Single article

DOI: 10.47026/2413-4864-2021-3-35-47

Denisova T.G., Sergeeva A.I., Grigoreva A.S., Rechapova E.E., Sergeev I.I., Denisova E.A.

Possible Health Consequences for Newborns from Mothers WHO Suffered COVID-19 During Pregnancy

Keywords: COVID-19, SARS-CoV-2, pregnancy, newborns, fetus

According to the WHO statement dated March 11, 2020, the coronavirus infection SARS-CoV-2 has reached the scale of a pandemic and is currently a world health problem. A special group of the population that requires increased attention is pregnant women due to the fact that pneumonia occupies the third place in the structure of indirect causes of maternal mortality. Pregnant women whose immune system has changed appeared to be at an increased risk of infection. Pregnancy is a risk factor for the development of a more severe course of acute respiratory viral diseases and influenza. To date, the issue of intrauterine transmission of coronavirus disease remains completely unexplored, which causes fear among pregnant women for the future generation. Addition of a new coronavirus infection SARS-CoV-2 has a negative impact on pregnancy, childbirth and the postpartum period, the health of newborns, especially in patients with a burdened obstetric history. Pregnancy itself and childbirth do not affect the course of COVID-19, but the infection addition can complicate the course of gestation, causing respiratory distress syndrome, premature birth and spontaneous miscarriages, congenital pneumonia and antenatal death of newborns born from covid-positive mothers. The literature published from December 1, 2019 to July 30, 2021 was searched in several databases, including PubMed, Web of Science, Google Scholar and the WHO COVID-19 database, of which 52 articles were selected for detailed consideration. The relevant literature was searched to understand the issues of infection transmission to newborns from infected mothers and the clinical manifestations of the disease in the former. As a result, it was found that newborns can become infected with SARS-Cov-2 in close contact with infected patients or asymptomatic virus carriers. However, based on the data of modern literature, it is impossible to unequivocally answer the questions posed, more facts are needed to solve the problem. The practical significance of the work is that the results of the study should be used for further studying the consequences of COVID-19 for the health of newborn children.

