{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T17:02:09Z","timestamp":1775581329411,"version":"3.50.1"},"reference-count":34,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T00:00:00Z","timestamp":1639526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Neonatal COVID-19 is rare and mainly results from postnatal transmission. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), however, can infect the placenta and compromise its function. We present two cases of decreased fetal movements and abnormal fetal heart rhythm 5 days after mild maternal COVID-19, requiring emergency caesarean section at 29 + 3 and 32 + 1 weeks of gestation, and leading to brain injury. Placental examination revealed extensive and multifocal chronic intervillositis, with intense cytoplasmic positivity for SARS-CoV-2 spike antibody and SARS-CoV-2 detection by RT-qPCR. Vertical transmission was confirmed in one case, and both neonates developed extensive cystic peri-ventricular leukomalacia.<\/jats:p>","DOI":"10.3390\/v13122517","type":"journal-article","created":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T21:47:36Z","timestamp":1639604856000},"page":"2517","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Decreased Fetal Movements: A Sign of Placental SARS-CoV-2 Infection with Perinatal Brain Injury"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6181-3126","authenticated-orcid":false,"given":"Guillaume","family":"Favre","sequence":"first","affiliation":[{"name":"Materno-Fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Mazzetti","sequence":"additional","affiliation":[{"name":"Clinic of Pediatrics, Department Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carole","family":"Gengler","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Bertelli","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6849-6178","authenticated-orcid":false,"given":"Juliane","family":"Schneider","sequence":"additional","affiliation":[{"name":"Clinic of Neonatology, Department Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Laubscher","sequence":"additional","affiliation":[{"name":"Clinic of Pediatrics, Department Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland"},{"name":"Department of Pediatrics, R\u00e9seau Hospitalier Neuch\u00e2telois, 2000 Neuch\u00e2tel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romina","family":"Capoccia","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, R\u00e9seau Hospitalier Neuch\u00e2telois, 2000 Neuchatel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatemeh","family":"Pakniyat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, R\u00e9seau Hospitalier Neuch\u00e2telois, 2000 Neuchatel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u00e8s","family":"Ben Jazia","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, R\u00e9seau Hospitalier Neuch\u00e2telois, 2000 Neuchatel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B\u00e9atrice","family":"Eggel-Hort","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, H\u00f4pital du Valais\u2014Centre Hospitalier du Valais Romand\u2014Site de Sion, 1951 Sion, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"de Leval","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3021-8129","authenticated-orcid":false,"given":"L\u00e9o","family":"Pomar","sequence":"additional","affiliation":[{"name":"Materno-Fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland"},{"name":"Midwifery Department, School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9529-3317","authenticated-orcid":false,"given":"Gilbert","family":"Greub","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland"},{"name":"Infectious Diseases Service, Department of Internal Medicine, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9914-6496","authenticated-orcid":false,"given":"David","family":"Baud","sequence":"additional","affiliation":[{"name":"Materno-Fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0897-6529","authenticated-orcid":false,"given":"Eric","family":"Giannoni","sequence":"additional","affiliation":[{"name":"Clinic of Neonatology, Department Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e40","DOI":"10.1016\/S0140-6736(20)30311-1","article-title":"2019-nCoV epidemic: What about pregnancies?","volume":"395","author":"Favre","year":"2020","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.15585\/mmwr.mm6944e2","article-title":"Birth and Infant Outcomes Following Laboratory-Confirmed SARS-CoV-2 Infection in Pregnancy\u2014SET-NET, 16 Jurisdictions, March 29\u2013October 14, 