Pregnant women experience physiological changes such as pulmonary adaptation due to an elevated diaphragm and altered cell immunity. These factors can predispose pregnant women to enhanced susceptibility to severe viral pneumonia infection, leading to adverse pregnancy outcomes associated with increased mortality and morbidity in neonates. Currently, the COVID-19 pandemic has reported over 230 million cases reported globally and generated evidence on raising concerns about maternal infection on the added risk of adverse neonatal outcomes. The review aims to evaluate the effects of COVID- 19 on neonatal outcomes of infected pregnant women. We conducted the systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. To identify relevant articles based on the inclusion and exclusion criteria on COVID-19 infected pregnancies and the neonatal outcomes, we searched four databases (PubMed, Embase, Scopus and Web of Science) from January 01, 2020 to June 20, 2021 by using medical subject heading and keywords under the PECO concept (P = pregnant women, E = COVID-19, O = neonatal outcome). We also assessed the risk of bias of the selected articles. We found that newborns of COVID-19 positive mothers are more likely to be born prematurely and by caesarean section. They need NICU admissions mainly due to prematurity related to maternal COVID-19 status at delivery. We did not find any evidence linking maternal COVID-19 status to low Apgar score, low birthweight, neonatal resuscitation at birth and neonatal death. Neonatal SARS-CoV-2 positive status was infrequently reported. The possibility of vertical transmission was raised, which may contribute to a large number of preterm births and caesarean deliveries in the COVID-19 positive mothers, but there is a paucity of evidence on vertical transmission. There is a shift in focus from vertical to horizontal transmission in the case of neonatal COVID-19 infection, thereby emphasizing the implementation of safety precautions while balancing the need to allow breastfeeding and mother-to-infant skin contact. This systematic review provides evidence on the necessity of close monitoring of neonates of COVID-19 positive mothers and taking preventive measures against the acquisition of COVID-19 in neonates.
Cite this paper
Khong, J. , Teoh, J. , Hashim, S. S. S. and Jahan, N. K. (2021). Neonatal Outcomes of COVID-19 Positive Pregnant Women: A Systematic Review. Open Access Library Journal, 8, e8019. doi: http://dx.doi.org/10.4236/oalib.1108019.
Wang, C.L., Liu, Y.Y., Wu, C.H., Wang, C.Y., Wang, C.H. and Long, C.Y. (2021) Impact of COVID-19 on Pregnancy. International Journal of Medical Sciences, 18, 763-767. https://doi.org/10.7150/ijms.49923
Ahn, D.G., Shin, H.J., Kim, M.H., Lee, S., Kim, H.S., Myoung, J., et al. (2020) Current Status of Epidemiology, Diagnosis, Therapeutics, and Vaccines for Novel Coronavirus Disease 2019 (COVID-19). Journal of Microbiolog and Biotechnology, 30, 313-324. https://doi.org/10.4014/jmb.2003.03011
Di Mascio, D., Khalil, A., Saccone, G., Rizzo, G., Buca, D., Liberati, M., et al. (2020) Outcome of Coronavirus Spectrum Infections (SARS, MERS, COVID-19) during Pregnancy: A Systematic Review and Meta-Analysis. American Journal of Obstetrics & Gynecology MFM, 2, Article ID: 100107.
https://doi.org/10.1016/j.ajogmf.2020.100107
Maleki Dana, P., Kolahdooz, F., Sadoughi, F., Moazzami, B., Chaichian, S. and Asemi, Z. (2020) COVID-19 and Pregnancy: A Review of Current Knowledge. Le infezioni in Medicina, 28, 46-51.
