SHEA Pediatric Leadership Council commentary: Ambulatory management of neonates born to mothers infected with severe acute respiratory coronavirus virus 2 (SARS-CoV-2)

Available data indicate that vertical transmission of SARS-CoV-2 infection is very uncommon, but the risk of infection from transmission in the delivery room or in the days after delivery has not been established.2 The Centers for Disease Control and Prevention (CDC) considers a neonate born to a SARS-CoV-2 polymerase chain reaction (PCR)–positive woman to have suspected infection.3 As such, these neonates are potentially contagious. Newborns of women with a history of symptomatic or asymptomatic SARS-CoV-2 infection with onset of symptoms or SARS-CoV-2 detection, respectively, >10 days prior to delivery (or >20 days in cases of severe infection or an immunocompromised status) are not contagious. [...]the newborn can be cared for using standard isolation precautions unless there is concern for exposure from other persons in the household or close contacts. 3. Personnel who will be in the exam room with the neonate should also wear eye protection (ie, eye shields, face shields, or safety goggles; regular eyeglasses are not sufficient), gown, and gloves.5 A surgical mask is sufficient, but according to the local health system and department of health guidelines, an N95 respirator or higher level of protection can be used. c. If needed, an oropharyngeal or nasopharyngeal swab can be obtained in the ambulatory office setting while wearing PPE recommended by the health system for test collection. [...]it is plausible that an infant may acquire SARS-CoV-2 in the delivery room, from the mother while rooming in, or from another person in the household or close contact following hospital discharge. [...]infants should be considered potentially infected until at least 14 days after the last exposure to an infectious household member or close contact.