Vertical transmission of SARS-CoV-2 – data from the German COVID-19 related obstetric and neonatal outcome study (CRONOS)
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.
Funding source: CAU/UKSH, Land Schleswig-Holstein
Funding source: Krumme-Stiftung Kiel
Funding source: DGPM
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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.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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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.
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Competing interests: The authors state no conflict of interest.
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Research funding: The CRONOS-Network received funding from CAU/UKSH, Land Schleswig-Holstein, DGPM, and, Krumme-Stiftung Kiel.
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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).
© 2023 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Mini Review
- Artificial intelligence in the NICU to predict extubation success in prematurely born infants
- Original Articles – Obstetrics
- Amniotic fluid embolism: a reappraisal
- 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
- 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
- The effect of uterine closure technique on cesarean scar niche development after multiple cesarean deliveries
- The association between obesity and the success of trial of labor after cesarean delivery (TOLAC) in women with past vaginal delivery
- Validation of an automated software (Smartpelvic™) in assessing hiatal area from three dimensional transperineal pelvic volumes of pregnant women: comparison with manual analysis
- Pathogenic recurrent copy number variants in 7,078 pregnancies via chromosomal microarray analysis
- Obstetric pulmonary embolism and long-term cardiovascular symptoms: a cross-sectional study in Western Mexico
- Clinical characteristics and outcomes of women with adenomyosis pain during pregnancy: a retrospective study
- Disparities in preconception health indicators in U.S. women: a cross-sectional analysis of the behavioral risk factor surveillance system 2019
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- Effects of sildenafil on Doppler parameters, maternal and neonatal outcomes in the active labor phase of low-risk pregnancies: a randomized clinical trial
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- ChatGPT, artificial intelligence and the Journal of Perinatal Medicine: correspondence
- Re: to the Letter to the Editor: “ChatGPT and artificial intelligence in the Journal of Perinatal Medicine”
- Retraction
- Clinical potential of human amniotic fluid stem cells