Possibility Of Vertical Transmission Research Articles

The Innate Immune Response in DENV- and CHIKV-Infected Placentas and the Consequences for the Fetuses: A Minireview.

Dengue virus (DENV) and chikungunya (CHIKV) are arthropod-borne viruses belonging to the Flaviviridae and Togaviridae families, respectively. Infection by both viruses can lead to a mild indistinct fever or even lead to more severe forms of the diseases, which are characterized by a generalized inflammatory state and multiorgan involvement. Infected mothers are considered a high-risk group due to their immunosuppressed state and the possibility of vertical transmission. Thereby, infection by arboviruses during pregnancy portrays a major public health concern, especially in countries where epidemics of both diseases are regular and public health policies are left aside. Placental involvement during both infections has been already described and the presence of either DENV or CHIKV has been observed in constituent cells of the placenta. In spite of that, there is little knowledge regarding the intrinsic earlier immunological mechanisms that are developed by placental cells in response to infection by both arboviruses. Here, we approach some of the current information available in the literature about the exacerbated presence of cells involved in the innate immune defense of the placenta during DENV and CHIKV infections.

REVIEW ARTICLE: HISTOPATHOLOGICAL CHANGES IN PLACENTA AND RELATIONSHIP WITH CORONAVIRUS INFECTION DURING PREGNANCY

During Covid-19 pandemic, Severe Acute Respiratory Syndrome - Coronavirus 2 (SARS-CoV-2) was significantly more severe in pregnant women than in non-pregnant women, leading in a number of health-related consequences that impacted healthcare, including fetal and maternal ramifications. Infection by coronavirus 2 can harm placental tissue by causing a variety of alterations.
 The majority of patients with SARS-CoV-2 are asymptomatic or have moderate symptoms related to upper respiratory infections that could sometimes escalate to severely sickness, injury of multi-organ, system failure, and death.
 Evidence about the effects of maternal infection is growing. Emerging information points to an increase in the dangers associated with obstetrics, such as stillbirth, gestational diabetes, maternal problems, preterm births, hypertensive disorder, reduced intrauterine fetal growth, and a chance of neonatal impairments of development. Generally, it remains contradictory concerns regarding the possibility of vertical transmission. 
 Further analysis is needed on the placenta and its role in pregnancies with COVID-19 since impairment of placental function effects on fate of pregnancy. The reviewed studies referred to present of changes in the architecture of tissues as histopathological alterations accompanied coronavirus 2 outbreaks. The current review study can be a guide that helps doctors and researchers in the future to clarify effective plans in diagnosing and treating cases of this epidemic to prevent the risks it causes.

Impacts of the Covid-19 pandemic on the mental health of pregnant women

The COVID-19 pandemic has been a worldwide problem, causing considerable repercussions on the physical and mental health of many people. This impact has a significant prevalence on the mental health of pregnant women, especially women in early pregnancy and younger. In this context, this study sought to discuss the various impacts caused by the COVID-19 pandemic on the mental health of pregnant women. This study is an integrative review that aims to answer the following guiding question “What is the latest information on the impacts of the COVID-19 pandemic on the mental health of pregnant women?”. The search was performed in the Medline, LILACS and SciELO databases, including complete clinical trials published in the last 5 years, in Portuguese, English and Spanish. Eleven articles were selected, making up this review's final sample. As a result, it was noted that the mental health of pregnant women was significantly impaired during the pandemic phase, increasing the occurrence of mental suffering, fear, depression, anxiety and stress. All these conditions were related to direct and indirect impacts of the pandemic, such as difficulty in accessing prenatal care, insecurities about an unpredictable virus, possibility of vertical transmission, decline in professional status and reduced income. Furthermore, it was found that high-quality sleep, higher levels of resilience, low screen time and physical exercise acted as protective factors against symptoms of anxiety and depression. It is concluded, therefore, that the COVID-19 pandemic is related to an increase in the prevalence of anxiety, depression and worsening of previous mental disorders in pregnant women, showing the need for public intervention to improve perinatal mental health during the period affected by the new coronavirus.