References

  1. Anesteziologo-reanimatsionnoe obespechenie patsientov s novoi koronavirusnoi infektsiei COVID-19: metod. Rekomendatsii (versiya № 2 ot 18.04.2020 g.) [Anesthetic and resuscitation support for patients with new coronavirus infection COVID-19: guidelines (version no. 2 dated 04.18.2020)]. Available as: https://rmapo.ru/uploads/korona/mpk-kv-2.pdf.
  2. Bezhenar’ V.F., Ailamazyan E.K., Zazerskaya I.E. et al. Kratkie klinicheskie rekomendatsii. Taktika vedeniya beremennykh, rozhenits i rodil’nits s podozreniem ili podtverzhdennoi infektsiei COVID-19 [Management of pregnant women, women in labor and postpartum women with suspected or confirmed COVID-19 infection]. MKB-10: U07.2, U07.1. St. Petersburg, EkoVektor Publ., 2020, 47 p. DOI: https://doi.org/10.17816/JOWDS20201.
  3. Bezhenar’ V.F., Zazerskaya I.E., Bettikher O.A., Nesterov I.M., Bautin A.E. Spornye voprosy akusherskoi taktiki pri vedenii beremennosti i rodorazreshenii patsien-tok s novoi koronavirusnoi infektsiei COVID-19 [Controversial issues of obstetric tactics in the management of pregnancy and delivery of patients with the new coronavirus infection COVID-19]. Akusherstvo i ginekologiya, 2020, no. 5, pp. 13–21. DOI: https://dx.doi.org/10.18565/aig.2020.5.13-21.
  4. Bettokki S., Veretski A., Ivanov D.O., Kondo U., Krylov K.Yu., Lisi F., Petragliya F., Reznik V.A., Rukhlyada N.N., Saini S., Sanabria D. Obobshchennyi plan raboty akusherskikh statsionarov i ambulatorii v usloviyakh pandemii s podozreniem ili podtverzhdennym COVID-19 [Generalized work plan for obstetric hospitals and outpatient clinics in a pandemic with suspected or confirmed COVID-19]. Akusherstvo i ginekologiya, 2020, no. 5, pp. 34–41. DOI: https://dx.doi.org/10.18565/aig.2020.5.34-41.
  5. Bezhenar’ V.F., Zazerskaya E., eds. Vnebol’nichnye pnevmonii u beremennykh: differentsial’naya diagnostika, osobennosti lecheniya, akusherskaya taktika v usloviyakh pandemii novoi koronavirusnoi infektsii COVID-19 [Community-acquired pneumonia in pregnant women: differential diagnosis, treatment features, obstetric tactics in a pandemic of the new coronavirus infection COVID-19]. MKB-10 (J13–J16 i J18; U07.1, U07.2). St. Petersburg, EkoVektor Publ. 2020, 95 p. DOI: https://doi.org/10.17816/JOWDS20202.
  6. Ignatko I.V., Strizhakov A.N., Timokhina E.V., Denisova Yu.V. Novaya koronavirusnaya infektsiya (COVID-19): printsipy organizatsii akusherskoi pomoshchi v usloviyakh pandemii [New coronavirus infection (COVID-19): principles for organizing obstetric care in a pandemic]. Akusherstvo i ginekologiya, 2020, no. 5, pp. 22–33. DOI: https://dx.doi.org/10.18565/aig.2020.5.22-33.
  7. Priputnevich T.V., Gordeev A.B., Lyubasovskaya L.A., Shabanova N.E. Novyi koronavirus SARS-CoV-2 i beremennost’: obzor literatury [The new SARS-CoV-2 coronavirus and pregnancy: a literature review]. Akusherstvo i ginekologiya, 2020, no. 5, pp. 6–12. DOI: https://dx.doi.org/10.18565/aig.2020.5.6-12.
  8. Rukovodstvo po profilaktike i lecheniyu novoi koronavirusnoi infektsii COVID-19 [Guidelines for the prevention and treatment of the novel coronavirus infection, COVID-19]. First Academic Hospital of Zhejiang University School of Medicine; compiled from clinical practice. Available at: https://ria.ru/ips/op/COVID_19_Book.pdf.
  9. A message for pregnant women and their families. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZOG), updated Friday 6 August 2021. Available at: https://ranzcog.edu.au/statements-guidelines/covid-19-statement/information-for-pregnant-women.
  10. Accelerated emergency use authorization (EUA) Summary. SARS-cov-2 ASSAY (Rutgers Clinical Genomics Laboratory). Food and Drug Administration (FDA), April 20, 2020. Available at: https://www.fda.gov/media/136875/download.
  11. Algarroba G.N., Rekawek P., Vahanian S.A., Khullar P., Palaia T., Peltier M.R. et al. Visualization of SARS-CoV-2 virus invading the human placenta using electron microscopy. Am J Obstet Gynecol., 2020, vol. 223(2), pp. 275–278. DOI: 10.1016/j.ajog.2020.05.023.
  12. Alzamora M.C., Paredes T., Caceres D., Webb C.M., Valdez L.M., La Rosa M. Severe COVID-19 during pregnancy and possible vertical transmission. Am J Perinatol., 2020, vol. 37(08), pp. 861–865. DOI: 10.1055/s-0040-1710050.
  13. Baud D., Greub G., Favre G., Gengler C., Jaton K., Dubruc E. et al. Second-trimester miscarriage in a pregnant woman with SARS-CoVo-2 infection. Journal of the American Medical Association (JAMA), 2020, vol. 323(21), pp. 2198–2200. DOI: 10.1001/jama.2020.7233.
