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Despite reports of neonatal COVID\u201019, SARS\u2010CoV\u20102 has not been consistently isolated in perinatal samples, thus definitive proof of transplacental infection is still lacking. To address these questions, we assessed investigative tools used to confirm maternal\u2010fetal infection and known protective mechanisms of the placental barrier that prevent transplacental pathogen migration. Forty studies of COVID\u201019 pregnancies reviewed suggest a lack of consensus on diagnostic strategy for congenital infection. Although real\u2010time polymerase chain reaction of neonatal swabs was universally performed, a wide range of clinical samples was screened including vaginal secretions (22.5%), amniotic fluid (35%), breast milk (22.5%) and umbilical cord blood. Neonatal COVID\u201019 was reported in eight studies, two of which were based on the detection of SARS\u2010CoV\u20102 IgM in neonatal blood. Histological examination demonstrated sparse viral particles, vascular malperfusion and inflammation in the placenta from pregnant women with COVID\u201019. The paucity of placental co\u2010expression of ACE\u20102 and TMPRSS2, two receptors involved in cytoplasmic entry of SARS\u2010CoV\u20102, may explain its relative insensitivity to transplacental infection. Viral interactions may utilise membrane receptors other than ACE\u20102 thus, tissue susceptibility may be broader than currently known. Further spatial\u2010temporal studies are needed to determine the true potential for transplacental migration.<\/jats:p>","DOI":"10.1002\/pd.5765","type":"journal-article","created":{"date-parts":[[2020,6,12]],"date-time":"2020-06-12T07:11:06Z","timestamp":1591945866000},"page":"1655-1670","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Mechanisms and evidence of vertical transmission of infections in pregnancy including <scp>SARS\u2010CoV<\/scp>\u20102s"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8570-8427","authenticated-orcid":false,"given":"Aniza P.","family":"Mahyuddin","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology National University Hospital  Singapore Singapore"},{"name":"Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhiram","family":"Kanneganti","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology National University Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeslyn J.L.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology National University Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pooja S.","family":"Dimri","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology National University Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin L.","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology National University Hospital  Singapore Singapore"},{"name":"Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arijit","family":"Biswas","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology National University Hospital  Singapore Singapore"},{"name":"Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5433-9315","authenticated-orcid":false,"given":"Sebastian E.","family":"Illanes","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Universidad de los Andes  Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Citra N. 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