Vertical transmission of SARS‐CoV‐2: A prospective cross‐sectional study from a tertiary center

Abstract

The aim was to investigate the association of the delivery mode and vertical transmission of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) through the samples of vaginal secretions, placenta, cord blood, or amniotic fluid as well as the neonatal outcomes. This cross‐sectional study presents an analysis of prospectively gathered data collected at a single tertiary hospital. Sixty‐three pregnant women with confirmed coronavirus disease 2019 (COVID‐19) participated in the study. Vertical transmission of SARS‐CoV‐2 was analyzed with reverse transcriptase‐polymerase chain reaction (RT‐PCR) tests and blood tests for immunoglobulin G (IgG)–immunoglobulin M (IgM) antibodies. All patients were in the mild or moderate category for COVID‐19. Only one placental sample and two of the vaginal secretion samples were positive for SARS‐CoV‐2. Except for one, all positive samples were obtained from patients who gave birth by cesarean. All cord blood and amniotic fluid samples were negative for SARS‐CoV‐2. Two newborns were screened positive for COVID‐19 IgG–IgM within 24 h after delivery, but the RT‐PCR tests were negative. A positive RT‐PCR result was detected in a neof a mother whose placenta, cord blood, amniotic fluid, and vaginal secretions samples were negative. He died due to pulmonary hemorrhage on the 11th day of life. In conclusion, we demonstrated that SARS‐CoV‐2 can be detectable in the placenta or vaginal secretions of pregnant women. Detection of the virus in the placenta or vaginal secretions may not be associated with neonatal infection. Vaginal delivery may not increase the incidence of neonatal infection, and cesarean may not prevent vertical transmission. The decision regarding the mode of delivery should be based on obstetric indications and COVID‐19 severity.

Research Progress in Vertical Transmission of SARS-CoV-2 Among Infants Born to Mothers with COVID-19

“…Most existing studies indeed indicated that vaginal delivery may not increase the incidence of neonatal SARS-CoV-2 infection, and cesarean section may not prevent vertical transmission [ 11 , 12 ]. Though Sinaci et al [ 13 ] proved that SARS-CoV-2 can be detected in the placenta or vaginal secretions of COVID-19-positive pregnant women, the risk of contracting COVID-19 in these vaginally delivered newborns has not increased. Therefore, the method of delivery should be based on the obstetric situation, and not all COVID-19-positive pregnant women should be delivered by cesarean section.…”

Developmental Aspects of SARS-CoV-2, Potential Role of Exosomes and Their Impact on the Human Transcriptome

“…Interestingly, they further found specific anti-SARS-CoV-2 IgM and IgG antibodies in one sample of umbilical cord blood and milk, and three documented cases of vertical transmission with SARS-CoV-2 infection, as well as a strong inflammatory response [44]. A cross-sectional study on 63 pregnant women with mild to moderate COVID-19 at a single hospital showed that two vaginal secretion samples and one placental sample tested positive [45]. Within one day of birth, two neonates tested positive for COVID-19, and IgG and IgM, but RT-PCR test was negative [45].…”

“…A cross-sectional study on 63 pregnant women with mild to moderate COVID-19 at a single hospital showed that two vaginal secretion samples and one placental sample tested positive [45]. Within one day of birth, two neonates tested positive for COVID-19, and IgG and IgM, but RT-PCR test was negative [45].…”

Circulation of SARS-CoV-2 Variants among Children from November 2020 to January 2022 in Trieste (Italy)

“…The study found that COVID-19 is milder and has lower hospitalization rates among children than adults [ 9 ]. Regarding neonates, SARS-CoV-2 infection seems to be mainly transmitted from mothers, even if vertical transmission is still unclear [ 10 , 11 ]. Family clusters might be the main source of infection for children [ 12 ], while educational settings increase the circulation of the virus among adolescents [ 13 ].…”