive care units allows us to respond quickly to changes in disease patterns,” said Reese Clark, MD, executive director of the Pediatrix Center for Research, Education, Quality and Safety. “We have had a long and productive collaboration with Duke, which has helped us to improve neonatal care. We share what we’re seeing in our clinical data warehouse so that others can learn from the research we are doing. COVID-19 has created many challenges. The good news is that babies seem to be doing well independent of the type of exposure.”