Mohamadian, M., Chiti, H., Shoghli, A., Biglari, S., Parsamanesh, N. and Esmaeilzadeh, A. (2021) COVID-19: Virology, Biology and Novel Laboratory Diagnosis. The Journal of Gene Medicine, 23, Article No. e3303.
https://doi.org/10.1002/jgm.3303
Abedzadeh-Kalahroudi, M., Sehat, M., Vahedpour, Z. and Talebian, P. (2021) Maternal and Neonatal Outcomes of Pregnant Patients with COVID-19: A Prospective Cohort Study. International Journal of Gynecology & Obstetrics, 153, 449-456.
https://doi.org/10.1002/ijgo.13661
Figueiro-Filho, E.A., Yudin, M. and Farine, D. (2020) COVID-19 during Pregnancy: an Overview of Maternal Characteristics, Clinical Symptoms, Maternal and Neonatal Outcomes of 10,996 Cases Described in 15 Countries. Journal of Perinatal Medicine, 48, 900-911. https://doi.org/10.1515/jpm-2020-0364
Yao, W.L., Qiu, J.C., Xiao, Z.R. and Ouyang, S. (2020) Pregnancy and COVID-19: Management and Challenges. Revista do Instituto de Medicina Tropical de São Paulo, 62, Article No. e62. https://doi.org/10.1590/S1678-9946202062062
Goldenberg, R.L., Culhane, J.F., Iams, J.D. and Romero, R. (2008) Epidemiology and Causes of Preterm Birth. Lancet, 371, 75-84.
https://doi.org/10.1016/S0140-6736(08)60074-4
Chawanpaiboon, S., Vogel, J.P., Moller, A.B., Lumbiganon, P., Petzold, M., Hogan, D., et al. (2019) Global, regIonal, and National Estimates of Levels of Preterm Birth in 2014: A Systematic Review and Modelling Analysis. The Lancet Global Health, 7, e37-e46. https://doi.org/10.1016/S2214-109X(18)30451-0
Akhtar, H., Patel, C., Abuelgasim, E. and Harky, A. (2020) COVID-19 (SARS-CoV-2) Infection in Pregnancy: A Systematic Review. Gynecologic and Obstetric Investigation, 85, 295-306. https://doi.org/10.1159/000509290
Papapanou, M., Papaioannou, M., Petta, A., Routsi, E., Farmaki, M., Vlahos, N., et al. (2021) Maternal and Neonatal Characteristics and Outcomes of COVID-19 in Pregnancy: An Overview of Systematic Reviews. International Journal of Environmental Research and Public Health, 18, Article No. 596.
https://doi.org/10.3390/ijerph18020596
Phoswa, W.N. and Khaliq, O.P. (2020) Is Pregnancy a Risk Factor of COVID-19? European Journal of Obstetrics & Gynecology and Reproductive Biology, 252, 605-609. https://doi.org/10.1016/j.ejogrb.2020.06.058
Salem, D., Katranji, F. and Bakdash, T. (2021) COVID-19 Infection in Pregnant Women: Review of Maternal and Fetal Outcomes. International Journal of Gynecology & Obstetrics, 152, 291-298. https://doi.org/10.1002/ijgo.13533
Al-Matary, A., Almatari, F., Al-Matary, M., AlDhaefi, A., Alqahtani, M.H.S., Alhulaimi, E.A., et al. (2021) Clinical Outcomes of Maternal and Neonate with COVID-19 Infection—Multicenter Study in Saudi Arabia. Journal of Infection and Public Health, 14, 702-708. https://doi.org/10.1016/j.jiph.2021.03.013
Angelidou, A., Sullivan, K., Melvin, P.R., Shui, J.E., Goldfarb, I.T., Bartolome, R., et al. (2021) Association of Maternal Perinatal SARS-CoV-2 Infection with Neonatal Outcomes during the COVID-19 Pandemic in Massachusetts. JAMA Network Open, 4, Article ID: e217523. https://doi.org/10.1001/jamanetworkopen.2021.7523
Gabriel, M.A.M., Vergeli, M.R., Carbonero, S.C., Sole, L., Molina, T.C., Calle, I.R., et al. (2020) Maternal, Perinatal and Neonatal Outcomes with COVID-19: A Multicenter Study of 242 Pregnancies and Their 248 Infant Newborns during Their First Month of Life. The Pediatric Infectious Disease Journal, 39, E393-E397.
