Singh Vinita, Barik Archana, Mishra Minakshi, Diwakar Kumar, Choudhary Anisha, Mehta Neelam
Obstetrics and Gynaecology, Tata Main Hospital, Jamshedpur, IND.
Obstetrics and Gynaecology/DNB, Tata Main Hospital, Jamshedpur, IND.
Cureus. 2024 Jan 9;16(1):e51926. doi: 10.7759/cureus.51926. eCollection 2024 Jan.
The World Health Organisation (WHO) has established criteria to diagnose vertical transmission in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to determine the incidence of vertical transmission of SARS-CoV-2 using WHO criteria in a tertiary care centre in eastern India.
A hospital-based prospective observational study was conducted from June 2021 to February 2022 on women admitted for delivery with a positive nasopharyngeal (NP) swab and a SARS-CoV-2 real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test. Following the delivery, the amniotic fluid (AF) and swab from the placenta were tested for SARS-CoV-2 by the Truenat test. The umbilical cord and maternal blood were analyzed to detect immunoglobulin M (IgM) and immunoglobulin G (IgG). The nasopharyngeal swabs of the newborns were tested for SARS-CoV-2 by RT-PCR.
Forty-eight SARS-CoV-2-positive asymptomatic women were included in the study. Twenty-eight (58.3%) were delivered via cesarean section. Preterm delivery occurred in 13 (27.1%) cases. In only one case, vertical transmission was confirmed as the neonate had a positive nasopharyngeal SARS-CoV-2 RT-PCR test and the cord blood was IgM positive (suggesting an immune response in the neonate). The placenta was positive in three cases, and amniotic fluid was positive in two. However, vertical transmission was deemed unlikely in these cases as there was no evidence of immune response or viral persistence according to the WHO criteria. There was one stillbirth, and it tested negative for SARS-CoV-2.
This study strengthens the evidence of vertical transmission in COVID-19-positive asymptomatic mothers. The data suggest a low transmission rate.
世界卫生组织（WHO）已制定了诊断严重急性呼吸综合征冠状病毒2（SARS-CoV-2）垂直传播的标准。本研究旨在使用WHO标准确定印度东部一家三级护理中心SARS-CoV-2垂直传播的发生率。
2021年6月至2022年2月，对因分娩入院且鼻咽拭子（NP）检测呈阳性及SARS-CoV-2实时逆转录聚合酶链反应（RT-PCR）检测呈阳性的女性进行了一项基于医院的前瞻性观察研究。分娩后，通过Truenat检测对羊水（AF）和胎盘拭子进行SARS-CoV-2检测。分析脐带血和母血以检测免疫球蛋白M（IgM）和免疫球蛋白G（IgG）。通过RT-PCR对新生儿的鼻咽拭子进行SARS-CoV-2检测。
48名SARS-CoV-2阳性无症状女性纳入研究。28例（58.3%）通过剖宫产分娩。13例（27.1%）发生早产。仅1例确诊为垂直传播，因为新生儿鼻咽SARS-CoV-2 RT-PCR检测呈阳性且脐带血IgM阳性（提示新生儿有免疫反应）。3例胎盘呈阳性，2例羊水呈阳性。然而，根据WHO标准，这些病例不太可能发生垂直传播，因为没有免疫反应或病毒持续存在的证据。有1例死产，SARS-CoV-2检测呈阴性。
本研究强化了COVID-19阳性无症状母亲垂直传播的证据。数据表明传播率较低。
