The New Indian Journal of OBGYN. 12(1):197-201

Possibility of vertical transmission in Covid - 19 pregnancy - a hospital based prospective cohort study from Kerala, India

Swapna CS, Jayanthi TK, Sheeba PM, Chandrika CV, Anila Mathews, Jayasree PK

ABSTRACT

Background: Knowledge regarding the possible risk of vertical transmission is very limited, but is crucial for guiding and counselling patient and also essential for formulating the principles of obstetric management. Aim: To estimate the incidence rate of vertical transmission of Corona virus disease 2019 (COVID - 19) in the third trimester. Materials and methods: A prospective cohort study was conducted among 50 consecutive admitted pregnant women who were infected with COVID - 19 in the 3rd trimester. To study the possibility of vertical transmission the collection of 3 biological samples were done namely 1) amniotic fluid, 2) cord blood and 3) nasopharyngeal swab samples from neonates collected after 24 hours of birth. All samples were processed for RNA isolation using QIAGEN QI Amp @ RNA minikit, according to manufactures instructions. The samples were subjected to RTPCR using SD Biosensor kit, detecting both E gene and RdRp genes. Results: Among the participated pregnant women (n=50), all were in their third trimester and 60 % were asymptomatic (B1 category) and 40% symptomatic (B2 category). 34% of the patients delivered after 10 days of testing COVID positive, 28% delivered between 3 to 10 days and 38% delivered in less than 72 hours. Of the total sample 34 % underwent vaginal delivery, 2% had instrumental delivery and 56% had caesarean section. Among the babies born, 66% were stable, with normal vitals and laboratory parameters. 12 % required NICU admission for monitoring. There was 1 term intrauterine death. The 3 biological samples collected for determining vertical transmission were amniotic fluid, cord blood and nasopharyngeal swab samples collected on the neonates after 24 hours of birth. All the collected biological samples tested negative for COVID-19 RNA. No maternal intensive care unit admission, maternal sepsis, or maternal mortality was observed. Conclusion: In our cohort study of pregnant women with COVID-19 infection during the third trimester of pregnancy we found that the risk of vertical transmission to the neonate is negligible.