COVID-19 in Pregnant Women, Maternal-Fetal Involvement, and Vertical Mother-to-Child Transmission: A Systematic Review.

Pregnant women are included in the COVID-19 risk groups even if they do not have any pathology. This requires an analysis of research focused on pregnant women to understand the impact of SARS-CoV-2 on their condition. There is also a need to know whether there is vertical mother-to-child transmission, as well as other consequences in case the pregnant woman is infected and COVID-19 positive. A systematic review was carried out to analyze the existing information on the complications of a pregnant woman infected with the SARS-CoV-2 coronavirus and the possibility of vertical transmission from mother to child, registered in the PROSPERO website and searched in the PubMed, Scopus, CINAHL, and Cochrane Library databases. Finally, 22 articles were included in the review. The review suggests that vertical transmission from mother to child could be exceptionally possible at the time of delivery or breastfeeding, but not through the placenta. It is interesting to point out the good acceptance of vaccination by pregnant women, which may be the reason for the low infectivity. Further research on pregnant women should be carried out to provide evidence on vertical mother-to-child transmission and the role of breast milk in relation to SARS-CoV-2.

COVID-19 Positive Neonates from Pregnant Women with COVID-19 in Kasih Ibu Hospital Surakarta

Kasih Ibu Hospital from October 2019 to January 2021 has become the referral maternal COVID-19 hospital in Surakarta, Central Java. Until now, research on pregnant women with COVID-19 in Indonesia is still very limited, it is still unknown whether there are possibility of vertical transmission from mother to baby, while pregnant women are among the vulnerable population. The purpose of this study is to provide an overview of the findings of positive infant outcomes for COVID-19 in pregnant women with confirmed COVID-19 at Kasih Ibu Hospital, Surakarta. Data collection was carried out by tracing medical records which were then presented in the form of distributions based on gestational age, infant birth weight, infant APGAR score, and infant COVID-19 status. Out of 62 pregnant women confirmed positive for COVID-19, 20 babies (32.3%) had PCR swab tests positive for COVID-19. All babies were born in good shape (APGAR score 8-10) and 4 babies were found with low birth weight, one of whom also had hypospadias. There were no reports of neonatal asphyxia and infant mortality.

Tracking Clostridium perfringens strains from breeding duck farm to commercial meat duck farm by multilocus sequence typing

Clostridium perfringens (C. perfringens) is an important zoonotic food-borne pathogenic microorganism. Currently, there are many reports on the prevalence of C. perfringens in poultry farms, while few studies on the prevalence and infection source of C. perfringens in egg hatcheries. The present study was undertaken to investigate and track C. perfringens from one breeding duck farm, one duck egg hatchery and one commercial meat duck farm along the production chain. A total of 334 isolates were obtained from 788 samples, including 316 type A strains (94.61 %), 11 type F strains (3.29 %) and seven type G strains (2.10 %). Antimicrobial susceptibility testing revealed that 61.87 % of the tested isolates were multidrug-resistant. Multilocus sequence typing showed that 66 representative isolates encompassed 60 different sequence types (STs), clustered in ten clonal complexes (CCs) and 20 singletons. CC2 was the most popular CC, accounting for 58.82 % (10/17) of the strains from breeding duck farm. Some strains of duck embryos were distributed in the same ST or CC as strains from breeding duck farm and duck egg hatchery, indicating close genetic relationship between them. The study showed that isolates from breeding duck farm had formed a dominant CC through long-term evolution, some duck embryos had been infected with C. perfringens during the incubation period and the infected strains should be from the duck egg hatchery or breeding duck farm with the possibility of vertical transmission. The close relationship between strains from breeding ducks and duck embryos, the high antibiotic resistance of isolates and the presence of cpe-positive or netB-positive isolates indicated that alert should be paid to such risks associated with these.

