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Inborn Neonates
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* Indicates required question
Reporting Institution / Hospital
*
NCR
Luzon
Visayas
Mindanao
MATERNAL CHARACTERISTICS
Maternal Age
*
<20 years
20-35 years
>35 years
Previous Maternal Morbidity (Pre-pregnancy) / May have multiple answers
*
Obesity
Infertility
Hypothyroidism
Autoimmune disease
Respiratory disease
Coagulation disorder
Heart disease
Hypertension
Diabetes mellitus
None
Other:
Required
Gestational Pathology / May have multiple answers
*
Diabetes
Preeclampsia
Anemia
Hypothyroidism
Chorioamnionitis
PROM
UTI
Respiratory infection
TORCH Infection
None
Other:
Required
Antenatal Corticosteroids Administered
*
Yes
No
Live Births
*
Singleton
Twins
Triplets
Mode of Delivery
*
Vaginal
Cesarean
Maternal COVID-19 Infection During Gestation
*
First Trimester
Second Trimester
Third Trimester
Maternal Clinical Manifestations / May have multiple answers
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Cough
Fever
General malaise or fatigue
Dyspnea
Myalgias
Anorexia
Anosmia and/or ageusia
Odynophagia
Sore throat
Headache
Diarrhea
None
Other:
Required
Rupture of Membranes
*
<18 hours
≥18 hours
Maternal Intensity of Symptoms
*
Asymptomatic
Mild (no signs of pneumonia or hypoxia)
Moderate (with clinical signs of non-severe pneumonia)
Severe (with clinical signs of severe pneumonia or severe ARI)
Critical (with ARDS, sepsis and/or septic shock)
Maternal Diagnostic Tests
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Positive RT- PCR Result
Positive Antigen Result
Positive IgM Antibodies
Positive IgG Antibodies
Highly suggestive clinical features
Interval between first positive maternal test for SARS-CoV-2 and date of neonatal birth
*
≤ 14 days
15 - 30 days
1 - 3 months
>3 months
Interval between onset of first maternal symptoms for SARS-CoV-2 and date of neonatal birth
*
≤ 14 days
15 - 30 days
1 - 3 months
>3 months
Maternal Management / May have multiple answers
*
Hydroxychloroquine
Antimicrobials
Antivirals (Remdesivir)
Low molecular-wt heparin
Interferon b-1b
Dexamethasone
Tocilizumab
Ivermectin
Oxygen therapy
Respiratory support
Other:
Required
Maternal COVID-19 Vaccination
*
Yes
No
Maternal COVID-19 Infection & Vaccination Status
*
Infected, vaccinated
Infected, unvaccinated
Non-infected, vaccinated
Non-infected, unvaccinated
Maternal COVID-19 Vaccination Timing
*
Prepregnancy
During pregnancy, first trimester
During pregnancy, second trimester
During pregnancy, third trimester
None
Maternal COVID-19 Vaccine Type
*
mRNA vaccine (Pfizer, Moderna)
Viral vector vaccine (Astra, Janssen, Sputnik)
Inactivated vaccine (Sinovac, Sinopharm, Covaxin)
Protein subunit vaccine (Novavax)
None
NEONATAL CHARACTERISTICS
Birth Weight
*
<1000 grams
1000 - 1499 grams
1500 - 2499 grams
2500 - 3500 grams
>3500 grams
Gestational Age (completed weeks)
*
<29 weeks
29 - 32 weeks
33 - 36 weeks
37 - 42 weeks
>42 weeks
APGAR Score at 1 Minute
*
0 -3
4 -6
7 - 10
APGAR Score at 5 Minutes
*
0 -3
4 - 6
7 - 10
Neonatal Resuscitation Maneuvers / May have multiple answers
*
Nasopharyngeal suctioning
Positive pressure ventilation
Endotracheal intubation
Cardiac compression
Epinephrine administration
Volume expansion
None
Required
Immediate thorough drying and skin-to-skin contact
*
Yes
No
Properly-timed Cord Clamping
*
Yes
No
Non-separation and early initiation of breastfeeding within 1 hour of life
*
Yes
No
Rooming-in
*
Yes
No
Mode of Feeding
*
Breastfeeding
Bottle-feeding
Cup feeding
Orogastric catheter
Various modes
Type of Feeding
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Mother's own milk
Donated human milk
Mixed
Formula milk
Diagnostic Test
*
RT-PCR
Antigen Test
Age First RT-PCR Test Taken
*
Birth to <24 hours
24 - 48 hours
49 - 72 hours
>72 hours
First RT-PCR Test Result
*
Positive
Negative
Second RT-PCR Test Taken
*
Yes
No
Age Second RT-PCR Test Taken
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48 - 72 hours
>72 hours
Not taken
Second RT-PCR Test Result
*
Positive, previous negative
Positive, previous positive
Negative, previous positive
Negative, previous negative
Not taken
Admission to the NICU
*
Yes, immediately after birth
Yes, after having been roomed-in
Yes, after having been discharged
No
Neonatal Signs During Hospitalization / May have multiple answers
*
Fever (>37.8° C)
Cough
Cyanosis
Respiratory distress
Vomiting/diarrhea
Abdominal distention/feeding intolerance
Hypotonia
Seizures
None
Other:
Required
Onset of Neonatal Symptoms
*
<24 hours
24 - 72 hours
>72 hours
Asymptomatic
Maximal Level of Respiratory Support During Hospitalization
*
Supplemental oxygen
CPAP
NIPPV
Mechanical ventilation/CMV
None
Interventions Given / May have multiple answers
*
Antibiotics
Antivirals
Intravenous fluids
Iloprost
Sildenafil
Dopamine
Dobutamine
Epinephrine
Surfactant
Hydrocortisone
Dexamethasone
Intravenous Immunoglobulin (IVIG)
Therapeutic hypothermia
None
Other:
Required
Duration of Hospital Stay
*
1 - 7 days
8 - 14 days
>14 days
Disposition
*
Home discharge with mother
Home discharge with caregiver
Isolation Unit (TTMF) discharge with mother
Isolation Unit (TTMF) discharge with caregiver
Regular discharge after prolonged NICU stay with resolution of medical problems
Died
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