The first case of new crown mother-to-child transmission has been confirmed

, although many previous studies have suggested that the new coronavirus may have been transmitted vertically from mother to child, there has been no conclusive evidence.
doctors at a hospital in Paris, France, have reported a case of a fetus infected with a new coronavirus in its mother's womb, according to a new study in nature-newsletter. The fetus was born with brain swelling and neurological disorders associated with the new coronavirus, and the newborn has now recovered.
previous studies suggest that the new coronavirus may be mother-to-child transmission, but this study provides the first definitive evidence," said Danielle De Luca, a doctor at Antoine Beclere Hospital and lead author of the study. It is of great significance to know whether and how the new coronavirus infects the fetus, to prevent infection in newborns, to optimize pregnancy management, and to better understand the new coronavirus.reported that in March 2020, a 23-year-old pregnant woman who was 35 weeks and 2 days pregnant was admitted to a hospital in Paris, France, two days before she was admitted to hospital with fever, sputum, severe cough and other symptoms.
tests confirmed the presence of the new coronavirus E and S genes in the pregnant woman's blood, nasopharyngeal swabs and vaginal swabs. The pregnant woman was in good condition before the diagnosis of the new coronavirus, and both ultrasound and routine examination showed normal.
the third day of hospitalization, doctors monitored the heart rate of class III fetuses, and this "pain sign" in the fetus is likely to cause adverse neonatal outcomes. Taking into account the maternal respiratory symptoms, the team immediately performed a caesarean section on the pregnant woman under complete isolation and general anaesthetic.Wang Haibin, chief surgeon at Wuhan Children's Hospital, told China Science Daily: "Pregnant women have a heavy burden on their own bodies, especially the heart and lungs, and are more likely to be resistant to the virus after contracting the new coronavirus, so many confirmed pregnant women in Wuhan in the early stages of early caesarean section or termination of pregnancy." In
to ensure that all potential sources of the virus are preserved intact, the team collected clear amniosis before breaking the membrane. Using virological and pathological analysis, the team found that the E and S genes of the new coronavirus were positive in amniotic and placental tissue, and that the concentration of the new coronavirus in the placenta was higher than that of amniotic water and in the blood of pregnant women and newborns.
researchers also found that the placenta showed the same inflammatory performance as the state of maternal inflammation caused by the new coronavirus infection. "The new coronavirus is causing a noticeable inflammatory response, which is manifested in a very high viral load."
De Luca, a professor of health, said: "Because of the need to analyze maternal blood, amniota, placenta and newborn blood and so on. It is difficult to obtain all samples during an outbreak, especially in an emergency. This is also an important reason why people only suspect that the new coronavirus may be mother-to-child transmission, but there is no definitive evidence. Thethen give birth to a baby boy with a birth weight of 2540 grams, with a gaternal age of 35 weeks and 5 days. In order to eliminate all external "pollution", the baby boy was transferred to the neonatal intensive care unit in complete isolation.
when entering the ward, the baby boy's Sarnat score, echo heart map and lung ultrasound, vital signs and other health parameters showed normal. The doctor pulled the tube six hours after the baby boy entered the ward, took blood before pulling the tube for capillaries blood gas analysis and blood routine examination, the results showed that they were normal.
team also collected nasopharyngeal and rectal swabs from the baby boy an hour after the caesarean section, and again on the third and 18th days of the baby boy's birth, both of which detected the presence of the new coronavirus E and S genes. In addition, the male baby boy's blood and bronchor pulmonary perfusion test results were also positive.
is also worth noting that the baby boy on the 3rd day after birth, began to appear irritability, feeding difficulties, muscle dystagulation high spasms, horn bow back and other symptoms. In addition, the baby boy's cerebrospinal fluid (CSF) was negative for the new coronavirus.
Doctors had hesitated to use Redsiver due to a lack of clinical guidance for the treatment of infants with neo-coronary infections, but the condition gradually improved within three days, and the second cerebrospinal fluid sample taken by doctors on the fifth day of the baby boy's birth showed normality, but mild stress loss and feeding difficulties persisted. Doctors tested the baby boy again 11 days after birth and found that the baby boy's MRI showed the high intensity of whiteness around the brain chamber and under the bi-sided forehead cortical cortical.is gratifying to note that the baby boy eventually recovered without receiving antiviral drugs and other special treatments and was discharged 18 days later, "almost entirely on his own." Three months later, his mother had no symptoms.
study showed that neurological examination and MRI showed further improvement, and growth and other clinical tests showed normality, based on follow-up nearly 2 months after the baby boy was born.
