Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Perinatal outcome and possible vertical transmission of coronavirus disease 2019: experience from North India

  • Sharma, Ritu (Department of Obstetrics & Gynecology, Government Institute of Medical Sciences) ;
  • Seth, Shikha (Department of Obstetrics & Gynecology, Government Institute of Medical Sciences) ;
  • Sharma, Rakhee (Department of Obstetrics & Gynecology, Government Institute of Medical Sciences) ;
  • Yadav, Sanju (Department of Pediatrics, Government Institute of Medical Sciences) ;
  • Mishra, Pinky (Department of Obstetrics & Gynecology, Government Institute of Medical Sciences) ;
  • Mukhopadhyay, Sujaya (Department of Pediatrics, Government Institute of Medical Sciences)
  • Received : 2020.10.10
  • Accepted : 2021.02.05
  • Published : 2021.05.15
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Abstract

Background: The 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. Purpose: This study evaluated the effect of coronavirus disease 2019 (COVID-19) on neonatal outcomes and the scope of vertical transmission. Methods: This 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. Results: A 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. Conclusion: COVID-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.

Keywords

Acknowledgement

We would like to thank all the residents, nursing staff, and the laboratory staff involved in the management of these motherneonate dyads.

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