key: cord-0988211-yqpq1n2t
authors: Siddhi, P. S.; Kollurage, U.; Fassaludhin, N.; Price, M. J.
title: Impact of COVID-19 on Neonatal outcomes
date: 2022-04-01
journal: Pediatr Neonatol
DOI: 10.1016/j.pedneo.2022.03.005
sha: 268dfaef7ed751ebe8c7412e79e99e728aa57836
doc_id: 988211
cord_uid: yqpq1n2t

nan

We would like to extend our congratulations to B. Hekimoglu and F. Acar on their recent publication of "Effects of COVID-19 pandemic period on neonatal mortality and morbidity" 1 . This retrospective cohort study conducted at a tertiary center in Turkey demonstrated high neonatal morbidity and mortality during the pandemic in comparison to the pre-pandemic period. There was a rise in incidences of Hypoxic Ischemic Encephalopathy (HIE) during the first wave of the pandemic. Similarly, we observed high incidence rate of HIE from a large retrospective observational study in a local neonatal unit in the UK within the pre-pandemic and pandemic periods (29 months). The pre-pandemic period included neonates born from January 2019 to March 2020 (15 months) and the pandemic period from April 2020 to May 2021 (14 months). The incidence of preterm births, congenital anomalies, and HIE as well as their mortalities between these periods were compared. Here in, we recorded 8825 live births within the study period. No differences were observed in live births (p = 0.99) and ethnicity (p = 0.66) between the two periods. However, we observed an increase in neonatal admissions (943 vs. 866, p < 0.01), an increase in birth rate with gestational ages within 27-32 weeks (1.3% vs. 0.5%, p < 0.01) and 32-37 weeks (5.4% vs. 3.2%, p < 0.01) during the pandemic period as compared to pre-pandemic period.

Although there was a net increase in the occurrence of complex syndromes during the pandemic, it was not significant (p = 0.21). Meanwhile, there was an increase in the incidence of HIE during the pandemic period (0.23% vs. 0.06 %, p = 0.03). All neonates with HIE were SARS-COV2 negative. No differences in the neonatal deaths were observed (0.02% vs. 0.09%, p = 0.2).

Regardless of the similarity in design and methodology, the UK study encompassed a large cohort over a protracted period (two peaks of pandemic). Furthermore, the differences in the health care systems and socio-economic backgrounds cannot be ignored. An increase in neonatal admissions secondary to preterm births was observed in the UK study, similar to a systematic review published in 2021. This review was a patient-level pooled analysis that included 23 studies and revealed an increase in preterm births (< 37 weeks) during the first wave 2 . Findings related to increased incidence of HIE in the UK and the Turkey studies is a cause for concern. HIE is a multi-systemic condition and whether this is a direct or indirect effect of the pandemic needs further validation.

Effects of COVID-19 pandemic period on neonatal mortality and morbidity

Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis