Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn
This case report describes the birth of an infant to a mother with PCR-confirmed Covid-19, who had elevated IgM antibodies to SARS-CoV-2 at birth despite no physical contact (mother wore a mask and did not hold her), suggesting the possibility of infection in utero.
Source:
Journal of the American Medical Association
SPS commentary:
The authors note that although infection at delivery cannot be ruled out, IgM antibodies do not usually appear until 3-7 days after infection, and the elevated levels in the neonate were seen two hours after birth. The report is limited to a single case, and by the fact that no PCR testing of amniotic fluid or placenta was performed. They acknowledge that a series of 9 pregnant women found no mother-child transmission and say additional examination of maternal and newborn samples are required to confirm this preliminary observation.
An editorial accompanying this research paper, and another published early online in JAMA, notes that there was no virologic evidence for congenital infection in these cases (negative PCR swab) to support the suggested in utero transmission; “nevertheless the serological data are provocative for a virus that is believed to be spread by respiratory secretions and—given the modeling showing that a significant percentage of the world’s population, many of them pregnant women, will be infected over the next weeks or months—it is one that deserves careful consideration.” Currently the data are not conclusive and additional research is required to confirm this preliminary observation.