2020","volume":"69","author":"Woodworth","year":"2020","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"m3320","DOI":"10.1136\/bmj.m3320","article-title":"Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: Living systematic review and meta-analysis","volume":"370","author":"Allotey","year":"2020","journal-title":"BMJ"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"13898","DOI":"10.1038\/s41598-021-92357-y","article-title":"Maternal outcomes and risk factors for COVID-19 severity among pregnant women","volume":"11","author":"Vouga","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e40","DOI":"10.1017\/S0950268820000370","article-title":"Maternal caesarean section infection (MACSI) in Sierra Leone: A case-control study","volume":"148","author":"Marotta","year":"2020","journal-title":"Epidemiol. Infect."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/S2352-4642(20)30342-4","article-title":"Characteristics and outcomes of neonatal SARS-CoV-2 infection in the UK: A prospective national cohort study using active surveillance","volume":"5","author":"Gale","year":"2021","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"5164","DOI":"10.1038\/s41467-020-18982-9","article-title":"Synthesis and systematic review of reported neonatal SARS-CoV-2 infections","volume":"11","author":"Raschetti","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1093\/jpids\/piaa153","article-title":"Severe Acute Respiratory Syndrome Coronavirus 2 Placental Infection and Inflammation Leading to Fetal Distress and Neonatal Multi-Organ Failure in an Asymptomatic Woman","volume":"10","author":"Schoenmakers","year":"2020","journal-title":"J. Pediatr. Infect. Dis. Soc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e439","DOI":"10.1097\/INF.0000000000002941","article-title":"Congenital SARS-CoV-2 Infection in a Neonate with Severe Acute Respiratory Syndrome","volume":"39","author":"Correia","year":"2020","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3572","DOI":"10.1038\/s41467-020-17436-6","article-title":"Transplacental transmission of SARS-CoV-2 infection","volume":"11","author":"Vivanti","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1212\/WNL.0000000000010729","article-title":"Concomitant SARS-CoV-2 infection and severe neu-rologic involvement in a late-preterm neonate","volume":"95","author":"Ceratto","year":"2020","journal-title":"Neurology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1093\/jpids\/piaa165","article-title":"Severe Acute Respiratory Syndrome Coronavirus-2 Pneumonia in a Newborn Treated with Remdesivir and Coronavirus Disease 2019 Convalescent Plasma","volume":"10","author":"Hopwood","year":"2021","journal-title":"J. Pediatr. Infect. Dis. Soc."},{"key":"ref_13","unstructured":"(2021, February 23). Definition and Categorization of the Timing of Mother-to-Child Transmission of SARS-CoV-2. Available online: https:\/\/www.who.int\/publications-detail-redirect\/WHO-2019-nCoV-mother-to-child-transmission-2021.1."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2198","DOI":"10.1001\/jama.2020.7233","article-title":"Second-Trimester Miscarriage in a Pregnant Woman With SARS-CoV-2 Infection","volume":"323","author":"Baud","year":"2020","journal-title":"JAMA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"403","DOI":"10.2217\/fmb.15.152","article-title":"Ten years of R&D and full automation in molecular diagnosis","volume":"11","author":"Greub","year":"2016","journal-title":"Future Microbiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"ftaa061","DOI":"10.1093\/femspd\/ftaa061","article-title":"Comparison of SARS-CoV-2 RT-PCR on a high-throughput molecular diagnostic platform and the cobas SARS-CoV-2 test for the diagnostic of COVID-19 on various clinical samples","volume":"78","author":"Opota","year":"2020","journal-title":"Pathog. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"698","DOI":"10.5858\/arpa.2015-0225-CC","article-title":"Sampling and Definitions of Placental Lesions: Amsterdam Placental Workshop Group Consensus Statement","volume":"140","author":"Khong","year":"2016","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1036.e1","DOI":"10.1016\/j.cmi.2021.03.029","article-title":"Recommendations for accurate genotyping of SARS-CoV-2 using amplicon-based sequencing of clinical samples","volume":"27","author":"Kubik","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1038\/s41564-020-0770-5","article-title":"A dynamic nomenclature proposal for SARS-CoV-2 lineages to assist genomic epidemiology","volume":"5","author":"Rambaut","year":"2020","journal-title":"Nat. Microbiol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Berezowska, S., Lefort, K., Ioannidou, K., Ndiaye, D.