  14. Cimolai N. Conflicting evidence on vertical transmission and maternal SARS-CoV-2 infection. Canadian Medical Association Journal (CMAJ), 2020, vol. 192(47), E1547. DOI: 10.1503/cmaj.76892.
  15. Coronavirus (COVID-19) Infection in Pregnancy. Royal College of Obstetricians and Gynaecologists, Version 8, Publ. 17 April 2020. Available at: https://www.rcm.org.uk/media/3892/2020-04-17-coronavirus-covid-19-infection-in-pregnancy.pdf.
  16. Coronavirus disease (COVID-19) technical guidance: Infection prevention and control/WASH. World Health Organization. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/infection-prevention-and-control.
  17. Coronavirus disease (COVID-19): Pregnancy and childbirth. World Health Organization, Sept. 2, 2020. Available at: https://www.who.int/news-room/q-a-detail/q-a-on-covid-19-pregnancy-childbirth-and-breastfeeding.
  18. De Rose D.U., Piersigilli F., Ronchetti M.P. et al. Novel Coronavirus disease (COVID-19) in newborns and infants: what we know so far. Italian Journal of Pediatrics, 2020, vol. 46, Article number 56. DOI: https://doi.org/10.1186/s13052-020-0820-x.
  19. Dumitriu D., Emeruwa U.N., Hanft E. et al. Outcomes of Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection at a Large Medical Center in New York City. JAMA Pediatrics, 2021, vol. 175(2), pp. 157–167. DOI: 10.1001/jamapediatrics.2020.4298.
  20. Farghaly M.A.A., Kupferman F., Castillo F., Kim R.M. Characteristics of Newborns Born to SARS-CoV-2-Positive Mothers: A Retrospective Cohort Study. American Journal of Perinatology, 2020, vol. 37(13), pp. 1310–1316. DOI: 10.1055/s-0040-1715862.
  21. He Z., Fang Y., Zuo Q., Huang X., Lei Y., Ren X. et al. Vertical transmission and kidney damage in newborns from coronavirus disease 2019 infection pregnant mother. International Journal of Antimicrobial Agents, 2020, vol. 57(2), 106260. DOI: 10.1016/j.ijantijmicrag.2020.106260.
  22. Hecht J.L., Quade B., Deshpande V., Mino-Kenudson M., Ting T.T., Desai N. et al. SARS-CoV-2 can infect the placenta and is not associated with specific placental histopathology: a series of 19 placentas from COVID-19-positive mothers. Modern Pathology, 2020, vol. 33, pp. 2092–2103. DOI: https://doi.org/10.1038/s41379-020-0639-4.
  23. Huijun Chen, Juanjuan Guo et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet, 2020, vol. 395(10226), pp. 809–815. DOI: https://doi.org/10.1016/S0140-6736(20)30360-3.
  24. Kalafat E., Yaprak E., Cinar G., Varli B., Ozisik S., Uzun C. et al. Lung ultrasound and computed tomographic findings in pregnant woman with COVID-19. Ultrasound in Obstetrics and Gynecology, 2020, vol. 55(6), pp. 835–837. DOI: 10.1002/uog.22034.
  25. Kirtsman M, Diambomba Y, Poutanen SM, Malinowski AK, Vlachodimitropoulou E, Parks WT, et al. Probable congenital SARS-CoV-2 infection in a neonate born to a woman with active SARS-CoV-2 infection. Canadian Medical Association Journal (CMAJ), 2020, vol. 192(24), pp. E647–E650. DOI: 10.1503/cmaj.200821.
  26. Lee D.H., Lee J., Kim E., Woo K., Park H.Y., An J. Emergency cesarean section performed in a patient with confirmed severe acute respiratory syndrome coronavirus-2 – a case report. Korean Journal of Anesthesiology, 2020, vol. 73(4), pp. 347–351. DOI: 10.4097/kja.20116.
  27. Li J., Wang Y., Zeng Y., Song T., Pan X., Jia M., He F., Hou L., Li B., He S., et al. Critically ill pregnant patient with COVID-19 and neonatal death within two hours of birth. International Journal Gynecology and Obstetrics, 2020, vol. 150, pp. 126–128. DOI: 10.1002/ijgo.13189.
  28. Liu W., Wang J., Li W., Zhou Z., Liu S., Rong Z. Clinical characteristics of 19 neonates born to mothers with COVID-19. Frontiers in Medicine, 2020, vol. 14(2), pp. 193–198. DOI: 10.1007/s11684-020-0772-y.
  29. Looken-Lokken E.M., Walker C.L., Delaney S., Kachikis A., Kretzer N.M., Erickson A., Resnick R., Vanderhoeven J., Hwang J.K., Barnhart N., et al. Clinical Characteristics of 46 Pregnant Women with a SARS-CoV-2 Infection in Washington State. American Journal of Obstetrics and Gynecology, MFM, 2020. DOI: 10.1016/j.ajog.2020.05.031.
  30. Lü M., Qiu L., Jia G., Guo R., Leng Q. Single-cell expression profiles of ACE2 and TMPRSS2 reveals potential vertical transmission and fetus of SARS-CoV-2. Aging, 2020, vol. 12(20), pp. 19880–19897. DOI: 10.18632/aging.104015.
