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Neonatal pulmonary function tests in infants born to COVID-19 positive mothers

Journal of Perinatology volume 45, pages 1431–1437 (2025)Cite this article

Subjects

Abstract

Objective

To compare pulmonary function tests (PFTs), specifically passive respiratory system compliance (Crs), in infants of mothers positive for COVID-19 during pregnancy compared to PFTs from a historical cohort of matched, healthy reference infants.

Study design

A prospective cohort study of infants born to COVID-19 positive mothers. Crs was measured with the single breath occlusion technique. Historical cohort data was obtained from a pre-COVID-19 data repository. Respiratory questionnaires were done at 1-year postnatal age.

Results

Twenty-four PFTs in the COVID-19 cohort were compared with PFTs from 24 reference subjects. Infants of the COVID-19 positive mothers had a Crs of 3.57 ml/cmH2O versus 3.76 mL/cmH2O in the reference group (p > 0.05). The remaining PFT outcomes were comparable between groups. The COVID-19 infants reported more allergic symptoms and conditions through 1-year.

Conclusion

We found no difference in Crs in infants of mothers with COVID-19 during pregnancy compared to a historical pre-COVID reference cohort.

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Fig. 1: Participant flow tree offspring of COVID-19+ pregnant women.

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Data availability

Datasets that support the findings of this study are available from the corresponding author, upon reasonable request.

References

  1. WHO Coronavirus (COVID-19) dashboard (2020). Accessed: 29th Sept 2024: https://covid19.who.int

  2. Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320.

    Article  PubMed  Google Scholar 

  3. Angelidou A, Sullivan K, Melvin PR, Shui JE, Goldfarb IT, Bartolome R, et al. Association of Maternal Perinatal SARS-CoV-2 Infection With Neonatal Outcomes During the COVID-19 Pandemic in Massachusetts. JAMA Netw Open. 2021;4:e217523.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395:809–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. DeBolt CA, Bianco A, Limaye MA, Silverstein J, Penfield CA, Roman AS, et al. Pregnant women with severe or critical coronavirus disease 2019 have increased composite morbidity compared with nonpregnant matched controls. Am J Obstet Gynecol. 2021;224:510.

    Article  Google Scholar 

  6. Gurol-Urganci I, Jardine JE, Carroll F, Draycott T, Dunn G, Fremeaux A, et al. Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection at the time of birth in England: national cohort study. Am J Obstet Gynecol. 2021;225:522.

    Article  PubMed Central  Google Scholar 

  7. Villar J, Ariff S, Gunier RB, Thiruvengadam R, Rauch S, Kholin A, et al. Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatr. 2021;175:817–26.

    Article  PubMed  Google Scholar 

  8. Lindsay L, Calvert C, Shi T, Carruthers J, Denny C, Donaghy J, et al. Neonatal and maternal outcomes following SARS-CoV-2 infection and COVID-19 vaccination: a population-based matched cohort study. Nat Commun. 2023;14:5275.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Faure-Bardon V, Isnard P, Roux N, Leruez-Ville M, Molina T, Bessieres B, et al. Protein expression of angiotensin-converting enzyme 2, a SARS-CoV-2-specific receptor, in fetal and placental tissues throughout gestation: new insight for perinatal counseling. Ultrasound Obstet Gynecol. 2021;57:242–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Letko M, Marzi A, Munster V. Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B betacoronaviruses. Nat Microbiol. 2020;5:562–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Li M, Chen L, Zhang J, Xiong C, Li X. The SARS-CoV-2 receptor ACE2 expression of maternal-fetal interface and fetal organs by single-cell transcriptome study. PLoS One. 2020;15:e0230295.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Manjili RH, Zarei M, Habibi M, Manjili MH. COVID-19 as an Acute Inflammatory Disease. J Immunol. 2020;205:12–9.

    Article  CAS  PubMed  Google Scholar 

  13. Gappa M, Colin AA, Goetz I, Stocks J. Passive respiratory mechanics: the occlusion techniques. Eur Respir J. 2001;17:141–8.

    Article  CAS  PubMed  Google Scholar 

  14. McEvoy CT, Schilling D, Clay N, Jackson K, Go MD, Spitale P, et al. Vitamin C supplementation for pregnant smoking women and pulmonary function in their newborn infants: a randomized clinical trial. JAMA. 2014;311:2074–82.

    Article  PubMed  PubMed Central  Google Scholar 

  15. McEvoy C, Venigalla S, Schilling D, Clay N, Spitale P, Nguyen T. Respiratory function in healthy late preterm infants delivered at 33-36 weeks of gestation. J Pediatr. 2013;162:464–9.

    Article  PubMed  Google Scholar 

  16. Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiology of COVID-19 Among Children in China. Pediatrics. 2020;16:e20200702.

  17. Stoicescu ER, Iacob R, Iacob ER, Ghenciu LA, Oancea C, Manolescu DLTiny Lungs, Big Differences: Navigating the Varied COVID-19 Landscape in Neonates vs. Infants via Biomarkers and Lung Ultrasound. Biomedicines. 2024;12:425.

  18. Doratt BM, Sureshchandra S, True H, Rincon M, Marshall NE, Messaoudi I Mild/asymptomatic COVID-19 in unvaccinated pregnant mothers impairs neonatal immune responses. JCI Insight. 2023;8:e172658.

