Current standard protocols of RT-PCR of nasopharyngeal swab in neonatal patient is not sensitive enough for determination of vertical transmission

Abstract The pandemic experienced in recent months has raised questions that should be investigate in the clinical practice. Transplacental transmission of SARS-CoV-2 and the consequences to the fetus and newborn have called attention due to the increasing number of infections, contradicting previous evidences that there was no possibility of coronavirus transmission from the mother to the fetus. We presented three cases of pregnant women with positive SARS-CoV-2 antibodies serology on admission in Naval Hospital Marcílio Dias (HNMD), Rio de Janeiro, Brazil. Samples of umbilical cord blood was double positive (IgM and IgG) for one patient, double negative for one patient and positive for IgG and negative for IgM for third patient. Maternal and neonatal nasopharyngeal swab samples analyzed by PCR for SARS-CoV-2 was positive for two maternal patients and negative for all newborns tested. It was possible to detect the SARS-CoV-2 in amniotic fluid and umbilical cord blood using the nested-PCR technics, thus being successfully evidenced transplacental transmission. We suggested that nasopharyngeal swab PCR test of neonates does not have a correlation with vertical transmission and thus, this molecular test is not useful for investigation of transplacental infection.

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Current standart protocols of RT-PCR of nasopharyngeal swab in neonatal patient is not sensitive enough for determination of vertical transmission

10.21203/rs.3.rs-228645/v1 ◽

2021 ◽

Author(s):

Maria Alice Fusco ◽

Vinícius Mantini ◽

Jarba S. S. Júnior ◽

Raphael G. C. Gomes ◽

Camilla G. Salmont ◽

...

Keyword(s):

Cord Blood ◽

Umbilical Cord ◽

Vertical Transmission ◽

Umbilical Cord Blood ◽

Nasopharyngeal Swab ◽

Transplacental Transmission ◽

Double Positive ◽

Neonatal Patient ◽

Naval Hospital

Abstract The pandemic experienced in recent months has raised questions that should be investigate in the clinical practice. Transplacental transmission of SARS-CoV-2 and the consequences to the fetus and newborn have called attention due to the increasing number of infections, contradicting previous evidences that there was no possibility of coronavirus transmission from the mother to the fetus. In this work we showed three cases of pregnant women with positive SARS-CoV-2 antibodies serology on admission in Naval Hospital Marcílio Dias (HNMD), Rio de Janeiro, Brazil. Samples of umbilical cord blood was double positive (IgM and IgG) for one patient, double negative for one patient and positive for IgG and negative for IgM for third patient. Maternal and neonatal nasopharyngeal swab samples analyzed by PCR for SARS-CoV-2 was positive for two maternal patients and negative for all newborns tested. It was possible to detect the SARS-CoV-2 in amniotic fluid and umbilical cord blood using the nested-PCR technics, thus being successfully evidenced transplacental transmission. We suggested that nasopharyngeal swab PCR test of neonates does not have a correlation with vertical transmission and thus, this molecular test is not useful for investigation of transplacental infection.

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Relationship between expression of HBV-infection markers in placenta and clinical data of mothers and their newborns

Journal Infectology ◽

10.22625/2072-6732-2021-13-2-95-101 ◽

2021 ◽

Vol 13 (2) ◽

pp. 95-101

Author(s):

M. A. Belopolskaya ◽

V. E. Karev ◽

V. Yu. Avrutin ◽

A. V. Dmitriev ◽

D. A. Gusev

Keyword(s):

