Maternal-Fetal Implications of SARS CoV-2 Infection during Pregnancy, Viral, Serological Analyses of Placenta and Cord Blood

Souhail Alouini, Jerôme Guinard, Olivier Belin, Louis Mesnard, Evelyne Werner, Thierry Prazuck and Chantal Pichon
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Souhail Alouini: Department of Obstetrics and Gynecology, Centre Hospitalier Régional d’Orléans, 45100 Orléans, France
Jerôme Guinard: Department of Microbiology, Virology and Parasitology, Centre Hospitalier Régional d’Orléans, 45100 Orléans, France
Olivier Belin: Department of Anesthesiology and Reanimation, Centre Hospitalier Régional d’Orléans, 45100 Orléans, France
Louis Mesnard: Department of Obstetrics and Gynecology, Centre Hospitalier Régional d’Orléans, 45100 Orléans, France
Evelyne Werner: Department of Pediatrics and Neonatal Intensive Unit Care, Centre Hospitalier Régional d’Orléans, 45100 Orléans, France
Thierry Prazuck: Department of Infectious and Tropical Diseases, Centre Hospitalier Régional d’Orléans, 45100 Orléans, France
Chantal Pichon: Centre de Biophysique Moléculaire, CNRS, Université d’Orléans, 45100 Orléans, France

IJERPH, 2022, vol. 19, issue 4, 1-9

Abstract: Objective: There are few data on the maternal–fetal transmission of SARS-CoV-2 and its outcomes. This study aimed to evaluate pregnancy outcomes of pregnant women infected by SARS-CoV-2, to detect SARS-CoV-2 in placenta and different newborns’ samples and search antibodies in cord blood. Methods: This was a prospective study of pregnant women diagnosed with SARS-CoV-2 infection from May 2020 to May 2021. At delivery, the placentas were investigated for SARS-CoV-2 using RT-PCR, cord blood. Mothers’ blood samples were tested by SARS-CoV-2 serology. PCR of nasopharyngeal, anal and gastric swabs (NPSs) of newborns was performed according to pediatric indications. Results: Among 3626 pregnant women presenting at maternity to deliver, 45 mothers had COVID-19 during their pregnancy or at delivery (32 ± 4.8 years). Most of them were multiparous and in the third trimester. There were 35 (77%) women who remained in ambulatory, while 10 (22%) were hospitalized for severe pneumonia, digestive symptoms, and/or fetal tachycardia. Thirty-eight delivered vaginally, and 7 had a cesarean delivery with normal Apgar scores (9 ± 1.6 at 5 min) and umbilical artery pH (7.22 ± 0.08). Two mothers required ICU admission after cesarean section for fetal and maternal distress. Of the 46 newborns, 6 were premature births (13%) and 5 IUGR (intra-uterine growth restriction,11%). RT-PCR SARS-CoV-2 was positive for 1/30 placental, and 1/33 neonatal anal swabs and negative in all other cases and in gastric swabs. SARS-CoV-2 IgG was positive in 20/41 cord blood samples (49%) and their mothers’ samples. IgM was negative in the 23 cord blood samples. Conclusions: Pregnancy outcomes in women diagnosed with COVID-19 during their pregnancy were favorable in most cases. However, some women with severe clinical forms required hospitalization and ICU admission. Preterm births and intrauterine growth retardations were relatively frequent. Vaginal delivery was possible in most cases. SARS-CoV-2 IgG antibodies were positive and elevated in most cord blood samples of newborns. They are possibly of maternal origin, suggesting a probable mechanism of fetal protection against SARS-CoV-2 infection. No SARS-CoV-2 IgM was found in the cord blood samples. Detection of SARS-CoV-2 in placenta is rare.

Keywords: COVID-19; SARS-CoV-2; SARS-CoV-2 antibodies; coronavirus; cord blood; pregnancy; maternal–fetal transmission; real time-PCR; placenta (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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