Table 2b.

Analysis of evidence of congenital/ intrapartum/postpartum transmission

Author (reference) (samples positive/total tested)	Samples +ve	Foetal/neonatal status	Alternate explanation for clinical features	Mother to child transmission (n)
Groß R et al(2/2)52	NP >D7	Respiratory symptoms (2), icterus (1)	Alternate explanation: excluded in 1; respiratory syncytial virus +ve in 1	Neonatal infection acquired post partum: confirmed (1) unlikely (1)
Buonsenso et al(1/2)53	1st: NP −ve on D1, D4 and +ve on D15, placenta, AF, rectal swab:negative, weak IgG +ve, IgM −ve second - Placenta, Breast milk-+ve but cord blood negative in neonate with NP negative result	Symptoms: absent	–	Neonatal infection acquired post partum: confirmed (asymptomatic) (1st) possible congenital infection (2nd)
Vivanti A et al(1/1)29	NP +ve at 1 hour, D3, D18; rectal swab +ve at 1 hour, D3, D18; vaginal swab, NBAL, neonatal blood +ve	Irritability, poor feeding, axial hypertonia and opisthotonos	Alternate explanation: excluded	Confirmed congenital infection
Kirtsman M et al(1/1)35	NP +ve at birth, D2, D7 Placenta (foetal side) +ve Stool +ve D7, BM +ve	Hypothermia, feeding difficulties, hypoglycaemic, neutropenia	Alternate explanation: excluded	Probable congenital infection
Zamaniyan M et al(1/1)30	NP: −ve at 0 hours, +ve at D2, D4, D6 AF before rupture of membranes +ve cord blood and vaginal secretion: negative	Fever (1)	Alternate explanation: not identified	Confirmed congenital infection
Wang S et al(1/1)51	NP +ve at 36 hours placenta, cord blood, BM:−ve	Vomiting, lymphopenia, abnormal liver enzyme levels	Alternate explanation: excluded	Neonatal infection acquired intra partum: possible
Khan S et al(2/17)64	NP +ve within 24 hours	NNP	Alternate explanation: not identified	Neonatal infection acquired intra partum: possible
Zeng L et al(3/33)41	NP +ve at D2, D4, −ve at D6	RD (1); cyanosis, feeding intolerance (1); fever (2); NNP (3); lethargy, fever (1); lethargy, fever, NNP, vomiting leukocytosis, lymphocytopenia (1); preterm- neonatal RDS, NNP, lymphocytopenia (1)	Alternate explanation: excluded	Neonatal infection acquired intra partum: possible NP not done at birth, no other samples tested
Hu X et al(1/7)42	NP +ve at 36 hours; foetal urine, AF are negative	Symptoms: absent	–	Neonatal infection acquired intra partum: possible NP not done at birth
Knight M et al(12/244)23	NP +ve at <12 hours (6) NP +ve at >12 hours (6)	Neonatal encephalopathy (1)	–	Congenital infection possible (1) Other evidences lacking
Alzamora M et al(1/1)78	NP +ve at 16 hours and 48 hours Cord blood IgM and IgG negative at D1 and D5	Respiratory difficulty and cough	Alternate explanation: excluded	Neonatal infection acquired intra partum: confirmed NP not done at birth
Hantoushzadeh et al(1/4)75	NP −ve on D1, +ve on D7	NNP, lymphopenia (1)	–	Neonatal infection acquired post partum: confirmed
Pierce-Williams R et al(1/33)63	Negative at 24 hours, +ve at 48 hours	Symptoms: absent	–	Neonatal infection acquired post partum: confirmed
Nayak A et al(3/131)26	NP +ve on D1; −ve on D5	Neonatal seizures, MAS (1)	–	Probable neonatal infection acquired intra partum
Nie R et al(1/26)68	NP +ve at 36 hours, negative: D4, D8, D15; cord blood, placenta:negative	Pulmonary infection (1)	Alternate explanation: not identified	Neonatal infection acquired intra partum: possible NP not done at birth
Savasi V et al(4/57)109	Timing of NP test could not be ascertained (early postpartum period)	–	–	–
Kayem G et al(2/181)25	Timing of test could not be ascertained	–	–	–
Patane L et al(2/22)39	1st: NP +ve at birth, >24 hours, >7 days 2nd: NP negative at birth, +ve on D7 Placenta: chronic intervillitis, PCR +ve in both placenta	Mild feeding difficulty (2)	–	Probable congenital infection (1) Possible congenital infection (1)
Ferrazzi E et al(3/42)28	NP +ve on D1, D3 (2) NP equivocal at birth but +ve on D3 (1)	Gastrointestinal symptoms, RD (2)	Alternate explanation: not identified	Neonatal infection acquired post partum: confirmed (1) Neonatal infection acquired intra partum: possible (2) Other evidences lacking
Govind A et al(1/9)61	NP at birth	NNP (1)	Alternate explanation: excluded	Neonatal infection acquired intra partum: confirmed? NP not done after 24 hours
Penfield C et al((3/11)103	NP: Negative (D1 and D5) Placenta and membrane +ve	Symptoms: absent		Neonatal infection acquired intra partum: possible
Baud D et al(1/1)33	NP, AF, vaginal swabs: negative Placenta +ve	2nd trimester spontaneous miscarriage		Confirmed congenital infection
Hosier H et al(1/1)32	Placenta, cord blood: both +ve	D&E at 22 weeks		Confirmed congenital infection
Pulinx B et al(2/2)31	AF, placenta: both +ve	DCDA twin at 24 weeks expelled		Confirmed congenital infection
Dong L et al(1/1)55	IgM level elevated NP negative at 2 hours,16 hours	Symptoms: absent	–	Possible congenital infection
Zeng H et al(1/1)54	NP negative; elevated IgM and IgG (2); elevated IgG, normal IgM (3)	Symptoms: absent	–	Possible congenital infection
Martínez-Perez O et al(5/82)65	NP +ve at birth and negative at 48 hours (3); NP negative at birth but +ve at D10 (2)	RD (2) Symptoms: absent (3)	Alternate explanation: not identified (2)	Neonatal infection acquired intra partum: probable (2) Neonatal infection acquired intra partum: possible (1) Neonatal infection acquired post partum: confirmed (2)
Kulkarni et al(1/1)117	NP, placenta, cord stump RT PCR- All +ve at 12 hours of life NP at D5 and D10 +ve	Fever, icterus and poor feeding	Alternate explanation:excluded	Confirmed congenital infection
Sisman J et al(1/1)70	NP +ve at 24 hours, 48 hours, D14 placenta +ve by electron microscopy	Fever, RD, icterus	Alternate explanation: excluded	Confirmed congenital infection

AF, amniotic fluid; BM, breast milk; DCDA, dichorionic diamniotic; D&E, dilatation and evacuation; NBAL, non-bronchoscopic broncho-alveolar lavage fluid; NNP, neonatal pneumonia; NP, neonatal pharyngeal/throat swab; RD, respiratory distress.