Possibility of Vertical Transmission of COVID-19 During Pregnancy, Labor and After Delivery: A Systematic Review Study

Background: In general, although the placenta is a good barrier to prevent infections, several cases of coronavirus disease 19 (COVID-19) transmission have been reported during pregnancy. Moreover, considering the potential for vertical maternal-fetal transmission, there is a concern that the fetus is at risk for congenital COVID-19. The aim of the present review and systematic study was to investigate the possibility of the vertical transmission of COVID-19 during pregnancy, labor, and postpartum using available data. Methods: Studies conducted by February 12, 2021 were included in this systematic review study. Articles were searched in Medline, Magiran, SID, Civilica, Irandoc, ScienceDirect, PubMed, EMBASE, Web of Science, Scopus, and Google Scholar using English keywords such as "Coronavirus", "COVID-19, "SARS-CoV-2", "Vertical intrauterine transmission", "Vertical transmission", "Vertical fetal infection", "Maternal infection", and "Fetal infection". The inclusion criterion included all observational studies related to vertical maternal-fetal transmission. Overall, 31 articles were completely analyzed after reviewing and deleting non-eligible and duplicate articles. Results: The results of reviewing 24 studies showed that collected samples were all negative but positive blood samples, immunoglobulin M (IgM) and IgG antibodies, and expression of placental factors were reported in seven studies. Conclusion: Although contradictory results were found in this study, the results of the samples revealed the lowest probability of vertical transmission. There was also no evidence confirming the effectiveness of cesarean section in reducing the rate of transmission. In general, adherence to hygienic protocols can have a significant impact on reducing neonatal incidence.

Neonatal Outcomes of Premature Infants Born to Women with the Novel Coronavirus (SARS-CoV-2) Infection: A Case Control Study.

Novel coronavirus disease 2019 (COVID-19) is a disease associated with atypical pneumonia caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The first cases of COVID-19 were reported in Wuhan at the end of 2019. Transmission usually occurs via infected droplets and close personal contact; the possibility of vertical transmission is still under debate. This retrospective study aimed to analyze clinical characteristics of premature infants born to mothers with symptomatic COVID-19 disease. This case control study compared the clinical and laboratory data of 20 premature infants born to mothers infected with SARS-CoV-2 with sex and gestational age-matched historical controls. The median gestational age and birth weight in both groups were similar. Respiratory distress developed in 11 (55.5%) infants in study group and 19 (47.5%) infants in control group. Mechanical ventilation and endotracheal surfactant administration rates were similar. Median duration of hospitalization was 8.5 (2-76) days in study group and 12 days in historical controls. Real-time reverse-transcription polymerase chain reaction tests (RT-PCR) of nasopharyngeal swab samples for SARS-CoV-2 were found to be negative twice, in the first 24 hours and later at 24 to 48 hours of life. No neutropenia or thrombocytopenia was detected in the study group. Patent ductus arteriosus, bronchopulmonary dysplasia, and necrotizing enterocolitis rates were similar between groups. No mortality was observed in both groups. To the best of our knowledge, this is one of the few studies evaluating the clinical outcomes of premature infants born to SARS-CoV-2 infected mothers. There was no evidence of vertical transmission of SARS-CoV-2 from symptomatic SARS-CoV-2-infected women to the neonate in our cohort. The neonatal outcomes also seem to be favorable with no mortality in preterm infants. · SARS-CoV-2 pandemic is a challenge for pregnant women.. · Neonatal outcomes of premature infants born to mothers infected with SARS-CoV-2 not well defined.. · SARS-CoV-2 infection seems to have no adverse effect on mortality and morbidity in premature infants..

COVID-19 in pregnant women and children: Insights on clinical manifestations, complexities, and pathogenesis.

Pregnancy changes the body's immune system to counteract the spectrum of infections, including COVID‐19, which can pose complications. Pregnant women are less likely to contract COVID‐19 infections than the general public. However, pregnant women are at slightly increased risk of becoming severely unwell if they do catch COVID‐19, and congenital conditions in pregnant women may worsen the state of infection and lead to critical stages and even mortality. The possibility of vertical transmission has been reported in only a few cases of COVID‐19; however, it was not noted in cases of SARS and MERS. Vaccination coverage in pregnant women remains a challenge. Children are the next suspected and vulnerable population to acquire infection after the first and second waves. Children are disproportionately infected compared with older populations, but the severity of infection is less compared to adults. This review highlights the complexities of COVID‐19 in pregnant women and the underlying reasons why children tend to be comparatively less severely affected. Ethnicity, nutrition, lifestyle, and therapeutics influence the severity of infection in children. Low expression of angiotensin‐converting enzyme 2 receptors, indigenous virus competence, and maternal immunity is the first‐line defense for children against COVID‐19. Habituating herbal medicines from childhood may help support a robust and defensive immune system to counteract novel antigens and encourage healthy generations.

