Mother-to-child transmission (MTCT)

What is the risk of mother-to-child SARS-Cov-2 transmission a) in utero, b) intrapartum, and c) postpartum?

What is the presence and persistence of the virus in amniotic fluid, cord blood, placenta, neonatal throat swabs, vaginal fluids, faeces, serology (IgM, IgG) and breast milk?

Diagram of transmission risks to baby as explained below
Transmission risks to baby

Version 4: updated 29 November 2020

  • Of the 4907 babies tested, 333 had a positive COVID-19 test.
  • 33 babies had a positive nasopharyngeal swab for the virus within 12 hours of birth. 62 had a positive nasopharyngeal swab on the first day of birth.
  • Of the 271 remaining babies: 152 had a positive nasopharyngeal swab after the first 24 hours of birth; 106 positive babies have no timing published; 10 babies were never positive by nasopharyngeal swab but were positive by serology IgM; 3 babies were positive on autopsy.      
  • In a few cases, the virus has been detected by RT-PCR in amniotic fluid (n=7), placenta and placental membranes (n=21), cord blood (n=6), vaginal fluid (n=5), neonatal plasma (n=7), and neonatal anal or faecal samples (n=16).
  • Studies varied in the rigour with which the mother-to-child transmission was ascertained.

To-date, there is insufficient evidence to confirm mother-to-child transmission of SARS-COV-2.

(v4.0 last search update on 29 November 2020; findings may change as new evidence emerges)

Disclaimer: The findings have not yet been peer reviewed and the sources cited should be checked. Any views expressed are those of the authors and not necessarily those of their institutions and organisations. 

Previous versions

Structured research question (PICO)

Mother-to-child transmission risk of COVID-19 infection
Population Babies born to mothers with suspected/confirmed COVID-19
Exposure In-utero, intrapartum, postpartum
Comparator -
Outcomes Offspring COVID infection status (confirmed, probable, possible, unlikely, not infected)
Viral levels in amniotic fluid, cord blood, vaginal fluids, breast milk, neonatal throat swabs, placenta; duration of viral shedding after COVID-19 symptom onset, after clinical resolution of signs/symptoms
Study design Observational studies

Findings

Full details to be published shortly. Currently undergoing peer review.