Background

Increased risks for poor neonatal outcomes have been reported for maternal SARS-CoV-2 and other pathogenic viral diseases including SARS, MERS, influenza; and Zika virus which has serious adverse effects on fetal growth and brain development.

The COVID-19 in pregnancy (CovPreg) has observed adverse effects of the pandemic on pregnant women, and in a separate study, known as THRIVE-GEN, we are tracking early childhood development, and seeing evidence of developmental delays, and poor home environment for child development, and family stress.

Given the limited knowledge of the maternal biomedical and psychosocial effects of COVID-19 on neonatal health, it is important to assess these effects, and implications may influence interventions to mitigate the effects of COVID-19 on neonatal health and development, such as more intensive vaccine policy for pregnant women and infants.

Primary objectives

1. Measure the SARS-CoV-2 burden in newborns:

• What is the prevalence of SARS-CoV-2 infection as assessed during the neonatal period?
• What is the prevalence of detectable maternal antibody (Ab) to SARS-CoV-2 during the neonatal period, and what is the persistence of such Ab at 6 months of age?
• What is the incidence of COVID-19 in infants during the first year?
• What is the morbidity and mortality of infants of SARS-CoV-2 exposed women.

2. Measure the level of COVID-19-related social factors:

• What is the stress in households and the nurturing and stimulation practices?
• What are the care-seeking practiced for post-natal care for infants?
• What is infant development at 6 months and 12 months?

3. Determine the COVID-19-associated morbidity, mortality and poor development of newborns/infants due to the above conditions.