Maternal and Neonatal Complications, Outcomes and Possibility of Vertical Transmission in Iranian Women with COVID-19.

The emergence and fast spread of coronavirus disease 2019 (COVID-19) threatens the world as a new public health crisis. Little is known about its effects during pregnancy. This study aimed to investigate the clinical manifestations of COVID-19 on maternal and neonatal outcomes. In this systematic review, PubMed, Scopus, Web of Science, and Google Scholar databases were searched focusing on pregnancy and perinatal outcomes of COVID-19. The initial search yielded 1236 articles, from which finally 21 unique studies, involving 151 pregnant women and 17 neonates, met the criteria. Mean ± SD age of included mothers and mean ± SD gestational age at admission were 30.6 ± 6.2 years and 30.8 ± 8.9 weeks, respectively. The common symptoms were fever, cough, fatigue, dyspnea and myalgia. The mortality rates of pregnant women and neonates were 28 out of 151 (18.5%) and 4 out of 17 (23.5%), respectively. Most of the neonates were preterm at the time of delivery. Three neonates had positive RT-PCR test on the first day after birth and three others on day two. On the average, neonate's PCR became positive on day 4 for the first time. Early diagnosis of COVID-19 is crucial due to the possibility of the prenatal complications. Strict prevention strategies may reduce the risk of mother to infant transmission.

COVID-19 in pregnancy: What we know from the first year of the pandemic

The COVID-19 pandemic has infected nearly 178 million people and claimed the lives of over 3.8 million in less than 15 months. This has prompted a flurry of research studies into the mechanisms and effects of SARS-CoV-2 viral infection in humans. However, studies examining the effects of COVID-19 in pregnant women, their placentae and their babies remain limited. Furthermore, reports of safety and efficacy of vaccines for SARS-CoV-2 in pregnancy are limited.This review concisely summarises the case studies and research on COVID-19 in pregnancy, to date. It also reviews the mechanism of infection with SARS-CoV-2, and its reliance and effects upon the renin-angiotensin-aldosterone system. Overall, the data suggest that infection during pregnancy can be dangerous at any time, but this risk to both the mother and fetus, as well as placental damage, increases during the third trimester. The possibility of vertical transmission, which is explored in this review, remains contentious. However, maternal infection with SARS-CoV-2 can increase risk of miscarriage, preterm birth and stillbirth, which is likely due to damage to the placenta.

