Table 2.
Maternal and perinatal characteristics of fetal death with confirmed in utero mother-to-child transmission of SARS-CoV-233 41 42 43 44 45 46
| Author, year | Maternal characteristics | Mode of delivery | Measures to prevent SARS-CoV-2 MTCT | Tests for SARS-CoV-2 MTCT | Fetal and neonatal characteristics | |
|---|---|---|---|---|---|---|
| Initial test | Further tests | |||||
| Babal P, 2021 | Age 32 years; NP PCR+ | Vaginal delivery | Not reported | Fetal tissues PCR+ | Placental tissue PCR+, IHC+, ISH+ Umbilical cord tissue PCR+ |
28 weeks gestational age 3315 g birthweight |
| Lesieur E, 2021 | Age 40 years, G3P2; severe symptoms of cough and fever; NP PCR+ at 23 weeks | Vaginal delivery | Not reported | Fetal tissues PCR+ | Placental tissue PCR+ and IHC+ | 24 weeks gestational age 528 g birthweight |
| Patane L, 2022 (twin 1) | Age 35 years; NP PCR+ | Vaginal delivery (stillbirth) | Not reported | Fetal tissues PCR+ | Placental tissue PCR+, IHC+, ISH+ Cord PCR+ |
21 weeks gestational age |
| Patane L, 2022 (twin 2) | Age 35 years; NP PCR+ | Vaginal delivery (stillbirth) | Fetal tissues PCR+ | Placental tissue PCR+, IHC+, ISH+ Cord PCR+ |
21 weeks gestational age | |
| Rodrigues M, 2020 | Age 19 years, no past medical history; nasopharyngeal PCR+ just before delivery; symptomatic | Vaginal delivery (stillbirth) | Not reported | Fetal tissues PCR+ on autopsy | No fetal heartbeat at 34 weeks, small for gestational age (third centile) 1460 g birthweight |
|
| Valdespino-Vazquez, MY 2020 (twins) | Age 28 years, G4P3 Fever, headache, arthralgia, fatigue at 13 weeks Also had dark vaginal bleeding NP PCR initially negative but became positive |
Vaginal delivery (miscarriage) | Not reported | Fetal organs PCR+, immunofluorescence+, in both fetuses Fetus A EM+ in lung |
Placenta PCR+, EM+, immunofluorescence+ in both placentas | 13 weeks gestational age Diamniotic twin pregnancy, both found with no heartbeat at 13 weeks Fetus A was 12 cm in length and 37 g Fetus B severely macerated |
| Vivanti A, 2021 | Age 27 years, G2P1 NP PCR+ at 31 weeks |
IUFD at 32 weeks | Not reported | Fetal tissue PCR+ | Placental tissue PCR+ NP PCR+ at <48 h |
32 weeks gestational age 2248 g birthweight |
| Zaigham M, 2022 (baby 1) | Age 31 years, G2P1 NP PCR+ at 34 weeks |
IUFD at 35 weeks | Not reported | Fetal tissue PCR+ | Placental tissue PCR+ NP swab PCR+ |
35 weeks gestational age 2200 g birthweight |
| Zaigham M, 2022 (baby 2) | Age 25 years, G1P0 NP PCR+ at 33 weeks |
IUFD at 34 weeks | Not reported | Fetal tissue PCR+ | Placental tissue PCR+ | 34 weeks gestational age 2190 g birthweight |
Mother-to-child transmission was according to World Health Organization classification. NP RT-PCR=nasopharyngeal reverse transcriptase polymerase chain reaction; NICU=neonatal intensive care unit; IHC=immunohistochemistry; ISH=in situ hybridisation; GxPx= Gravida number, parity number; IUFD=intra-uterine fetal death; Dx=day number; EM= electron microscopy.
*
Classified as “confirmed” in utero as tests were repeated <24 h, despite not meeting WHO criteria of positive test result at 24-48 h (appendix 3).