Imaging Confirms Mother-to-Child COVID-19 Transfer

March 27, 2020

Study contradicts earlier research that had not shown transmission was possible.

Despite earlier research indicating that pregnant mothers can’t pass COVID-19 to their unborn children, a new study out of China indicates transmission is possible. Together, CT, X-ray, and DNA testing can confirm the transfer.

A new study published March 26 in JAMA Pediatrics revealed that nearly 10 percent of newborns analyzed tested positive for SARS-CoV-2, the virus that causes COVID-19. These results underscore the need for more stringent infection control measures for this population that is highly vulnerable.

“It is crucial to screen pregnant women and implement strict infection control measures, quarantine of infected mothers, and close monitoring of neonates at risk of COVID-19,” wrote lead study author Wenhao Zhou, Ph.D., from Children’s Hospital of Fudan University.

Initial analyses of pregnant women and COVID-19 have concentrated on whether pregnancy and delivery worsen COVID-19 pneumonia. These studies have shown no evidence to suggest that these women can transfer the virus to their newborns. To make that assessment, previous investigators have examined amniotic fluid, cord blood, and breast milk – all of which have tested negative for SARS-Cov-2.

But, no studies had been done to-date to examine maternal-fetal transfer.

Related Content: CT Findings: Pregnancy and Childbirth Don’t Augment COVID-19 Pneumonia

To test whether mother-to-newborn transmission is occurring, however, Zhou’s team examined every newborn born at Wuhan Children’s Hospital between January and February of this year. All total, 33 newborns were examined, and three tested positive for COVID-19 infection based on reverse transcriptase-polymerase chain reaction (RT-PCR) testing and either X-ray or CT. The team confirmed with RT-PCR testing that the mothers were also infected with SAR-CoV-2.

“Because strict infection control and prevention procedures were implemented during the delivery, it is likely that the sources of SARS-CoV-2 in the neonates’ upper respiratory tracts or anuses were maternal in origin,” Zhou wrote.

Among the three newborns, symptoms were relatively mild, falling in line results from previous studies looking at children. All outcomes were favorable.

The first and second newborns with confirmed SARS-CoV-2 infection were both born around 40 weeks gestation. On the second day of life, they both exhibited lethargy and fever. One experienced vomiting. A chest X-ray revealed COVID-19 pneumonia in both babies. Additionally, RT-PCR testing confirmed positive viral infection on days 2 and 4, but by day 6, they tested negative.

The third newborn was delivered early at approximately 31 weeks and required resuscitation. A chest X-ray showed both pneumonia and neonatal respiratory distress syndrome. With treatment – non-invasive ventilation, caffeine, and antibiotics – these conditions resolved by day 14.

These findings show, the team asserted, that vertical maternal-fetal transmission of COVID-19 can’t be ruled out. Consequently, clinicians must remain on alert for any signs of early-onset infection from mothers who have tested positive for SAR-CoV-2.