O-019 COVID – Impact on reproduction and reproductive practice

textA highly infectious novel coronavirus (now referred to as SARS-CoV-2) was first noted in December 2019 in Wuhan, Hubei Province, China, and by March 11, 2020, was declared a global pandemic by the WHO. The widespread community transmission of a virus, new to our species, continues to raise urgent questions about implications for pregnant women and those considering conception. Almost immediately, international committees, including ASRM and ESHRE, drew up guidelines to protect the public and our patients. Across the globe, clinics were closed, patients turned away and questions regarding spread of the virus, safety during early pregnancy and potential impact on fertility and pregnancy began to arise. Where are we now? What have we learned? And what more do we need to know to improve our ability to care for and counsel our patients?Clinic Practice – While there was considerable controversy in the U.S., closing clinics was the correct course of action when an unknown virus had entered our countries and so little was known and resources (think NY, think Italy) were inadequate. The majority of clinics pivoted to more virtual visits and stopped transfers and retrievals. The duration of these changes varied across states and countries, with most clinics now functioning at full capacity for procedures but still utilizing virtual visits for many patients. We will discuss what we learned from this process, including impact on clinics and patients, as well as the greater community in which we all live.Pregnancy – The physiology of pregnancy, including increased heart rate and oxygen consumption, decreased lung capacity and a shift away from cell-mediated immunity, all increased the risk for severe illness. Studies have now shown this increased risk for severe disease, mechanical ventilation and even death in pregnant women compared with their non-pregnant counterparts. Additionally, there is increased risk for pre-term labor and fetal death. Studies suggest infection earlier in pregnancy increases risk for complications. What about our patients? The first trimester is a highly critical period for fetal development. As a result, infectious and non-infectious exposures, occurring during the first trimester, are most likely to lead to severe effects on fetal development. Preliminary results no increased risk for pregnancy loss and no effect on nuchal translucency. However, some studies have shown the possibility of vertical transmission and increase in fetal inflammation. We will review the literature and update on current understanding of first trimester exposure and consequences for both mother and child.Infertility – SARS-CoV-2 utilizes the angiotensin-converting enzyme 2 (ACE2) receptor for viral entry. The ACE2 receptor is present in both the male and female reproductive systems. Early case studies of severe cases of COVID-19 identified orchitis, while the presence in non-fatal disease remains controversial. Lowered sperm counts have been identified and some studies have found SARS-CoV-2 viral particles in the semen. ACE2 receptor is present in both the ovary and the endometrium, while infection is possible, there have been few studies specifically looking at these endpoints and no clear risk identified for women.Vaccination – The rapid development and deployment of effective vaccination has brought hope to end the pandemic, even as new variants are arising. While vaccine hesitancy is common in many places, the mis-information regarding association between vaccines and infertility has hit our field particularly hard. Updating information to share with our patients, colleagues and friends will be critical to move forward and combat the pandemic.Trial registration numberStudy fundingFunding source

COVID-19 and breastfeeding: can SARS-CoV-2 be spread through lactation?

SARS-CoV-2 is a new betacoronavirus that was first reported in the Hubei province, China, in December 2019. The virus is likely transmitted through air droplets. However, there are reported cases where SARS-CoV-2-RNA was found in other samples, such as blood or stool. Nonetheless, there is limited information concerning the presence of viral RNA in pregnancy-related samples, specifically breast milk. However unlikely, there is still uncertainty regarding the possibility of vertical transmission from mother to infant through breastfeeding. This review aims to synthetize the literature written so far on this topic. Despite not being extensively researched, vertical transmission through breast milk seems unlikely. Case series showed that milk samples from mothers with COVID-19 were almost entirely negative. So far, there have been only 9 recorded cases of viral shedding in milk samples, uncertain however of the viability of the particles. Furthermore, WHO and UNICEF strongly encourage commencing breastfeeding after parturition, underlining the benefits of lactation. Moreover, some studies have proven the existence of IgG and IgA anti-SARS-CoV-2-antibodies in the maternal milk that could possibly play an important part in the neonate’s protection against the virus. Vertical transmission through lactation seems unlikely, most studies pointing towards the safety of breastfeeding. However, further larger-scale studies need to be performed in order to clarify a yet uncertain matter.

COVID-19 Infection during Pregnancy: Risk of Vertical Transmission, Fetal, and Neonatal Outcomes.

The COVID-19 pandemic is a worldwide, critical public health challenge and is considered one of the most communicable diseases that the world had faced so far. Response and symptoms associated with COVID-19 vary between the different cases recorded, but it is amply described that symptoms become more aggressive in subjects with a weaker immune system. This includes older subjects, patients with chronic diseases, patients with immunosuppression treatment, and pregnant women. Pregnant women are receiving more attention not only because of their altered physiological and immunological function but also for the potential risk of viral vertical transmission to the fetus or infant. However, very limited data about the impact of maternal infection during pregnancy, such as the possibility of vertical transmission in utero, during birth, or via breastfeeding, is available. Moreover, the impact of infection on the newborn in the short and long term remains poorly understood. Therefore, it is vital to collect and analyze data from pregnant women infected with COVID-19 to understand the viral pathophysiology during pregnancy and its effects on the offspring. In this article, we review the current knowledge about pre-and post-natal COVID-19 infection, and we discuss whether vertical transmission takes place in pregnant women infected with the virus and what are the current recommendations that pregnant women should follow in order to be protected from the virus.

