Histopathologic placental findings in severe acute respiratory syndrome coronavirus 2 exposed gravida compared to unexposed controls: a single center retrospective cohort study.

BACKGROUND

Little is known about the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the placenta. Existing studies have study design limitations but suggest a relationship between SARS-CoV-2 and placental injury.

OBJECTIVE

To assess if SARS-CoV-2 maternal infection is associated with higher rates of placental histopathology compared to unexposed controls.

STUDY

DESIGN

A single-center retrospective cohort study of pregnant patients with placental histopathologic results with or without prenatal SARS-CoV-2 infection. Co-primary outcomes were maternal (MVM) and fetal vascular malperfusion (FVM) pathologic lesions. Bivariate and multivariable logistic regression analyses were performed.

RESULTS

Among 1923 pregnant patients, 490 (25.5 %) had prenatal SARS-CoV-2 infection. Rates of maternal and fetal vascular malperfusion were similar between SARS-CoV-2 exposed and unexposed groups. A low-risk sub-cohort analysis of 150 exposed gravidas and 191 unexposed controls restricting to patients without potential confounding variables related to placental pathology revealed a higher rate of MVM in the SARS-CoV-2 group (RR 1.7; 95 %CI 1.02-2.2).

CONCLUSIONS

Although rates of histopathology were not increased with maternal SARS-CoV-2 infection in the overall cohort, a sub-group analysis using low-risk subjects without confounding factors revealed a 70 % increase in the rate of MVM.