Clinical characteristics of children exposed to the SARS-CoV-2 during pregnancy
DOI:
https://doi.org/10.33448/rsd-v14i12.50331Keywords:
SARS-CoV-2, COVID-19, Newborn, Pregnancy, Epidemiology.Abstract
Introduction: Exposure to SARS-CoV-2 during pregnancy can cause effects in newborns, such as respiratory difficulties, jaundice, and developmental risks. Vertical transmission remains uncertain. Given these uncertainties and the importance of infant care, investigating the impacts of in utero exposure is warranted. Objective: To analyze the clinical characteristics and evolution of children up to 2 years of age exposed to SARS-CoV-2 during pregnancy. Methods: This is a cross-sectional observational study, through the analysis of medical records of children exposed to COVID-19 during pregnancy between 2020 and 2025. Data collection was conducted at the Pediatric Specialties Center in Leme-SP. After tabulation in Excel®, data were analyzed using IBM SPSS software, with descriptive analysis and Chi-square test. Patient confidentiality was maintained. Results: 25 medical records were evaluated. Exposure to the virus occurred in the third trimester of pregnancy (56%), second (20%) and first (16%). All patients had normal newborn screening tests, with good weight, height and neuropsychomotor development. Low birth weight occurred in 8% and 16% were exclusively breastfed. Serology for SARS-CoV-2, performed in the first 30 days of life, revealed reactive IgG in 72% of cases, with no reactive IgM. Children exposed to SARS-CoV-2 during pregnancy presented clinical consequences such as congenital syphilis, upper respiratory tract infections, tachypnea with increased cardiac area, elevated cardiac enzymes CPK and CPKMB, suspected ASD, infectious gastroenteritis, and dermatological conditions. Conclusion: Our study demonstrated no vertical transmission of SARS-CoV-2 in the studied population. The evolution of the infants was considered satisfactory.
References
Bringel, R. A., Sousa, J. F., Reisi, L. M. A. M. C., & Vale, M. S. (2020). Covid-19 mother-infant binomial: A case report from the University Hospital of Maranhão. Pediatric Residency, 10(3), 1–3. https://doi.org/10.25060/residpediatr-2020.v10n3-395
Brito, S. B. R., Braga, I. O., Cunha, C. C., Palácio, M. A. V., & Takenami, I. (2020). COVID-19 pandemic: The biggest challenge for the 21st century. Vigilância Sanitária em Debate, 54–63. https://doi.org/10.22239/2317-269X.01531
Carvalho, B. C., Kloppel, L. N., & Vieira, R. C. (2022). COVID-19 infection in pregnancy. Femina, 50(5), 308–310. https://docs.bvsalud.org/biblioref/2022/08/1380710/femina-2022-505-308-310.pdf
Costa, B. O. C., Oliveira, F. P. B., Cordeiro, G. F. T., Brugger, E. B. A., Silva, A. D., et al. (2023). Autism spectrum disorder in primary health care: Challenges for multidisciplinary care. SMAD, Revista Eletrônica Saúde Mental Álcool e Drogas, 19(1), 13–21. https://doi.org/10.11606/issn.1806-6976.smad.2023.180473
Costa Neto, P. L. O. & Bekman, O. R. (2009). Análise estatística da decisão. (2ed). Editora Blucher.
Dosedla, E., Gasparová, P., Ballová, Z., Radaljová, K., & Calda, P. (2023). Epidermolysis in a newborn of a mother affected by COVID-19 in the 3rd trimester of pregnancy. Ceska Gynekologie, 88(1), 13–16. https://doi.org/10.48095/cccg202313
Edlow, A. G., Castro, V. M., Shock, L. L., Haneuse, S., Kaimal, A. J., & Perlis, R. H. (2023). Sex-specific neurodevelopmental outcomes among offspring of mothers with SARS-CoV-2 infection during pregnancy. JAMA Network Open, 6(3), e234415. https://doi.org/10.1001/jamannetworkopen.2023.4415
Fajardo-Martinez, V., Ferreira, F., Fuller, T., Cambou, M. C., Kerin, T., Paiola, S., et al. (2024). Neurodevelopmental delay in children exposed to maternal SARS-CoV-2 in-utero. Scientific Reports, 14, 11851. https://doi.org/10.1038/s41598-024-61918-2
Falahi, S., Abdoli, A., & Kenarkoohi, A. (2023). Maternal COVID-19 infection and the fetus: Immunological and neurological perspectives. New Microbes and New Infections, 53, 101135. https://doi.org/10.1016/j.nmni.2023.101135
Foratori-Junior, G. A., Mosquim, V., Machado, M. A. A. M., & Sales-Peres, S. H. C. (2021). COVID-19 and its relation to pregnancy and neonates: A systematic review. Brazilian Journal of Maternal and Child Health, 21(3), 697–727. https://doi.org/10.1590/1806-93042021000300002
Freire, M. D., Rocha, A. A., Souza, F. T., Lima, T. B., & Guimarães, A. O. (2023). Covid-19 and maternal-fetal complications: A literature review. Brazilian Journal of Implantology and Health Sciences, 5(4), 2169–2186. https://doi.org/10.36557/2674-8169.2023v5n4p2169-2186
Furlan, M. C. R., Jurado, S. R., Uliana, C. H., Silva, M. E. P., Nagata, L. A., & Maia, A. C. F. (2020). A systematic review of pregnancy and coronavirus infection: Maternal, fetal and neonatal outcomes. Revista Cuid, 11(2), e1211. https://doi.org/10.1002/ijgo.13329
