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Well, it's been 3 months - let's check and see how we are doing with perinatal #COVID19. @EBNEO 1/x https://twitter.com/InfectiousNeo/status/1241387166045032451
Perinatal transmission: Absolutely. The rate looks like it's hovering right around 2-3%, with no immediately obvious differences between separation of mother/baby and couplet care. @AAPneonatal is doing a great job with their collaborative. 2/x
Congenital transmission: Absolutely, probably rare. England, France, and now Dallas have all reported confirmed cases
https://www.nature.com/articles/s41467-020-17436-6
https://pubmed.ncbi.nlm.nih.gov/32658097/
3/x
https://www.nature.com/articles/s41467-020-17436-6
https://pubmed.ncbi.nlm.nih.gov/32658097/
3/x
These are all late congenital infection, and so far they've done well. I think the MRI findings in the French report has more to do with fetal distress/hypoxia due to mother's illness than direct COVID19 effect on the neonatal brain, but time will tell...
4/x
4/x
Early congenital infection - still too soon to tell. Earliest 2nd trimester babies are about to deliver, but the proof will be in mothers who are currently in their first trimester during the large, sustained US peak (refuse to call it a second wave) 5/x
That means that women who have estimated dates of delivery in the November-February range will provide the bulk of our epidemiology data regarding early congenital infection with #COVID19. 6/x
Don't blow off the risk - we've had trouble from other respiratory positive-sense RNA viruses and malformations in the past. 7/x
Pregnancy disruptions - almost certainly. In addition to the anecdotal data that is building up on listservs, the early epidemiological data is concerning:
https://jamanetwork.com/journals/jama/fullarticle/2768389
8/x
https://jamanetwork.com/journals/jama/fullarticle/2768389
8/x
I still don't know why everyone was falling all over themselves to declare pregnant women at no increased risk from #COVID19, when we KNOW how viruses behave in pregnancy.
9/x
9/x
So, for #COVID19:
Postnatal infection - yes
Perinatal infection - yes, ~3%?
Late congenital infection - yes, rare
Early congenital infection - answers coming in the winter
Pregnancy disruption - yes, almost certainly.
10/10
Postnatal infection - yes
Perinatal infection - yes, ~3%?
Late congenital infection - yes, rare
Early congenital infection - answers coming in the winter
Pregnancy disruption - yes, almost certainly.
10/10
