Doctors say a newborn baby born in Toronto contracted the coronavirus while in utero. Unfortunately, this isn't the first case of coronavirus that was suspected to have been transmitted while the baby was in the womb — but the specifics of the birth are helping medical professionals understand how the virus can be passed from mother to child.
The baby's mother was a 40-year-old woman who was exhibiting coronavirus symptoms when she arrived at the hospital.
The case was reported in the May 14 issue of the Canadian Medical Association Journal. Although the mother's name has not published, the case stated that she entered the hospital with coronavirus symptoms, including myalgia, decreased appetite, fatigue, dry cough, and a temperature of 102.2 degrees within the 24 hours before she went to the hospital.
She didn't need any respiratory support while in medical care, but her doctors did determine that she needed a "semi-urgent" C-section at 35 weeks.
Her doctors performed the surgery under regional anesthesia, with airborne, droplet, and contact precautions taken to lessen the chances of the virus being spread. Once the baby was delivered, the study stated that the amniotic fluid was "clear" and the baby was described as being "vigorous" after birth. Thankfully, the baby didn't need any help breathing after birth.
Doctors took a nasopharyngeal swab on the day the baby was born, the day after, and then a week after the newborn was delivered.
Sadly the tests revealed the same thing: "all three of the [baby's] nasopharyngeal swabs were positive for SARS-CoV-2 gene targets via RT-PCR testing," the study reported.
Doctors also performed a neonatal plasma test four days after the baby was born, which was positive, and took a stool sample, which tested positive on day seven.
Doctors are still trying to figure out how the newborn contracted the virus.
In similar cases in which newborns tested positive for the coronavirus, it's been hard for doctors to pinpoint that the virus was transmitted while in utero. Things such as contact with the mother during vaginal birth, being held by the mother after birth, and breastfeeding are all possible ways the virus could have been spread and make it hard for doctors to make any definitive findings.
But in this case, there were several factors that made things clearer. For one, the mother had reduced immune system function, which would have left her body more vulnerable to the virus, WebMD stated. They also tested her placenta, which showed tissue inflammation "consistent with primary viral infection."
Using this information, plus the fact that the baby was born via a C-section, had not come into contact with the mother's vaginal tract, and all proper precautions were taken during the operation (meaning there was a low chance the newborn contracted the virus from someone else in the room), doctors "suspect the possibility of a transamniotic route of [coronavirus] infection via the placenta," the study noted.
Dr. Adi Davidov, associate chairman of gynecology at Staten Island University Hospital in New York City, told WebMD that in his opinion, this case "clearly shows that there is a small possibility that COVID can be transmitted in utero."
Davidov added that although most people believe that COVID-19 is a respiratory virus, "it can occasionally be found in other areas of the body."
Those other areas include the uterus and the placenta. But Davidov wants people to know that this type of transmission isn't common.
"Given that we have now delivered hundreds of mothers infected with the SARS-CoV-2 and we have not seen this phenomenon, it is pretty safe to assume that this is a rare phenomenon," he noted. "Nonetheless, it is important for clinicians to be aware of this situation and to screen all newborns for COVID-19."
The baby was discharged from the hospital four days after he was born.
The baby's mother took him for a routine screening three days later, and it was determined that the baby did not have a fever, cough or feeding difficulties, according to Forbes. Thirty days later, doctors called to follow up with the family, and the mother reported that the baby was "thriving."
WebMD stated that although the baby tested positive for coronavirus, the newborn did not develop COVID-19, which is technically the name of the disease caused by the coronavirus.
The study went on to state that "all health care providers attending an infected woman's delivery and caring for the baby in the NICU should recognize this risk and use appropriate personal protective equipment to prevent droplet, contact and aerosol transmission [of the coronavirus]."
It also stressed the importance of testing the nasopharynx, placenta and cord blood of babies born to women with confirmed or suspected cases of coronavirus as soon as possible after birth and after a baby is cleansed, Forbes reported. In addition, careful documentation of body samples should happen when trying to pinpoint the source of the virus.
