Evaluation of SARS-CoV-2 Mother-to-Child Vertical Transmission: Prospective and Observational Study

Alper Divarci; Ali Bulbul; Evrim Kiray Bas; Gulen Hurkal Yigitler; Alev Aydin; Hasan Avsar; Emel Celebi Congur; Hasan Sinan Uslu; Ebru Turkoglu Unal

doi:10.1055/s-0043-1771349

Journal of Pediatric Infectious Diseases, Table of Contents

J Pediatr Infect Dis 2023; 18(05): 261-265
DOI: 10.1055/s-0043-1771349

Original Article

Evaluation of SARS-CoV-2 Mother-to-Child Vertical Transmission: Prospective and Observational Study

Authors

Alper Divarci

¹Department of Neonatology, University of Health Science, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye
Ali Bulbul

¹Department of Neonatology, University of Health Science, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye
Evrim Kiray Bas

¹Department of Neonatology, University of Health Science, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye
Gulen Hurkal Yigitler

²Department of Microbiology, University of Health Science, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye
Alev Aydin

³Department of Perinatology, University of Health Science, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye
Hasan Avsar

¹Department of Neonatology, University of Health Science, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye
Emel Celebi Congur

⁴Department of Infection Disease, University of Health Science, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye
Hasan Sinan Uslu

¹Department of Neonatology, University of Health Science, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye
Ebru Turkoglu Unal

¹Department of Neonatology, University of Health Science, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye

Abstract

Objective The COVID-19 pandemic was declared a pandemic and a global health emergency by the World Health Organization (WHO) on March 11, 2020. COVID-19 infection is the most common cause of life-threatening acute respiratory tract infection in adults and older people but more mildly in the childhood age group. While the pandemic continues, there is no clear information about the vertical transmission of COVID-19 infection from the mother to the baby.

Methods In our study, we aimed to examine vertical virus transmission (breast milk, amniotic fluid, placenta) in pregnant women with COVID-19 infection and to examine the demographic, clinical, and laboratory characteristics of these infants. Our prospective and observational study was conducted in our hospital between March 1, 2020 and July 31, 2021.

Results During the study period, a total of 24 infants were included. All infants were admitted to the neonatal intensive care unit for postnatal follow-up. The virus was not detected in breast milk or amniotic fluids by the SARS-COV-2 reverse transcription polymerase chain reaction (RT-PCR) test, and no evidence of vertical transmission was found.

Conclusion In our study, no life-threatening complication was found in the babies of mothers infected with COVID-19 at birth. Babies born to mothers with COVID-19 infection did not develop any system findings that required specific treatment.