Viral Load ◽

Hepatitis B ◽

Cord Blood ◽

Umbilical Cord ◽

Vertical Transmission ◽

Umbilical Cord Blood ◽

Structural Changes ◽

Antiviral Treatment ◽

Undetectable Viral Load ◽

Hbv Infection

Vertical transmission of viral hepatitis B (HBV) is one of the main transmission ways in endemic regions. There is a relationship between structural changes in the placenta and the clinical course of HBV infection. The risk of vertical transmission of hepatitis B depends on the condition of the placenta.The goal of this work was to study the relationship between HBsAg and / or HBcorAg expression in placenta on the one hand, and clinical parameters of mothers and newborns on the other hand.The study included 19 patients with CHB who gave birth at the Botkins infectious disease hospital in 2019. The first group included patients with markers of HBV infection (HBsAg and / or HBcorAg) detectable via immunohistochemical examination in at least one of the layers of the placenta. In patients from the second group, no markers of HBV infection were detected in any layer of the placenta. Inflammatory changes in placenta were detected in all women from the first group and in 9 (64%) women from the second group. HBsAg in umbilical cord blood was detected in 3 (16%) newborns. In two patients, whose children had HBsAg in the umbilical cord blood, no markers of HBV infection were detected in placenta. In the first group, only one newborn had HBsAg in umbilical cord blood. In two patients receiving an antiviral treatment during pregnancy, markers of HBV infection were identified in the placenta. Markers of HBV infection in placenta were also detected in women with undetectable viral load.ConclusionsMarkers of HBV infection can be found in placenta at low maternal viral load.HBsAg in umbilical cord blood can be detected even in patients with no markers of HBV infection in placenta.Antiviral treatment during pregnancy does not prevent the possibility of placenta’s infection with HBV.

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Analysis of SARS-CoV-2 vertical transmission during pregnancy

Nature Communications ◽

10.1038/s41467-020-18933-4 ◽

2020 ◽

Vol 11 (1) ◽

Cited By ~ 7

Author(s):

Claudio Fenizia ◽

Mara Biasin ◽

Irene Cetin ◽

Patrizia Vergani ◽

Davide Mileto ◽

...

Keyword(s):

Cord Blood ◽

Umbilical Cord ◽

Vertical Transmission ◽

Umbilical Cord Blood ◽

Inflammatory Responses ◽

Vaginal Mucosa ◽

Cord Plasma ◽

Expression Of Genes ◽

Obstetric Management ◽

The Impact

Abstract The impact of SARS-CoV-2 infection during gestation remains unclear. Here, we analyse the viral genome on maternal and newborns nasopharyngeal swabs, vaginal swabs, maternal and umbilical cord plasma, placenta and umbilical cord biopsies, amniotic fluids and milk from 31 mothers with SARS-CoV-2 infection. In addition, we also test specific anti-SARS-CoV-2 antibodies and expression of genes involved in inflammatory responses in placentas, and in maternal and umbilical cord plasma. We detect SARS-CoV-2 genome in one umbilical cord blood and in two at-term placentas, in one vaginal mucosa and in one milk specimen. Furthermore, we report the presence of specific anti-SARS-CoV-2 IgM and IgG antibodies in one umbilical cord blood and in one milk specimen. Finally, in the three documented cases of vertical transmission, SARS-CoV-2 infection was accompanied by a strong inflammatory response. Together, these data support the hypothesis that in utero SARS-CoV-2 vertical transmission, while low, is possible. These results might help defining proper obstetric management of COVID-19 pregnant women, or putative indications for mode and timing of delivery.

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Transplacental Transmission of Filarial Infections and Its Impact on Oxidative Stress and Immune Responses during Foetal Life in Bamenda, North West Cameroon

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2020/v41i1330345 ◽

2020 ◽

pp. 26-38

Author(s):

Lemnui Benardette ◽

Oumar Mahamat ◽

Ntonifor Helen Ngum ◽

Ngwenyi Annie- Dorette ◽

Theresia Kuo Akenji

Keyword(s):