  31. Lv Y., Gu B., Chen Y., Hu S., Ruan T., Xu G. et al. No intrauterine vertical transmission in pregnancy with COVID-19: a case report. Journal of Infection and Chemotherapy, 2020, vol. 26(12), pp. 1313–1315. DOI: 10.1016/j.jiac.2020.07.015.
  32. Mirbeyk M., Saghazadeh A., Rezaeicorresponding N. A systematic review of pregnant women with COVID-19 and their neonates. Archives Gynecology and Obstetrics, 2021, vol. 304(1), pp. 5–38. DOI: 10.1007/s00404-021-06049-z.
  33. Naves do Amaral W., Leão de Moraes C. Maternal Coronavirus Infections and Neonates Born to Mothers with SARS-CoV-2: A Systematic Review. Healthcare (Basel), 2020, vol. 8(4), p. 511. DOI: https://doi.org/10.3390/healthcare8040511.
  34. Palalioglu R.M., Mahammadaliyeva A., Erbiyik H.I., Muhcu M. COVID-19 in third trimester may not be as scary as you think, it can be innocent: evaluating vertical transmission from a COVID-19 positive asymptomatic pregnant woman with early membrane rupture. Journal Obstetrics and Gynaecology Research, 2020, vol. 47(2), pp. 838–842. DOI: https://doi.org/10.1111/jog.14584.
  35. Patanè L., Morotti D., Giunta M.R., Sigismondi C., Piccoli M.G., Frigerio L. et al. Vertical transmission of COVID-19: SARS-CoV-2 RNA on the fetal side of the placenta in pregnancies with COVID-19 positive mothers and neonates at birth. American Journal of Obstetrics and Gynecology, MFM, 2020, vol. 2(3), 100145. DOI: 10.1016/j.ajogmf.2020.100145.
  36. Penfield C.A., Brubaker S.G., Limaye M.A., Lighter J., Ratner A.J., Thomas K.M. et al. Detection of SARS-CoV-2 in placental and fetal membrane samples. American Journal of Obstetrics and Gynecology, MFM, 2020, vol. 2(3), 100133. DOI: 10.1016/j.ajogmf.2020.100133.
  37. Pique-Regi R., Romero R., Tarca A.L., Luca F., Xu Y., Alazizi A. et al. Does the human placenta express the canonical cell entry mediators for SARS-CoV-2. Elife, 2020, vol. 9, e58716. DOI: 10.7554/eLife.58716.
  38. Ronchi A., Pietrasanta C., Zavattoni M. et al. Evaluation of Rooming-in Practice for Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Italy. JAMA Pediatrics, 2021, vol. 175(3), pp. 260–266. DOI: 10.1001/jamapediatrics.2020.5086.
  39. Rubio Lorente A.M., Pola Guillén M., López Jimenez N., Moreno-Cid Garcia-Suelto M., Rodriguez Rodriguez E., Pascual Pedreño A. Study of amniotic fluid in pregnant women infected with SARS-CoV-2 in first and second trimester: is there evidence of vertical transmission. Journal of Maternal-Fetal and Neonatal Medicine, 2020. DOI: 10.1080/14767058.2020.1811669.
  40. Schwartz D.A., Graham A.L. Potential maternal and infant outcomes from Coronavirus 2019-nCoV (SARS-CoV-2) infecting pregnant women: Lessons from SARS, MERS, and other human coronavirus infections. Viruses. 2020, vol. 12(2), p. 194. DOI: https://doi.org/10.3390/v12020194.
  41. Sisman J., Jaleel M., Moreno W., Rajaram V. et al. Intrauterine Transmission of SARS-COV-2 Infection in a Preterm Infant. Case Reports Pediatric Infectious Diseases Journals, 2020, vol. 39(9), e265-e267. DOI:10.1097/INF.0000000000002815.
  42. Umakanthan S., Sahu P., Ranade A.V., Bukelo M.M., Rao J.S., Abrahao-Machado L.F., Dahal S., Kumar H., Kv D. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgraduate Medical Journal, 2020, vol. 96(1142), pp. 753–758. DOI: 10.1136/postgradmedj-2020-138234.
  43. Wang S., Guo L., Chen L., Liu W., Cao Y., Zhang J. et al. A case report of neonatal COVID-19 infection in China. Clinical Infectious Diseases, 2020, vol. 71(15), pp. 853–857. DOI: 10.1093/cid/ciaa225.
  44. Wang X., Zhou Z., Zhang J., Zhu F., Tang Y., Shen X. A case of 2019 novel coronavirus in a pregnant woman with preterm delivery. Clinical Infectious Diseases, 2020, vol. 71(15), pp. 844–846. DOI: 10.1093/cid/ciaa200.
  45. Wong S.F., Chow K.M., Leung T.N., Ng W.F., Ng T.K., Shek C.C., Ng P.C., Lam P.W., Ho L.C., To W.W., Lai S.T., Yan W.W., Tan P.Y. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. American Journal of Obstetrics and Gynecology, 2004, vol. 191(1), pp. 292–297. DOI: https://doi.org/10.1016/j.ajog.2003.11.019.
  46. Zamaniyan M., Ebadi A., Aghajanpoor S., Rahmani Z., Haghshenas M., Azizi S. Preterm delivery, maternal death, and vertical transmission in a pregnant woman with COVID-19 infection. Prenat Diagn., 2020, vol. 40(13), pp. 1759-1761 DOI: 10.1002/pd.5713.
  47. Zambrano L.I., Fuentes-Barahona I.C., Bejarano-Torres D.A., Bustillo C., Gonzales G., Vallecillo-Chinchilla G. et al. A pregnant woman with COVID-19 in Central America. Travel Medicine and Infectious Disease, 2020, vol. 36, 101639. DOI: 10.1016/j.tmaid.2020.101639.

