tetano
Editor, Senior Moderator
Am J Obstet Gynecol MFM
. 2020 Aug 15;100211.
doi: 10.1016/j.ajogmf.2020.100211. Online ahead of print.
Histopathological evaluation of placentas after diagnosis of maternal SARS-CoV-2 infection
Moti Gulersen[SUP] 1 [/SUP], Lakha Prasannan[SUP] 1 [/SUP], Hima Tam Tam[SUP] 1 [/SUP], Christine N Metz[SUP] 2 [/SUP], Burton Rochelson[SUP] 1 [/SUP], Natalie Meirowitz[SUP] 3 [/SUP], Weiwei Shan[SUP] 4 [/SUP], Morris Edelman[SUP] 5 [/SUP], Karmaine A Millington[SUP] 5 [/SUP]
Affiliations
Abstract
Background: The impact of maternal SARS-CoV-2 infection on placental histopathology is not well known.
Objectives: To determine if significant placental histopathological changes occur after diagnosis of SARS-CoV-2 infection in pregnancy and whether these changes are correlated with the presence or absence of symptoms associated with infection.
Study design: Retrospective cohort study of women diagnosed with SARS-CoV-2 infection who delivered at a single center from April 9[SUP]th[/SUP] to April 27[SUP]th[/SUP], 2020, and had placental specimens reviewed by pathology. Women with singleton gestations and laboratory-confirmed SARS-CoV-2 infection were eligible for inclusion. Historical controls selected from a cohort of women who delivered 6 months prior to the study period were matched in a 1:1 fashion by week of gestation at delivery. Histopathological characteristics were evaluated in each placenta and the incidence of these findings were compared between placentas after diagnosis of maternal SARS-CoV-2 infection and historical controls, as well as between placentas from patients with or without typical symptoms related to infection. Statistical analysis included use of Wilcoxon rank sum test and Fisher's exact test for comparison of categorical and continuous variables. Statistical significance was defined as P value < 0.05.
Results: A total of 50 placentas after diagnosis of maternal SARS-CoV-2 infection and 50 historical controls were analyzed. Among placentas from patients diagnosed with SARS-CoV-2 infection, 3 (6%) were preterm (33 3/7, 34 6/7 and 36 6/7 weeks of gestation), 16 (32%) were from patients with typical symptoms related to infection and 34 (68%) were from patients without typical symptoms related to the infection. All patients had diagnosis of SARS-CoV-2 infection in the third trimester. Decidual vasculopathy was not visualized in any of the placentas from patients diagnosed with SARS-CoV-2 infection. There was no statistically significant difference in placental histopathological characteristics between the groups. SARS-CoV-2 testing for all neonates at 24 hours of life was negative.
Conclusions: Based on our data, there are no significant placental histopathological changes that occur after diagnosis of SARS-CoV-2 infection in the third trimester of pregnancy compared to a gestational age-matched historical control group. Similar incidences of histopathological findings were also discovered when comparing placentas from patients with SARS-CoV-2 infection with or without the presence of symptoms typically related to infection.
Keywords: COVID-19; coronavirus; decidual vasculopathy; fetal vascular malperfusion; histopathology; maternal vascular malperfusion; placental pathology; thrombosis; thrombotic vasculopathy; thrombus.
. 2020 Aug 15;100211.
doi: 10.1016/j.ajogmf.2020.100211. Online ahead of print.
Histopathological evaluation of placentas after diagnosis of maternal SARS-CoV-2 infection
Moti Gulersen[SUP] 1 [/SUP], Lakha Prasannan[SUP] 1 [/SUP], Hima Tam Tam[SUP] 1 [/SUP], Christine N Metz[SUP] 2 [/SUP], Burton Rochelson[SUP] 1 [/SUP], Natalie Meirowitz[SUP] 3 [/SUP], Weiwei Shan[SUP] 4 [/SUP], Morris Edelman[SUP] 5 [/SUP], Karmaine A Millington[SUP] 5 [/SUP]
Affiliations
- PMID: 32838277
- PMCID: PMC7428686
- DOI: 10.1016/j.ajogmf.2020.100211
Abstract
Background: The impact of maternal SARS-CoV-2 infection on placental histopathology is not well known.
Objectives: To determine if significant placental histopathological changes occur after diagnosis of SARS-CoV-2 infection in pregnancy and whether these changes are correlated with the presence or absence of symptoms associated with infection.
Study design: Retrospective cohort study of women diagnosed with SARS-CoV-2 infection who delivered at a single center from April 9[SUP]th[/SUP] to April 27[SUP]th[/SUP], 2020, and had placental specimens reviewed by pathology. Women with singleton gestations and laboratory-confirmed SARS-CoV-2 infection were eligible for inclusion. Historical controls selected from a cohort of women who delivered 6 months prior to the study period were matched in a 1:1 fashion by week of gestation at delivery. Histopathological characteristics were evaluated in each placenta and the incidence of these findings were compared between placentas after diagnosis of maternal SARS-CoV-2 infection and historical controls, as well as between placentas from patients with or without typical symptoms related to infection. Statistical analysis included use of Wilcoxon rank sum test and Fisher's exact test for comparison of categorical and continuous variables. Statistical significance was defined as P value < 0.05.
Results: A total of 50 placentas after diagnosis of maternal SARS-CoV-2 infection and 50 historical controls were analyzed. Among placentas from patients diagnosed with SARS-CoV-2 infection, 3 (6%) were preterm (33 3/7, 34 6/7 and 36 6/7 weeks of gestation), 16 (32%) were from patients with typical symptoms related to infection and 34 (68%) were from patients without typical symptoms related to the infection. All patients had diagnosis of SARS-CoV-2 infection in the third trimester. Decidual vasculopathy was not visualized in any of the placentas from patients diagnosed with SARS-CoV-2 infection. There was no statistically significant difference in placental histopathological characteristics between the groups. SARS-CoV-2 testing for all neonates at 24 hours of life was negative.
Conclusions: Based on our data, there are no significant placental histopathological changes that occur after diagnosis of SARS-CoV-2 infection in the third trimester of pregnancy compared to a gestational age-matched historical control group. Similar incidences of histopathological findings were also discovered when comparing placentas from patients with SARS-CoV-2 infection with or without the presence of symptoms typically related to infection.
Keywords: COVID-19; coronavirus; decidual vasculopathy; fetal vascular malperfusion; histopathology; maternal vascular malperfusion; placental pathology; thrombosis; thrombotic vasculopathy; thrombus.