Open Access Maced J Med Sci. 2023 Feb 06; 11(B):293-298. 293 Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2023 Feb 06; 11(B):293-298. https://doi.org/10.3889/oamjms.2023.11196 eISSN: 1857-9655 Category: B - Clinical Sciences Section: Gynecology and Obstetrics COVID-19 during the Third Semester of Pregnancy: Maternal Characteristic, Possibility of Intrauterine Transmission and Neonatal Outcome in Aceh, Indonesia Cut Meurah Yeni 1 * , Zinatul Hayati 2 , Sarjani M. Ali 1 , Hasanuddin Hasanuddin 1 , Rusnaidi Rusnaidi 1 , Cut Rika Maharani 1 1 Department of Obstetrics and Gynaecology, Faculty of Medicine, Syiah Kuala University, Dr. Zainoel Abidin General Hospital, Aceh Province, Indonesia; 2 Department of the Clinical Microbiology Section, Faculty of Medicine, Syiah Kuala University, Dr. Zainoel Abidin General Hospital, Aceh Province, Indonesia Abstract BACKGROUND: Pregnant women are vulnerable against COVID-19 infection due to physiological and immunological changes. COVID-19 in pregnancy afects fetal well-being with a potential for vertical infection. AIM: This study aims to determine the incidence of vertical infection and anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in infants born to mothers with positive COVID-19 infection. MATERIALS AND METHODS: Amniotic fuid, swabs of the newborn’s nasopharynx and oropharynx, and swabs of the placenta were examined using reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2. Serological examination was performed by Electro-Chemiluminescence Immunoassay on infant’s blood. RESULTS: Four of 33 pregnant women gave birth to infants positive SARS-CoV-2 infection. RT-PCR examination of all amniotic fuid and placental swabs was negative for SARS-CoV-2. Four of 33 infants (12.1%) showed negative polymerase chain reaction (PCR) results but positive SARS-CoV-2 antibodies, another 4 newborns (12.1%) showed positive PCR results, but no SARS-CoV-2 antibodies detected. The remaining 25 babies (75.8%) showed both negative PCR and serologic results. CONCLUSION: No evidence of vertical transmission found in this study. Edited by: Ksenija Bogoeva-Kostovska Citation: Yeni C M, Hayati Z, Ali SM, Hasanuddin H, Rusnaidi R, Maharani CR. COVID-19 during the Third Semester of Pregnancy: Maternal Characteristic, Possibility of Intrauterine Transmission, and Neonatal Outcome in Aceh, Indonesia. Open Access Maced J Med Sci. 2023 Feb 06; 11(B):293-298. https://doi.org/10.3889/oamjms.2023.11196 Keywords: Anti-SAR-CoV-2 antibody; COVID-19; Pregnancy; Vertical infection *Correspondence: Cut Meurah Yeni, Department of Obstetrics and Gynaecology, Faculty of Medicine, Syiah Kuala University, Dr. Zainoel Abidin General Hospital, Aceh Province, Indonesia. E-mail: cutmeurahyeni@ unsyiah.ac.id Received: 31-Oct-2022 Revised: 28-Dec-2022 Accepted: 27-Jan-2023 Copyright: © 2023 Cut Meurah Yeni, Zinatul Hayati, Sarjani M. Ali, Hasanuddin Hasanuddin, Rusnaidi Rusnaidi, Cut Rika Maharani Funding: This study was funded by Universitas Syiah Kuala (The Ministry of Education, Culture, Research, and Technology)–Lector Research Scheme Financial Year 2021 (161/UN11.2.1/PT.01.03/PNBP/2021) Competing Interests: The authors have declared that no competing interests exist Open Access: This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial 4.0 International License (CC BY-NC 4.0) Introduction Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has become a rapidly growing global pandemic worldwide. Although COVID-19 can afect anyone, pregnant women may be more susceptible to this viral infection because of the physiological and immunological changes during pregnancy, and one of the main consequences of viral pneumonia is death during pregnancy that occurs worldwide [1]. COVID-19 in both mother and fetus also required placental tropism of the virus, so that the virus will infect placental cells and thereby be transmitted to the fetal side [2]. To date, there are limited cases of placental infection caused by SARS-CoV-2 have been reported from the previous studies [3], [4], [5], [6], [7]. In fve previous publications, there were seven placentas from 19 patients examined using reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2; however, no SARS-CoV-2 infection was found in each of these placentas. Furthermore, histopathological analysis of the three placentas did not reveal any signifcant lesions [8], [9], [10], [11], [12]. Congenital infection in intrauterine fetal death or stillbirth is confrmed if virus is detected by polymerase chain reaction (PCR) examination of fetal tissue and placenta or from microscopy electrolysis by detecting the presence of viral particles in tissue or on viral growth in fetal tissue/placental tissue [13]. Zeng et al. found that infants from COVID-19- infected mother had IgG and IgM concentrations higher than the normal level (<10 AU/mL), although the throat swabs and blood samples all had negative RT-PCR test results, and none of them showed signs of infection. Zeng et al. emphasized that the newborn may develop Since 2002