Maternal Transmission of SARS-CoV-2: Safety of Breastfeeding in Infants Born to Infected Mothers

Coronavirus disease 2019 (COVID-19) is a recent epidemic disease caused by severe acute respiratory syndrome virus type 2 (SARS-CoV-2). In pregnancy, SARS-Cov-2 infection creates additional alarm due to concerns regarding the potential for transmission from the mother to the baby during both the antenatal and postpartum times. In general, breastfeeding is seldom disallowed because of infection of the mother. However, there are few exceptions with regards to certain infectious organisms with established transmission evidence from mother to infant and the link of infection of a newborn with significant morbidity and mortality. It is confirmed that pregnant women can become infected with SARS-CoV-2, although the debate on the possible vertical transmission of SARS-CoV-2 infection during pregnancy is still open. In this regard, the literature is still poor. On the contrary, the information on the safety of breastfeeding even during infections seems reassuring when the mother takes the necessary precautions. However, there are still answered questions regarding the precautions to be taken during breastfeeding by COVID-19 patients. This paper reviews the existing answers to these and many other questions. This review therefore presents a summary of the present-day understanding of infection with SARS-CoV-2 and discusses the answers around the maternal transmission of COVID-19 and the potential threat of breastfeeding to babies born to infected pregnant mothers. In conclusion, intrauterine transmission of SARS-CoV-2 infection is less likely to occur during pregnancy. Most studies suggest that COVID-19 is not transmitted through breast milk. Correspondingly, COVID-19-infected neonates might acquire the infection via the respiratory route because of the postnatal contact with the mother rather than during the prenatal period. International organizations encourage breastfeeding regardless of the COVID-19 status of the mother or child as long as proper hygienic and safety measures are adhered to so as to minimize the chance of infant infection by droplets and direct contact with the infected mother. Pasteurized donor human milk or infant formula as supplemental feeding can be quite beneficial in the case of mother–infant separation till breastfeeding is safe.

Alobar Holoprosencephaly with Cebocephaly in a Neonate Born to an HIV-Positive Mother in Eastern Uganda

Background. Holoprosencephaly (HPE) is a rare cerebrofacial abnormality resulting from the complete or partial failure of the diverticulation and cleavage of the primitive forebrain. It has an incidence at birth of 1:16000. Case Presentation. We report a case of a 2600 g newborn female delivered by an HIV-infected mother in whom an antenatal ultrasound scan at 34 weeks’ gestation reported features of fetal alobar holoprosencephaly. The neonate was born with cebocephaly, a monkey-like head, and did not survive for more than 30 minutes following delivery by caesarian section despite oxygen therapy. Conclusion. Alobar HPE with cebocephaly remains incompatible with life. In this resource-limited setting, the diagnosis was made clinically, and only an ultrasound scan was performed to confirm the diagnosis. Chromosomal analysis could have given more information.

Associative influence of new coronavirus infection SARS-CoV-2 during pregnancy on formation of neurological disorders in newborns: clinical case

The Severe Acute Respiratory Syndrome caused by Coronavirus-2 (SARS-CoV-2) has a destructive impact on the population all over the world. In this scenario, the extent, to which the disease will affect more vulnerable individuals, such as pregnant women, is a major concern. Since pregnancy can be a risk factor for respiratory viral infections, there are significant differences regarding the severity of COVID-19 between pregnant and non-pregnant women. In these circumstances, there arises a serious problem associated with the possibility of harm to the health and neuropsychiatric development of the posterity of infected mothers. The acute inflammatory response observed during the disease can lead to several types of nervous system disorders in the newborn. In the light of neuroimmune interactions on the mother-fetus hematoplacental relationship, a clinical case is described that reflects the consequences for the nervous and psychoneurological development of the newborn from SARS-CoV-2 infected mother.

Detection and phylogeny of Wolbachia in field-collected Aedes albopictus and Aedes aegypti from Manila City, Philippines

Wolbachia is the most common bacterial endosymbiont of arthropods, such as the medically important Aedes albopictus and Aedes aegypti. Both Wolbachia and mitochondrial DNA are maternally inherited. This study collected 12 adult Ae. albopictus and 359 Ae. aegypti from 183 households in a dengue-prone area, Manila, Philippines, between June and September 2017. Aedes larvae (n = 509) were also collected from 17 water containers from 11 households. The DNA of the Aedes larvae and adults were screened for the presence of Wolbachia using the wsp and 16S markers, following optimized polymerase chain reaction (PCR) conditions, and sequenced. We also performed PCR using the mitochondrial DNA cox1 marker and sequenced the Wolbachia-positive samples. Our results showed that 3 out of 359 (0.84%) adult Ae. aegypti and 12 out of 12 (100%) adult Ae. albopictus were Wolbachia positive, whereas all larvae tested negative for Wolbachia (0/509; 0%). The wsp marker revealed six Wolbachia-positive Ae. albopictus, whereas the 16S marker showed Wolbachia in three Ae. aegypti and ten Ae. albopictus. Three Wolbachia-positive Ae. albopictus from one household were found to have a single haplotype for all Wolbachia (wsp and 16S) and mitochondrial cox1 markers. This result can be used to infer that maternal transmission of Wolbachia in the household because siblings of a Wolbachia-infected mother mosquito share the Wolbachia and mitochondrial genomes. Our results suggest that the combined sequencing analyses of Wolbachia (wsp and 16S) and mitochondrial DNA can infer maternal transmission in field-collected mosquitoes.