-R., Maison, D., Petrovas, C., Rotman, S., Piazzon, N., Milowich, D., and Sala, N. (2021). Postmortem Cardiopulmonary Pathology in Patients with COVID-19 Infection: Single-Center Report of 12 Autopsies from Lausanne, Switzerland. Diagnostics, 11.","DOI":"10.3390\/diagnostics11081357"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1038\/s41591-020-0897-1","article-title":"Antibody responses to SARS-CoV-2 in patients with COVID-19","volume":"26","author":"Long","year":"2020","journal-title":"Nat. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1097\/AOG.0000000000004440","article-title":"Maternal Antibody Response, Neutralizing Potency, and Placental Antibody Transfer After Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection","volume":"138","author":"Joseph","year":"2021","journal-title":"Obstet. Gynecol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.ajog.2020.09.003","article-title":"Stability of severe acute respiratory syndrome coronavirus 2 RNA in placenta and fetal cells","volume":"224","author":"Pomar","year":"2021","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Schwartz, D.A., and Morotti, D. (2020). Placental Pathology of COVID-19 with and without Fetal and Neonatal Infection: Trophoblast Necrosis and Chronic Histiocytic Intervillositis as Risk Factors for Transplacental Transmission of SARS-CoV-2. Viruses, 12.","DOI":"10.3390\/v12111308"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e212","DOI":"10.1097\/INF.0000000000002735","article-title":"Neonatal Early-Onset Infection With SARS-CoV-2 in a Newborn Presenting with Encephalitic Symptoms","volume":"39","author":"Lorenz","year":"2020","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.jpeds.2010.12.053","article-title":"Decreasing incidence and severity of cerebral palsy in prematurely born children","volume":"159","author":"Groenendaal","year":"2011","journal-title":"J. Pediatr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/B978-0-444-64029-1.00007-2","article-title":"Preterm brain Injury: White matter injury","volume":"162","author":"Schneider","year":"2019","journal-title":"Handb. Clin. Neurol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1038\/s41582-020-0398-3","article-title":"Lifting the mask on neurological manifestations of COVID-19","volume":"16","author":"Pezzini","year":"2020","journal-title":"Nat. Rev. Neurol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"135567","DOI":"10.1016\/j.neulet.2020.135567","article-title":"Neurological issues in children with COVID-19","volume":"743","author":"Lin","year":"2021","journal-title":"Neurosci. Lett."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e1029","DOI":"10.1212\/NXI.0000000000001029","article-title":"Encephalopathies Associated with Severe COVID-19 Present Neurovascular Unit Alterations Without Evidence for Strong Neuroinflammation","volume":"8","author":"Perriot","year":"2021","journal-title":"Neurol.\u2014Neuroimmunol. Neuroinflammation"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Stafstrom, C.E., and Jantzie, L.L. (2020). COVID-19: Neurological Considerations in Neonates and Children. Children, 7, Available online: www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7552690\/.","DOI":"10.3390\/children7090133"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e2020010132","DOI":"10.1542\/peds.2020-010132","article-title":"Fetal Inflammatory Response Syndrome Associated with Maternal SARS-CoV-2 Infection","volume":"147","author":"McCarty","year":"2020","journal-title":"Pediatrics"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4121","DOI":"10.1093\/bioinformatics\/bty407","article-title":"Nextstrain: Real-time tracking of pathogen evolution","volume":"34","author":"Hadfield","year":"2018","journal-title":"Bioinformatics"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e029093","DOI":"10.1136\/bmjopen-2019-029093","article-title":"Impact of Ebola outbreak on reproductive health services in a rural district of Sierra Leone: A prospective observational study","volume":"9","author":"Quaglio","year":"2019","journal-title":"BMJ Open"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/13\/12\/2517\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:48:27Z","timestamp":1760168907000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/13\/12\/2517"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,15]]},"references-count":34,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["v13122517"],"URL":"https:\/\/doi.org\/10.3390\/v13122517","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,15]]}}}