Keywords

COVID-19 - neonatology - breast milk - virolactia - vertical transmission

Full Text

References

References
1 Dhochak N, Singhal T, Kabra SK, Lodha R. Pathophysiology of COVID-19: why children fare better than adults?. Indian J Pediatr 2020; 87 (07) 537-546
2 Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed 2020; 91 (01) 157-160
3 Yee J, Unger L, Zadravecz F. et al. Novel coronavirus 2019 (COVID-19): Emergence and implications for emergency care. J Am Coll Emerg Physicians Open 2020; 1 (02) 63-69
4 Lu Q, Shi Y. Coronavirus disease (COVID-19) and neonate: what neonatologist need to know. J Med Virol 2020; 92 (06) 564-567
5 Hoffmann M, Kleine-Weber H, Krüger N, Müller M, Drosten C, Pöhlmann S. The novel coronavirus 2019 (2019-nCoV) uses the SARS-coronavirus receptor ACE2 and the cellular protease TMPRSS2 for entry into target cells. bioRxiv 2020; 2020 .01.31.929042
6 Hoffmann M, Kleine-Weber H, Schroeder S. et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020; 181 (02) 271-280.e8
7 Begemann M, Gross O, Wincewicz D. et al. Addressing the “hypoxia paradox” in severe COVID-19: literature review and report of four cases treated with erythropoietin analogues. Mol Med 2021; 27 (01) 120
8 Lee PI, Hu YL, Chen PY, Huang YC, Hsueh PR. Are children less susceptible to COVID-19?. J Microbiol Immunol Infect 2020; 53 (03) 371-372
9 Dong Y, Mo X, Hu Y. et al. Epidemiology of COVID-19 Among Children in China. Pediatrics 2020; 145 (06) e20200702
10 Lu X, Zhang L, Du H. et al; Chinese Pediatric Novel Coronavirus Study Team. SARS-CoV-2 infection in children. N Engl J Med 2020; 382 (17) 1663-1665
11 Antoun L, Taweel NE, Ahmed I, Patni S, Honest H. Maternal COVID-19 infection, clinical characteristics, pregnancy, and neonatal outcome: a prospective cohort study. Eur J Obstet Gynecol Reprod Biol 2020; 252: 559-562
12 Rozycki HJ, Kotecha S. Covid-19 in pregnant women and babies: what pediatricians need to know. Paediatr Respir Rev 2020; 35: 31-37
13 CDC COVID-19 Response Team. Severe outcomes among patients with Coronavirus Disease 2019 (COVID-19): United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep 2020; 69 (12) 343-346
14 Yazdanpanah F, Yazdanpanah S, Rezaei N. COVID-19 delta variation; more contagious or more pernicious?. Acta Biomed 2022; 92 (06) e2021454
15 Guan M, Johannesen E, Tang CY. et al. Intrauterine fetal demise in the third trimester of pregnancy associated with mild infection with the SARS-CoV-2 delta variant without protection from vaccination. J Infect Dis 2022; 225 (05) 748-753
16 DeSisto CL, Wallace B, Simeone RM. et al. Risk for stillbirth among women with and without COVID-19 at delivery hospitalization: United States, March 2020-September 2021. MMWR Morb Mortal Wkly Rep 2021; 70 (47) 1640-1645
17 Bulbul A, Agirgol E, Uslu S. et al. COVID-19 management in newborn babies in the light of recent data: breastfeeding, rooming-in and clinical symptoms. Sisli Etfal Hastan Tip Bul 2020; 54 (03) 261-270
18 Szczygiol P, Baranska K, Korczak I. et al. COVID-19 in pregnancy, management and outcomes among pregnant women and neonates: results from tertiary care center in Wroclaw. Ginekol Pol 2022; 93 (01) 47-53
19 Akin IM, Kanburoglu MK, Tayman C. et al; Neo-Covid Study Group. Epidemiologic and clinical characteristics of neonates with late-onset COVID-19: 1-year data of Turkish Neonatal Society. Eur J Pediatr 2022; 181 (05) 1933-1942
20 Erdeve Ö, Çetinkaya M, Baş AY. et al. The Turkish Neonatal Society proposal for the management of COVID-19 in the neonatal intensive care unit. Turk Pediatri Ars 2020; 55 (02) 86-92
21 Groß R, Conzelmann C, Müller JA. et al. Detection of SARS-CoV-2 in human breastmilk. Lancet 2020; 395 (10239): 1757-1758
22 Jafari M, Pormohammad A, Sheikh Neshin SA. et al. Clinical characteristics and outcomes of pregnant women with COVID-19 and comparison with control patients: a systematic review and meta-analysis. Rev Med Virol 2021; 31 (05) 1-16
23 Bülbül A, Keskin LŞ, Zübarioğlu AU. et al. Follow up processes of newborn babies in delivery room: two-year statistical evaluation. Med Bull Sisli Etfal Hosp 2017; 51 (03) 191-194
24 Oncel MY, Akın IM, Kanburoglu MK. et al; Neo-Covid Study Group. A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. Eur J Pediatr 2021; 180 (03) 733-742
25 Vassilopoulou E, Feketea G, Koumbi L, Mesiari C, Berghea EC, Konstantinou GN. Breastfeeding and COVID-19: from nutrition to immunity. Front Immunol 2021; 12: 661806
26 Costa S, Posteraro B, Marchetti S. et al. Excretion of SARS-CoV-2 in human breast milk. Clin Microbiol Infect 2020; 26 (10) 1430-1432
27 Vivanti AJ, Vauloup-Fellous C, Prevot S. et al. Transplacental transmission of SARS-CoV-2 infection. Nat Commun 2020; 11 (01) 3572
28 Bastug A, Hanifehnezhad A, Tayman C. et al. Virolactia in an asymptomatic mother with COVID-19. Breastfeed Med 2020; 15 (08) 488-491
29 Lackey KA, Pace RM, Williams JE. et al. SARS-CoV-2 and human milk: what is the evidence?. Matern Child Nutr 2020; 16 (04) e13032
30 World Health Organization. Breastfeeding and COVID-19: scientific brief. 23 June 2020. 2020. Accessed June 26, 2023 at: https://apps.who.int/iris/handle/10665/332639
31 UNICEF. Infant and young child feeding in the context of COVID-19. 2020 . Retrieved from the Emergency Nutrition Network (ENN). Accessed June 26, 2023 at: www.ennonline.net/covid19iycfbrief
32 Davanzo R, Moro G, Sandri F, Agosti M, Moretti C, Mosca F. Breastfeeding and coronavirus disease-2019: ad interim indications of the Italian Society of Neonatology endorsed by the Union of European Neonatal & Perinatal Societies. Matern Child Nutr 2020; 16 (03) e13010