Author(s)

Perumalsathya Sankaranarayanan¹, Harshitha Shanmuganathan¹, Devika Sanil Kumar², Lal Devayani Vasudevan Nair^1*, Santosh Kamalakannan³

¹Department of Pediatrics, Saveetha Medical College and Hospital, Chennai, India.
²Department of Research and Development, Saveetha Medical College and Hospital, Chennai, India,.
³Department of Neonatology, Saveetha Medical College and Hospital, Chennai, India.

Background: Pregnant women and newborns are highly susceptible to Covid-19, manifesting as multisystem inflammatory syndrome-New-born (MISC-N) in many babies born to Covid positive mothers. The relationship between Covid-19 infection during pregnancy and neonatal neurodevelopmental outcome, if any, is unclear necessitating a follow-up study in this aspect. Methods: 16 babies with MIS-N, born to symptomatic Covid antibody positive mothers were enrolled. Demographic profile, treatment details and biochemical parameters were analyzed with neurodevelopmental follow-up. Results: 25% mothers received 2 doses of Covid vaccine; 50% had oligohydramnios and 75% received antenatal steroids. 87.5% were preterm of which 62.5% required surfactant with ventilator support and 75% required ionotropic support. Significant association was found between the antibody level and D-dimer levels with the ferritin and LDH levels of the baby (p < 0.05); gestational age with LDH and D-dimer levels (p < 0.05) and Covid antibody level of the baby vs the duration of ventilator requirement (P-value-0.0009). D-dimer values of babies were positively associated with both maternal antibody and D-dimer levels. Neurodevelopmental follow-up done at 6 months of corrected gestational age showed 37.5% were normal, 37.5% hypertonic and 25% hypotonic. HINE score was below 60 in 62.5%. Development assessment using Bayley-III showed a delay in the motor domain (62.5%), cognitive domain (56.25%) and language domain (62.5%). Conclusion: Neurodevelopmental problems occur in babies born to Covid positive mothers and should be stratified as “high risk”. Anticipatory guidance to prospective mothers for preterm care should be given. Covid antibody titre and D-dimer levels may help to predict the NICU stay, ventilator requirement and the adverse neurodevelopmental outcomes in these babies.

Neurodevelopment, Covid-19, Pregnancy, Multisystem Inflammatory Syndrome, Biochemical Markers, D-Dimer, HINE Score

Sankaranarayanan, P. , Shanmuganathan, H. , Kumar, D. , Nair, L. and Kamalakannan, S. (2022) Multisystem Inflammatory Syndrome-Neonate: Biochemical Parameters as Early Marker of Adverse Neurodevelopmental Outcome. Open Journal of Pediatrics, 12, 767-782. doi: 10.4236/ojped.2022.125078.