A study, published in Nature Communications, aimed to clarify the transmission route, clinical features and outcomes of neonatal (newborns under 28 days old) COVID-19 infections. A total of 176 published cases of neonatal SARS-CoV-2 infections were analysed. Researchers found that 70% of the infections were a result of environmental transmission and occurred after birth. Approximately 30% of the infections were attributed to vertical transmission (from mother to baby either during or straight after birth) which supported the potential of transmission of SARS-CoV-2 across the placenta.
The analysis showed that half the infected babies developed symptoms, the most common was fever followed by gastrointestinal, respiratory and neurological signs. Lung imaging was abnormal in about 64% of cases. These symptoms are similar to those found in adults and had favourable outcomes.
Neonates who were not separated from their infected mothers seemed to have a higher incidence of SARS-CoV-2 infections occurring after the first 72 hours of life. The researchers believe “that a correct and complete counselling should be given to families in order to allow a well-informed choice. This should factor in the benefits of mother-neonate bonding, the risk of neonatal infection, their usually (but not exclusively) benign outcome and the higher maternal contagiousness during the symptomatic period”. Breastfeeding did not appear to be associated with infection suggesting that viral transmission through breast milk is rare.