Can COVID-19 be transmitted from the mother to the newborn?

Coronavirus disease 2019 (COVID-19) spread rapidly around the world in 2020, causing more than 6.2 million deaths and a widespread economic crisis. Most often, the disease causes mild flu-like symptoms, but it can progress to more serious illnesses, causing organ failure and long-term damage.

Severe acute respiratory symptom coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, spreads between hosts primarily by droplet infection, but may also follow other routes.

Researchers at Gregory Maranhão, a hospital university, are investigating the spread of the disease from pregnant women to newborns, and the results are Pediatric Infectious Diseases Journal..

the study

Pregnant women with microbiologically confirmed SARS-CoV-2 infection during pregnancy or childbirth were eligible for inclusion in studies conducted at 13 different Spanish hospitals. Diagnosis should be confirmed using reverse transcriptase-polymerase chain reaction (RT-PCR) in the nasopharyngeal swab. Population statistics and medical history, including time of diagnosis, comorbidities, maternity history, and clinical manifestations of infection, as well as perinatal and childbirth clinical data were collected.

Samples were taken from pregnant women at the time of diagnosis and delivery, and nasopharyngeal swabs were taken from the infant within 48 hours after delivery. Breast milk samples were collected by hand or by milking. Biological samples were tested for the presence of SARS-CoV-2 RNA using a commercially available kit.

The Blumberg classification was used to classify how the infection is transmitted from the mother to the baby. This is because intrauterine transmission must be positive for nasopharyngeal swabs, amniotic fluid, or neonatal blood within 24 hours, and for neonatal airway swabs within 24 hours or within the first week. Defines that IgM is positive. Delivery / early postnatal infections are defined as requiring a negative RT-PCR swab in the neonatal airway within 24 hours after delivery and a positive swab in the same airway 24 hours later. Superficial exposure / transient viremia Nasopharyngeal swabAmniotic fluid, cord blood, or neonatal blood is within 24 hours, but there is no evidence of a persistent or immune response.

Statistical analysis consisted of the use of median and interquartile ranges of continuous variables, and categorical variables expressed as absolute frequencies and percentages. The categorical variables were compared using X ^ 2 or Fisher’s exact test, and the continuous variables were evaluated using the Wilcoxon rank sum test.

In total, details of 174 women infected with SARS-CoV-2 during pregnancy were recorded, and 177 newborns were recorded in detail. At birth, 39% of women had an acute infection, 30% had a recent infection, and 31% had a past infection. 115 maternal blood samples and 81 placenta samples were collected for RT-PCR, revealing only one viral load in both the blood sample and placenta. It comes from a woman who showed mild clinical symptoms 48 hours before delivery. The newborn tested negative for SARS-CoV-2 and remained asymptomatic. No viral load was detected in the breast milk sample.

All RT-PCR results for umbilical cord blood and neonatal blood samples were negative, but viral load was detected in 3 neonatal urine samples and 3 meconium samples, all of which were by nasopharyngeal RT-PCR. SARS-CoV-2 infection was positive. A 48-hour cotton swab.

All newborns were tested within the first 48 hours after delivery, but only 12 infants showed positive test results. Researchers have determined that 3 of the infants have an intrauterine infection, 5 have an intranatal or early postnatal infection, and 2 have a secret contamination or transient viremia. As expected, she was born to a mother who was acutely infected during childbirth. Only two of the infected newborns showed symptoms and both resolved without serious adverse events. Statistical analysis showed no significant difference between the onset of symptoms in infected and uninfected newborns and admission to the neonatal intensive care unit.

Conclusion

This study reveals that intrauterine infection of SARS-CoV-2 appears very rare, but it is possible-early postnatal infection by contact with an infected person is much more frequent.

Healthy infants infected this way are mostly asymptomatic or have mild symptoms and appear to be largely resistant to the disease. Although it is still difficult to determine the presence of viremia, researchers have shown that the disease is very unlikely to infect breast milk.

Overall, this study may help inform healthcare professionals and reassure infected pregnant women.