https://doi.org/10.1097/INF.0000000000002902
Gupta, P., Kumar, S. and Sharma, S.S. (2021) SARS-CoV-2 Prevalence and Maternal-Perinatal Outcomes among Pregnant Women Admitted for Delivery: Experience from COVID-19-Dedicated Maternity Hospital in Jammu, Jammu and Kashmir (India). Journal of Medical Virology, 93, 5505-5514.
https://doi.org/10.1002/jmv.27074
Hcini, N., Maamri, F., Picone, O., Carod, J.F., Lambert, V., Mathieu, M., et al. (2021) Maternal, Fetal and Neonatal Outcomes of Large Series of SARS-CoV-2 Positive Pregnancies in Peripartum Period: A Single-Center Prospective Comparative Study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 257, 11-18. https://doi.org/10.1016/j.ejogrb.2020.11.068
Khoury, R., Bernstein, P.S., Debolt, C., Stone, J., Sutton, D.M., Simpson, L.L., et al. (2020) Characteristics and Outcomes of 241 Births to Women with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection at Five New York City Medical Centers. Obstetrics & Gynecology, 136, 273-282.
https://doi.org/10.1097/AOG.0000000000004025
Malik, S., Surve, S., Wade, P., Kondekar, S., Sawant, V., Shaikh, M., et al. (2021) Clinical Characteristics, Management, and Short Term Outcome of Neonates Born to Mothers with COVID-19 in a Tertiary Care Hospital in India. Journal of Tropical Pediatrics, 67, Article No. fmab054. https://doi.org/10.1093/tropej/fmab054
Maraschini, A., Corsi, E., Salvatore, M.A., Donati, S. and It OSSC-WG (2020) Coronavirus and Birth in Italy: Results of a National Population-Based Cohort Study. Annali dell’Istituto Superiore di Sanità, 56, 378-389.
https://doi.org/10.1101/2020.06.11.20128652
Norman, M., Navér, L., Söderling, J., Ahlberg, M., Hervius Askling, H., Aronsson, B., et al. (2021) Association of Maternal SARS-CoV-2 Infection in Pregnancy with Neonatal Outcomes. JAMA, 325, 2076-2086.
https://doi.org/10.1001/jama.2021.5775
Oncel, M.Y., Akin, I.M., Kanburoglu, M.K., Tayman, C., Coskun, S., Narter, F., et al. (2021) A Multicenter Study on Epidemiological and Clinical Characteristics of 125 Newborns Born to Women Infected with COVID-19 by Turkish Neonatal Society. European Journal of Pediatrics, 180, 733-742.
https://doi.org/10.1007/s00431-020-03767-5
Saccone, G., Sen, C., Di Mascio, D., Galindo, A., Grunebaum, A., Yoshimatsu, J., et al. (2021) Maternal and Perinatal Outcomes of Pregnant Women with SARS-CoV-2 Infection. Ultrasound in Obstetrics & Gynecology, 57, 232-241.
https://doi.org/10.1002/uog.23107
Sánchez-Luna, M., Fernández Colomer, B., de Alba Romero, C., Alarcón Allen, A., Baña Souto, A., Camba Longueira, F., et al. (2021) Neonates Born to Mothers with COVID-19: Data from the Spanish Society of Neonatology Registry. Pediatrics, 147, Article ID: e2020015065. https://doi.org/10.1542/peds.2020-015065
Singh, V., Choudhary, A., Datta, M.R. and Ray, A. (2021) Maternal and Neonatal Outcomes of COVID-19 in Pregnancy: A Single-Centre Observational Study. Cureus, 13, Article ID: e13184. https://doi.org/10.7759/cureus.13184
Bellos, I., Pandita, A. and Panza, R. (2021) Maternal and Perinatal Outcomes in Pregnant Women Infected by SARS-CoV-2: A Meta-Analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology, 256, 194-204.
https://doi.org/10.1016/j.ejogrb.2020.11.038
Di Toro, F., Gjoka, M., Di Lorenzo, G., De Santo, D., De Seta, F., Maso, G., et al. (2021) Impact of COVID-19 on Maternal and Neonatal Outcomes: A Systematic Review and Meta-Analysis. Clinical Microbiology and Infection, 27, 36-46.