Effects of COVID-19 infection during pregnancy

Women develop important changes in their cardiovascular and respiratory systems during pregnancy. They also have important changes in their immune system which are necessary to tolerate foreign fetal tissue. These expected alterations can increase the likelihood of poor outcomes with certain respiratory infections, especially viral infection. There is extensive literature describing COVID-19 in pregnant women, and there is evidence that this virus can infect the placenta, raising implications for maternal-fetal transmission. Women who contract COVID-19 during pregnancy are at increased risk of preterm labor and other perinatal complications when compared to non-pregnant women. Trials on the safety and efficacy of the COVID-19 vaccines during pregnancy are in progress; several reproductive societies have recommended that women who are planning to get pregnant or are pregnant should get vaccination since there are few reports of adverse events in pregnant women who have received vaccines. Healthcare providers will need to address concerns of infertility, the possibility of vertical transmission, and neonatal infection with women regarding timely vaccination against this disease and other necessary precautions.
 Keywords: coronavirus, COVID-19, pregnancy, placental pathology, vertical transmission

Potential effects of COVID-19 on reproductive systems and fertility; assisted reproductive technology guidelines and considerations: a review.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) employs the angiotensin-converting enzyme 2 (ACE2) receptor in the renin-angiotensin system for viral entry. The ACE2 receptor is present in both female and male reproductive systems, and reports of multi-organ involvement have led to uncertainty regarding its effects on the reproductive system and fertility. We review the existing literature regarding the function of ACE2 and the renin-angiotensin system in the female and male reproductive systems to postulate the possible implications of SARS-CoV-2 regarding fertility. Because of the presence of ACE2 in the ovaries, SARS-CoV-2 infection may disrupt ovarian function and hence oocyte quality. Higher expression of ACE2 in the endometrium with age and during the secretory phase raises concern about increased susceptibility to infection during periods of high ACE2 expression. The possibility of vertical transmission and the presence of ACE2 in the placenta and during pregnancy are also discussed. The presence of SARS-CoV-2 RNA in semen is controversial, but impaired semen quality has been found in men with moderate coronavirus disease 2019 infection. Evidence of orchitis and hormonal changes seen in male coronavirus disease 2019 infection may lead to infertility. The implications of these effects on assisted reproductive technology (ART) outcomes are also explored. The ART guidelines from different fertility societies for the management of patients treated with ART are provided. The importance of prioritising 'time-sensitive' patients for ART, counselling patients about the uncertainty and risks of ART, and pregnancy during the pandemic is discussed. Recommendations are also provided for infection control and safe regulation of ART centres and laboratories.

Assessment of the Possibility of Vertical Transmission of COVID-19: A Systematic Review and Meta-analysis Protocol

Background: The Coronavirus disease 2019 (COVID-19) outbreak has put a great burden on global health and healthcare systems. There is controversy regarding the possibility of vertical transmission of COVID-19. This proposed systematic review will be done to assess the possibility of vertical transmission of COVID-19 based on currently published literature. Methods: In this study, all published observational studies, including cross-sectional, cohort, and case-control studies, as well as case reports and case series, in peer-reviewed journals in any language until the end of July 2020 will be assessed. Editorials, commentaries, and letters to editors will be excluded from the review. Searching will be conducted using international bibliographic databases, including PubMed, Embase, and Web of Science based on Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. The search strategy will be improved and finalized based on the results of the primary search. Data extraction of the included articles will be performed by two researchers using the Zotero and review manager (revMan) software. The heterogeneity of the articles will be assessed using DerSimonian & Laird Q test and I2 statistic. The pooled estimated prevalence of vertical transmission of COVID-19 will be performed using the Metaprop command. Publication bias will be assessed using Begg’s rank correlation and the Egger weighted regression methods Results: Based on the reviewers comments the results section was deleted because this manuscript was a systematic review protocol. Conclusion: The findings of this study will help practitioners and health care providers in decision-making for the care and management of COVID-19-infected pregnant women.

