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Am J Perinatol 2024; 41(S 01): e1451-e1458
DOI: 10.1055/a-2234-8064
Original Article

Maternal COVID-19 Infection Associated with Fetal Systemic Inflammatory Complications in COVID-19-Negative Neonates: A Case-Series

Devin McKissic
1   Division of Neonatology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington
,
Francisco A. Perez
2   Department of Radiology, University of Washington and Seattle Children's Hospital, Seattle, Washington
,
Mihai Puia-Dumitrescu
1   Division of Neonatology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington
,
Ramah Ryan
1   Division of Neonatology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington
,
D Taylor Hendrixson
1   Division of Neonatology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington
3   Division of Infectious Disease, Department of Pediatrics, University of Washington, Seattle, Washington
,
Zeenia Billimoria
1   Division of Neonatology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington
,
Robert DiGeronimo
1   Division of Neonatology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington
,
Taylor Sawyer
1   Division of Neonatology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington
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Abstract

Objective This study aimed to examine fetal and neonatal inflammatory and neurologic complications associated with maternal coronavirus disease 2019 (COVID-19) infection.

Study Design Case-series using a convenience sample of neonates cared for in a large referral-based children's hospital neonatal intensive care unit between September 2021 and May 2022.

Results We identified seven neonates with exposure to maternal severe acute respiratory syndrome related coronavirus 2 (SARS-CoV-2) and a presentation consistent with inflammatory complications. All had some degree of neurologic injury with neuroimaging findings including restricted diffusion indicating injury in the white matter, cortex, deep gray structures, and splenium of the corpus callosum as well as intracranial hemorrhage. In addition, many infants had cytopenia and abnormal coagulation studies. Placental pathology, when available, revealed inflammation, clot with calcifications, and hematomas with associated infarcts.

Conclusion Neonates born to mothers with SARS-CoV-2, even when negative for the virus themselves, may have complications consistent with a systemic inflammatory syndrome. Placental pathology as well as neurologic imaging in infants with neurologic findings may help to support this diagnosis.

Key Points

  • A systemic inflammatory response may cause illness in babies born to mothers with a history of COVID-19.

  • Inflammatory markers and placental pathology are helpful in supporting this diagnosis.

  • Consider neuroimaging in infants of mothers with a history of COVID-19 with neurologic findings.

Keywords

inflammation - neonate - neurologic injury - COVID-19


Publikationsverlauf

Eingereicht: 19. Juli 2023

Angenommen: 19. Dezember 2023

Accepted Manuscript online:
22. Dezember 2023

Artikel online veröffentlicht:
11. Januar 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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