Babies born to mothers with Covid-19 have low probability of acquiring the infection either in utero, intrapartum or exposure in the early postpartum period, suggests a systematic review and meta-analysis in The BMJ.¹

Allotey et al conducted a systematic review and meta-analysis of 472 studies involving 28,952 mothers (including post-abortion women) with Covid-19 and 18,237 babies born to them from December 2019 to August 2021.

Results show that 1.8% of 14,271 babies born to mothers with SARS-CoV-2 infection had positive RT PCR for Covid-19.  

Fourteen out of the 592 SARS-CoV-2 positive babies had confirmed mother-to-child transmission. Of these, seven acquired the infection in utero, two contracted the infection intrapartum, while five acquired the infection in the early postnatal period. Neonatal outcomes data for 800 SARS-CoV-2 positive children showed that there were 20 stillbirths, 23 neonatal deaths and eight early pregnancy losses; 749 of them were alive at the end of follow-up.

Mothers with severe infection or those who required ICU admission or who developed postnatal infection were more likely to have Covid-positive children with an odds ratio of 2.4, 3.5 and 5.0, respectively. Maternal death was also a risk factor for COVID-19 infection in the children (OR 14). However, no such association was noted for preterm birth, mode of delivery or trimester when the mother became Covid-positive.

This meta-analysis has provided evidence for mother to child transmission of SARS-CoV-2, although “the overall risk is likely to be low”, say the authors. It was less than 2% in this review. This study has also identified risk factors associated with SARS-CoV-2 infection in children born to Covid-positive mothers.

Reference

1. Allotey J, et al. SARS-CoV-2 positivity in offspring and timing of mother-to-child transmission: living systematic review and meta-analysis. BMJ. 2022 Mar 16;376:e067696. doi: 10.1136/bmj-2021-067696.