Oxidative Stress ◽

Immune Response ◽

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Colorimetric Method ◽

Transplacental Transmission ◽

Oxidative Stress Status ◽

Total Oxidative Stress ◽

Umbilical Cords

Background: Women commonly harbour filarial infections during their childbearing years, raising the possibility that the developing foetus may be exposed to filarial antigens in the uterus and thereby have altered immunity and susceptibility to infection during early childhood. However, there are no concrete proofs to justify the risk of infections in infants born from mothers having filarial infections during pregnancy. Aim: The purpose of this study was to assess the prevalence of microfilariae in umbilical cord blood and respective mothers and to evaluate the relationship between the cord blood filarial infection and the oxidative stress status and concentration of IL-2, IL-10, IL-13, INF-γ and IgG in umbilical cord blood. Methods: This was a nested case–control study of cords and mothers of normal gestational age (>250 days of gestation). A total of 316 pairs of umbilical cords and mothers were examined. The presence of microfilariae was assessed by microscopy in mothers and cords. Oxidative stress status (total oxidative stress and total oxidative defence) and nitric oxide of umbilical cord and mother’s blood were investigated by the colorimetric method. ELISA was carried out for IL-2, IL-10, IL-13, INF-γ in umbilical cord and mother’s blood. Equally, umbilical cords were subjected to ELISA for total IgG. Results: Results obtained showed that microfilariae had a prevalence of 32.9% and 29.7% in umbilical cord blood and women at time of delivery respectively. High levels of total oxidative stress (TOS) with low total oxidative defence (TAD) was found in filarial infected (Mf +ve) umbilical cord and mother’s blood compared to controls or uninfected (Mf -ve) cords and mothers blood. IL-2 was lower in the blood of microfilariae infected cords and mothers, while INF-γ, IL-13 and IL-10 were higher as compared to microfilariae negative cords and mothers. Equally, plasma total IgG concentration was higher in microfilariae positive cords compared to the negative cords and positively correlated with IL-10. Conclusions: There is high frequency of transplacental transmission of microfilariae. Cord blood filarial infections were associated with a high TOS, a protective immune response with low IL-2 and high INF-γ, and a typical Th2 immune response that was associated with higher concentration of immune total IgG regulatory cytokine IL-10 and IL-13 in neonate.

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IN−UTERO MOTHER−TO−CHILD SARS−CoV−2 TRANSMISSION: viral detection and fetal immune response

10.1101/2020.07.09.20149591 ◽

2020 ◽

Cited By ~ 1

Author(s):

Claudio Fenizia ◽

Mara Biasin ◽

Irene Cetin ◽

Patrizia Vergani ◽

Davide Mileto ◽

...

Keyword(s):

Inflammatory Response ◽

Cord Blood ◽

Pregnant Women ◽

Umbilical Cord ◽

Vertical Transmission ◽

Umbilical Cord Blood ◽

In Utero ◽

Vaginal Mucosa ◽

Cord Plasma ◽

The Impact

Pregnancy is known to increase the risk of severe illnesses in response to viral infections. Therefore, the impact of SARS−CoV−2 infection during gestational ages might be detrimental and the potential vertical transmission should be thoroughly studied. Herein, we investigated whether SARS−CoV−2 vertical transmission is possible and, in case, whether this results in a fetal involvement. Additionally, we analyzed the role of the antibody and the inflammatory responses in placenta and plasma from SARS−CoV−2−positive pregnant women and fetuses. 31 SARS−CoV−2 pregnant women were enrolled. Real−time PCR was performed to detect the virus on maternal and newborns nasopharyngeal swabs, vaginal swabs, maternal and umbilical cord plasma, placenta and umbilical cord biopsies, amniotic fluids and milk. Maternal and umbilical cord plasma, and milk were tested for specific anti−SARS−CoV−2 antibodies. RNA expression quantification of genes involved in the inflammatory response was performed on four selected placentas. On maternal and umbilical cord plasma of the same subjects, secreted cytokines/chemokines were quantified. SARS−CoV−2 is found in at-term placentae and in the umbilical cord blood, in the vaginal mucosa of pregnant women and in milk. Furthermore, we report the presence of specific anti−SARS−CoV-2 IgM and IgG antibodies in the umbilical cord blood of pregnant women, as well as in milk specimens. Finally, a specific inflammatory response is triggered by SARS−CoV−2 infection in pregnant women at both systemic and placental level, and in umbilical cord blood plasma. Our data strongly support the hypothesis that in−utero vertical transmission is possible in SARS−CoV−2 positive pregnant women. This is essential for defining proper obstetric management of COVID−19 pregnant women, or putative indications for mode and timing of delivery.

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In-Utero Mother-to-Child SARS-CoV-2 Transmission: Viral Detection and Fetal Immune Response

10.21203/rs.3.rs-45729/v1 ◽

2020 ◽

Author(s):

Claudio Fenizia ◽

Mara Biasin ◽

Irene Cetin ◽

Patrizia Vergani ◽

Davide Mileto ◽

...

