BackgroundCoronavirus disease 2019 (COVID-19) in pregnant women and neonates may adversely affect neonatal outcome, but literature remains limited.MethodsThis is a retrospective analysis of all infants born to mothers with and without COVID-19 at an Indonesian national referral hospital between March and September 2020.ResultsA total of 393 neonates were delivered by 389 mothers, of whom 204 (52.4%) had COVID-19. Symptomatic and asymptomatic mothers with COVID-19 had similar seropositivity rates (53.6% vs 69.8%, p = 0.090). Neonates born to noninfected mothers were more likely to experience asphyxia at minute 1 of life (p = 0.005), to be diagnosed with TTN (p = 0.048) and sepsis (p = 0.022) and to require resuscitation (p = 0.008) than those born to infected mothers. Nine (2.4%) out of 377 tested infants were positive for SARS-CoV-2, of whom 4 had noninfected mothers. Neonates of mothers with symptomatic COVID-19 were less likely to be seropositive (30.0% vs 52.4%, p = 0.024) and more likely to acquire COVID-19 (p = 0.026) than those born to asymptomatically infected mothers.ConclusionThis study suggests that maternal COVID-19, particularly when occurring in late pregnancy, was not associated with an increase in acute neonatal complications.