Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct:128:23-28.
doi: 10.1016/j.placenta.2022.08.006. Epub 2022 Aug 28.

Placental pathological findings in coronavirus disease 2019: Perinatal outcomes

Gelson Farias Arcos Júnior  1 , Rossana Pulcineli Vieira Francisco  1 , Beatriz Kill  1 , Stela Verzinhasse Peres  1 , Maria Augusta B C Gibelli  2 , Silvia Maria Ibidi  2 , Werther Brunow de Carvalho  2 , Angelica Braz Simões  3 , Maria de Lourdes Brizot  1 , Regina Schultz  4 , Mariana Azevedo Carvalho  5 ; HC-FMUSP-Obstetric COVID-19 Study Group
Affiliations

Placental pathological findings in coronavirus disease 2019: Perinatal outcomes

Gelson Farias Arcos Júnior et al. Placenta. 2022 Oct.

Abstract

Introduction: Placental alterations caused by severe acute respiratory coronavirus-2 (SARS-CoV-2) infection have already been described, but most studies used small sample groups and the difference according to the severity of the disease has not been verified. Our objective was to describe placental alterations in patients with coronavirus disease 2019 (COVID-19) and analyze the association of pathological placental findings with the clinical parameters of COVID-19 and perinatal results.

Methods: This was a nested study within a prospective cohort study involving 109 symptomatic pregnant women with COVID-19. The prevalence of observed placental alterations was described, and the associations of pathological findings with the clinical parameters of COVID-19 severity and with perinatal outcomes were assessed.

Results: The frequency of types of placental features was poor maternal vascular perfusion in 45% of cases, poor fetal vascular perfusion in 33.9%, hematogenous origin infection in 32.1%, and morphological changes corresponding to ascending infection in 21.1%. Hematogenous infection differed significantly according to COVID-19 severity (p = 0.008), with a prevalence ratio (PR) of 1.74 (95% confidence interval, 1.02-2.98) in the moderate COVID-19 group compared to the mild COVID-19 group. Among the perinatal outcomes, there was an unexpected inverse association between prematurity and placental infection of hematogenous origin, with lower rates of prematurity among cases with inflammation of hematogenous origin (p = 0.029).

Discussion: Moderate SARS-Cov-2 infection presented a higher prevalence of placental pathological findings. There was no association of placental findings with adverse perinatal outcomes.

Keywords: COVID-19; Infectious pregnancy complications; Perinatal mortality; Placenta.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
A. Large focus of avascular villi, a focus of chronic villitis and intervillous thrombosis (hematoxilyn-eosin, original magnification 10×). B. Thrombosis of a chorionic artery with intramural fibrin deposition (hematoxilyn-eosin, original magnification 10×).
Fig. 2
Fig. 2
A. Peripheral capillary proliferation of stem villi (hematoxilyn-eosin, original magnification 10×). B. Chorangiosis, with more then ten vessels in terminal villi (hematoxilyn-eosin, original magnification 10×).
See this image and copyright information in PMC

References

    1. Grasselli G., Tonetti T., Protti A., Langer T., Girardis M., Bellani G., Laffey J., Carrafiello G., Carsana L., Rizzuto C., Zanella A., Scaravilli V., Pizzilli G., Grieco D.L., Di Meglio L., de Pascale G., Lanza E., Monteduro F., Zompatori M., Filippini C., Locatelli F., Cecconi M., Fumagalli R., Nava S., Vincent J.L., Antonelli M., Slutsky A.S., Pesenti A., Ranieri V.M., Lissoni A., Rossi N., Guzzardella A., Valsecchi C., Madotto F., Bevilacqua F., Di Laudo M., Querci L., Seccafico C. Pathophysiology of COVID-19-associated acute respiratory distress syndrome: a multicentre prospective observational study. Lancet Respir. Med. 2020;8:1201–1208. doi: 10.1016/S2213-2600(20)30370-2. - DOI - PMC - PubMed
    1. Narang K., Enninga E.A.L., Gunaratne M.D.S.K., Ibirogba E.R., Trad A.T.A., Elrefaei A., Theiler R.N., Ruano R., Szymanski L.M., Chakraborty R., Garovic V.D. SARS-CoV-2 infection and COVID-19 during pregnancy: a multidisciplinary review. Mayo Clin. Proc. 2020;95:1750–1765. doi: 10.1016/j.mayocp.2020.05.011. - DOI - PMC - PubMed
    1. Kotlar B., Gerson E., Petrillo S., Langer A., Tiemeier H. 2021. The Impact of the COVID-19 Pandemic on Maternal and Perinatal Health: a Scoping Review. - DOI - PMC - PubMed
    1. Knight M., Bunch K., Vousden N., Morris E., Simpson N., Gale C., Obrien P., Quigley M., Brocklehurst P., Kurinczuk J.J. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. BMJ. 2020;369 doi: 10.1136/bmj.m2107. - DOI - PMC - PubMed
    1. Prochaska E., Jang M., Burd I. COVID-19 in pregnancy: placental and neonatal involvement. Am. J. Reprod. Immunol. 2020;84 doi: 10.1111/aji.13306. 0–2. - DOI - PMC - PubMed

Publication types