Keyword(s):

Inflammatory Response ◽

Cord Blood ◽

Pregnant Women ◽

Umbilical Cord ◽

Vertical Transmission ◽

Umbilical Cord Blood ◽

In Utero ◽

Vaginal Mucosa ◽

Cord Plasma ◽

The Impact

Abstract Pregnancy is known to increase the risk of severe illnesses in response to viral infections. Therefore, the impact of SARS-CoV-2 infection during gestational ages might be detrimental and the potential vertical transmission should be thoroughly studied.Herein, we investigated whether SARS-CoV-2 vertical transmission is possible and, in case, whether this results in a fetal involvement. Additionally, we analyzed the role of the antibody and the inflammatory responses in placenta and plasma from SARS-CoV-2-positive pregnant women and fetuses.31 SARS-CoV-2 pregnant women were enrolled. Real-time PCR was performed to detect the virus on maternal and newborns’ nasopharyngeal swabs, vaginal swabs, maternal and umbilical cord plasma, placenta and umbilical cord biopsies, amniotic fluids and milk. Maternal and umbilical cord plasma, and milk were tested for specific anti-SARS-CoV-2 antibodies. RNA expression quantification of genes involved in the inflammatory response was performed on four selected placentas. On maternal and umbilical cord plasma of the same subjects, secreted cytokines/chemokines were quantified.SARS-CoV-2 is found in at-term placentae and in the umbilical cord blood, in the vaginal mucosa of pregnant women and in milk. Furthermore, we report the presence of specific anti-SARS-CoV-2 IgM and IgG antibodies in the umbilical cord blood of pregnant women, as well as in milk specimens. Finally, a specific inflammatory response is triggered by SARS-CoV-2 infection in pregnant women at both systemic and placental level, and in umbilical cord blood plasma.Our data strongly support the hypothesis that in-utero vertical transmission is possible in SARS-CoV-2 positive pregnant women. This is essential for defining proper obstetric management of COVID-19 pregnant women, or putative indications for mode and timing of delivery.

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High Incidence of Herpes Simplex Virus-1 in Cord Blood and Placenta Infection of Women in Southern Brazil

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0039-1700794 ◽

2020 ◽

Vol 42 (01) ◽

pp. 005-011

Author(s):

Emiliana Claro Avila ◽

Fabiana Finger-Jardim ◽

Carla Vitola Gonçalves ◽

Vanusa Pousada da Hora ◽

Marcelo Alves Soares ◽

...

Keyword(s):

Risk Factors ◽

Cord Blood ◽

Umbilical Cord ◽

Vertical Transmission ◽

Umbilical Cord Blood ◽

Human Herpesvirus ◽

Placental Tissue ◽

University Hospital ◽

Nested Polymerase Chain Reaction ◽

Hsv 1

Abstract Objective Estimate the prevalence of human herpesvirus type 1 HSV-1 DNA in placental samples, its incidence in umbilical cord blood of newborns and the associated risk factors. Methods Placental biopsies and umbilical cord blood were analyzed, totaling 480 samples, from asymptomatic parturients and their newborns at a University Hospital. Nested polymerase chain reaction (PCR) and gene sequencing were used to identify the virus; odds ratio (OR) and relative risk (RR) were performed to compare risk factors associated with this condition. Results The prevalence of HSV-1 DNA in placental samples was 37.5%, and the incidence in cord blood was 27.5%. Hematogenous transplacental route was identified in 61.4% from HSV-1+ samples of umbilical cord blood paired with the placental tissue. No evidence of the virus was observed in the remaining 38.6% of placental tissues, suggesting an ascendant infection from the genital tract, without replication in the placental tissue, resulting in intra-amniotic infection and vertical transmission, seen by the virus in the cord blood. The lack of condom use increased the risk of finding HSV-1 in the placenta and umbilical cord blood. Conclusion The occurrence of HSV-1 DNA in the placenta and in cord blood found suggests vertical transmission from asymptomatic pregnant women to the fetus.

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