Current DateSeptember 24, 2021

Coronavirus: can mothers transmit the virus to their baby in utero?

Can Covid-19 be transmitted to a baby in utero? Researchers around the world are trying to answer this question and argue over the odds. The latest study published on this subject suggests that it is possible.

A newborn baby has tested positive for Covid-19 in the UK. Her mother had been admitted to North Middlesex Hospital near London a few days before giving birth for pneumonia, but it is not known whether the virus was transmitted to the baby in utero or after he was born. The question now in most pregnant women’s minds is whether the virus can be passed to a baby during pregnancy?

If opinions differ on this subject, a recent study published in the journal Jama Pediatrics suggests that it is possible. Chinese researchers followed 33 pregnant women infected with covid-19 at a children’s hospital in Wuhan, China, where the epidemic broke out. Three male babies were born by cesarean section and tested positive the day after their birth. “The most common symptom was shortness of breath and affected 4 of the 33 newborns,” say the researchers.

Symptoms on a case-by-case basis

The first baby to test positive was born at 40 weeks of pregnancy. The birth was performed by cesarean section due to an amniotic fluid full of meconium (excrement accumulated in the intestines of the fetus) and maternal pneumonia due to Covid-19. The next day, the infant suffered from lethargy (intense fatigue) and fever and was transferred to the neonatal intensive care unit. The baby also suffered from pneumonia: “Nasopharyngeal and anal swabs were positive for SARS-CoV-2 on days 2 and 4 of the baby’s life and negative on day 6.”

The second baby was born at 40 weeks and 4 days of gestation and by cesarean section, also because of maternal pneumonia due to Covid-19. He experienced lethargy, vomiting and fever. Tests have shown leukocytosis (an abnormal increase in the number of white blood cells in the blood), lymphocytopenia (which indicates a decrease in lymphocytes) and a high level of creatine kinase (an enzyme found in muscles). He also suffered from pneumonia and like the first, “nasopharyngeal and anal swabs were positive for SARS-CoV-2 on days 2 and 4 of life and negative on day 6.”

Finally, the third baby was born prematurely at 31 weeks due to fetal distress (a decrease in his oxygenation). He was born by caesarean section also because of maternal pneumonia caused by the virus and required resuscitation. He suffered from “chest distress and pneumonia confirmed by a chest X-ray, which were cured on the 14th day of life after treatment with non-invasive ventilation, caffeine and antibiotics”, write the researchers.

“Since strict infection control and prevention procedures have been put in place during delivery, it is likely that sources of SARS-CoV-2 in the upper respiratory tract or in the anus of newborns were of maternal origin ”, conclude the researchers. However, a probability is not a certainty and many experts have kept a skeptical attitude.

A study deemed inconclusive by many experts

Doctor Pat O’Brien, obstetrician consultant and vice-president of the Royal College of Obstetricians and Gynecologists (United Kingdom), says that “this study cannot confirm how the three babies contracted the virus and we note that the the first test for all three babies was not done until the second day of life, which increases the possibility that an infection had occurred after birth. Nevertheless, he concedes, it is possible that an infection may have occurred in utero, but this study is not conclusive. ”

Dr. Erica Watson, Lecturer in Reproductive Biology at the University of Cambridge (United Kingdom), recalls that “several other studies have excluded the transmission of Covid-19 in the uterus, one of which has revealed that the blood from the umbilical cord (the baby’s blood) and the amniotic fluid (the fluid that surrounds the baby in the womb) had been tested negative. Based on the evidence available to date, it is unlikely that a a baby will contract Covid-19 in the womb and therefore it is unlikely that babies will be born with the infection. ”

An opinion shared by Dr. Elizabeth Whittaker, a pediatric infectious disease consultant at St Marys Paddington Hospital: “There is still no conclusive evidence that the virus can be contracted in the womb and it is more likely whether infants were exposed during childbirth or immediately afterwards. ”

However, she adds, “this study provides reassuring information to pregnant women who will give birth during the pandemic”, in particular because “two of the three babies were born at term and developed mild symptoms which disappeared within a few days without require significant medical intervention. The third was born prematurely and although it tested positive, it followed the clinical course expected for most infants born at 31 weeks’ gestation with good results. ”