Congenital infection of SARS-CoV-2 in live-born neonates: a population-based descriptive study

Clin Microbiol Infect. 2021 Oct;27(10):1521.e1-1521.e5. doi: 10.1016/j.cmi.2021.06.016. Epub 2021 Jun 19.


Objective: To evaluate the evidence of mother-to-child transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods: This is a descriptive, multicentre, observational study in nine tertiary care hospitals throughout Spain. The study population was women with coronavirus disease 2019 during pregnancy. Mother-to-child transmission was defined as positive real-time RT-PCR of SARS-CoV-2 in amniotic fluid, cord blood, placenta or neonatal nasopharyngeal swabs taken immediately after birth.

Results: We included 43 women with singleton pregnancies and one with a twin pregnancy, as a result we obtained 45 samples of placenta, amniotic fluid and umbilical cord blood. The median gestational age at diagnosis was 34.7 weeks (range 14-41.3 weeks). The median interval between positive RT-PCR and delivery was 21.5 days (range 0-141 days). Fourteen women (31.8%, 95% CI 18.6%-47.6%) were positive at the time of delivery. There was one singleton pregnancy with SARS-CoV-2 RT-PCR positive in the placenta, amniotic fluid and umbilical cord blood (2.2%, 95% CI 0.1%-11.8%). Nasopharyngeal aspiration was performed on 38 neonates at birth, all of which were negative (0%, 95% CI 0%-9.3%). In 11 neonates the nasopharyngeal aspiration was repeated at 24-48 hours, and one returned positive (9.1%, 95% CI 0.2%-41.3%).

Conclusions: The presence of SARS-CoV-2 in placenta, amniotic fluid and cord blood shows that mother-to-child transmission is possible but uncommon.

Keywords: Congenital infection; Coronavirus disease 2019; Mother-to-child transmission; Pregnancy; Severe acute respiratory syndrome coronavirus 2.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Amniotic Fluid / virology
  • COVID-19 / congenital*
  • COVID-19 / virology
  • Female
  • Fetal Blood / virology
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical*
  • Middle Aged
  • Nasopharynx / virology
  • Placenta / virology
  • Pregnancy
  • Pregnancy Complications, Infectious / virology*
  • SARS-CoV-2 / isolation & purification*
  • Spain / epidemiology
  • Tertiary Care Centers
  • Young Adult