https://doi.org/10.1016/j.cmi.2020.10.007
Poon, L.C., Yang, H., Kapur, A., Melamed, N., Dao, B., Divakar, H., et al. (2020) Global Interim Guidance on Coronavirus Disease 2019 (COVID-19) during Pregnancy and Puerperium from FIGO and Allied Partners: Information for Healthcare Professionals. International Journal of Gynecology & Obstetrics, 149, 273-286.
https://doi.org/10.1002/ijgo.13156
Tadas, M.P., Prashanthi, S. and Waikar, M. (2021) Maternal and Neonatal Outcomes of Pregnant Women with Covid-19: A Case-Control Study at a Tertiary Care Center in India. Journal of South Asian Federation of Obstetrics and Gynaecolog, 13, 44-49. https://doi.org/10.5005/jp-journals-10006-1850a
Mboya, I.B., Mahande, M.J., Obure, J. and Mwambi, H.G. (2020) Predictors of Perinatal Death in the Presence of Missing Data: A Birth Registry-Based Study in Northern Tanzania. PLoS ONE, 15, Article ID: e0231636.
https://doi.org/10.1371/journal.pone.0231636
Chamseddine, R.S., Wahbeh, F., Chervenak, F., Salomon, L.J., Ahmed, B. and Rafii, A. (2020) Pregnancy and Neonatal Outcomes in SARS-CoV-2 Infection: A Systematic Review. Journal of Pregnancy, 2020, Article ID: 4592450.
https://doi.org/10.1155/2020/4592450
Anand, P., Yadav, A., Debata, P., Bachani, S., Gupta, N. and Gera, R. (2021) Clinical Profile, Viral Load, Management and Outcome of Neonates Born to COVID 19 Positive Mothers: A Tertiary Care Centre Experience from India. European Journal of Pediatrics, 180, 547-559. https://doi.org/10.1007/s00431-020-03800-7
Ehrenstein, V. (2009) Association of Apgar Scores with Death and Neurologic Disability. Clinical Epidemiology, 1, 45-53. https://doi.org/10.2147/CLEP.S4782
Moster, D., Lie, R.T., Irgens, L.M., Bjerkedal, T. and Markestad, T. (2001) The Association of Apgar Score with Subsequent Death and Cerebral Palsy: A Population-Based Study in Term Infants. The Journal of Pediatrics, 138, 798-803.
https://doi.org/10.1067/mpd.2001.114694
Lie, K.K., Grøholt, E.K. and Eskild, A. (2010) Association of Cerebral Palsy with Apgar Score in Low and Normal Birthweight Infants: Population Based Cohort Study. BMJ, 341, Article No. c4990. https://doi.org/10.1136/bmj.c4990
Dubey, P., Reddy, S.Y., Manuel, S. and Dwivedi, A.K. (2020) Maternal and Neonatal Characteristics and Outcomes among COVID-19 Infected Women: An Updated Systematic Review and Meta-Analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology, 252, 490-501.
https://doi.org/10.1016/j.ejogrb.2020.07.034
Huntley, B.J.F., Mulder, I.A., Di Mascio, D., Vintzileos, W.S., Vintzileos, A.M., Berghella, V., et al. (2021) Adverse Pregnancy Outcomes among Individuals with and without Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Systematic Review and Meta-Analysis. Obstetrics & Gynecology, 137, 585-596.
https://doi.org/10.1097/AOG.0000000000004320
Kinney, H.C. (2006) The Near-Term (Late Preterm) Human Brain and Risk for Periventricular Leukomalacia: A Review. Seminars in Perinatology, 30, 81-88.
https://doi.org/10.1053/j.semperi.2006.02.006
Mwaniki, M.K., Atieno, M., Lawn, J.E. and Newton, C.R. (2012) Long-Term Neurodevelopmental Outcomes after Intrauterine and Neonatal Insults: A Systematic Review. Lancet, 379, 445-452. https://doi.org/10.1016/S0140-6736(11)61577-8
Madinger, N.E., Greenspoon, J.S. and Ellrodt, A.G. (1989) Pneumonia during Pregnancy: Has Modern Technology Improved Maternal and Fetal Outcome? American Journal of Obstetrics and Gynecology, 161, 657-662.
