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Infect Drug Resist . In-Utero Maternal-to-Fetal Transmission of COVID-19: An Immunological and Virological Study in the Eastern Province of Saudi Ar

tetano

Editor, Senior Moderator
Infect Drug Resist


. 2025 Mar 12:18:1393-1403.
doi: 10.2147/IDR.S501533. eCollection 2025. In-Utero Maternal-to-Fetal Transmission of COVID-19: An Immunological and Virological Study in the Eastern Province of Saudi Arabia

Hibah A Alzayer[SUP] 1 2 [/SUP], Basavaraja C Hunasemarada[SUP] 1 [/SUP], Arwa Alumran[SUP] 3 [/SUP], Shaikha Aldossary[SUP] 4 [/SUP], Reem A Al Dossary[SUP] 1 [/SUP]



Affiliations
Abstract

Background: Coronavirus disease 2019 (COVID-19) is a respiratory illness caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). The pandemic potential of the virus along with its severity posed a threat to all individuals particularly pregnant women. Multiple studies suggested the possibility of vertical transmission of COVID-19 with variable findings.
Aim: This study aims to assess the frequency of COVID-19 vertical transmission and identify maternal and neonatal complications.
Materials and methods: A retrospective study of 17 months for all pregnant women attending for delivery who tested positive using SARS-CoV-2 polymerase chain reaction (PCR) (n = 80) and their neonates (n = 81) who were tested by both SARS-CoV2 PCR and viral IgG and IgM antibodies detection using immunochromatography. A matched control group of PCR negative mothers (n = 51) was included. All testing was done within 24-48 hours, and the neonates of positive mothers were immediately and completely separated from their mothers as per the hospital policy.
Results: A total of 263 individuals were included in the study. Out of 80 SARS-CoV2 PCR positive mothers, 4 (5%) had PCR positive neonates and one (1.3%) had SARS-CoV2 IgM positive neonates. The commonest presentation of COVID-19 in mothers were cough (11.4%) and dyspnea (10%). In addition, the need for ICU admission and antibiotics usage was significantly higher in SARS-CoV2 PCR positive mothers (p value 0.042, 0.003 respectively). On the other hand, neonates of SARS-CoV2 PCR positive mothers had a higher risk of low birth weight and NICU admission (p value < 0.001).
Conclusion: This study, with its unique infection control protocol for managing SARS-CoV2 PCR-positive mothers and the use of immunological testing for neonates, provides evidence for in-utero SARS-CoV2 transmission, and interpretation of the results should be in conjunction with the WHO categorization of the timing of mother-to-fetal transmission. Further studies are needed to assess the impact of viral genetic evolution on the risk of maternal-fetal transmission.

Keywords: IgM; PCR; SARS-CoV-2; in-utero; transmission.

 
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