Vertical transmission of SARS‐CoV2 during pregnancy: A high‐risk cohort

Maeda, Mariane de Fátima Yukie; Brizot, Maria de Lourdes; Gibelli, Maria Augusta Bento Cicaroni; Ibidi, Silvia Maria; de Carvalho, Werther Brunow; Hoshida, Mara Sandra; Machado, Clarisse Martins; Sabino, Ester Cerdeira; de Oliveira da Silva, Lea Campos; Jaenisch, Thomas; Mendes‐Correa, Maria Cássia Jacintho; Mayaud, Philippe; Francisco, Rossana Pulcinelli Vieira

OBJECTIVE: Identify the potential for and risk factors of SARS‐CoV‐2 vertical transmission. METHODS: Symptomatic pregnant women with COVID‐19 diagnosis in whom PCR for SARS‐CoV‐2 was performed at delivery using maternal serum and at least one of the biological samples: cord blood (CB), amniotic fluid (AF), colostrum and/or oropharyngeal swab (OPS) of the neonate. The association of parameters with maternal, AF and/or CB positivity and the influence of SARS‐CoV‐2 positivity in AF and/or CB on neonatal outcomes were investigated. RESULTS: Overall 73.4% (80/109) were admitted in hospital due to COVID‐19, 22.9% needed intensive care and there were four maternal deaths. Positive RT‐PCR for SARS‐CoV‐2 was observed in 14.7% of maternal blood, 13.9% of AF, 6.7% of CB, 2.1% of colostrum and 3.7% of OPS samples. The interval between COVID‐19 symptoms and delivery was inversely associated with SARS‐CoV‐2 positivity in the maternal blood (p = 0.002) and in the AF and/or CB (p = 0.049). Maternal viremia was associated with positivity for SARS‐CoV‐2 in AF and/or CB (p = 0.001). SARS‐CoV‐2 positivity in the compartments was not associated with neonatal outcomes. CONCLUSION: Vertical transmission is possible in pregnant women with COVID‐19 and a shorter interval between maternal symptoms and delivery is an influencing factor.