65 Outcomes of Neonates Admitted to the NICU during the COVID-19 Pandemic: Comparison with a Pre-Pandemic Cohort

Abstract Introduction/Background The effect of the COVID-19 pandemic on neonatal outcomes is not yet completely understood. Objectives To compare the neonatal outcomes of very preterm infants admitted to Canadian NICUs pre- and during the COVID-19 pandemic. Design/Methods This retrospective cohort study included infants born <33 weeks and admitted to tertiary Canadian NICUs participating in the Canadian Neonatal Network (CNN) database. The sample included 14,368 infants from two cohorts: 7,280 infants pre-pandemic (April 1, 2018 – December 31, 2019) and 7,088 infants during the pandemic (April 1, 2020 – December 31, 2021). Primary composite outcomes were mortality or major morbidity. Care practices and interventions were compared. Relative risk (RR) comparing the pandemic vs pre-pandemic periods were estimated using generalized estimated equations and adjusted for confounders. Results The characteristics of infants admitted before and during the pandemic were not significantly different. The incidence of mortality or major morbidity was similar pre- and during the pandemic (37%, 36% respectively; RR=1.01 [0.92, 1.01]; Table 1). Infant health outcomes were not significantly different between periods. There was a non-significant decrease in the exclusive receipt of mothers’ own milk (MOM) at discharge (45% pre- and 37% during; RR=0.85 [0.68, 1.06]). Conclusion There was no difference in clinical outcomes between pre-pandemic and pandemic cohorts. The possibility of lower receipt of exclusive MOM at discharge during the COVID-19 pandemic needs further study.