https://doi.org/10.1016/0002-9378(89)90373-6
Benedetti, T.J., Valle, R. and Ledger, W.J. (1982) Antepartum Pneumonia in Pregnancy. American Journal of Obstetrics and Gynecology, 144, 413-417.
https://doi.org/10.1016/0002-9378(82)90246-0
Berkowitz, K. and LaSala, A. (1990) Risk Factors Associated with the Increasing Prevalence of Pneumonia during Pregnancy. American Journal of Obstetrics and Gynecology, 163, 981-985. https://doi.org/10.1016/0002-9378(90)91109-P
Schwartz, D.A. and Graham, A.L. (2020) Potential Maternal and Infant Outcomes from Coronavirus 2019-NCOV (SARS-CoV-2) Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections. Viruses, 12, Article No. 194. https://doi.org/10.3390/v12020194
Allotey, J., Stallings, E., Bonet, M., Yap, M., Chatterjee, S., Kew, T., et al. (2020) Clinical Manifestations, Risk Factors, and Maternal and Perinatal Outcomes of Coronavirus Disease 2019 in Pregnancy: Living Systematic Review and Meta-Analysis. The BMJ, 370, Article No. m3320. https://doi.org/10.1136/bmj.m3320
Royal College of Obstetricians and Gynaecologists (2021) Coronavirus (COVID-19) Infection in Pregnancy.
https://www.rcog.org.uk/globalassets/documents/guidelines/2021-08-25-coronavirus-covid-19-infection-in-pregnancy-v14.pdf
Boelig, R.C., Manuck, T., Oliver, E.A., Di Mascio, D., Saccone, G., Bellussi, F., et al. (2020) Labor and Delivery Guidance for COVID-19. American Journal of Obstetrics & Gynecology MFM, 2, Article ID: 100110.
https://doi.org/10.1016/j.ajogmf.2020.100110
Martínez-Perez, O., Vouga, M., Cruz Melguizo, S., Forcen Acebal, L., Panchaud, A., Muñoz-Chápuli, M., et al. (2020) Association between Mode of Delivery among Pregnant Women with COVID-19 and Maternal and Neonatal Outcomes in Spain. JAMA, 324, 296-299. https://doi.org/10.1001/jama.2020.10125
Auriti, C., De Rose, D.U., Tzialla, C., Caforio, L., Ciccia, M., Manzoni, P., et al. (2020) Vertical Transmission of SARS-CoV-2 (COVID-19): Are Hypotheses More than Evidences? American Journal of Perinatology, 37, S31-S38.
https://doi.org/10.1055/s-0040-1714346
Dingom, M.A.N., Sobngwi, E., Essiben, F., Assiga, A.N., Wasnyo, Y.F., Ngate, A., et al. (2020) Maternal and Fetal Outcomes of COVID-19 Pregnant Women Followed Up at a Tertiary Care Unit: A Descriptive Study. Open Journal of Obstetrics and Gynecology, 10, 1482-1491. https://doi.org/10.4236/ojog.2020.10100135
Wu, Y., Liu, C., Dong, L., Zhang, C., Chen, Y., Liu, J., et al. (2020) Coronavirus Disease 2019 among Pregnant Chinese Women: Case Series Data on the Safety of Vaginal Birth and Breastfeeding. BJOG: An International Journal of Obstetrics & Gynaecology, 127, 1109-1115. https://doi.org/10.1111/1471-0528.16276
Aslan, M.M., Uslu Yuvaci, H., Köse, O., Toptan, H., Akdemir, N., Köroglu, M., et al. (2020) SARS-CoV-2 Is Not Present in the Vaginal Fluid of Pregnant Women with COVID-19. The Journal of Maternal-Fetal & Neonatal Medicined.
