José Ramón López Tabrane Provincial Women's and Children's Hospital, Medical University of Matanzas, Matanzas, Cuba.
Eliseo Noel Caamaño Pediatric Provincial Hospital, Medical University of Matanzas, Matanzas, Cuba.
MEDICC Rev. 2021 Jan;23(1):72-83. doi: 10.37757/MR2021.V23.N1.13. Epub 2021 Jan 30.
Both intrauterine and intrapartum mother-to-child transmission of SARS-CoV-2 have been reported. However, there is still disagreement as to the likelihood and frequency of such vertical transmission.
Summarize and analyze the published evidence on forms of SARS-CoV-2 vertical transmission (either intrauterine or intrapartum).
We carried out a review of literature published in English and Spanish from January 1, 2020 through October 30, 2020. Search engines included PubMed/MEDLINE, SciELO, LILACS, Cochrane, Google Scholar, ResearchGate and medRxiv. There were no restrictions concerning type of study. The review included 48 original research articles, 11 review articles, a meta-analysis, 2 pre-published articles, 15 systematic reviews, and 10 editorials or comments.
Medical thinking on congenital or intrapartum maternal-fetal/neonatal transmission of SARS-CoV-2 has evolved from preliminary evidence that was divided as to whether these forms of vertical transmission were even possible to current evidence support ing both forms of transmission and hypothesizing as to the mechanisms that guide them. The presence of the SARS-CoV-2 virus in maternal, placental, fetal or neonatal tissues has been demonstrated by RT-PCR, specific immunoglobulin detection tests, immunostaining and in-situ hybridization. It is estimated that infections acquired either congenitally or intrapartum occur in 1.8%-8.0% of newborns born to women who test positive for COVID-19 at the end of their pregnancies. This review found 53 neonates who were diagnosed with COVID-19 in the first 48 hours of life by either RT-PCR or specific IgM tests. According to criteria outlined in this review, the timing of infection corresponded to congenital or intrapartum transmission in 39.6% (21/53) of COVID-19-positive newborns, to postpartum transmission in 15.1% (8/53) and remains unspecified in 45.3% (24/53).
Congenital and intrapartum SARS-CoV-2 infection in the fetus/newborn is possible, but rare. International collaborative studies using common epidemiological surveillance instruments would allow for a more precise specification of the frequency of congenital and intrapartum SARS-CoV-2 infection at the population level.
已有报道称，SARS-CoV-2 可经宫内和分娩时母婴传播。然而，对于这种垂直传播的可能性和频率，仍存在争议。
总结和分析已发表的关于 SARS-CoV-2 垂直传播（宫内或分娩时）形式的证据。
我们对 2020 年 1 月 1 日至 2020 年 10 月 30 日期间发表的英文和西班牙文文献进行了综述。搜索引擎包括 PubMed/MEDLINE、SciELO、LILACS、Cochrane、Google Scholar、ResearchGate 和 medRxiv。研究类型没有限制。综述包括 48 篇原始研究文章、11 篇综述文章、1 项荟萃分析、2 篇预发表文章、15 项系统评价和 10 篇社论或评论。
关于 SARS-CoV-2 通过母体经胎盘/胎儿/新生儿垂直传播的医学思维已经从初步证据发展而来，这些初步证据对这些垂直传播形式是否可能发生存在分歧，到目前为止的证据支持这两种传播形式，并假设指导这些传播形式的机制。通过 RT-PCR、特异性免疫球蛋白检测试验、免疫染色和原位杂交，已经证明 SARS-CoV-2 病毒存在于产妇、胎盘、胎儿或新生儿组织中。据估计，在妊娠末期 COVID-19 检测呈阳性的女性所生的新生儿中，有 1.8%-8.0%的新生儿感染了先天性或分娩时获得的感染。本综述发现，有 53 例新生儿在出生后 48 小时内通过 RT-PCR 或特异性 IgM 检测被诊断为 COVID-19。根据本综述中列出的标准，感染时间与 39.6%（53 例中的 21 例）COVID-19 阳性新生儿的先天性或分娩时传播相符，15.1%（53 例中的 8 例）与产后传播相符，45.3%（53 例中的 24 例）仍未明确。
胎儿/新生儿中存在先天性和分娩时的 SARS-CoV-2 感染是可能的，但很少见。使用通用流行病学监测工具的国际合作研究将使我们能够更准确地确定人群中先天性和分娩时 SARS-CoV-2 感染的频率。
