Outcomes in neonates born to mothers with COVID-19 during the second wave in India

Eur J Pediatr. 2022 Sep;181(9):3537-3543. doi: 10.1007/s00431-022-04546-0. Epub 2022 Jul 8.


COVID-19 pandemic has affected all age groups globally including pregnant women and their neonates. The aim of the study was to understand outcomes in neonates of mothers with COVID-19 during the first and second waves of COVID-19 pandemic. A retrospective analysis of 2524 neonates born to SARS-CoV-2-infected mothers was conducted during the first wave (n = 1782) and second wave (n = 742) of the COVID-19 pandemic at five study sites of the PregCovid registry in Maharashtra, India. A significant difference was noted in preterm birth, which was higher in the second wave (15.0%, 111/742) compared to the first wave (7.8%, 139/1782) (P < 0.001). The proportion of neonates requiring NICU admission was significantly higher in the second wave (19.0%, 141/742) as compared to that in the first wave (14.8%, 264/1782) (P < 0.05). On comparing regional differences, significantly higher neonatal complications were reported from Mumbai metropolitan region (P < 0.05). During the second wave of COVID-19, birth asphyxia and prematurity were 3.8- and 2.1-fold higher respectively (P < 0.001). Neonatal resuscitation at birth was significantly higher in second wave (3.4%, 25/742 vs 1.8%, 32/1782) (P < 0.05). The prevalence of SARS-CoV-2 infection in neonates was comparable (4.2% vs 4.6%) with no significant difference between the two waves.

Conclusion: Higher incidence of adverse outcomes in neonates born to SARS-CoV-2-infected mothers in the second wave of COVID-19 as compared to the first wave.

Trial registration: PregCovid study is registered with the Clinical Trial Registry of India (CTRI/2020/05/025423, Registered on 28/05/2020).

What is known: • The second wave of COVID-19 was more lethal to pregnant women than the first wave. Newborns are at risk of developing complications.

What is new: • Birth asphyxia, prematurity, and neonatal resuscitation at birth were significantly higher in the second wave as compared to those in the first wave of the COVID-19 pandemic in India.

Keywords: NICU; Neonatal complications; SARS-CoV-2; Second wave.

MeSH terms

  • Asphyxia / epidemiology
  • COVID-19* / epidemiology
  • Female
  • Humans
  • India / epidemiology
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Infant, Newborn, Diseases* / epidemiology
  • Infectious Disease Transmission, Vertical
  • Mothers
  • Pandemics
  • Pregnancy
  • Pregnancy Complications, Infectious* / epidemiology
  • Premature Birth* / epidemiology
  • Resuscitation
  • Retrospective Studies
  • SARS-CoV-2