Investigating the risk of maternal-fetal transmission of SARS-CoV-2 in early pregnancy

Placenta. 2021 Mar:106:25-29. doi: 10.1016/j.placenta.2021.02.006. Epub 2021 Feb 14.

Abstract

Introduction: The possibility of vertical transmission of SARS-CoV-2 from the mother to the fetus is one of the most crucial issues regarding the COVID-19 effects on pregnancy. In this study, we aimed to explore the risk of maternal-fetal transmission before 24 weeks of gestation, through analysis of abortion materials collected from PCR-positive women with pregnancy loss. To the best of our knowledge, apart from case reports, this study is the first prospective work on the vertical transmission of SARS-CoV-2 in early pregnancy.

Methods: The patients who had attended our clinic with the diagnosis of pregnancy loss before 24 weeks of gestation were screened for COVİD-19. Vertical transmission in PCR-positive women was assessed through the presence of SARS-CoV-2 RNA in fetal-placental tissues by rt-PCR test.

Results: 24 of 210 (%11,4) pregnant women participating in the study had positive rt-PCR results. Placenta and curettage material samples of these PCR-positive patients were analyzed and all valid test results (21 samples) were negative for SARS CoV-2 RNA. In three cases, the rt-PCR results were invalid due to failed internal controls.

Discussion: In the literature, the possibility of intrauterine vertical transmission of SARS-CoV-2 is still controversial. The findings of the present study did not reveal any evidence of vertical transmission of SARS-CoV-2 in early pregnancy.

Keywords: Early pregnancy; Maternal-fetal transmission; Placenta; SARS-CoV-2; rt-PCR.

MeSH terms

  • Abortion, Spontaneous / diagnosis
  • Abortion, Spontaneous / epidemiology
  • Abortion, Spontaneous / etiology
  • Abortion, Spontaneous / virology
  • Adult
  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology
  • COVID-19 / therapy
  • COVID-19 / transmission*
  • Female
  • Fetus / pathology
  • Fetus / virology
  • Gestational Age
  • Humans
  • Infectious Disease Transmission, Vertical* / statistics & numerical data
  • Maternal-Fetal Exchange / physiology
  • Placenta / pathology
  • Placenta / virology
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis*
  • Pregnancy Complications, Infectious / epidemiology
  • Pregnancy Complications, Infectious / therapy
  • Pregnancy Complications, Infectious / virology
  • Pregnancy Outcome / epidemiology
  • Pregnancy Trimester, First
  • Pregnancy Trimester, Second
  • Prospective Studies
  • RNA, Viral / isolation & purification
  • Risk Factors
  • SARS-CoV-2 / isolation & purification
  • SARS-CoV-2 / physiology*
  • Turkey / epidemiology
  • Young Adult

Substances

  • RNA, Viral