https://doi.org/10.1080/14767058.2020.1793318
Dumitriu, D., Emeruwa, U.N., Hanft, E., Liao, G.V., Ludwig, E., Walzer, L., et al. (2021) Outcomes of Neonates Born to Mothers with Severe Acute Respiratory Syndrome Coronavirus 2 Infection at a Large Medical Center in New York City. JAMA Pediatrics, 175, 157-167. https://doi.org/10.1001/jamapediatrics.2020.4298
Sankaran, D., Nakra, N., Cheema, R., Blumberg, D. and Lakshminrusimha, S. (2021) Perinatal SARS-CoV-2 Infection and Neonatal COVID-19: A 2021 Update. Neoreviews, 22, e284-e295. https://doi.org/10.1542/neo.22-5-e1001
American Academy of Pediatrics (2020) SONPM National Registry for Surveillance and Epidemiology of Perinatal COVID-19 Infection: Section on Neonatal-Pernatal Medicine. https://my.visme.co/view/ojq9qq8e-npc-19-registry
Kotlyar, A.M., Grechukhina, O., Chen, A., Popkhadze, S., Grimshaw, A., Tal, O., et al. (2021) Vertical Transmission of Coronavirus Disease 2019: A Systematic Review and Meta-Analysis. American Journal of Obstetrics and Gynecology, 224, 35-53.e3.
https://doi.org/10.1016/j.ajog.2020.07.049
Pierce-Williams, R.A.M., Burd, J., Felder, L., Khoury, R., Bernstein, P.S., Avila, K., et al. (2020) Clinical Course of Severe and Critical Coronavirus Disease 2019 in Hospitalized Pregnancies: A United States Cohort Study. American Journal of Obstetrics & Gynecology MFM, 2, Article ID: 100134.
https://doi.org/10.1016/j.ajogmf.2020.100134
Chen, H.J., Guo, J.J., Wang, C., Luo, F., Yu, X.C., Zhang, W., et al. (2020) Clinical Characteristics and Intrauterine Vertical Transmission Potential of COVID-19 Infection in Nine Pregnant Women: A Retrospective Review of Medical Records. Lancet, 395, 809-815. https://doi.org/10.1016/S0140-6736(20)30360-3
Yockey, L.J., Lucas, C. and Iwasaki, A. (2020) Contributions of Maternal and Fetal Antiviral Immunity in Congenital Disease. Science, 368, 608-612.
https://doi.org/10.1126/science.aaz1960
Dong, L., Tian, J., He, S., Zhu, C., Wang, J., Liu, C., et al. (2020) Possible Vertical Transmission of SARS-CoV-2 from an Infected Mother to Her Newborn. JAMA, 323, 1846-1848. https://doi.org/10.1001/jama.2020.4621
Kimberlin, D.W. and Stagno, S. (2020) Can SARS-CoV-2 Infection Be Acquired in Utero? More Definitive Evidence Is Needed. JAMA, 323, 1788-1789.
https://doi.org/10.1001/jama.2020.4868
Raschetti, R., Vivanti, A.J., Vauloup-Fellous, C., Loi, B., Benachi, A. and De Luca, D. (2020) Synthesis and Systematic Review of Reported Neonatal SARS-CoV-2 Infections. Nature Communications, 11, Article No. 5164.
Wang, L., Shi, Y., Xiao, T., Fu, J., Feng, X., Mu, D., et al. (2020) Chinese Expert Consensus on the Perinatal and Neonatal Management for the Prevention and Control of the 2019 Novel Coronavirus Infection (First Edition). Annals of Translational Medicined, 8, Article No. 47. https://doi.org/10.21037/atm.2020.02.20
Centers for Disease Control and Prevention (2020) Interim Considerations for Infection Prevention and Control of Coronavirus Disease 2019 (COVID-19) in Inpatient Obstetric Healthcare Settings. [Updated 18 February 2020].
https://stacks.cdc.gov/view/cdc/85196
World Health Organization (WHO) (2021) COVID-19 Clinical Management: Living Guidance [Updated 25 January 2021].
