SARS-CoV-2 vertical transmission in a twin-pregnant woman: a case report

Sessa, Rosa; Masciullo, Luisa; Filardo, Simone; Pietro, Marisa Di; Brandolino, Gabriella; Brunelli, Roberto; Gabriela, Paola; Terrin, Gianluca; Viscardi, Maria Federica; Anastasi, Emanuela; Porpora, Maria Grazia

doi:10.1016/j.ijid.2022.10.019

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…Maternal and fetal blood samples were not examined for the presence of anti SARS-CoV-2 antibodies or SARS-CoV-2 viral RNA. Vertical transmission can, therefore, not be entirely excluded as the cause of fetal death [11][12][13]. This should certainly be viewed as a limitation of this report despite postmortem fetal evaluation revealing no sign of fetal viral infection.…”

Section: Discussionmentioning

confidence: 85%

“…Maternal COVID-19 has been shown to be associated with an increased incidence of small-for-gestational age neonatal birth weight, preterm birth, and approximately doubled risk of stillbirth [1,[7][8][9][10]. Neonatal infections due to vertical SARS-CoV-2 transmission have been infrequently reported, but they can occur under certain biologic conditions [11][12][13]. Several potential mechanisms that could cause impairment of placen-tal function from COVID-19 infection have been proposed so far.…”

Section: Introductionmentioning

confidence: 99%

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Mixed Intervillositis in SARS-CoV-2 Infection Associated with Fetal Death: A Case Report

Gjakov¹,

Kopač

Pohar³

et al. 2022

Case Reports in Obstetrics and Gynecology

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Maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been shown in epidemiological studies to be associated with an increased risk of stillbirth. Several histopathologic features of placental SARS-CoV-2 infection have been proposed as potential causes of fetal death. We present a case of an otherwise healthy G3P1 women with mild symptoms of SARS-CoV-2 infection at 23 6/7 weeks of gestation. At 25 2/7 weeks, she presented with signs and symptoms of preterm labor and decreased fetal movements. Fetal death was diagnosed at admission. Placental pathology showed pronounced placental mixed intervillositis. Inflammatory infiltrate caused extreme narrowing of intervillous space leading to placental malfunction and fetal death. Placental tissue SARS-CoV-2 infection was confirmed by positive immunohistochemistry staining of syncytiotrophoblasts with spike protein antibody. The case presented suggests that SARS-CoV-2 associated inflammatory placental changes pose an elevated risk for the fetus.

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Mixed Intervillositis in SARS-CoV-2 Infection Associated with Fetal Death: A Case Report

Gjakov¹,

Kopač

Pohar³

et al. 2022

Case Reports in Obstetrics and Gynecology

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“…Of the included 58 studies, nine were carried out in the United States [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ], six in Italy [ 46 , 47 , 48 , 49 , 50 , 51 ], five in Brazil [ 52 , 53 , 54 , 55 , 56 ], four in France [ 57 , 58 , 59 , 60 ], four in Iran [ 61 , 62 , 63 , 64 ], three in Germany [ 65 , 66 , 67 ], three in Spain [ 68 , 69 , 70 ], two in Portugal [ 71 , 72 ], two in Romania [ 73 , 74 ], two in Russia [ 75 , 76 ], one in Peru [ 77 ], Slovakia [ 78 ], Columbia [ 79 ], China [ 80 ], Turkey [ 81 ], Switzerland [ 82 ], Ireland [ 83 ], India [ 84 ], Canada [ 85 ], UK [ 86 ], Mexico [ 87 ], Singapore [ 88 ], Malaysia [ 89 ], B...…”

Section: Resultsmentioning

confidence: 99%

Maternal Fever and Reduced Fetal Movement as Predictive Risk Factors for Adverse Neonatal Outcome in Cases of Congenital SARS-CoV-2 Infection: A Meta-Analysis of Individual Participant Data from Case Reports and Case Series

