From the Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Grupo de Investigación en Infectología Pediátrica, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
Pediatr Infect Dis J. 2022 Jun 1;41(6):466-472. doi: 10.1097/INF.0000000000003518. Epub 2022 May 6.
The vertical transmission of severe acute respiratory coronavirus-2 (SARS-CoV-2) remains highly debated. Here, we evaluated SARS-CoV-2-transmission in newborns with intrauterine conditions.
This was a prospective, observational and multicentric study involving 13 Spanish hospitals included in the GEStational and NEOnatal-COVID cohort. Pregnant women with microbiologically confirmed SARS-CoV-2 infection during any trimester of pregnancy or delivery and their newborns were included from March to November 2020. Demographic, clinical and microbiological data were also obtained. Viral loads were analyzed in different maternal and newborn biological samples (placenta, breast milk and maternal blood; urine, meconium and newborn blood).
A total of 177 newborns exposed to SARS-CoV-2 were included. Newborns were tested by reverse transcriptase-polymerase chain reaction using nasopharyngeal swabs within the first 24-48 hours of life and at 14 days of life. In total 5.1% were considered to have SARS-CoV-2 infection in the neonatal period, with 1.7% considered intrauterine and 3.4% intrapartum or early postnatal transmission cases. There were no differences in the demographic and clinical characteristics of the pregnant women and their newborns' susceptibility to infections in their perinatal history or background.
Intrauterine transmission of SARS-CoV-2 is possible, although rare, with early postnatal transmission occurring more frequently. Most infected newborns remained asymptomatic or had mild symptoms that evolved well during follow-up. We did not find any maternal characteristics predisposing infants to neonatal infection. All infected newborn mothers had acute infection at delivery.Although there was no presence of SARS-CoV2 in cord blood or breast milk samples, SARS-CoV-2 viral load was detected in urine and meconium samples from infected newborns.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的垂直传播仍存在较大争议。在此，我们评估了存在宫内异常的新生儿中 SARS-CoV-2 的传播情况。
这是一项前瞻性、观察性和多中心研究，纳入了来自西班牙 13 家医院的 138 名孕妇，这些孕妇在妊娠的任何一个阶段或分娩时均经微生物学证实感染了 SARS-CoV-2。纳入标准为：在妊娠期间或分娩时感染 SARS-CoV-2 的孕妇及其新生儿。还获得了人口统计学、临床和微生物学数据。分析了不同的产妇和新生儿生物样本（胎盘、母乳和产妇血液；尿液、胎便和新生儿血液）中的病毒载量。
共纳入 177 例暴露于 SARS-CoV-2 的新生儿。新生儿在出生后 24-48 小时内和第 14 天通过鼻咽拭子进行逆转录-聚合酶链反应（RT-PCR）检测。新生儿期有 5.1%被认为感染了 SARS-CoV-2，其中 1.7%为宫内感染，3.4%为分娩期或产后早期传播病例。孕妇及其新生儿在围产期病史或背景方面，其人口统计学和临床特征以及对感染的易感性无差异。
SARS-CoV-2 可能存在宫内传播，尽管罕见，但更常发生于产后早期传播。大多数感染的新生儿无症状或有轻度症状，在随访期间均得到良好的发展。我们未发现任何使婴儿易感染新生儿的母亲特征。所有感染新生儿的母亲在分娩时均有急性感染。虽然脐带血或母乳样本中未检测到 SARS-CoV-2，但在感染新生儿的尿液和胎便样本中检测到 SARS-CoV-2 病毒载量。