Verification of Maternal Transmission of Wolbachia in Field-collected Aedes Albopictus and Aedes Aegypti Using a Combination of Wolbachia and Mitochondrial DNA Sequencing

Wolbachia is the most common bacterial endosymbiont of arthropods, such as the medically important Aedes albopictus and Aedes aegypti. Both Wolbachia and mitochondrial DNA are maternally inherited. This study collected 12 adult Aedes albopictus and 359 Aedes aegypti from 183 households in a dengue-prone area, Manila, Philippines, between June and September 2017. Aedes larvae (n = 509) were also collected from 17 water containers from 11 households. The DNA of the Aedes larvae and adults were screened for the presence of Wolbachia using the wsp and 16S markers, following optimized polymerase chain reaction (PCR) conditions, and sequenced. We also performed PCR using the mitochondrial DNA cox1 marker and sequenced the Wolbachia-positive samples. Our results showed that three out of 359 (0.84%) adult Ae. aegypti and 12 out of 12 (100%) adult Ae. albopictus were Wolbachia positive, while all of the larvae tested negative for Wolbachia (0/509; 0%). The wsp marker revealed six Wolbachia-positive Ae. albopictus, while the 16S marker showed Wolbachia in three Ae. aegypti and 10 Ae. albopictus. Three Wolbachia-positive Ae. albopictus from one household were found to have a single haplotype for all Wolbachia (wsp and 16S) and mitochondrial cox1 markers. This result indicates maternal transmission of Wolbachia in the household because siblings of a Wolbachia-infected mother mosquito share the Wolbachia and mitochondrial genomes. Our results showed the feasibility of combined sequencing analyses of Wolbachia (wsp and 16S) and mitochondrial DNA to test maternal transmission in field-collected mosquitoes.

Impact of joint management of a COVID-19 mother and her newborn on the virus transmission: a case report

Background Since last year, COVID-19, the disease caused by the novel Sars-Cov-2 virus, has been globally spread to all the world. COVID-19 infection among pregnant women has been described. However, transplacental transmission of Sars-Cov-2 virus from infected mother to the newborn is not yet established. The appropriate management of infants born to mothers with confirmed or suspected COVID-19 and the start of early breastfeeding are being debated. Case presentation We report a case of the joint management of a healthy neonate with his mother tested positive for Covid-19 before the delivery and throughout neonatal follow-up. The infection transmission from the mother to her baby is not described, even after a long period of contact between them and breastfeeding. Conclusion It may consider an appropriate practice to keep mother and her newborn infant together in order to facilitate their contact and to encourage breastfeeding, although integration with infection prevention measures is needed.

Vertical transmission potential of SARS-CoV-2 from infected mother to twin neonates

Background: Limited details are available regarding the vertical transmission potential of COVID-19 infection in pregnant women. The authors' current study aimed to report the vertical transmission potential of COVID-19 infection in a woman pregnant with twins. Case description: The authors report the case of a 27-year-old woman infected with SARS-CoV-2. The patient was pregnant with dichorionic diamniotic fraternal twins and admitted to Renmin Hospital of Wuhan University, Wuhan, China. After undergoing a cesarean section, the patient gave birth to premature twins, who tested positive for COVID-19 infection. Interpretation: Findings from this case suggest a possibility of intrauterine infection caused by vertical transmission in a woman infected with COVID-19.

Vertical Transmission of COVID-19: A Case Report and Review of Literature

Coronavirus disease 2019 (COVID-19) pandemic will continue affecting pregnant women with possibility of vertical transmissions. However, knowledge and evidences regarding vertical transmission of COVID-19 are just emerging. This information is very crucial in the obstetrical care of COVID-19 infected women as well as in the care of newborn born to COVID-19 positive mothers. We report a case of vertical transmission in a neonate born to asymptomatic COVID-19 infected mother. Newborn was immediately shifted to isolation nursery and formula feed was started. The nasopharyngeal swab of newborn taken at 42 hours of life tested positive for SARS-CoV-2 by RT-PCR. Therefore the vertical transmission in COVID-19 is possible. Despite this, the neonatal outcome is good. Keywords: Duodenal atresia; flip flop circulation; neonates; persistent pulmonary hypertension of newborn

Assessment of the Prevalence of Urinary Tract Infection among Pregnant and Non-Pregnant Women in the Kingdom of Saudi Arabia

Urinary tract infections (UTIs) are common in pregnant women mainly caused by Escherichia coli and should be treated correctly to prevent complications in both the mother and her child. Pregnancy is associated with physiological and functional urinary tract changes which promote ascending infections from the urethra. In this paper, we aimed to assess the prevalence of UTI in pregnant and non-pregnant women in the KSA and to measure their awareness about signs, symptoms and complications of this infection. It was conducted through a questionnaire, among pregnant and non-pregnant women online. It consists of 15 questions including socio-demographic and other questions such as time and number of infections, type of treatment, symptoms associated with the infection, weight of child during birth. Our results showed that about 46.3% of participating women had UTI, 5.6% of them were diabetic. About 66.8% of women become infected at age range from 20-39 years old. Also, 22.3% women had once UTI during pregnancy, 13.3% had twice and 21.7% had more than twice during pregnancy. The child's weight during birth from UT infected mother was low in 21.9%. Pregnant women who refuse to receive treatment will be suspected to many complications and their children. From these results we can conclude that high percentage (half of them) of participating women were infected in urinary tract and the most affected age between 20-39 years old and some of them with diabetes. So, we can recommend to introduce educational seminars to pregnant or non-pregnant women to be more awareness with UTIs, signs and symptoms and complications and how to protect themselves from infection.