French baby infected with coronavirus in the womb in first confirmed case

French doctors have reported what is believed to be the first case of a pregnant woman passing Covid-19 to her baby in the womb.

Within days of being born, the newborn boy developed inflammation in the brain. This condition occurred when the virus crossed the placenta and infected the fetus before birth. The baby has since made a good recovery.

The case study was published in Nature Communications, and tracks the birth of several babies who are suspected to have caught coronavirus in the womb.Until now, doctors were not able to rule out the possibility that the babies caught the disease delivery, or soon after birth.

“Unfortunately there is no doubt about the transmission in this case,” said Daniele De Luca, medical director of paediatrics and neonatal critical care at the Antoine Béclère hospital in Paris. “Clinicians must be aware that this may happen. It’s not common, that’s for sure, but it may happen and it must be considered in the clinical workout.”

The mother, 23, was admitted to the hospital on 24 March with a fever and severe cough. Shortly after being admitted, she tested positive for Covid-19, having caught the virus late in the third trimester.

Three days after she arrived in hospital, doctors monitoring the baby noticed signs of distress.

They performed an emergency caesarean with the mother under general anaesthetic. The baby was immediately isolated in a neonatal intensive care unit and intubated due to effects from the general anaesthetic.

After baby’s blood and lung fluid were tested, he was diagnosed with Covid-19, and other viral, bacterial and fungal infections were ruled out. After further tests, it was revealed that the virus had spread from the mother’s blood into the placenta. In the placenta, the virus replicated and caused inflammation, and infected to the baby.

“The reason this has not been demonstrated before is that you need a lot of samples,” De Luca said. “You need the maternal blood, the newborn blood, the cord blood, the placenta, the amniotic fluid, and it’s extremely difficult to get all these samples in a pandemic with emergencies all around.

“There have been some suspected cases, but they remain suspected because nobody had the opportunity to test all of this and check the pathology of the placenta. The virus was most present in the placenta, which is rich in the same receptors found in the lungs that Covid-19 uses to enter human cells.

The baby initially seemed healthy, but three days after birth he became irritable and started feeding badly. He developed muscle spasms that made his head, neck and back arch backwards. MRI scans revealed signs of gliosis, a side effect of neurological injury, which can cause brain scarring.

When the boy was born, there was no clinical guidance for treating babies with coronavirus. The doctors considered administering remdesivir, an antiviral drug, but as the baby since was gradually recovering by itself, they decided not to administer specific medication. De Luca said a recent follow-up scan was “almost normal”.

“You can see the glass as half empty or half full. The bad news is that in this case history, the virus is attacking the baby, reaching the baby and causing symptoms. The good news is that at the end of the day, the baby very much recovered. The baby is clinically fine,” he said.

“Pregnant women should be reassured,” De Luca added. “Pregnancy is very controlled and if you have something like this, it can be controlled. In most cases there will be no damage to the baby. There are many things we can do, but we can’t close our eyes and say this is never going to happen.”

Although is very rare for babies to catch coronavirus from their mothers, De Luca said that social distancing and hand washing is “very much common sense and important whether you are pregnant or not”.