SARS-CoV-2 in first trimester pregnancy – does it affect the fetus?

Abstract

Background Several viral infections are known to be harmful to the fetus in the first trimester of pregnancy and can cause increased nuchal translucency thickness and pregnancy loss. Currently, no evidence exists regarding possible effects of SARS-CoV-2 in first trimester pregnancies. Methods Cohort 1 included pregnant women with a double test taken between Feb. 17 and Apr. 23, 2020, during the SARS-CoV-2 epidemic peak in Denmark. The double test was taken as part of the first trimester risk assessment. Cohort 2 included women with a first trimester pregnancy loss before double test. Serum from the double test or from a blood sample, in case of pregnancy loss, was analyzed for SARS-CoV-2 antibodies. The results were correlated to the nuchal translucency thickness and the number of pregnancy losses. Results In total, 1,019 pregnant women with double test and 36 women with pregnancy loss participated in the study. Thirty (2.9%) women had SARS-CoV-2 antibodies in the serum from the double test. All women with pregnancy loss prior to the double test were negative for SARS-CoV-2 antibodies. There were no significant differences in nuchal translucency thickness for women testing positive (n=14) versus negative (p=0.20) or grey zone (n=16) versus negative (p=0.28). In total, 54 women experienced a pregnancy loss of whom two had grey zone or positive SARS-CoV-2 antibodies. Conclusion Maternal SARS-CoV-2 infection did not seem harmful in first trimester pregnancies. Infection had no effect on the nuchal translucency thickness and women with SARS-CoV-2 antibodies were not overrepresented among women with pregnancy loss.

COVID-19 and Pregnancy: Vertical Transmission and Inflammation Impact on Newborns

“…For these reasons, cohort studies were performed on pregnant women infected with SARS-CoV-2 either in their first or second trimester, to seek the correlation between miscarriage and COVID-19. Cosma S et al and La Cour Freiesleben N et al came to the conclusion that there was no correlation between infection in the first trimester and miscarriage referring to their cohort studies [ 51 , 52 , 53 ]. However Shende P et al reported the case of an asymptomatic pregnant woman tested positive for SARS-CoV-2 at her 8th week of gestation who ended up negative at 13th week of gestation with fetal demise revealed by ultrasonography.…”

COVID-19 and Pregnancy

“…In this way, caution is needed when extrapolating this results to the population of other countries. 36 Thus, due to the lack of evidence, it is recommended that embryos/fetuses and or placentae aborted by pregnant women with COVID-19 should be treated as infected tissues and adequately discarded. The study of material via histopathological examination and RT-PCR test for SARS-CoV-2 should be performed whenever it is possible.…”

“…We highlight the Danish study that did not find alterations in translucency or double marker test. 36…”

COVID-19: Uncertainties from Conception to Birth

“…Infection was not associated with increased thickness of the nuchal translucency or risk of pregnancy loss. 55 However, other viruses, depending on the gestational age at the moment of infection, have been associated with congenital anomalies and developmental delay later on, like Zika. 56 Thus, the little time since the first studies on the behavior of SARS-CoV-2 is insufficient to evaluate its real impact on neonates.…”