https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-1
Centeno-Tablante, E., Medina-Rivera, M., Finkelstein, J.L., Rayco-Solon, P., Garcia-Casal, M.N., Rogers, L., et al. (2021) Transmission of SARS-CoV-2 through Breast Milk and Breastfeeding: A Living Systematic Review. Annals of the New York Academy of Sciences, 1484, 32-54. https://doi.org/10.1111/nyas.14477
Sahin, D., Tanacan, A., Erol, S.A., Anuk, A.T., Eyi, E.G.Y., Ozgu-Erdinc, A.S., et al. (2020) A Pandemic Center’s Experience of Managing Pregnant Women with COVID-19 Infection in Turkey: A Prospective Cohort Study. International Journal of Gynecology & Obstetrics, 151, 74-82. https://doi.org/10.1002/ijgo.13318
Yang, N., Che, S., Zhang, J., Wang, X., Tang, Y., Wang, J., et al. (2020) Breastfeeding of Infants Born to Mothers with COVID-19: A Rapid Review. Annals of Translational Medicine, 8, Article No. 618. https://doi.org/10.21037/atm-20-3299
American Academy of Pediatrics (2021) Breastfeeding Guidance Post Hospital Discharge for Mothers or Infants with Suspected or Confirmed SARS-Co V-2 Infection.
https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/breastfeeding-guidance-post-hospital-discharge/
Farghaly, M.A.A., Kupferman, F., Castillo, F. and Kim, R.M. (2020) Characteristics of Newborns Born to SARS-CoV-2-Positive Mothers: A Retrospective Cohort Study. American Journal of Perinatology, 37, 1310-1316.
https://doi.org/10.1055/s-0040-1715862
Stuebe, A. (2020) Should Infants Be Separated from Mothers with COVID-19? First, Do No Harm. Breastfeeding Medicine, 15, 351-352.
https://doi.org/10.1089/bfm.2020.29153.ams
Cheema, R., Partridge, E., Kair, L.R., Kuhn-Riordon, K.M., Silva, A.I., Bettinelli, M.E., et al. (2020) Protecting Breastfeeding during the COVID-19 Pandemic. American Journal of Perinatology, 1-7. https://doi.org/10.1055/s-0040-1714277
Rawat, M., Chandrasekharan, P., Hicar, M.D. and Lakshminrusimha, S. (2020) COVID-19 in Newborns and Infants-Low Risk of Severe Disease: Silver Lining or Dark Cloud? American Journal of Perinatology, 37, 845-849.
https://doi.org/10.1055/s-0040-1710512
Molloy, E.J. and Bearer, C.F. (2020) COVID-19 in Children and Altered Inflammatory Responses. Pediatric Research, 88, 340-341.
https://doi.org/10.1038/s41390-020-0881-y
Carsetti, R., Quintarelli, C., Quinti, I., Piano Mortari, E., Zumla, A., Ippolito, G., et al. (2020) The Immune System of Children: The Key to Understanding SARS-CoV-2 Susceptibility? The Lancet Child & Adolescent Health, 4, 414-416.
https://doi.org/10.1016/S2352-4642(20)30135-8
Dhochak, N, Singhal, T., Kabra, S.K. and Lodha, R. (2020) Pathophysiology of COVID-19: Why Children Fare Better than Adults? The Indian Journal of Pediatrics, 87, 537-546. https://doi.org/10.1007/s12098-020-03322-y
Song, R., Preston, G. and Yosypiv, I.V. (2012) Ontogeny of Angiotensin-Converting Enzyme 2. Pediatric Research, 71, 13-19. https://doi.org/10.1038/pr.2011.7
Bunyavanich, S., Do, A. and Vicencio, A. (2020) Nasal Gene Expression of Angiotensin-Converting Enzyme 2 in Children and Adults. JAMA, 323, 2427-2429.
https://doi.org/10.1001/jama.2020.8707
Li, M., Chen, L., Zhang, J., Xiong, C. and Li, X. (2020) The SARS-CoV-2 Receptor ACE2 Expression of Maternal-Fetal Interface and Fetal Organs by Single-Cell Transcriptome Study. PLoS ONE, 15, Article ID: e0230295.
https://doi.org/10.1371/journal.pone.0230295
