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SARS-CoV-2 Infection Among Maternal-Infant Dyads in Ontario, Canada

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Although reports of COVID-19 infection among infants are rare,13 many professional bodies have issued recommendations for the screening and management of neonates.24 Since April 1, 2020, polymerase chain reaction testing within 24 hours of birth has been recommended in Ontario—Canada’s largest province—for all infants born to mothers with confirmed SARS-CoV-2 infection at delivery.2 For this study, population-based birth registry, laboratory, and public health case data were assessed to describe SARS-CoV-2 testing outcomes among infants born during the COVID-19 pandemic and their mothers.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: June 1, 2021.

Published: August 9, 2021. doi:10.1001/jamanetworkopen.2021.20150

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Fitzpatrick T et al. JAMA Network Open.

Corresponding Author: Astrid Guttmann, MDCM, MSc, ICES, G1 06, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada (astrid.guttmann@ices.on.ca).

Author Contributions: Mr Wilton and Dr Guttmann had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Fitzpatrick, Chung, Guttmann.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Fitzpatrick, Guttmann.

Critical revision of the manuscript for important intellectual content: Fitzpatrick, Wilton, Chung.

Statistical analysis: Fitzpatrick, Wilton.

Administrative, technical, or material support: Fitzpatrick, Guttmann.

Supervision: Guttmann.

Conflict of Interest Disclosures: Dr Guttmann reported receiving funding through ICES from the Ontario Ministry of Health (MOH) to ICES (formerly, the Institute for Clinical Evaluative Sciences), including specific funding for COVID-19–related work during the conduct of the study. No other disclosures were reported.

Funding/Support: This study was supported by ICES, which is funded by the Ontario MOH and MLTC, as well as the Ontario Health Data Platform (OHDP), a Province of Ontario initiative to support Ontario’s ongoing response to COVID-19 and its related effects.

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The opinions, results, and conclusions are those of the authors and are independent from the funding source. No endorsement by ICES, the Ontario MOH or MLTC, the OHDP and its partners, or the Province of Ontario is intended or should be inferred.

Additional Contributions: The authors thank Public Health Ontario for access to case level data from the integrated Public Health Information System (iPHIS); Case and Contact Management System (CCM) Plus, and COVID-19 laboratory data as well as assistance with data interpretation. They also thank the staff of Ontario’s public health units who are responsible for COVID-19 case and contact management and data collection within iPHIS/CCM Plus.

Additional Information: Parts of this report are based on data and information compiled and provided by the Ontario MOH, the Canadian Institute for Health Information, and Public Health Ontario.

References
1.
Edlow  AG , Li  JZ , Collier  AY ,  et al.  Assessment of maternal and neonatal SARS-CoV-2 viral load, transplacental antibody transfer, and placental pathology in pregnancies during the COVID-19 pandemic.   JAMA Netw Open. 2020;3(12):e2030455. doi:10.1001/jamanetworkopen.2020.30455 PubMedGoogle Scholar
2.
Cavicchiolo  ME , Trevisanuto  D , Lolli  E ,  et al.  Universal screening of high-risk neonates, parents, and staff at a neonatal intensive care unit during the SARS-CoV-2 pandemic.   Eur J Pediatr. 2020;179(12):1949-1955. doi:10.1007/s00431-020-03765-7 PubMedGoogle ScholarCrossref
3.
Stuebe  A .  Should infants be separated from mothers with COVID-19? first, do no harm.   Breastfeed Med. 2020;15(5):351-352. doi:10.1089/bfm.2020.29153.ams PubMedGoogle ScholarCrossref
4.
Provincial Council for Maternal and Child Health. Maternal-neonatal COVID-19 general guideline. Updated October 22, 2020. Accessed February 1, 2021. https://www.pcmch.on.ca/wp-content/uploads/2020/10/MatNeo-COVID-19-Guide_OCT222020.pdf
5.
Chung  H , Fung  K , Ferreira-Legere  LE ,  et al. COVID-19 laboratory testing in Ontario: patterns of testing and characteristics of individuals tested, as of April 30, 2020. ICES. Accessed September 30, 2020. https://www.ices.on.ca/Publications/Atlases-and-Reports/2020/COVID-19-Laboratory-Testing-in-Ontario
6.
Ronchi  A , Pietrasanta  C , Zavattoni  M ,  et al.  Evaluation of rooming-in practice for neonates born to mothers with severe acute respiratory syndrome coronavirus 2 infection in Italy.   JAMA Pediatr. 2021;175(3):260-266. doi:10.1001/jamapediatrics.2020.5086 PubMedGoogle ScholarCrossref
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