COVID-19: early data show no vertical transmission risk in pregnant women

  • Chen H, et al
  • Lancet
  • 13 Feb 2020

  • curated by Liz Scherer
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Early data suggest there is no vertical transmission of the 2019 novel coronavirus SARS-CoV-2 in late pregnancy among pregnant women with confirmed COVID-19 pneumonia. 
  • A related editorial calls the findings "valuable" for these emergent circumstances.

Why this matters

  • Counseling, screening, and follow-up are important in pregnant patients. 
  • Neonates born to women with confirmed COVID-19 should be isolated for ~14 days from birth, and breastfeeding and close maternal contact should be avoided.

Key results

  • 9 third-trimester pregnancies (range, 36-39 weeks, +4 days); age range, 26-40 years; 6/9 testing samples.
  • 9/9 had cesarean sections.
  • Symptoms: low fever (36.5-38.8°C) without chills (7 before delivery; other 2 developed fever postpartum); cough (n=4), myalgia (n=3), sore throat (n=2), malaise (n=2), gastrointestinal illness (n=1), shortness of breath (n=1).
  • Pregnancy complications: fetal distress (n=2), premature rupture of membranes (n=2), gestational diabetes (n=1), preeclampsia (n=1).
  • Labs: lymphopenia (9 cells/L; n=5), C-reactive protein (>10 mg/L; n=6), elevated liver enzymes (n=3), low/normal white cell count (n=7).
  • 8/9: typical COVID-9 chest CT images.
  • 9/9 live births, no neonatal asphyxia.
  • 9/9 had 1-min Apgar scores of 8-9 and 5-min Apgar scores of 9-10.

Study design

  • Retrospective case review describing clinical characteristics, potential intrauterine vertical transmission of COVID-19 in pregnant women hospitalized with confirmed COVID-19 pneumonia.
  • Funding: Hubei Science and Technology Plan; Wuhan University Medical Development Plan.

Limitations

  • Small sample.
  • Early pregnancy transmission potential unclear.
  • Intrapartum, uterine ascending transmission risk unclear.