Background: This study is to estimate the prevalence and to determine the risk factors for neonatal Covid-19 infection .

Methods: Retrospective analysis of all deliveries in Covid-19-infected mothers in a tertiary care centre in North Kerala from 15 April 2020 to 15 October 2020 .

Results: Of the 350 Covid-19-positive pregnancies 223 delivered, two were intrauterine foetal demises . In total , 32 out of 221 newborns were Covid-19-positive (14.47 %). The risk was more in vaginal delivery group (17.39 %) compared to caesarean group (13.16 %). The breastfeeding and rooming-in group (18.79 %) had more infection than those babies who were not breastfed and separated from mother (1.78 %).14 out of 86 (16.28 %) babies delivered within 7 days of mothers turning negative became positive compared to 2 out of 23 (8.7 %) babies delivered between 7 and 14 days of negative result (Odds ratio of 2.04). None of the babies delivered 14 days after negative result has become positive .

Conclusions: The present study shows that neonatal Covid-19 infection is not rare . The risk is greater in vaginal delivery group and those babies who are breastfed and allowed to stay with mothers . Delaying delivery more than 7 days after mother becoming negative protects the newborn from getting infection.