Clinical and immunological characteristics of full-term newborns from mothers with COVID-19 during pregnancy

The long-term consequences of COVID-19 still remain among priority issues. Special attention should be paid to the state of health of newborns whose mothers suffered a coronavirus infection during pregnancy. The aim of our study was to evaluate clinical and immunological parameters in full-term newborns from mothers who underwent COVID-19 during pregnancy. We have performed a prospective cohort comparative study. A group of full-term newborns from mothers who had mild or moderate COVID-19 at different stages of pregnancy (n = 134) was compared with a group of newborns from mothers who were not exposed to SARS-CoV-2 infection during their pregnancy (n = 84). Individual health indices and immunological characteristics were also evaluated at the age of 3 months of infants’ life. For statistical analysis, the Microsoft Excel computer software package (2010), SPSS Statistics version 22.0 (IBM Microsoft, USA) was used. Statistical hypotheses about the absence of intergroup differences in quantitative characteristics were tested using the Mann–Whitney U criterion, the Student’s criterion, and binary characteristics were assessed with Chi-square test (÷2). Qualitative data are presented as an absolute value (n) and percentages. The results were considered reliable at a significance level of p0.05. It was found that, in the neonatal period, there were no statistically significant differences in gender characteristics, anthropometric characteristics and Apgar scores between the groups. There were no differences in the incidence rate in the neonatal period. At the age of 3 months of life, there was a higher incidence of somatic and neurological morbidity in children whose mothers had suffered a new coronavirus infection during pregnancy (OR = 3.78 (1.5; 9.51); p0.001). It was found that the levels of hematocrit (p = 0.001), lymphocytes (p0.001), platelets (p0.001) were statistically significantly lower in newborns in group I. When analyzing the levels of umbilical cord blood cytokines in the two groups, it was found that the levels of TNF, IL-6, VEGF-A, IL-10, IL-1á, IL-1â, IL-8 (p ≤ 0.001) were higher in group I compared with group II. The levels of cytokines in their mothers showed a positive correlation with appropriate indexes in umbilical cord blood. Strong positive associations were found in the mother-child pairs on the 3rd trimester of pregnancy, in terms of TNFá, IL-1â, moderate positive correlations were revealed for IL-8, IL-10. Hence, despite the absence of clinical manifestations of infectious process and other disorders of early neonatal adaptation, the laboratory changes in general blood counts and active expression of proinflammatory cytokines in newborns whose mothers suffered COVID-19 during pregnancy may suggest the presence of a fetal systemic inflammatory response. An increased morbidity at the age of 3 months may be the result of low-level inflammation.