University of Miami

UM Health Case Study Shows COVID-19 Transmitted From Mom to Baby, Causing Brain Injury

The study titled “Maternal SARS-CoV-2, Placental Changes and Brain Injury in Two Neonates” was published Thursday in the journal Pediatrics.

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Researchers at the University of Miami Health System and the Miller School of Medicine published a study that showed in two cases, COVID-19 was transmitted from mothers to newborn babies through the placenta and caused brain damage.

The study titled “Maternal SARS-CoV-2, Placental Changes and Brain Injury in Two Neonates” was published Thursday in the journal Pediatrics.

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In the study, two infants were admitted to the NICU unit at Holtz Children's Hospital and tested negative for the virus at birth but had significantly elevated SARS-CoV-2 antibodies detected in their bloodstream - indicating that "either antibodies crossed the placenta, or passage of the virus occurred and the immune response was the baby’s," according to the report.

University of Miami
The image on the left is one of the patient's placentas, and on the right is a scan of her baby's brain. The arrows point to the presence of the COVID-19 virus.

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Both infants experienced seizures, small head sizes and developmental delays, and one infant died at 13 months old. An autopsy showed the COVID virus present in his brain.

“Many women are affected by COVID-19 during pregnancy, but to see these kinds of problems in their infants at birth was clearly unusual,” said Dr. Shahnaz Duara, the medical director of the NICU at Holtz Children’s Hospital and senior author on the study. “We’re trying to understand what made these two pregnancies different, so we can direct research towards protecting vulnerable babies.” 

In both cases, the moms contracted COVID-19 in the second trimester. Both are Hispanic women in their early 20s with two very different bouts with COVID — one was severely sick and the other had a mild case.

The other baby who was also the subject of the study — a little girl — was in hospice at the time the study was written, NBC6 was told.

Doctors told NBC6 this study is meant to be an alert to the medical community and not to cause panic. They emphasized that the majority of pregnant women who get COVID go on to have healthy babies, but that’s not the case for everyone.

Early in the pandemic, a group of neonatologists had observed transient lung disease and sometimes blood pressure issues among newborns who had similarly tested negative at birth but were born to mothers who tested positive.

“If we saw a baby who presented this way, we would call it hypoxic-ischemic encephalopathy (brain damage caused by decreased blood flow),” said Dr. Michael Paidas, professor and chair of the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of Miami Miller School of Medicine. “But it wasn’t lack of blood flow to the placenta that caused this. As best we can tell, it was the viral infection.”

The authors stress that these were rare occurrences with UM clinicians having seen hundreds of pregnant women and delivering mothers with COVID-19 positivity. In both cases, the mothers contracted the infection in their second trimesters and subsequently cleared it, but one had a repeat infection in their third trimester.

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