About authors

Denisova Tamara G.
Doctor of Medical Sciences, Professor, Department of Obstetrics and Gynecology, Chuvash State University, Russia, Cheboksary (tomadenisova@rambler.ru; ORCID: https://orcid.org/0000-0002-0517-2632)
Sergeeva Adelina I.
Candidate of Medical Sciences, Head of the Department of Pediatrics and Pediatric Surgery, Chuvash State University, Russia, Cheboksary (sergeyeva@list.ru; ORCID: https://orcid.org/0000-0003-2973-625X)
Grigorieva Alexandra S.
3rd Year Student of the Medicine Faculty, Chuvash State University, Russia, Cheboksary (aleksaumka01@mail.ru; ORCID: https://orcid.org/0000-0002-5761-8384)
Rechapova Enje E.
4th Year Student of the Medicine Faculty, Chuvash State University, Russia, Cheboksary (endzhe.rechapova@mail.ru; ORCID: https://orcid.org/0000-0001-5072-4814)
Sergeev Ivan I.
Assistant Lecturer, Department of Pediatrics and Pediatric Surgery, Chuvash State University, Russia, Cheboksary (sergeyeva@list.ru; ORCID: https://orcid.org/0000-0003-1921-8774)
Denisova Elena A.
Candidate of Medical Sciences, Associate Professor, Department of Obstetrics and Gynecology, Chuvash State University, Russia, Cheboksary (gubanova.elena@gmail.com; ORCID: https://orcid.org/0000-0002-5054-3826)

Article link

Denisova T.G., Sergeeva A.I., Grigoreva A.S., Rechapova E.E., Sergeev I.I., Denisova E.A. Possible Health Consequences for Newborns from Mothers WHO Suffered COVID-19 During Pregnancy [Electronic resource] // Acta medica Eurasica. – 2021. – №3. P. 35-47. – URL: http://acta-medica-eurasica.ru/en/single/2021/3/5/. DOI: 10.47026/2413-4864-2021-3-35-47.