"We observed a newborn that was actually infected with the new coronavirus in the mother," he said. "In this case, we clearly showed neurological and inflammatory outcomes in the neonatal cerebrospinal fluid, and since the newborn was not infected with other viruses and germs, the whiteness damage indicated in neuroimaging may have been caused by inflammation of blood vessels caused by the new coronavirus infection, as similar images have been found in adult patients," the researchers said. Notably
, the researchers said: "Angiosin-converting enzyme 2 (ACE2) is a carrier of the new coronavirus, which is highly expressed in placental tissue, and when maternal viralemia occurs, the virus reaches the placenta, which infects the placenta and leads to neonatal viralemia." "
data show that the expression of ACE2 in fetal or neonatal tissue changes over time and peaks at the end of pregnancy and the first few days after birth," the researchers said. Wang Haibin explained:
The virus appears in the human blood has a certain timing, pregnant women in the latter stages of pregnancy against the new coronavirus immunity is not strong enough to remove the new coronavirus in the blood in time, reduce the amount of virus in the blood, and thus form viralemia." Most pregnant women who are infected with the new coronavirus in the early stages can be removed by autoimmune power, just like patients with the late neo-coronavirus Fuyang, although the virus nucleic acid is excreted but can not isolate the live virus. "
" we provide a comprehensive case study that proves that in the last few weeks of pregnancy, the new coronavirus can pass through the placenta to the fetus, and that the newborn has neurological clinical symptoms associated with the new coronavirus infection. "However, there is no definitive literature to confirm the spread and effects of the new coronavirus on the fetus in the early stages of pregnancy," said Daniele De Luca. "
an interesting case, but it shouldn't be a big problem for pregnant women," said Marian Knight, professor of maternal and child population health at Oxford University, according to Reuters. In the thousands of babies born to pregnant women infected with the new coronavirus, no more than 1% or 2% of babies who test positive for the new coronavirus do not have to panic. "
" fetuses through the mother infected with the new coronavirus is very rare, women can rest assured that pregnancy is not an important risk factor for them and the fetus. Andrew Shennan, professor of obstetrics and gynecology at King's College London, agrees: "From data on 244 babies born to mothers infected with the new coronavirus in the UK, 95 per cent of the fetuses showed no signs of contracting the new coronavirus.
Previously, Chinese Academy of Engineering, Peking University Third Hospital President Qiao Jie has told the media: "Maternal infection with the new coronavirus can produce IgG antibodies, the antibody can be transmitted to the fetus through the placenta, the fetus was born with this antibody, the antibody is protective, so from the current delivery of newborns, overall relatively safe." "
" antibody production can not be used as an indicator of infection, to determine whether infected with the new coronavirus also need to have symptoms and detect viral nucleic acids. Wang Haibin added, "Newborns infected with the new coronavirus through vertical mother-to-child transmission require strict conditions, in general, infected with the new coronavirus to form viralemia of pregnant women, low blood load of the virus, so the risk of infection in newborns is much lower than the infection caused by the living environment after birth."
Huang Hufeng, a member of the Chinese Academy of Sciences and president of the International Institute of Maternal and Child Health, affiliated with Shanghai Jiaoxuan University School of Medicine, said in an interview with the China Science Daily: "For the birth of a pregnant child with neo-crown pneumonia, newborns have been diagnosed with neo-crown pneumonia or suspected neo-crown pneumonia, in addition to the possibility of vertical transmission of mother-to-child, the possibility of infection in the production process is also relatively large, because newborns are exposed to neo-crown pneumonia naked after birth." In
this regard, Huang suggested: "After the birth of a pregnant woman with neo-crown pneumonia, the newborn should immediately leave the environment of delivery, the application of isolation devices or isolation box transport, to reduce the risk of infection of newborns." (Source: Tian Ruiying, China Science Journal)
related paper information: