Double Jeopardy: The Intersection of COVID-19 and Pregnancy in an Educational Hospital, Northern Iran, Gorgan.

With the onset of the severe acute respiratory syndrome coronavirus-2 pandemic, controversial theories emerged regarding the potential consequences of the virus on pregnant women and delivery outcomes. Over the past three years, various studies have reported various data on pregnant women infected with covid and pregnancy-related complications, including preterm birth, stillbirth, preeclampsia, cesarean delivery. However; the exact influence of the virus and possibility of vertical transmission remained unclear. Here, we described the clinical features and delivery outcomes in 16 laboratory confirmed COVID-19-infected mothers who referred to a hospital in northern Iran from August 2020 to December 2021. We collected Clinical records, laboratory results, and chest CT scans,as well as samples as maternal peripheral blood, umbilical cord blood, placental blood, vaginal secretions, placental tissue, breast milk after the first lactation, neonatal throat swab, and peripheral blood. We evaluated all the aforementioned specimens based on molecular and serological assays to answer the questions raised on the possibility of vertical transmission of COVID-19 and transfer of maternal immunity to the neonates. SARS-CoV-2 RNA was not detected in vaginal secretions and placental tissue. SARS-CoV-2 IgG and IgM antibodies were detected in 15 and 4 maternal blood samples, respectively, in one breast milk sample (IgM), two umbilical cord blood (IgG) samples, two placental blood (IgG) and two neonatal blood (IgG) samples. Chest CT scans of abnormal cases revealed typical signs of viral pneumonia. The current study suggests an association between SARS-CoV-2 infection and an increased risk of preterm birth. However, no intrauterine vertical transmission of SARS-CoV-2 was identified. These results also suggest passive IgG transfer from infected mothers to their neonates.