# Mechanisms of Zika Virus Maternal-Fetal Transmission

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2022 · $230,328

## Abstract

ABSTRACT
In response to NOT-OD-20-120, we submit this competitive revision of grant # R01 HD091218 04
(Mechanisms of Zika Virus Maternal-Fetal Transmission) to investigate the impact of COVID-19 and testing for
the causative virus, SARS-CoV-2, among pregnant women and their infants. Pregnant women are a vulnerable
and high-risk population, as COVID-19 is associated with an increased risk of preterm birth, cesarean section,
and maternal intensive care. The objectives of this study are to: (a) evaluate the full impact of SARS-CoV-2 in
pregnancy to inform testing strategies, (b) examine the factors that impede testing during pregnancy, and (c)
use study data to devise implementation strategies that improve SARS-CoV-2 testing in pregnancy and
prenatal care during the pandemic. To do so, we propose to prospectively enroll two cohorts of pregnant
women: 1) exposed (SARS-CoV-2 positive), and 2) unexposed (SARS-CoV-2 negative as defined by antibody
testing at the beginning of pregnancy, every trimester, and at delivery). Women who initially enroll as
unexposed but later test positive for SARS-CoV-2 antibodies will cross over to the exposed cohort. In total, an
estimated 179 pregnant women will be followed per cohort. In Aim 1, we will evaluate patients' and providers'
perceptions of SARS-CoV-2 testing during pregnancy and the influence of COVID-19 on maternal care-
seeking behavior and anxiety via surveys and semi-structured interviews. We hypothesize suboptimal uptake
of testing among pregnant women due to the fear of repercussions from a positive test. In Aim 2, we will
determine the effect of SARS-CoV-2 infection during pregnancy on the risk of preterm birth and other adverse
pregnancy outcomes in symptomatic and asymptomatic disease. We hypothesize that SARS-CoV-2 infection
will increase the risk of preterm birth by 12%, regardless of disease severity. In Aim 3, we will estimate the risk
of mother-to-fetus SARS-CoV-2 transmission and viral presence in umbilical cord blood, placenta, and
amniotic fluid by assaying for viral RNA in the neonate, cord blood, and placenta. We hypothesize that SARS-
CoV-2 can be transmitted from mother to fetus. Collectively, Aims 1-3 will be interpreted by investigators, our
Scientific Advisory Board (experts in obstetrics, infectious disease, implementation science, disparities) and
our Community Advisory Board (an obstetric social worker, pregnant women, and a director of a community
obstetrics clinic) who will apply data to devising targeted implementation strategies designed for rapid
community dissemination to improve testing and prenatal care. In sum, this study will fill knowledge gaps on
the impact of SARS-CoV-2 infection and current utilization of diagnostic testing in pregnancy. Further, it will
create implementation strategies to overcome barriers to testing, increase uptake, and promote acceptance
and sustainability of testing. Lastly, this study will help determine optimal testing strategies by examining the
...

## Key facts

- **NIH application ID:** 10620965
- **Project number:** 3R01HD091218-05S1
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Michael S Diamond
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $230,328
- **Award type:** 3
- **Project period:** 2017-04-01 → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10620965

## Citation

> US National Institutes of Health, RePORTER application 10620965, Mechanisms of Zika Virus Maternal-Fetal Transmission (3R01HD091218-05S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10620965. Licensed CC0.

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