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Vertical transmission of SARS-CoV-2 – data from the German COVID-19 related obstetric and neonatal outcome study (CRONOS)

  • Nadine Mand ORCID logo EMAIL logo , Mario Rüdiger , Matthias Hütten , Rolf Felix Maier , Lars Mense and Ulrich Pecks
Published/Copyright: January 5, 2024
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 52 Issue 2

Abstract

Objectives

We aimed to determine the frequency of SARS-CoV-2 positivity in newborns born to mothers with peripartum SARS-CoV-2 infection in a German cohort, to identify potential risk factors associated with neonatal SARS-CoV-2 infection, and to present short-term outcomes of newborns with vertical transmission of SARS-CoV-2.

Methods

Data on women with SARS-CoV-2 infection occurring anytime during their pregnancy was gathered prospectively within the CRONOS registry. From April 2020 to February 2023 a total of 8,540 women had been registered. The timing and the probability of mother-to-child transmission in neonates born to women with perinatal SARS-CoV-2 infection were classified using the WHO classification system. The severity of maternal infection, maternal vaccination status, type of dominant virus, and perinatal outcome parameters were analyzed as potential risk factors for neonatal SARS-CoV-2 infection.

Results

6.3 % resp. 42.9 % of tested newborns and stillbirths were SARS-CoV-2 positive. 2.1 % of newborns with confirmed and possible SARS-CoV-2 infection were identified. Severe maternal COVID-19 (odds ratio 4.4, 95 % confidence interval 1.8–11.1) and maternal infection with the Delta virus (OR 3.2, 1.4–7.7) were associated with neonatal SARS-CoV-2 infection. Newborns with a confirmed or possible infection were significantly more often admitted to the NICU (65.2 % neonatal infection vs. 27.5 % non, p<0.001).

Conclusions

The rate of neonatal SARS-CoV-2 positivity was higher in our cohort than previously reported, neonatal SARS-CoV-2 infections were rare. Our data emphasizes confirmative testing should be performed in newborns of SARS-CoV-2 infected mothers to identify neonatal SARS-CoV-2 infection as an underlying pathology leading to NICU admission.

Keywords: neonatal SARS-CoV-2; vertical transmission; pregnancy
Corresponding author: Nadine Mand, MD, Department of Pediatrics, Philipps University of Marburg, Baldingerstraße, 35043 Marburg, Germany, E-mail: .

Funding source: CAU/UKSH, Land Schleswig-Holstein

Funding source: Krumme-Stiftung Kiel

Funding source: DGPM

  1. Research ethics: Ethical approval was obtained from the Ethics Committee of the University of Schleswig-Holstein (UKSH) (AZ: D 451/20) and local Ethical Committees as appropriate.

  2. Informed consent: Informed consent was obtained from all individuals included in this study.

  3. Author contributions: NM designed and conducted the analyses reported in this study and wrote the manuscript. UP contributed significantly to the design of these analyses. MH, LM, RFM, UP and MR all contributed significantly to the final draft of this manuscript by discussing the results and their interpretations and by revising earlier drafts. UP and MR are the principal investigators of the CRONOS Network. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: The CRONOS-Network received funding from CAU/UKSH, Land Schleswig-Holstein, DGPM, and, Krumme-Stiftung Kiel.

  6. Data availability: The raw data can be obtained on request from the corresponding author.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/jpm-2023-0299).

Received: 2023-07-20
Accepted: 2023-10-07
Published Online: 2024-01-05
Published in Print: 2024-02-26

© 2023 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

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  9. The association between obesity and the success of trial of labor after cesarean delivery (TOLAC) in women with past vaginal delivery
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  15. Vertical transmission of SARS-CoV-2 – data from the German COVID-19 related obstetric and neonatal outcome study (CRONOS)
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  17. Pregnancy and neonatal outcomes of SARS-CoV-2 infection discovered at the time of delivery: a tertiary center experience in North Italy
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  19. Original Articles – Fetus
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  22. Letters to the Editor
  23. ChatGPT, artificial intelligence and the Journal of Perinatal Medicine: correspondence
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https://doi.org/10.1515/jpm-2023-0299
Keywords for this article
neonatal SARS-CoV-2; vertical transmission; pregnancy

Articles in the same Issue

  1. Frontmatter
  2. Mini Review
  3. Artificial intelligence in the NICU to predict extubation success in prematurely born infants
  4. Original Articles – Obstetrics
  5. Amniotic fluid embolism: a reappraisal
  6. A multivariable prediction model for intra-amniotic infection in patients with preterm labor and intact membranes including a point of care system that measures amniotic fluid MMP-8
  7. Analysis of gastric fluid in preterm newborns supports the view that the amniotic cavity is sterile before the onset of parturition: a retrospective cohort study
  8. The effect of uterine closure technique on cesarean scar niche development after multiple cesarean deliveries
  9. The association between obesity and the success of trial of labor after cesarean delivery (TOLAC) in women with past vaginal delivery
  10. Validation of an automated software (Smartpelvic™) in assessing hiatal area from three dimensional transperineal pelvic volumes of pregnant women: comparison with manual analysis
  11. Pathogenic recurrent copy number variants in 7,078 pregnancies via chromosomal microarray analysis
  12. Obstetric pulmonary embolism and long-term cardiovascular symptoms: a cross-sectional study in Western Mexico
  13. Clinical characteristics and outcomes of women with adenomyosis pain during pregnancy: a retrospective study
  14. Disparities in preconception health indicators in U.S. women: a cross-sectional analysis of the behavioral risk factor surveillance system 2019
  15. Vertical transmission of SARS-CoV-2 – data from the German COVID-19 related obstetric and neonatal outcome study (CRONOS)
  16. Effects of sildenafil on Doppler parameters, maternal and neonatal outcomes in the active labor phase of low-risk pregnancies: a randomized clinical trial
  17. Pregnancy and neonatal outcomes of SARS-CoV-2 infection discovered at the time of delivery: a tertiary center experience in North Italy
  18. The impact of the COVID-19 pandemic on antenatal care provision and associated mental health, obstetric and neonatal outcomes
  19. Original Articles – Fetus
  20. Left atrial strain in fetal echocardiography – could it be introduced to everyday clinical practice?
  21. The evaluation of fetal interventricular septum with M-mode and spectral tissue Doppler imaging in gestational diabetes mellitus: a case-control study
  22. Letters to the Editor
  23. ChatGPT, artificial intelligence and the Journal of Perinatal Medicine: correspondence
  24. Re: to the Letter to the Editor: “ChatGPT and artificial intelligence in the Journal of Perinatal Medicine”
  25. Retraction
  26. Clinical potential of human amniotic fluid stem cells
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