India's first case of vertical coronavirus transmission from mother to child documented in Pune hospital
The infant required intensive care but made a full recovery in three weeks, after which she and the mother were discharged in June.
Doctors in Pune have confirmed that it is possible for a pregnant woman with a COVID-19 infection to transmit the virus to her child through the placenta. This came after the first documented case of vertical transmission (from mother to child) was documented in a Pune hospital, with the infant showing a severe case of the illness.
The first COVID-positive birth in the country was a baby girl, born to a 22-year-old mother at the BJ Medical College and Sassoon General Hospital on 27 May, as per a report in Hindustan Times. The infant required intensive care but made a full recovery in three weeks, after which she was discharged in June.
The newborn and mother were isolated at birth, after the mother was thought to have contracted COVID-19 , according to a Times of India report. The baby, too, appeared to have severe signs of the infection, including a fever, lethargy and abnormal blood parameters that suggested inflammation.
"The baby required intensive care in terms of high flow oxygen support for a week but recovered completely over three weeks. Both the woman and infant were discharged upon recovery 21 days after the delivery,” the hospital’s paediatrician Dr Aarti Kinikar told TOI.
Researchers from the BJ Medical College and Sassoon General Hospital reported that they found proof that the SARS-CoV-2 virus was transmitted from mother to child through the placenta. The placenta is the physical link between the mother's uterus and the growing foetus through which the mother's blood is filtered and essential nutrition passes into the amniotic fluid that surrounds the foetus.
The Indian Council of Medical Research (ICMR), in an April advisory, pointed to emerging evidence that suggested a pregnant woman can transmit the coronavirus infection to her unborn baby. The release highlight that it is still unclear what proportion of COVID-19 pregnancies affect a foetus, and that vertical transmission from mother to foetus was a probability that is still being studied. The guidance on how to manage COVID-19 in pregnant women also followed.
Scientists have pointed out that vertical infection is well-documented in other viral epidemics, like in HIV and Zika virus infections. However, in the case of COVID-19 , there is a lack of scientific literature to validate the probability of vertical transmission.
The global research community pegged this form of transmission as unlikely and rare, but possible. There have also been other cases of 'transplacental' vertical transmission of SARS-CoV-2 from mother to child. Many cases in which the foetus appeared to have antibodies, without the mother testing positive for coronavirus have also been reported.
This points to uncertainty about how a foetus is infected, and under what conditions a COVID-19 -positive mother can pass on the infection to her foetus.
It is important to note that these are new findings; it was previously believed that the virus cannot cross the placenta and infect the baby.
With 250+ papers on COVID-19 and infant feeding since February, researchers are beginning to contribute to the understudied science of breast milk.