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
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Takeaway

  • Early data suggest there is no 2019 novel coronavirus (COVID-19) vertical transmission 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 (n=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 alanine aminotransferase or aspartate aminotransferase (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.