Objective: The extent of vertical transmission (VT) of SARS-CoV-2 from mothers to neonates is still uncertain. We aimed to determine the incidence of VT. Study design: In this prospective cohort study, all mother diagnosed with SARS-CoV-2 infection at time of delivery or up to one week prior and their neonate managed in a tertiary referral hospital for pregnancy complicated by COVID-19 in Rome, from April 2 to December 22, 2020, were included. Maternal infection was defined as nasopharyngeal swab test results positive for SARS-CoV-2 RT-PCR. Biological samples were collected before, at, and after delivery to test positivity for SARS-CoV-2 RT-PCR and anti-SARS-CoV-2 specific antibodies. Results: The cohort included 95 women and 96 neonates with documented SARS-CoV-2 test results. Four neonates (4.2%) tested positive. The incidence of VT, according to the guidance criteria for diagnosing perinatal SARS-CoV-2 infection, was 5.2%. Neonatal symptoms were due to prematurity or fetal distress: symptomatic infants had lower median [min-max] gestational age (38.1 [29.3-40.6] vs 39.3 [33.9-41.9] weeks; p=.036), 1-min (9 [3-9] vs 9 [7-10]; p=.036), and 5-min Apgar scores (10 [6-10] vs 10 [8-10]; p=.012) than asymptomatic infants, and needed more frequently assistance in the delivery room (22.2% vs 2.5%; p=.008). Only 6 (7.1%) neonates had anti-SARS-CoV-2 specific antibodies, despite the ongoing maternal infection. Conclusions: The incidence of VT is low as is the detection of specific anti-SARS-CoV-2 antibodies in cord blood when infection is contracted late in pregnancy. This would suggest poor protection of infants against horizontal transmission of the virus.
Vertical Transmission of SARS-COV-2 during pregnancy: a prospective Italian cohort study
Di Simone, Nicoletta;
2022-01-01
Abstract
Objective: The extent of vertical transmission (VT) of SARS-CoV-2 from mothers to neonates is still uncertain. We aimed to determine the incidence of VT. Study design: In this prospective cohort study, all mother diagnosed with SARS-CoV-2 infection at time of delivery or up to one week prior and their neonate managed in a tertiary referral hospital for pregnancy complicated by COVID-19 in Rome, from April 2 to December 22, 2020, were included. Maternal infection was defined as nasopharyngeal swab test results positive for SARS-CoV-2 RT-PCR. Biological samples were collected before, at, and after delivery to test positivity for SARS-CoV-2 RT-PCR and anti-SARS-CoV-2 specific antibodies. Results: The cohort included 95 women and 96 neonates with documented SARS-CoV-2 test results. Four neonates (4.2%) tested positive. The incidence of VT, according to the guidance criteria for diagnosing perinatal SARS-CoV-2 infection, was 5.2%. Neonatal symptoms were due to prematurity or fetal distress: symptomatic infants had lower median [min-max] gestational age (38.1 [29.3-40.6] vs 39.3 [33.9-41.9] weeks; p=.036), 1-min (9 [3-9] vs 9 [7-10]; p=.036), and 5-min Apgar scores (10 [6-10] vs 10 [8-10]; p=.012) than asymptomatic infants, and needed more frequently assistance in the delivery room (22.2% vs 2.5%; p=.008). Only 6 (7.1%) neonates had anti-SARS-CoV-2 specific antibodies, despite the ongoing maternal infection. Conclusions: The incidence of VT is low as is the detection of specific anti-SARS-CoV-2 antibodies in cord blood when infection is contracted late in pregnancy. This would suggest poor protection of infants against horizontal transmission of the virus.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
