PDF herunterladen
Am J Perinatol 2022; 39(12): 1292-1298
DOI: 10.1055/a-1704-1929
Short Communication

Maternal COVID-19 Infection and Possible Associated Adverse Neurological Fetal Outcomes, Two Case Reports

Charlotte Archuleta
1   College of Medicine, University of Arizona College of Medicine, Phoenix, Arizona
2   Neonatal Intensive Care Unit, Banner – University Medical Center Phoenix, Phoenix, Arizona
,
Christine Wade
2   Neonatal Intensive Care Unit, Banner – University Medical Center Phoenix, Phoenix, Arizona
3   Mednax/Arizona Neonatology, Phoenix, Arizona
,
Becky Micetic
2   Neonatal Intensive Care Unit, Banner – University Medical Center Phoenix, Phoenix, Arizona
3   Mednax/Arizona Neonatology, Phoenix, Arizona
,
Ashley Tian
2   Neonatal Intensive Care Unit, Banner – University Medical Center Phoenix, Phoenix, Arizona
4   Department of Neurology and Neurosurgery, Banner Children's Specialists Neurology and Neurosurgery Clinic, Mesa, Arizona
,
Kartik Mody
1   College of Medicine, University of Arizona College of Medicine, Phoenix, Arizona
2   Neonatal Intensive Care Unit, Banner – University Medical Center Phoenix, Phoenix, Arizona
3   Mednax/Arizona Neonatology, Phoenix, Arizona
5   Department of Pediatrics, Creighton University School of Medicine, Phoenix Regional Campus, Phoenix, Arizona
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
    Lizenzen und Reprints

Abstract

Introduction The long-term effects of prenatal coronavirus disease 2019 (COVID-19) infection on the fetal brain are mostly unknown at this time; however, there is increasing evidence being published.

Case Report Two cases of severe ventriculomegaly, neurological dysfunction, and seizures were found in neonates with prenatal exposure to COVID-19 infection during the first and third trimesters of pregnancy.

Conclusion Inflammation during the prenatal and neonatal periods may be associated with neurological disorders or injury. Despite the presumed lack of vertical transmission, post-COVID-19 syndrome and its associated inflammation may have an impact on the unborn fetus. Hyper-vigilance and dissemination of adverse findings are of significant importance as we navigate through this evolving pandemic and its effects.

Key Points

  • Prenatal exposure to COVID-19 may affect the fetal brain.

  • There is a possibility of neonatal neurological sequelae from maternal COVID-19.

  • Does maternal COVID-19 infection cause infantile seizures?

Keywords

pregnancy - COVID-19 - fetus - neonate - neurological dysfunction - seizures - inflammation - brain


