COVID-19 in a cohort of pregnant women and their descendants, the MOACC-19 study

Abstract

Purpose: The Mother and Child COVID-19 study is a cohort recruiting pregnant women and their children in Cantabria, North of Spain, during COVID-19 pandemic in order to ascertain consequences of SARS-CoV-2 infection on pregnant women and their descendants. This article reports the cohort profile and preliminary results as recruitment is still open.

Participants: Three subcohorts can be identified at recruitment. Subcohort 1 includes women giving birth between 23 March and 25 May 2020; they have been retrospectively recruited and could have been exposed to COVID-19 only in their third trimester of pregnancy. Subcohort 2 includes women giving birth from 26 May 2020 on; they are being prospectively recruited and could have been exposed to COVID-19 in both their second and third trimesters of pregnancy. Subcohort 3 includes women in their 12 week of pregnancy prospectively recruited from 26 May 2020 on; they could have been exposed to COVID-19 anytime in their pregnancy. All women are being tested for SARS-CoV-2 infection using both RT-PCR for RNA detection and ELISA for anti-SARS-CoV-2 antibodies. All neonates are being tested for antibodies using immunochemoluminiscency tests; if the mother is tested positive for SARS-CoV-2 RNA, a nasopharyngeal swab is also obtained from the child for RT-PCR analysis.

Findings to date: As of 22 October, 1167 women have been recruited (266, 354 and 547 for subcohorts 1, 2 and 3, respectively). Fourteen women tested positive to SARS-CoV-2 RNA by the day of delivery. All 14 children born from these women tested negative for SARS-CoV-2 RNA.

Future plans: Children from women included in subcohort 3 are expected to be recruited by the end of 2020. Children will be followed-up for 1 year in order to ascertain the effect that COVID-19 on their development.

Keywords: epidemiology; maternal medicine; paediatric infectious disease & immunisation; public health.

Figure 1

Pregnant women recruitment for this study in the context of the COVID-19 pandemic evolution in Spain. The blue line represents the daily number of cases as reported to the ECDC up to 13 December 2020. The blue rectangles indicate the main legal restrictions. The yellow rectangles mark the recruitment period for each subcohort. The orange rectangles indicate the period of exposure to COVID-19 for each subcohort. Note on reported cases: peaks by 10, 22 and 28 May, and troughs by 19 April and 5 May are anomalies in the number of reported cases due to corrections in the series. From 1 July on, cases are not reported on Saturdays and Sundays, so number of cases on Mondays represent 3-day cumulative figures. ECDC, European Centre for Disease Prevention and Control.

Figure 2

Flow diagram of tasks performed in each sub-cohort.