Evaluation of Neonatal Outcomes in COVID-19 Positive Mothers Who Received Monoclonal Antibodies

To evaluate neonatal outcomes of mothers who had allergic reactions to monoclonal antibody (MAB) therapy. This is a retrospective cohort analysis of SARS-CoV-2 positive pregnant patients who received monoclonal antibodies for COVID-19 disease at a teaching community hospital from April 2021 to January 2022. Patients with allergic reactions to monoclonal antibodies were compared to those with no allergic reaction. Neonatal outcomes were compared in both groups including APGAR scores, birth weight, birth height, neonatal ICU admission, intubation, and length of hospital stay. Of the total 199 patients who received MAB, delivery data was available for 187 patients. Out of the 187 patients, 21 had allergic reactions. Mean gestational age was similar for both groups: 38 weeks 5 days ±1.4 days in the reaction group, 38 weeks and 3 days ± 3 days in the non-reaction group (p =0.36). Fetal weight was 3385 grams ± 484 g in the reaction group, 3319 grams ± 560 g in the non-reaction group (p = 0.52). Neonatal height 51.2cm ±2 cm in the reaction group, 50.5cm ±3.56 cm in the non-reaction group (p = 0.19). Median APGARs at 1 and 5 minutes were 8/9in the reaction group and 8/9 in the non-reaction group. None (0%) of the neonates in the allergic reaction group required NICU admission, with 14 (8.4%) in the non-reaction group requiring admission. Average newborn hospital stay in the reaction group was 1.9(±0.9) days, and in the non-reaction group 2.6±4.8 (p=0.24) days. There was no statistical difference in neonatal outcomes amongst mothers who had allergic reactions to COVID-19 MAB and those who did not.