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Vertical transmission of SARS-CoV2 during pregnancy: A high-risk cohort

Prenat Diagn. 2021 Jul;41(8):998-1008. doi: 10.1002/pd.5980. Epub 2021 Jun 14.

Abstract

Objective: Identify the potential for and risk factors of SARS-CoV-2 vertical transmission.

Methods: Symptomatic pregnant women with COVID-19 diagnosis in whom PCR for SARS-CoV-2 was performed at delivery using maternal serum and at least one of the biological samples: cord blood (CB), amniotic fluid (AF), colostrum and/or oropharyngeal swab (OPS) of the neonate. The association of parameters with maternal, AF and/or CB positivity and the influence of SARS-CoV-2 positivity in AF and/or CB on neonatal outcomes were investigated.

Results: Overall 73.4% (80/109) were admitted in hospital due to COVID-19, 22.9% needed intensive care and there were four maternal deaths. Positive RT-PCR for SARS-CoV-2 was observed in 14.7% of maternal blood, 13.9% of AF, 6.7% of CB, 2.1% of colostrum and 3.7% of OPS samples. The interval between COVID-19 symptoms and delivery was inversely associated with SARS-CoV-2 positivity in the maternal blood (p = 0.002) and in the AF and/or CB (p = 0.049). Maternal viremia was associated with positivity for SARS-CoV-2 in AF and/or CB (p = 0.001). SARS-CoV-2 positivity in the compartments was not associated with neonatal outcomes.

Conclusion: Vertical transmission is possible in pregnant women with COVID-19 and a shorter interval between maternal symptoms and delivery is an influencing factor.

MeSH terms

  • Adult
  • Amniotic Fluid / virology
  • Brazil / epidemiology
  • COVID-19 / mortality
  • COVID-19 / transmission*
  • COVID-19 / virology
  • Colostrum / virology
  • Female
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / statistics & numerical data*
  • Male
  • Pregnancy
  • Pregnancy Complications, Infectious / mortality
  • Pregnancy Complications, Infectious / virology*
  • Prospective Studies
  • SARS-CoV-2 / isolation & purification*
  • Young Adult