An Analysis of 38 Pregnant Women With COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes

• Published in: Archives of pathology & laboratory medicine (1976) Vol. 144; no. 7; pp. 799 - 805
• Main Author: Schwartz, David A
• Format: Journal Article
• Language: English
• Published: United States College of American Pathologists 01.07.2020
• Subjects: Adult; Analysis; China; China - epidemiology; Coronavirus infections; Coronavirus Infections - complications; Coronavirus Infections - epidemiology; Coronaviruses; COVID-19 - complications; COVID-19 - epidemiology; COVID-19 - transmission; Diseases; Epidemics; Female; Health aspects; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Lung diseases; Marburg virus disease; Maternal mortality; Middle East; Newborn infants; Obstetrics; Pandemics; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Complications, Infectious - virology; Pregnancy Outcome; Pregnant women; SARS-CoV-2; Severe Acute Respiratory Syndrome - complications; Severe Acute Respiratory Syndrome - epidemiology; China; Middle East
• ISSN: 0003-9985; 1543-2165; 1543-2165
• DOI: 10.5858/arpa.2020-0901-SA

The emergence of a novel coronavirus, termed SARS-CoV-2, and the potentially life-threatening respiratory disease that it can produce, COVID-19, has rapidly spread across the globe, creating a massive public health problem. Previous epidemics of many emerging viral infections have typically resulted in poor obstetric outcomes including maternal morbidity and mortality, maternal-fetal transmission of the virus, and perinatal infections and death. This article reviews the effects of 2 previous coronavirus infections-severe acute respiratory syndrome (SARS) caused by SARS-CoV and Middle East respiratory syndrome (MERS) caused by MERS-CoV-on pregnancy outcomes. In addition, it analyzes literature describing 38 pregnant women with COVID-19 and their newborns in China to assess the effects of SARS-CoV-2 on the mothers and infants, including clinical, laboratory, and virologic data, and the transmissibility of the virus from mother to fetus. This analysis reveals that unlike coronavirus infections of pregnant women caused by SARS and MERS, in these 38 pregnant women COVID-19 did not lead to maternal deaths. Importantly, and similar to pregnancies with SARS and MERS, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses. All neonatal specimens tested, including placentas in some cases, were negative by RT-PCR for SARS-CoV-2. At this point in the global pandemic of COVID-19 infection there is no evidence that SARS-CoV-2 undergoes intrauterine or transplacental transmission from infected pregnant women to their fetuses. Analysis of additional cases is necessary to determine if this remains true.