Vertical transmission of SARS-CoV-2 from infected pregnant mother to the neonate detected by cord blood real-time polymerase chain reaction (RT-PCR)

Rebello, Celso Moura; Fascina, Linus Pauling; Annicchino, Giuliana; Pinho, João Renato Rebello; Yoshida, Renata de Araújo Monteiro; Zacharias, Romy Schmidt Brock

doi:10.1038/s41390-020-01193-9

Cited by 5 publications

(4 citation statements)

References 7 publications

(6 reference statements)

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“…Although initial reports on SARS-CoV-2 vertical transmission found no evidence to support its occurrence in small sample sizes [65][66][67], these results remain controversial. Later investigations supported the notion of vertical transmission based on serological evaluations of RT-PCR-positive newborns (high levels of SARS-CoV-2-targeted IgM and inflammatory cytokines-IL6/IL10 [68][69][70][71][72][73]), amniotic fluid [70], and cord blood RT-PCR [74]. Recently, documentation of the SARS-CoV-2 genome on both sides of the placenta, maternal and fetal, apparently demonstrated transplacental transmission of SARS-CoV-2 [45].…”

Section: Discussionmentioning

confidence: 89%

Postmortem Documentation of SARS-CoV-2 in Utero and Postpartum Transmission, through Amniotic Fluid, Placental, and Pulmonary Tissue RT-PCR

et al. 2021

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The physiopathology of SARS-CoV-2 infection, during pregnancy and in early childhood, is poorly understood. Unfavorable maternal outcomes, the risk of vertical/postpartum transmission, and severe, multisystem involvement in infants and children highlight the importance of developing a cohesive treatment and nuanced prophylaxis strategy. In this study, we evaluate autopsy reports, pathological findings, and SARS-CoV-2 genome expression in three distinct clinical scenarios: maternal death due to severe COVID-19 with in utero fetal demise (27 weeks); mother with moderate COVID-19 and in utero fetal demise (29 weeks); and 2-month-old infant death with confirmed COVID-19 caregivers. We report the presence of the SARS-CoV-2 genome in amniotic fluid and placental tissue in the context of in utero transmission of SARS-CoV-2, but also in postmortem infant pulmonary tissue samples in a case of late postpartum SARS-CoV-2 transmission with asymptomatic, rapidly progressive disease, resulting in infant death. Key pathological findings offer a descriptive portrayal of maternal, in utero, and infantile COVID-19 pathogenesis. Further investigations are necessary to fully comprehend the clinical implications of SARS-CoV-2 infection during pregnancy, a prerequisite for adequate therapeutic management and harm reduction.

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Section: Discussionmentioning

confidence: 89%

Postmortem Documentation of SARS-CoV-2 in Utero and Postpartum Transmission, through Amniotic Fluid, Placental, and Pulmonary Tissue RT-PCR

et al. 2021

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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%

“…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…”

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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“…Of the included studies, 25 studies reported assessment of the placenta, of these 18 were case studies (Alamar I 2020, Birindwa EK 2020, Ferraiolo A 2020, Grimminck K 2020, Kulkarni R 2020, Hsu AL 2020, Lv Y 2020, Palalioglu RM 2020, Pulinx B 2020, Rebello CM 2020, Shende P 2020, Sisman J 2020, Stonoga E 2020, Tang J 2020, Von Kohorn I 2020, Zaigham M 2020, 2 were retrospective case series (Liu W 2020, Masmejan S 2020, 3 were cohort studies (Fenizia B 2020, Ogamba I 2020, Oncel MY 2020 and 2 were a cohort and a case series specifically studying placental samples (Smithgall MC 2020, Zhang P 2020) (Supplementary file Table 4. Findings of studies reporting placenta analysis).…”

Section: Detection Of Virus In the Placenta Using Pcr And Immunostainingmentioning

confidence: 99%

SARS-CoV-2 and the role of vertical transmission from infected pregnant women to their fetuses: systematic review.

Plüddemann

Spencer

Heneghan

et al. 2021

Preprint

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Background Vertical transmission of SARS-CoV-2 has been reported but does not appear to be common. This study aims to systematically review the evidence for vertical transmission of SARS-CoV-2. Methods This review is part of an Open Evidence Review on the transmission dynamics of SARS-CoV-2 and the role of intrauterine mother to fetus transmission. Literature searches were performed in the WHO Covid-19 Database, LitCovid, medRxiv, and Google Scholar for SARS-CoV-2 using keywords and associated synonyms, search date up to 20 December 2020, no language restrictions. Results We included 106 studies assessing vertical transmission of SARS-CoV-2 from pregnant women to their neonates: these studies comprised 40 reviews (21 fulfilled systematic review methodology, including risk of bias assessment of included studies) and 66 primary studies including 32 case reports (of up to two cases) and 34 prospective and retrospective cohort studies, prospective and retrospective case series, observational studies (including asymptomatic screening), database studies and a quality improvement project. Almost all were conducted in a hospital setting. The 32 case reports were considered to be at high risk of bias, due to the study design; across the 34 remaining primary studies, risk of bias was low to moderate. Sixteen case reports examined vertical transmission, which was not related to maternal symptomatology. For the cohort and case series studies, the percentage of positive neonates ranged from 0% to 22% across the studies. Twenty studies reported no positive vertical transmission. Three studies that reported the highest positivity rates of 11%, 15% and 22% had specifically selected neonates with a positive test (within up to 35 days) within the study population and were therefore more selective populations. Across the cohort and case series studies there were 65/2391 (2.7%) neonates born to mothers with a diagnosis of COVID-19 tested positive for SARS-CoV-2 within 24 hours of birth. No evidence correlated maternal symptomatology to vertical transmission. Mode of delivery did not correlate with rates of vertical transmission. Of 25 studies, 7 identified SARS-CoV-2 in placental tissue; some of these did not demonstrate vertical transmission to the neonate. No study reported the results of viral culture to detect SARS-CoV-2. Conclusions The results of these studies indicate that vertical transmission is possible, but is not frequent, and factors that influence when vertical transmission occurs are unknown. Further studies using standardised methods to establish viral infection are needed to establish vertical transmission rates and to assess clinical and other conditions affecting transmission.

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Vertical transmission of SARS-CoV-2 from infected pregnant mother to the neonate detected by cord blood real-time polymerase chain reaction (RT-PCR)

Abstract: Vertical transmission of SARS-CoV-2from infected pregnant mother to the neonate detected by cord blood real-time polymerase chain reaction (RT-PCR),

Cited by 5 publications

References 7 publications

Postmortem Documentation of SARS-CoV-2 in Utero and Postpartum Transmission, through Amniotic Fluid, Placental, and Pulmonary Tissue RT-PCR

Postmortem Documentation of SARS-CoV-2 in Utero and Postpartum Transmission, through Amniotic Fluid, Placental, and Pulmonary Tissue RT-PCR

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 and the role of vertical transmission from infected pregnant women to their fetuses: systematic review.

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