In a new study, researchers report that a baby girl in Texas – born prematurely to a mother with COVID-19 – is the strongest evidence to date that intrauterine (in the womb) transmission of SARS-CoV-2 can occur.
The findings suggest in utero transmission of COVID-19 from an infected mother to her infant.
The research was conducted by a team at The University of Texas Southwestern Medical Center, Dallas.
Numerous infants have now been delivered to pregnant women diagnosed with SARS-CoV-2, with the majority of these infants without respiratory illness or positive molecular evidence for SARS-CoV-2.
This study is the first to document intrauterine transmission of the infection during pregnancy, based on immunohistochemical and ultrastructural evidence of SARS-CoV-2 infection in the fetal cells of the placenta.
The authors report on an infant delivered to a mother diagnosed with COVID-19, who also had type 2 diabetes.
The infant was born at 34 weeks’ gestation after the mother had premature rupture of the membranes.
The baby was born “large for gestational age” (LGA) – an important complication in infants of diabetic mothers.
She was treated in the neonatal ICU due to prematurity and possible SARS-CoV-2 exposure.
The infant appeared initially healthy, with normal breathing and other vital signs. On the second day of life, she developed a fever and relatively mild breathing problems.
The baby tested positive for SARS-CoV-2 infection at 24 and 48 hours after birth.
She was treated with supplemental oxygen for several days but did not need mechanical ventilation.
COVID-19 tests remained positive for up to 14 days. At 21 days, the mother and infant were sent home in good condition.
The researchers examined the placenta, which showed signs of tissue inflammation.
In addition, specialized tests documented the presence of coronavirus particles as well as a protein (SARS-CoV-2 nucleocapsid protein) specific for the COVID-19 virus in fetal cells of the placenta.
Together, these findings confirmed that the infection was transmitted in the womb, rather than during or after birth.
Although data on COVID-19 remain very limited, the intrauterine transmission of SARS-CoV-2 appears to be a rare event, the team says.
They highlight several urgent priorities for further research, including the mechanisms and risk factors of in utero SARS-CoV-2 transmission and the outcomes of congenital COVID-19 in infants.
One author of the study is Julide Sisman, M.D.
The study is published in The Pediatric Infectious Disease Journal.
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