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To the Editor: A 28-year-old woman delivered a male infant at 39 weeks’ gestation after induction of labor. The infant had poor muscle tone and skin color at birth, with no respiratory effort or palpable pulses. Ventilation was initiated, and the pulse became evident with a heart rate of 120 beats per minute and oxygen saturation of 60%. The infant was intubated and stabilized with Apgar scores of 2, 3, and 4 at one, five, and 10 minutes, respectively. The infant was emergently transferred to the nearest tertiary care center and diagnosed with tetralogy of Fallot despite normal prenatal sonograms from 12 to 38 weeks’ gestation.

The mother’s medical history included dietcontrolled gestational diabetes mellitus, obesity, and mild third-trimester preeclampsia. At 18 weeks and four days’ gestation, the mother experienced mild congestion and cough with a loss of smell and taste sensation and was diagnosed with COVID-19 …