Vertical transmission of coronavirus disease 2019 among pregnant women in Manila City, Philippines: A case series

BACKGROUND: Vertical transmission in coronavirus disease 2019 (COVID-19) remains to be established, especially in view of the influence of maternal vaccination during pregnancy. This series presents cases of mothers, both vaccinated and unvaccinated, yielding at least one COVID-19-positive maternal throat, fetal, and breast milk, or neonatal throat and rectal specimen. METHODS: Within the delivery period and immediately post-delivery, samples were collected from the maternal-fetal dyad and then analyzed using reverse transcription polymerase chain reaction (RT-PCR) to determine the presence of severe acute respiratory syndrome coronavirus 2. A chart review and analysis of clinical history, pregnancy course, and delivery information were done for each dyad. FINDINGS: Seven maternal-fetal dyads were included in this study. Most mothers were young reproductive-aged women with good prenatal care; cesarean delivery was common. Outcomes were uniformly favorable despite universal neonatal COVID-19 positivity. Vaccinated mothers were asymptomatic even when RT-PCR–positive. Five dyads had concurrently COVID-19-positive samples. Higher gravidity and gestational comorbidities were linked to positive neonatal samples. CONCLUSION: Vertical transmission in COVID-19 has been observed in this case series, warranting a more comprehensive study and translation to public health policy.