Infants Born to Mothers With COVID-19 Appear Healthy

By Will Boggs MD

March 17, 2020

NEW YORK (Reuters Health) - Infants born to mothers with COVID-19 appeared to be healthy with no clinical evidence of COVID-19, according to a case series from Wuhan, China.

This early in the COVID-19 pandemic, little is known regarding infant and childhood infections and their clinical picture.

Writing in Frontiers in Pediatrics, Dr. Yalan Liu and colleagues from Tongji Medical College, Huang zhong University of Science and Technology in Wuhan describe the clinical course of four full-term infants born to pregnant women with COVID-19 infection during the third trimester.

Three infants were born by cesarean section due to concerns about symptomatic maternal infection; the fourth was born by vaginal delivery.

All infants were isolated from their mothers immediately after birth. All had 1-minute Apgar scores of 7-8 and 5-minute Apgar scores of 8-9.

Three infants tested negative for COVID-19 in throat swab specimens by RT-PCR 72 hours after birth; the fourth infant's parents declined testing.

Two infants were healthy and clinically normal, and two had transient rashes that resolved spontaneously. One infant developed transient tachypnea of the newborn requiring nasal continuous positive airway pressure, but his breathing became regular within three days. He was taking full formula on day 5 and was discharged from the neonatal intensive care unit on day 7.

All four babies were doing well and receiving formula feeding at last follow-up.

These findings, along with an earlier report, appear to indicate that vertical transmission of COVID-19, if it occurs, is rare.

There has been a case report of neonatal COVID-19 infection in China 36 hours after birth, but it remains unclear whether this is a case of vertical transmission from mother to child.

Dr. David A. Schwartz from Medical College of Georgia in Augusta, who recently reviewed potential maternal and infant outcomes from SARS-CoV-2, the causative agent in COVID-19, told Reuters Health by email, "At this time in the evolution of the SARS-CoV-2 pandemic, pregnant women with COVID-19 do not appear to be at risk for transmitting the virus to their fetus during the 3rd trimester. However, there remains little or no information available on the effects of COVID-19 infection occurring early in pregnancy."

"According to my analysis of a large number of pregnant women with COVID-19 and their infants, which is soon to be published in the Archives of Pathology & Laboratory Medicine, the journal of the College of American Pathologists, no maternal deaths have occurred and there are still no confirmed cases of intrauterine transmission of the virus to the fetus," he said. "I am also not aware of confirmed cases of intrauterine transmission from personal communications with my colleagues in China and elsewhere."

Dr. Liu did not respond to a request for comments.

SOURCE: Frontiers in Pediatrics, online March 16, 2020 and Clinical Infectious Diseases, online March 12, 2020.