Publikationsverlauf

Eingereicht: 09. November 2021

Angenommen: 12. November 2021

Accepted Manuscript online:
23. November 2021

Artikel online veröffentlicht:
11. Januar 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 de Vries LS. Viral infections and the neonatal brain. Semin Pediatr Neurol 2019; 32: 100769
    CrossrefPubMedGoogle Scholar
  • 2 Yeom JS, Park JS, Kim YS. et al. Neonatal seizures and white matter injury: role of rotavirus infection and probiotics. Brain Dev 2019; 41 (01) 19-28
    CrossrefPubMedGoogle Scholar
  • 3 Dugue R, Cay-Martínez KC, Thakur KT. et al. Neurologic manifestations in an infant with COVID-19. Neurology 2020; 94 (24) 1100-1102
    CrossrefPubMedGoogle Scholar
  • 4 Di Nicola P, Ceratto S, Dalmazzo C, Roasio L, Castagnola E, Sannia A. Concomitant SARS-CoV-2 infection and severe neurologic involvement in a late-preterm neonate. Neurology 2020; 95 (18) 834-835
    CrossrefPubMedGoogle Scholar
  • 5 Engert V, Siauw C, Stock A. et al. Severe brain damage in a moderate preterm infant as complication of post-COVID-19 response during pregnancy. Neonatology 2021; 118 (04) 505-508
    CrossrefPubMedGoogle Scholar
  • 6 Vivanti AJ, Vauloup-Fellous C, Prevot S. et al. Transplacental transmission of SARS-CoV-2 infection. Nat Commun 2020; 11 (01) 3572
    CrossrefPubMedGoogle Scholar
  • 7 Sukhikh G, Petrova U, Prikhodko A. et al. Vertical transmission of SARS-CoV-2 in second trimester associated with severe neonatal pathology. Viruses 2021; 13 (03) 447
    CrossrefPubMedGoogle Scholar
  • 8 Düppers AL, Bohnhorst B, Bültmann E, Schulz T, Higgins-Wood L, von Kaisenberg CS. Severe fetal brain damage subsequent to acute maternal hypoxemic deterioration in COVID-19. Ultrasound Obstet Gynecol 2021; 58 (03) 490-491
    CrossrefPubMedGoogle Scholar
  • 9 Yan K, Xiao FF, Jiang YW. et al. Effects of SARS-CoV-2 infection on neuroimaging and neurobehavior in neonates. World J Pediatr 2021; 17 (02) 171-179
    CrossrefPubMedGoogle Scholar
  • 10 Brum AC, Glasman MP, De Luca MC. et al. Ischemic lesions in the brain of a neonate with SARS-CoV-2 infection. Pediatr Infect Dis J 2021; 40 (09) e340-e343
    CrossrefPubMedGoogle Scholar
  • 11 Yildiz H, Yarci E, Bozdemir SE. et al. COVID-19-associated cerebral white matter injury in a newborn infant with afebrile seizure. Pediatr Infect Dis J 2021; 40 (07) e268-e269
    CrossrefPubMedGoogle Scholar
  • 12 Stafstrom CE, Jantzie LL. COVID-19: neurological considerations in neonates and children. Children (Basel) 2020; 7 (09) E133
    PubMedGoogle Scholar
  • 13 Di Nardo M, van Leeuwen G, Loreti A. et al. A literature review of 2019 novel coronavirus (SARS-CoV2) infection in neonates and children. Pediatr Res 2021; 89 (05) 1101-1108
    CrossrefPubMedGoogle Scholar
  • 14 Kim Y, Walser SA, Asghar SJ, Jain R, Mainali G, Kumar A. A comprehensive review of neurologic manifestations of COVID-19 and management of pre-existing neurologic disorders in children. J Child Neurol 2021; 36 (04) 324-330
    CrossrefPubMedGoogle Scholar
  • 15 Raschetti R, Vivanti AJ, Vauloup-Fellous C, Loi B, Benachi A, De Luca D. Synthesis and systematic review of reported neonatal SARS-CoV-2 infections. Nat Commun 2020; 11 (01) 5164
    CrossrefPubMedGoogle Scholar
  • 16 Iroegbu JD, Ifenatuoha CW, Ijomone OM. Potential neurological impact of coronaviruses: implications for the novel SARS-CoV-2. Neurol Sci 2020; 41 (06) 1329-1337
    CrossrefPubMedGoogle Scholar
  • 17 Goasdoué K, Miller SM, Colditz PB, Björkman ST. Review: the blood-brain barrier; protecting the developing fetal brain. Placenta 2017; 54: 111-116
    CrossrefPubMedGoogle Scholar
  • 18 Di Toro F, Gjoka M, Di Lorenzo G. et al. Impact of COVID-19 on maternal and neonatal outcomes: a systematic review and meta-analysis. Clin Microbiol Infect 2021; 27 (01) 36-46
    CrossrefPubMedGoogle Scholar
  • 19 Zamaniyan M, Ebadi A, Aghajanpoor S, Rahmani Z, Haghshenas M, Azizi S. Preterm delivery, maternal death, and vertical transmission in a pregnant woman with COVID-19 infection. Prenat Diagn 2020; 40 (13) 1759-1761
    CrossrefPubMedGoogle Scholar
