Peer-reviewed article
49. Effects of Maternal SARS-CoV-2 Infection on Neonatal Discharge Planning and Care: Exacerbation of Racial and Ethnic Healthcare Disparities
Jubulis J, Goddard A, Dibrigida S, McCarthy C ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how maternal SARS-CoV-2 infection affected newborn discharge planning and follow-up care at a large hospital in Maine between March 2020 and April 2021. Infants born to mothers with COVID-19 were more likely to be from racial and ethnic minority families, and these infants experienced significant delays in receiving in-person follow-up care compared to non-minority infants. The study found that only 13% of newborns born to infected mothers from racial minority backgrounds received an initial in-person follow-up visit with their primary care provider, compared to 56% of non-minority infants, despite recommendations for evaluation within 3-5 days after discharge.
Key points
- 63% of infants born to SARS-CoV-2 positive mothers were racial minorities, compared to 21% of unexposed infants
- Only 29% of infants exposed to maternal SARS-CoV-2 had an initial in-person follow-up visit with their primary care provider
- BIPOC infants had a median time to in-person follow-up of 21 days compared to 7.5 days for non-minority infants
- All discharged families received a thermometer and scale for home management, and no infants required readmission within one month
- The pandemic created barriers to following American Academy of Pediatrics recommendations for newborn evaluation 3-5 days after discharge, particularly for racial minority families
Limitations
This is a small single-site study with 24 exposed and 24 unexposed infants, limiting generalisability beyond Maine Medical Center. The study describes disparities but does not establish the mechanisms causing delayed follow-up or assess longer-term health outcomes beyond the first month.
Abstract
Abstract Background SARS-CoV-2 has exacerbated healthcare disparities. Maine’s population of 1.3 million is comprised of only 6% Black, Indigenous, People of Color (BIPOC); however, statewide 18% of SARS-CoV-2 infections have occurred in this group. This study examines newborn care inequities for infants born to mothers with SARS-CoV-2. Methods This study was conducted at Maine Medical Center in Portland, the largest hospital in Maine. Maternal SARS-CoV-2 infections from March 15, 2020 through April 1, 2021 were identified by PCR near time of delivery. Cases were matched to uninfected women by date of delivery. Chart review was conducted assessing demographic and clinical characteristics, comparing SARS-CoV-2 exposed and unexposed infants. The subset of SARS-CoV-2 exposed infants was further analyzed for trends in care by race. Protocol was exempt by MaineHealth IRB. Results Twenty four women and their infants were identified with maternal positive SARS-CoV-2 PCR just prior to delivery. An additional 24 unexposed infants were enrolled. When compared to unexposed infants, SARS-CoV-2 exposed were more likely to be racial minorities (63% vs 21%, p = 0.003), to have foreign-born mothers (58% vs 0.4%, p< 0.05) or to receive health care in a language other than English (29% vs 0.4%, p =0.02). For infants born to SARS-CoV-2 infected mothers, only 29% had initial follow up visit in person with their primary care provider (13% of BIPOC infants vs 56% of non-BIPOC infants, p = 0.03). Time to in-person follow up for exposed infants varied by race, with median time of 21 days (range 2-53 days) for racial minorities and 7.5 days (range 2-30 days) for non minorities. All families were discharged with a thermometer and scale for home management. No infants required re-admission during the month after discharge. One exposed infant tested positive for SARS-CoV-2. Conclusion The American Academy of Pediatrics recommends evaluation of newborns 3-5 days after discharge to identify maternal and child health factors affecting newborn well-being. The SARS-CoV-2 pandemic has made this challenging for patients, particularly for racial minorities. BIPOC pediatric patients were disproportionately affected by the pandemic in Maine, and were disproportionately affected by care discrepancies even when the infant was uninfected. Disclosures All Authors: No reported disclosures