  19. Camporota L, Cronin JN, Busana M, Gattinoni L, Formenti F. Pathophysiology of coronavirus-19 disease acute lung injury. Curr Opin Crit Care. 2022;28:9–16.

    PubMed  Google Scholar 

  20. Ozturk GK, Beken B, Dogan S, Akar HH. Pulmonary function tests in the follow-up of children with COVID-19. Eur J Pediatr. 2022;181:2839–47.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Ishqeir A NAAIGM. Increased Incidence of Persistent Pulmonary Hypertension of the Newborn Following Third Trimester Matrenal COVID-19 Infection. Eur Heart J. 2021. https://doi.org/10.1093/eurheartj/ehab724.1843.

  22. Iovine E, Di MG, Nenna R, La Regina DP, Mancino E, Petrarca L, et al. Lung function after SARS-CoV-2 infection: A prospective cohort study in children. Pediatr Pulmonol. 2023;58:2009–16.

    Article  PubMed  Google Scholar 

  23. Rigby FB, Pastorek JG. Pneumonia during pregnancy. Clin Obstet Gynecol. 1996;39:107–19.

    Article  CAS  PubMed  Google Scholar 

  24. Benedetti TJ, Valle R, Ledger WJ. Antepartum pneumonia in pregnancy. Am J Obstet Gynecol. 1982;144:413–7.

    Article  CAS  PubMed  Google Scholar 

  25. Man OM, Azamor T, Cambou MC, Fuller TL, Kerin T, Paiola SG, et al. Respiratory distress in SARS-CoV-2 exposed uninfected neonates followed in the COVID Outcomes in Mother-Infant Pairs (COMP) Study. Nat Commun. 2024;15:399.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Wroblewska-Seniuk K, Basiukajc A, Wojciechowska D, Telge M, Miechowicz I, Mazela J. Clinical Characteristics of Newborns Born to Mothers with COVID-19. J Clin Med. 2021;10:4383.

  27. Pawar R, Gavade V, Patil N, Mali V, Girwalkar A, Tarkasband V, et al. Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series. Children. 2021;8:572.

  28. Jordan BK, McEvoy CT. Trajectories of Lung Function in Infants and Children: Setting a Course for Lifelong Lung Health. Pediatrics. 2020;146:e20200417.

  29. McEvoy CT, Spindel ER. Pulmonary Effects of Maternal Smoking on the Fetus and Child: Effects on Lung Development, Respiratory Morbidities, and Life Long Lung Health. Paediatr Respir Rev. 2017;21:27–33.

    PubMed  Google Scholar 

  30. Owens L, Laing IA, Zhang G, Turner S, Le Souef PN. Airway function in infancy is linked to airflow measurements and respiratory symptoms from childhood into adulthood. Pediatr Pulmonol. 2018;53:1082–8.

    Article  PubMed  Google Scholar 

  31. Olsen SJ, Winn AK, Budd AP, Prill MM, Steel J, Midgley CM, et al. Changes in Influenza and Other Respiratory Virus Activity During the COVID-19 Pandemic - United States, 2020-2021. MMWR Morb Mortal Wkly Rep. 2021;70:1013–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Oregon Wildfire Response and Recovery-2020 Labor Day Wildfires After Action Report. 2024. https://wildfire-auth.oregon.gov/Documents/DMTF%20After%20Action%20Report.pdf

  33. Goshen S, Novack L, Erez O, Yitshak-Sade M, Kloog I, Shtein A, et al. The effect of exposure to particulate matter during pregnancy on lower respiratory tract infection hospitalizations during first year of life. Environ Health. 2020;19:90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors would like to thank the families who participated in this study and the neonatologists, obstetricians, neonatal fellows, and the staff of our Neonatal Intensive Care Unit for their help with the study.

Funding

Support from the Oregon Clinical and Translational Research Institute funded by grant UL1TR000128 from the National Center for Advancing Translational Sciences (CTM, KR) and the Pratt Family Foundation (KR).

Author information

Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA

    Katy Ruch, Kseniya Parkhotyuk, Diane Schilling, Mathew Olson, Kristin Milner & Cindy T. McEvoy

  2. Division of Pediatric Pulmonology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA

    Kelvin D. MacDonald

  3. Department of Psychology, Portland State University, Portland, OR, USA

    Shawn Mehess

Authors
  1. Katy Ruch
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  2. Kelvin D. MacDonald
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  3. Kseniya Parkhotyuk
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  4. Diane Schilling
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  7. Kristin Milner
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  8. Cindy T. McEvoy
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Contributions

KR: Data collection, data interpretation, primary author, KDM: Assisted in drafting the manuscript, KP, DS & MO: PFT data collection, KM: Assisted in study design & data collection, SM: Statistical analysis, CM: Principle investigator, study design, data interpretation, assisted in drafting the manuscript.

Corresponding author

Correspondence to Cindy T. McEvoy.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This study protocol was approved by the OHSU Institutional Review Board (IRB). Informed consent was obtained by the parent of each infant enrolled. This study was performed in accordance with the Declaration of Helsinki.

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Ruch, K., MacDonald, K.D., Parkhotyuk, K. et al. Neonatal pulmonary function tests in infants born to COVID-19 positive mothers. J Perinatol 45, 1431–1437 (2025). https://doi.org/10.1038/s41372-025-02237-w

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