Outcome of SARS-CoV-2 in pregnancy and newborns – is there a new kid in the TORCH block?

Objective. This study aimed to perform a systematic review of existing literature to assess the outcomes of pregnancy in women with COVID-19 infection and their newborns while estimating the possibility of vertical transmission. Materials and methods. We conducted a systematic literature research using Pubmed and Google Scholar covering the period from December 2019 to 20th of November 2020. The review was conducted in accordance with PRISMA guidelines. Outcomes. We included 16 studies – systematic reviews and meta-analyses published between May 2020 and November 2020 – which focused on perinatal outcomes of pregnant women with COVID-19 and 7 case reports of neonates with congenital transmission of COVID-19. Overall, the rate of COVID-19 cases in neonates of COVID-19 positive mothers was 3% with 95% CI [1.86, 4.24]). The preterm birth rate was 16.4% with 95% CI [10.5, 22.3] and the rate of stillbirths and foetal deaths was 1.4% (11 studies, 0 to 4.8%). From the 7 newborns with proved vertical transmission, majority were born preterm, with good birth weight and APGAR score and heterogenous symptoms; 4 developed severe symptoms. Overall progress and evolution for both mother and newborn was good. Conclusions. COVID-19 impact on pregnancy outcome is similar to general population in regard to preterm rate and stillbirth rate. Vertical transmission is possible and it seems to occur in about 3% of cases. Overall maternal and perinatal outcome is favourable and clinical presentation of in utero transmission of SARSCoV-2 in newborns is heterogenous.

Coronavirus disease 2019 in neonates

Coronavirus disease 2019 (COVID-19) as a global pandemic has become a major burden especially in the health care system and economy. COVID-19 has clinical presentations ranging from remain asymptomatic to severe acute respiratory distress syndrome (ARDS) and death. All age groups are susceptible to this virus, but it seems that children with COVID-19 have milder symptoms than adults. Neonates, however, have been reported to have more severe cases compared to older children. There is also a possibility of vertical transmission from mothers to their neonates which could not be ignored. This review provides current knowledge of COVID-19 in neonates.

Perinatal outcome and possible vertical transmission of coronavirus disease 2019: experience from North India.

BackgroundThe consequences of severe acute respiratory syndrome corona virus 2 on mother and fetus remain unknown due to a lack of robust evidence from prospective studies.PurposeThis study evaluated the effect of coronavirus disease 2019 (COVID-19) on neonatal outcomes and the scope of vertical transmission.MethodsThis ambispective observational study enrolled pregnant women with COVID-19 in North India from April 1 to August 31, 2020 to evaluate neonatal outcomes and the risk of vertical transmission.ResultsA total of 44 neonates born to 41 COVID-19–positive mothers were evaluated. Among them, 28 patients (68.3%) (2 sets of twins) were delivered within 7 days of testing positive for COVID-19, 23 patients (56%) (2 sets of twins) were delivered by cesarean section; 13 newborns (29.5%) had low birth weight; 7 (15.9%) were preterm; and 6 (13.6%) required neonatal intensive care unit admission, reflecting an increased incidence of cesarean delivery and low birth weight but zero neonatal mortality. Samples of cord blood, placental membrane, vaginal fluid, amniotic fluid, peritoneal fluid (in case of cesarean section), and breast milk for COVID-19 reverse transcription-polymerase chain reaction tested negative in 22 prospective delivery cases. Nasopharyngeal swabs of 2 newborns tested positive for COVID-19: one at 24 hours and the other on day 4 of life. In the former case, biological samples were not collected as the mother was asymptomatic and her COVID-19 report was available postdelivery; hence, the source of infection remained inconclusive. In the latter case, all samples tested negative, ruling out the possibility of vertical transmission. All neonates remained asymptomatic on follow-up. ConclusionCOVID-19 does not have direct adverse effects on the fetus per se. The possibility of vertical transmission is almost negligible, although results from larger trials are required to confirm our findings.