Risks to pregnant women, mothers with coronavirus and their children are of concern to many. About whether the infection is transmitted in utero and produced the mother and the baby antibodies to COVID-19, said the doctor of medical Sciences, head of the Clinic of obstetrics and gynecology in medical University they. P., Professor Vitaly Bezhenar. Turned out to have unexpected precedents and may be scientific discoveries.
Vitaliy, how can we explain the presence of children born from patients COVID-19 mothers antibodies to the virus?
– currently, according to information from the literature, conclusive evidence of vertical transmission of coronavirus infection from mother to child no. Described only 2 cases of the check PCR positive discharge of the nasopharynx for virus RNA COVID-19 newborns more than 30 hours after birth, with a negative previous tests.
However, the data provided no information about the isolation of the child, which increases the probability of infection in the neonatal period (after birth).
– it is Important in this situation, in what form and at what time a pregnant woman suffered a virus?
– the article In the scientific journal of the American medical Association reported that newborns two hours after birth from COVID positive mothers detected IgM antibodies. The result of PCR test showed a negative response as 2 hours after birth, and on the 16th day of life.
it is Known that IgM – antibodies due to their molecular weight and bulky structure do not cross the placental barrier. Thus it is possible that these antibodies producyruemy in the fetus in response to vertical transmission of the infection. However, such information is not definitive, such as “open” may be associated with changes of the placenta, leading to its permeability, or false positive testing.
This is a General rule that suffering from respiratory diseases of mothers give birth to healthy children? Or in this plan COVID-19 different from other viruses?
– Long for respiratory failure in pregnant women with COVID-19 increases risk of syndrome of delayed fetal development (sdfd) due to maternal hypoxia, which leads to hypoperfusion of the placenta and reduce oxygen delivery to the fetus. According to the National hospital of Singapore, sdfd complicates approximately 10% of pregnant women with coronavirus infection, at the same time, monitoring of the fetus was performed by the authors by ultrasonic evaluation of fetal growth.
How antibodies get into the baby’s body? What is the difference between antibodies of different classes, any of them may be transmitted in utero?
According to British American Hospital, the mother 41 years with identified coronavirus and typical CT pattern, in connection with the worsening of respiratory failure was made cesarean section. After crossing the umbilical cord of the child is immediately isolated, tested in real time gave a negative result for the presence of coronavirus and negative for the presence of antibodies IgM and IgG in the blood of the newborn.
after 16 hours of labor re-PCR study, the result is positive. Only on the 5th day of life is recorded the appearance of IgM antibodies in the blood of the child. Analysis of this clinical case demonstrates the possibility of postnatal infection at the stage of cesarean section, however, sterile operating conditions and compliance with isolation measures a newborn in the foregoing case, prevent a possible infection. Accordingly, an increased wariness in favor of the vertical path of transmission.
another scientific article States that 9 pregnant women with confirmed COVID-19 children had negative results of tests taken from 1 day to 9-day lives. There emphasize low expression of angiotensin-converting enzyme 2 in almost all cells of the placental barrier, suggesting that the placenta has almost no susceptible cells.
Can you talk about innate immunity to COVID-19 these children?
Research scientists in Hubei province has not proved intrauterine infection coronavirus infection among 46 newborns, receiving a negative test results, amniotic fluid, umbilical cord blood, breast milk and detachable urinary organs of the mother during the entire period of observation in hospital. Thus, the limited data on probable virus-specific intrauterine infection of fetus raise the suspicion in favor of transmission of coronavirus infection, but no conclusive data about the presence of children born from infected COVID-19 mothers of innate immunity for today.
so, to sum up: according to the main available today data, the coronavirus from mother to child in utero is not transmitted. In two known cases, when a newborn found covid-19, children, most likely, was not isolated from infected mother – that is, got the virus immediately after birth, but not in utero.
There is evidence that newborns IgM antibodies were detected two hours after birth, although they usually appear in the body within 3-7 days after infection. Tests of the swabs gave negative for the coronavirus – like two hours after birth, and 16 days. The IgM antibody does not overcome the placental barrier – that is, they could produce only the fruit itself, in response to the transmission. However, the data is not final – Spathe experts believe that there may be discoveries associated with the properties of the placenta.