Hu, H., Ma, F., Wei, X., & Fang, Y. (2021). Coronavirus fulminant myocarditis saved with glucocorticoid and human immunoglobulin. European Heart Journal, 42(2), 206. https://doi.org/10.1093/eurheartj/ehaa190
Jin, Y. H., Cai, L., Cheng, Z. S., Cheng, H., Deng, T., Fan, Y. P., et al. (2020). A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia. Military Medical Research, 7(1), 1–23. https://doi.org/10.1186/s40779-020-0233-6
Kappanayil, M., Balan, S., Alawani, S., Mohanty, S., Leeladharan, S. P., Gangadharan, S., et al. (2021). Multisystem inflammatory syndrome in a neonate temporally associated with prenatal exposure to SARS-CoV-2: A case report. The Lancet Child & Adolescent Health, 5(4), 304–308. https://doi.org/10.1016/S2352-4642(21)00055-9
Kumar, M., Saadaoui, M., & Khodor, A. S. (2022). Infections and pregnancy: Effects on maternal and child health. Frontiers in Cellular and Infection Microbiology, 12, 873253. https://doi.org/10.3389/fcimb.2022.873253
Luca, D. D., Vauloup-Fellous, C., Benachi, A., & Vivanti, A. (2023). Transmission of SARS-CoV-2 from mother to fetus or neonate: What to know and what to do? Seminars in Fetal and Neonatal Medicine, 28(1), 101429. https://doi.org/10.1016/j.siny.2023.101429
Malak, R., Kaczmarek, A., Fechner, B., Samborski, W., Kwiatkowski, J., Komisarek, O., et al. (2024). The importance of follow-up visits for children at risk of developmental delay—A review. Diagnostics, 14(16), 1764. https://pubmed.ncbi.nlm.nih.gov/39202251/
Moreira, S. J., Sbeghen, C., Gaio, G., Potrich, T., Brum, & Zuge, S. S. (2024). COVID-19 pandemic and the breastfeeding process by mothers infected: Scoping review. Journal of Nursing and Health Care, 13(1), e202401. https://doi.org/10.18554/reas.v13i1.6503e202401
Pan American Health Organization. (2020). SARS-CoV-2 transmission: Implications for infection prevention precautions. World Health Organization. https://iris.paho.org/handle/10665.2/52472
Pan American Health Organization, & Ministry of Health. (2024). Post-COVID in primary health care and specialized outpatient care. SUS Navigator Technical Series. https://doi.org/10.37774/9789275728383
Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [free ebook]. Santa Maria. Editora da UFSM.
Rente, A., Uzeato Junior, D., & Uzeato, K. M. (2020). Coronavirus and the heart: A case report on the evolution of COVID-19 associated with cardiological evolution. Brazilian Cardiology Archives, 114(5), 839–842. https://doi.org/10.36660/abc.20200263
Ruiz, A. A. U., Pérez, E. T. G., Linares, I. I. M., & Àlvares, Y. G. (2023). COVID-19 in pregnant women: Risk of complications during pregnancy and in the newborn. Medicentro, 27(3). http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30432023000300013
Shaw, K. A., Williams, S., Patrick, M. E., Valencia-Prado, M., Durkin, M. S., Howerton, E. M., et al. (2025). Prevalence and early identification of autism spectrum disorder among children aged 4 and 8 years—Autism and Developmental Disabilities Monitoring Network. MMWR Surveillance Summaries, 74(2), 1–22. https://doi.org/10.15585/mmwr.ss7402a1
Shitsuka, R. et al. (2014). Matemática fundamental para tecnologia (2ed). Editora Érica.
Suriñach-Ayats, B., Carbonell-Estarellas, E., Becerra-Hervas, J., López-Bernal, E., Boronat, S., & Moliner-Calderon, E. (2023). Epidemiology and characteristics of SARS-CoV-2 infection in the newborn and pregnant woman. Enfermedades Infecciosas y Microbiología Clínica, 41(8), 485–488. https://doi.org/10.1016/j.eimc.2022.04.009
Veloso, A. H. N., Barbosa, A. de M., Ribeiro, M. F. M., & Gervásio, F. M. (2024). Neurodevelopment in the first year of children exposed to SARS-CoV-2 during intrauterine period: Systematic review. Revista Gaúcha de Enfermagem, 45, e20240020. https://doi.org/10.1590/1983-1447.2024.20240020.pt
Vieira, A. C. M., Sales, G. K. L., & Silva, Z. B. (2025). Post-COVID-19 sequelae: A literature review on risk factors and health impacts. Research, Society and Development, 14(1). https://rsdjournal.org/rsd/article/view/50065/39242
Vieira, S. (2021). Introdução à bioestatística. Editora GEN/Guanabara Koogan.
Wang, S., Guo, L., Chen, L., Liu, W., Cao, Y., Zhang, J., & Feng, L. (2020). A case report of neonatal 2019 coronavirus disease in China. Clinical Infectious Diseases, 71(15), 853–857. https://doi.org/10.1093/cid/ciaa225
Wang, X., Yang, P., Zheng, J., Liu, P., Wei, C., Guo, J., et al. (2021). Dynamic changes of acquired maternal SARS-CoV-2 IgG in infants. Scientific Reports, 11(1), 8021. https://doi.org/10.1038/s41598-021-87535-x
Wastnedge, E. A. N., Reynolds, R. M., van Boeckel, S. R., Stock, S. J., Denison, F. C., Maybin, J. A., et al. (2021). Pregnancy and COVID-19. Physiological Reviews, 101, 303–318. https://doi.org/10.1152/physrev.00024.2020
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Júlia da Silva Grilo, Isabelle Campos Leite Domingues Borges, Patrícia Maria Wiziack Zago, Denilson Guimarães Meira
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
