Maternal transmission of COVID-19 to baby during pregnancy is uncommon

This shows a pregnant woman
These findings show that neonatal COVID-19 infection is uncommon, and also commonly asymptomatic in those babies who are affected. Image is in the public domain.

Summary: A systematic review of 49 studies reveals neonatal coronavirus infection is uncommon, and also commonly asymptomatic in infected babies. Data also showed infection rates were no higher when a baby was born vaginally, as opposed to delivered via cesarean section, breastfed, or allowed immediate contact with the mother after birth.

Source: University of Nottingham

Transmission of COVID-19 from mother to baby during pregnancy is uncommon, and the rate of infection is no greater when the baby is born vaginally, breastfed or allowed contact with the mother, according to a new study.

The research also found that babies that did test positive for COVID-19, were mostly asymptomatic. The findings are published in BJOG: An International Journal of Obstetrics and Gynaecology.

Many early reports in the literature on COVID-19 in pregnancy suggested that in order to reduce the risk of transmission of COVID-19 from mother to baby, it was safer to have a caesarean, to isolate the baby from the mother at birth and to formula feed, but there was very little evidence to support these guidelines.

To conclusively look at the risks associated with COVID-19 and pregnancy, experts from the School of Medicine at the University of Nottingham have undertaken a systematic review of 49 studies looking into this much talked about topic.

The studies reviewed included 666 neonates (newborn babies) and 655 women (as some women delivered twins). Of the women who delivered their babies vaginally, only eight out of 292 (2.7%) had a baby which tested positive for COVID-19.

Of the 364 women who had a caesarean, 20 (5.3%) of those had a baby which tested positive for COVID-19.

These findings show that neonatal COVID-19 infection is uncommon, and also commonly asymptomatic in those babies who are affected.

The data also showed that the infection rates to be no higher when the baby was born vaginally, breast fed or allowed contact with the mother immediately after birth.

The systematic review was an international effort carried out by Dr Kate Walker, Clinical Associate Professor in Obstetrics, and Jim Thornton, Professor of Obstetrics and Gynaecology, from the University of Nottingham, as well as experts at Dalhousie University, Canada and Monash University, Clayton, Australia, and University College Cork, Cork University Maternity Hospital, Ireland.

Dr Walker said: “There has been a lot of concern around whether pregnant women should be concerned for the health of their babies if they contract COVID-19.

“We wanted to look at the outcome for babies whose mothers contracted the virus and see if the route of birth, method of infant feeding and mother/baby interaction increased the risk of babies contracting the virus. From our results, we are satisfied that the chance of newborn infection with COVID-19 is low.

“We would also stress that a vaginal birth and breast feeding are safe for mothers who find themselves in these circumstances.”

Dr Jeannette Comeau, is a Paediatric Infectious Diseases Physician at Dalhousie University, she said: “I am happy to see that the data continues to be reassuring, supporting keeping the mother/infant pair together after birth, underlining that while occasional postnatal infant infection is detected, clinical course tends to be mild. From the cases of infection in the newborn we do not have confirmatory evidence that this infection was acquired in the womb or during birth.”

About this neuroscience research article

Source:
University of Nottingham
Media Contacts:
Charlotte Anscombe – University of Nottingham
Image Source:
The image is in the public domain.

Original Research: Open access
“Maternal transmission of SARS‐COV‐2 to the neonate, and possible routes for such transmission: A systematic review and critical analysis”. by Kate F Walker, Keelin O’Donoghue, Nicky Grace, Jon Dorling, Jeannette L Comeau, Wentao Li, Jim G Thornton.
BJOG doi:10.1111/1471-0528.16362

Abstract

Maternal transmission of SARS‐COV‐2 to the neonate, and possible routes for such transmission: A systematic review and critical analysis

Background
Early reports of COVID‐19 in pregnancy described management by caesarean, strict isolation of the neonate and formula feeding, is this practise justified?

Objective
To estimate the risk of the neonate becoming infected with SARS‐COV‐2 by mode of delivery, type of infant feeding and mother‐infant interaction

Search Strategy
Two biomedical databases were searched between September 2019 ‐ June 2020.

Selection Criteria
Case reports or case series of pregnant women with confirmed COVID‐19, where neonatal outcomes were reported.

Data Collection and Analysis
Data was extracted on mode of delivery, infant infection status, infant feeding and mother‐infant interaction. For reported infant infection a critical analysis was performed to evaluate the likelihood of vertical transmission.

Main Results
We included 49 studies which included 666 neonates and 655 women where information was provided on the mode of delivery and the infant’s infection status.

28/666 (4%) neonates had confirmed COVID‐19 infection postnatally. Of the 291 women who delivered vaginally, 8/292 (2.7%) neonates were positive. Of the 364 women who had a Caesarean birth, 20/374 (5.3%) neonates were positive.

Of the 28 neonates with confirmed COVID‐19 infection, 7 were breast fed, 3 formula fed, 1 was given expressed breast milk and in 17 neonates the method of infant feeding was not reported.

Conclusions
Neonatal COVID‐19 infection is uncommon, uncommonly symptomatic, and the rate of infection is no greater when the baby is born vaginally, breastfed or allowed contact with the mother.

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