Histopathological Changes and Clinical Outcomes in Placentas of COVID-19 Positive Mothers: A Cohort Study

Abstract

Introduction: Infection by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has been shown to affect multiple organs in the human body. Research shows that Coronavirus Disease (COVID-19)-positive pregnant women experience poorer perinatal outcomes related to placental infection, including higher risks of miscarriage, preeclampsia, preterm birth, and stillbirth. Aim: To evaluate the histopathological changes in the placentas of COVID-19-positive mothers and the associated foetal outcomes. Materials and Methods: This cohort study was conducted at Kalinga Institute of Medical Sciences (KIMS) Bhubaneswar, Odisha, India, over a period of one year and eight months, from November 2020 to July 2022. It included 23 COVID-19-positive pregnant females admitted for safe confinement during the first and second COVID-19 waves. Thirty COVID-19-negative pregnant women admitted for safe delivery during the same period served as controls. Placentas were collected, processed, and stained according to standard protocols. Descriptive data were interpreted as frequencies and percentages, and associations were tested using the Chi-square test. A p-value <0.05 was considered statistically significant. Results: The study included 23 cases (mean gestational age: 37 weeks and 5 days) and 30 controls (mean gestational age: 38 weeks and 6 days). The prevalence of Maternal Vascular Malperfusion (MVM) and Foetal Vascular Malperfusion (FVM) was found to be higher among cases than controls. Conclusion: Compared to controls, COVID-19-positive placentas showed a higher prevalence of both MVM and FVM. This might be attributable to the hypercoagulable state associated with COVID-19. Further research is needed to explore the potential effects of intrauterine inflammation on neonates exposed to COVID-19.

Keywords

• foetal vascular malperfusion
• maternal vascular malperfusion
• pregnant mothers