Impact of Gestational COVID-19 on Neonatal Outcomes

Abstract

Background: The vertical transmission of severe acute respiratory coronavirus-2 (SARS-CoV-2) remains highly debated. Here, we evaluated SARS-CoV-2-transmission in newborns with intrauterine conditions. Methods: This was a prospective, observational and multicentric study involving 13 Spanish hospitals included in the GEStational and NEOnatal-COVID cohort. Pregnant women with microbiologically confirmed SARS-CoV-2 infection during any trimester of pregnancy or delivery and their newborns were included from March to November 2020. Demographic, clinical and microbiological data were also obtained. Viral loads were analyzed in different maternal and newborn biological samples (placenta, breast milk and maternal blood; urine, meconium and newborn blood). Results: A total of 177 newborns exposed to SARS-CoV-2 were included. Newborns were tested by reverse transcriptase-polymerase chain reaction using nasopharyngeal swabs within the first 24–48 hours of life and at 14 days of life. In total 5.1% were considered to have SARS-CoV-2 infection in the neonatal period, with 1.7% considered intrauterine and 3.4% intrapartum or early postnatal transmission cases. There were no differences in the demographic and clinical characteristics of the pregnant women and their newborns’ susceptibility to infections in their perinatal history or background. Conclusions: Intrauterine transmission of SARS-CoV-2 is possible, although rare, with early postnatal transmission occurring more frequently. Most infected newborns remained asymptomatic or had mild symptoms that evolved well during follow-up. We did not find any maternal characteristics predisposing infants to neonatal infection. All infected newborn mothers had acute infection at delivery. Although there was no presence of SARS-CoV2 in cord blood or breast milk samples, SARS-CoV-2 viral load was detected in urine and meconium samples from infected newborns.

Can SARS-CoV-2 positive pregnant women affect the hearing of their newborns: A systematic review

“…However, SARS-CoV-2 can invade placental tissue and cause infection and inflammation in placental cells [35] . A prospective, multicenter investigation found that infection occurred in 5.1 % of newborns born to mothers infected with SARS-CoV-2 during pregnancy, implying that SARS-CoV-2 can be transmitted intrauterine [36] . Strong evidence from another study revealed that 12 % of SARS-CoV-2-positive pregnant women transmit the virus intrauterine, and that intrauterine transmission may even occur in asymptomatic individuals [37] .…”

SARS-CoV2 Infection During Pregnancy Causes Persistent Immune Abnormalities in Women Without Affecting the Newborns

“…The probability of viral vertical and perinatal transmission is still controversial. Some studies support that transmission of SARS-CoV2 during pregnancy is extremely low (18)(19)(20) while other published series have reported several cases of CoVid-19 infected newborns (21)(22)(23)(24). Nevertheless, it has been observed that a potent antibody response (IgM, IgG and IgA, especially) occurs in the serum and milk of mothers infected with SARS-CoV2 during pregnancy that can be transferred to the foetus before and after the birth.…”

Confirmed SARS-CoV-2 infection in Scottish neonates 2020-2022: a national, population-based cohort study

“…In keeping with the published rates of mother to infant transmission (5), we found just under 2% of babies born to women positive for SARS-CoV-2 at birth also had a positive test at some point in the neonatal period. Not all babies of infected women were tested at birth (see below), and it is possible that rates may have been higher if all were screened (10).…”