Bernad,

Duica,

Antoniadis

et al. 2023

Viruses

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Objectives: To determine risk factors for primary and secondary adverse neonatal outcomes in newborns with congenital SARS-CoV-2 infection.Data sources:PubMed/MEDLINE and Google Scholar from January 2020 to January 2022.Study eligibility criteria: newborns delivered after 24 weeks of gestation with confirmed/possible congenital SARS-CoV-2 infection, according to standard classification criteria.Methods: Execution of the IPD analyses followed the PRISMA-IPD statement. Univariate non-parametric tests compared numerical data distributions. Fisher’s exact or Chi-square test determined categorical variables’ statistical significance. Multivariate logistic regression revealed risk factors for adverse neonatal outcome.Results:Maternal fever was associated with symptomatic congenital infection (OR: 4.55, 95% CI:1.33–15.57). Two-thirds of women that reported decreased fetal movements were diagnosed with IUFD (p-value = 0.001). Reduced fetal movement increased the risk of intrauterine fetal death by 7.84 times (p-value = 0.016, 95% CI: 2.23–27.5). The risk of stillbirth decreased with gestational age at the time of maternal infection (p-value < 0.05, OR: 0.87, 95% CI: 0.79–0.97). Conclusions:Maternal fever and perception of reduced fetal movement may be predictive risk factors for adverse pregnancy outcome in cases with congenital SARS-CoV-2 infection.

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“…As for SARS-CoV-2 vertical transmission, in our study the transplacental passage was found only in one patient with a monochorial diamniotic twin pregnancy complicated by a selective intrauterine growth restriction (sIUGR). To date, published studies on SARS-CoV-2 vertical transmission report contradictory results [26,[38][39][40]. Several studies demonstrated the transplacental passage of SARS-CoV-2 viral particles through the maternal-fetal interface, with an estimated rate ranging from 3 to 8% of cases [37,41,42].…”

Section: Discussionmentioning

confidence: 99%

“…Although the scientific literature has widely described the pathophysiological mechanisms of SARS-CoV-2 infection during pregnancy [24][25][26], the maternal consequences, the risk of vertical transmission and the related neonatal outcomes have not been completely investigated [27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 Infection in Pregnancy: Clues and Proof of Adverse Outcomes

Sessa

Filardo

Masciullo

et al. 2023

IJERPH

Self Cite

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Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) represents one of the most threatening viral infections in the last decade. Amongst susceptible individuals, infected pregnant women might be predisposed to severe complications. Despite the extensive interest in SARS-CoV-2 research, the clinical course of maternal infection, the vertical transmission and the neonatal outcomes have not been completely understood yet. The aim of our study was to investigate the association between SARS-CoV-2 infection, obstetric outcomes and vertical transmission. Methods: A prospective observational study was performed, enrolling unvaccinated pregnant patients positive for SARS-CoV-2 (cases) and matched with uninfected pregnant women (controls). Maternal and neonatal nasopharyngeal swabs, maternal and cord blood, amniotic fluid and placenta tissue samples were collected; blood samples were tested for anti-S and anti-N antibodies, and histologic examination of placental tissues was performed. Results: The cases showed a significant association with the development of some obstetric complications, such as intrauterine growth restriction and pregnancy-associated hypothyroidism and diabetes, as compared to controls; their newborns were more likely to have a low birth weight and an arterial umbilical pH less than 7. The viral genome was detected in maternal and cord blood and placental samples in six cases. Conclusions: Pregnant women positive for SARS-CoV-2 infection are more likely to develop severe obstetric outcomes; their newborns could have a low birth weight and arterial pH. Vertical transmission seems a rare event, and further investigation is strongly needed.

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SARS-CoV-2 vertical transmission in a twin-pregnant woman: a case report

Cited by 4 publications

References 18 publications

Mixed Intervillositis in SARS-CoV-2 Infection Associated with Fetal Death: A Case Report

Mixed Intervillositis in SARS-CoV-2 Infection Associated with Fetal Death: A Case Report

Maternal Fever and Reduced Fetal Movement as Predictive Risk Factors for Adverse Neonatal Outcome in Cases of Congenital SARS-CoV-2 Infection: A Meta-Analysis of Individual Participant Data from Case Reports and Case Series

SARS-CoV-2 Infection in Pregnancy: Clues and Proof of Adverse Outcomes

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