Perinatal Transmission of 2019 Coronavirus Disease-Associated Severe Acute Respiratory Syndrome Coronavirus 2: Should We Worry?

We present 2 cases of coronavirus disease 2019 (COVID-19)-associated severe respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during the third trimester of pregnancy. Both mothers and newborns had excellent outcomes. We failed to identify SARS-CoV-2 in all of the products of conception and the newborns. This report provided evidence of low risk of intrauterine infection by vertical transmission of SARS-CoV-2.

Case series of 20 pregnant women with 2019 novel coronavirus disease in Wuhan, China.

AIM: To evaluate perinatal outcomes regarding clinical presentation in pregnancy and the vertical transmission potential of COVID-19. METHODS: Clinical records, laboratory findings, and chest computed tomography (CT) scans were retrospectively reviewed from 20 pregnant patients with laboratory-confirmed COVID-19 who were admitted to Renmin Hospital of Wuhan University and The Third Hospital of Wuhan, from Jan 20 to Mar 16, 2020, including three in the first-trimester, two in the second-trimester, and 15 in the third-trimester. Evidence of vertical transmission was assessed by testing for neonatal throat swab samples. The pathological changes of COVID-19 on the placenta is evaluated by hematoxylin-eosin staining. RESULTS: The most common symptoms of the pregnant women with SARS-CoV-2 infection were fever and cough, which is comparable to the nonpregnant adults with COVID-19 infection. Nobody was transferred to intensive care unit (ICU) for treatment and there were no maternal and neonatal deaths. However, there was one case with induced abortions on first-trimester (due to pregnant woman's concerns about COVID-19), one diagnosed with ectopic pregnancy, no intrauterine fetal deaths during the study period. Delivery occurred in 15 patients in the third trimester. Their incidence of preterm birth was 20%. Three of the four preterm births were spontaneous. The average length of stay was 20.77 days. No neonatal SARS-CoV-2 infection was detected. There were two placentas found with acute chorioamnionitis, one showed normal placenta morphology. CONCLUSION: In this case series study, COVID-19 had no short-term adverse effect on pregnant women except premature birth. The vertical transmission of SARS-CoV-2 did not occur in our study.

No obviously adverse pregnancy complications and outcomes of the recovered pregnant women from COVID-19.

The effects of SARS-COV-2 infection on the pregnant women and their fetus growth have attracted worldwide concern. Our case study aimed to investigate the neonatal clinical outcomes of the recovered pregnant women from COVID-19 in China, expecting to provide the clinical references of urgent need for other countries. Our study recruited a total of 12 recovered pregnant women from COVID-19 prior to pregnancy termination. The maternal and neonatal clinical characteristics were recorded. Of them, the placental pathological characteristics of five participants were evaluated following the standard guidelines. Two of them chose induced labour due to being worry about the potential adverse effects of medical treatment for COVID-19 by themselves. For the others, 8 gave birth by cesarean section with certain indications and 2 by vaginal delivery. Their neonates were all live birth with ≥ 37 gestational weeks and high Apgar scores of 9 ∼ 10. For the neonate related biological samples, they all have negative results of RNA test, including nasopharyngeal swab, umbilical cord blood, amniotic fluid, vaginal fluid, placenta, or umbilical cord. Most of other pathological indicators of placental examination suggested no abnormal syndromes. Overall, we did not find any abnormal pregnancy complications and neonatal outcomes among them. We concluded that excess adverse effect on the fetus development due to COVID-19 in the recovered pregnant women should be less influential, especially, induce abortion due to the anxiety of COVID-19 treatment should be not advisable.