Am J Perinatol 2020; 37(S 02): S31-S38
DOI: 10.1055/s-0040-1714346
Review Article

Vertical Transmission of SARS-CoV-2 (COVID-19): Are Hypotheses More than Evidences?

Cinzia Auriti
1  Neonatal Intensive Care Unit, Department of Medical and Surgical Neonatology, “Bambino Gesù” Children's Hospital IRCCS, Rome, Italy
,
Domenico Umberto De Rose
1  Neonatal Intensive Care Unit, Department of Medical and Surgical Neonatology, “Bambino Gesù” Children's Hospital IRCCS, Rome, Italy
,
Chryssoula Tzialla
2  Neonatal Intensive Care Unit, IRCCS Foundation Policlinico “San Matteo,” Pavia, Italy
,
Leonardo Caforio
3  Fetal Medicine and Surgery Unit, Department of Medical and Surgical Neonatology, “Bambino Gesù” Children's Hospital IRCCS, Rome, Italy
,
Matilde Ciccia
4  Neonatal Intensive Care Unit, Department of Women's and Children's Health, Maggiore Hospital, Bologna, Italy
,
Paolo Manzoni
5  Department of Pediatrics and Neonatology, University Hospital Degli Infermi, Biella, Italy
,
Mauro Stronati
2  Neonatal Intensive Care Unit, IRCCS Foundation Policlinico “San Matteo,” Pavia, Italy
› Author Affiliations
Funding None.

Abstract

In spite of the increasing, accumulating knowledge on the novel pandemic coronavirus severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), questions on the coronavirus disease-2019 (COVID-19) infection transmission from mothers to fetuses or neonates during pregnancy and peripartum period remain pending and have not been addressed so far. SARS-CoV-2, a RNA single-stranded virus, has been detected in the amniotic fluid, in the cord blood and in the placentas of the infected women. In the light of these findings, the theoretical risk of intrauterine infection for fetuses, or of peripartum infection occurring during delivery for neonates, has a biological plausibility. The extent of this putative risk might, however, vary during the different stages of pregnancy, owing to several variables (physiological modifications of the placenta, virus receptors' expression, or delivery route). This brief review provides an overview of the current evidence in this area. Further data, based on national and international multicenter registries, are needed not only to clearly assess the extent of the risk for vertical transmission, but also to ultimately establish solid guidelines and consistent recommendations.

Key Points

  • Questions on the COVID-19 infection transmission from mothers to fetuses or neonates during pregnancy and peripartum period remain pending so far.

  • The theoretical risk of intrauterine infection for fetuses, or of neonatal infection during delivery for neonates, has a biological plausibility.

  • A caution is recommended in the interpretation of clinical and laboratory data in neonates.

Authors' Contributions

C.A. and D.U.D.R. conceptualized and designed the review, analyzed the reported cases, drafted the initial manuscript, and reviewed and revised the manuscript. C.T., L.C., M.C., P.M., and M.S reviewed the extracted data and analyzed the cases and reviewed and revised the final manuscript including all tables and the figure. All authors critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.


Note

A shorter communication on this topic in Italian has been initially sent to the bulletin of the Italian Society of Neonatology (SIN Informa).




Publication History

Publication Date:
05 August 2020 (online)

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.