The Severity of Respiratory Distress Syndrome in Preterm Infants Born to Mothers with COVID-19 Infection

Background: Respiratory distress syndrome (RDS) is one of the most common respiratory problems in preterm infants. Many pregnant mothers were affected during the COVID-19 pandemic. However, there is limited information about the neonatal consequences in premature infants born to infected mothers. Distinguishing between the respiratory symptoms of COVID-19 and RDS is currently a challenge. Objectives: The present study was conducted to investigate the severity of RDS in premature infants with a gestational age of less than 34 weeks born to mothers infected with COVID-19. Methods: We performed a retrospective study including 60 premature infants with a gestational age of less than 34 weeks. Thirty of these infants were born to mothers infected with COVID-19, while the remaining 30 infants were born to mothers not infected with COVID-19. All infants were admitted to the NICU from March 2020 to September 2021. The primary outcome was the need for surfactant replacement therapy. Results: The patients in both groups were similar with respect to demographic characteristics. The duration of respiratory support was 12.92 ± 2.22 days in the COVID-positive group (group P) and 16.04 ± 3.72 days in the COVID-negative group (group N), with a P-value of 0.47. The need for auxiliary oxygen was 16.43 ± 3.59 days in group P and 16.10 ± 3.59 days in group N, with a P-value of 0.94. The length of hospital stay was 16.13 ± 2.60 days in group P and 19.37 ± 3.87 days in group N, with a P-value of 0.49. The need for resuscitation after birth was observed in 17 (56.7%) infants in group P and 6 (20%) infants in group N, with a P-value of 0.003. Five infants in group P had a fever, with a P-value of 0.03. Positive C-reactive protein (CRP) was detected in 17 (56.6%) infants in group P and 6 (20%) in group N, with a P-value of 0.003. Conclusions: In this study, the severity of neonatal RDS and mortality was not affected by maternal COVID-19 infection. Delivery room resuscitation was more frequently needed, and fever was more common in these infants. More studies are recommended to determine the neonatal respiratory consequences of COVID-19 infection with a larger number of patients.