  • 20 Juan J, Gil MM, Rong Z, Zhang Y, Yang H, Poon LC. Effect of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcome: systematic review. Ultrasound Obstet Gynecol 2020; 56 (01) 15-27
    CrossrefPubMedGoogle Scholar
  • 21 Alzamora MC, Paredes T, Caceres D, Webb CM, Valdez LM, La Rosa M. Severe COVID-19 during pregnancy and possible vertical transmission. Am J Perinatol 2020; 37 (08) 861-865
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 22 Brandt JS, Hill J, Reddy A. et al. Epidemiology of coronavirus disease 2019 in pregnancy: risk factors and associations with adverse maternal and neonatal outcomes. Am J Obstet Gynecol 2021; 224 (04) 389.e1-389.e9
    CrossrefPubMedGoogle Scholar
  • 23 Zeng H, Xu C, Fan J. et al. Antibodies in infants born to mothers with COVID-19 pneumonia. JAMA 2020; 323 (18) 1848-1849
    PubMedGoogle Scholar
  • 24 Dong L, Tian J, He S. et al. Possible vertical transmission of SARS-CoV-2 from an infected mother to her newborn. JAMA 2020; 323 (18) 1846-1848
    PubMedGoogle Scholar
  • 25 Zeng L, Xia S, Yuan W. et al. Neonatal early-onset infection with SARS-CoV-2 in 33 neonates born to mothers with COVID-19 in Wuhan, China. JAMA Pediatr 2020; 174 (07) 722-725
    CrossrefPubMedGoogle Scholar
  • 26 Wu YT, Liu J, Xu JJ. et al. Neonatal outcome in 29 pregnant women with COVID-19: a retrospective study in Wuhan, China. PLoS Med 2020; 17 (07) e1003195
    CrossrefPubMedGoogle Scholar
  • 27 Diriba K, Awulachew E, Getu E. The effect of coronavirus infection (SARS-CoV-2, MERS-CoV, and SARS-CoV) during pregnancy and the possibility of vertical maternal-fetal transmission: a systematic review and meta-analysis. Eur J Med Res 2020; 25 (01) 39
    CrossrefPubMedGoogle Scholar
  • 28 Di Mascio D, Khalil A, Saccone G. et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2020; 2 (02) 100107
    CrossrefPubMedGoogle Scholar
  • 29 Kasraeian M, Zare M, Vafaei H. et al. COVID-19 pneumonia and pregnancy; a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2020; 1-8
    PubMedGoogle Scholar
  • 30 Muhidin S, Behboodi Moghadam Z, Vizheh M. Analysis of maternal coronavirus infections and neonates born to mothers with 2019-nCoV; a systematic review. Arch Acad Emerg Med 2020; 8 (01) e49
    PubMedGoogle Scholar
  • 31 Della Gatta AN, Rizzo R, Pilu G, Simonazzi G. Coronavirus disease 2019 during pregnancy: a systematic review of reported cases. Am J Obstet Gynecol 2020; 223 (01) 36-41
    CrossrefPubMedGoogle Scholar
  • 32 Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: a systematic review of 108 pregnancies. Acta Obstet Gynecol Scand 2020; 99 (07) 823-829
    CrossrefPubMedGoogle Scholar
  • 33 Medeiros KS, Sarmento ACA, Martins ES, Costa APF, Eleutério Jr J, Gonçalves AK. Impact of SARS-CoV-2 (COVID-19) on pregnancy: a systematic review and meta-analysis protocol. BMJ Open 2020; 10 (11) e039933
    CrossrefPubMedGoogle Scholar
  • 34 Chi H, Chiu NC, Tai YL. et al. Clinical features of neonates born to mothers with coronavirus disease-2019: a systematic review of 105 neonates. J Microbiol Immunol Infect 2021; 54 (01) 69-76
    CrossrefPubMedGoogle Scholar
  • 35 Tsafaras GP, Ntontsi P, Xanthou G. Advantages and limitations of the neonatal immune system. Front Pediatr 2020; 8: 5
    CrossrefPubMedGoogle Scholar
  • 36 Levy A, Yagil Y, Bursztyn M, Barkalifa R, Scharf S, Yagil C. ACE2 expression and activity are enhanced during pregnancy. Am J Physiol Regul Integr Comp Physiol 2008; 295 (06) R1953-R1961
    CrossrefPubMedGoogle Scholar
  • 37 Li M, Chen L, Zhang J, Xiong C, Li X. The SARS-CoV-2 receptor ACE2 expression of maternal-fetal interface and fetal organs by single-cell transcriptome study. PLoS One 2020; 15 (04) e0230295
    CrossrefPubMedGoogle Scholar
  • 38 Cribiù FM, Erra R, Pugni L. et al. Severe SARS-CoV-2 placenta infection can impact neonatal outcome in the absence of vertical transmission. J Clin Invest 2021; 131 (06) 145427
    CrossrefPubMedGoogle Scholar
  • 39 Joma M, Fovet CM, Seddiki N, Gressens P, Laforge M. COVID-19 and pregnancy: vertical transmission and inflammation impact on newborns. Vaccines (Basel) 2021; 9 (04) 391
    CrossrefPubMedGoogle Scholar