Viruses (Sep 2022)

SARS-CoV-2 Infection and Pregnancy: Maternal and Neonatal Outcomes and Placental Pathology Correlations

  • Michał Pomorski,
  • Martyna Trzeszcz,
  • Agnieszka Matera-Witkiewicz,
  • Magdalena Krupińska,
  • Tomasz Fuchs,
  • Mariusz Zimmer,
  • Aleksandra Zimmer-Stelmach,
  • Anna Rosner-Tenerowicz,
  • Joanna Budny-Wińska,
  • Anna Tarczyńska-Podraza,
  • Klaudia Radziejewska,
  • Barbara Królak-Olejnik,
  • Anna Szczygieł,
  • Hanna Augustyniak-Bartosik,
  • Magdalena Kuriata-Kordek,
  • Karolina Skalec,
  • Izabela Smoła,
  • Ewa Morgiel,
  • Jakub Gawryś,
  • Adrian Doroszko,
  • Piotr Rola,
  • Małgorzata Trocha,
  • Krzysztof Kujawa,
  • Barbara Adamik,
  • Krzysztof Kaliszewski,
  • Katarzyna Kiliś-Pstrusińska,
  • Marcin Protasiewicz,
  • Janusz Sokołowski,
  • Ewa A. Jankowska,
  • Katarzyna Madziarska

DOI
https://doi.org/10.3390/v14092043
Journal volume & issue
Vol. 14, no. 9
p. 2043

Abstract

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There is accumulating evidence on the perinatal aspects of COVID-19, but available data are still insufficient. The reports on perinatal aspects of COVID-19 have been published on a small group of patients. Vertical transmission has been noted. The SARS-CoV-2 genome can be detected in umbilical cord blood and at-term placenta, and the infants demonstrate elevated SARS-CoV-2-specific IgG and IgM antibody levels. In this work, the analysis of clinical characteristics of RT-PCR SARS-CoV-2-positive pregnant women and their infants, along with the placental pathology correlation results, including villous trophoblast immunoexpression status for SARS-CoV-2 antibody, is presented. RT-PCR SARS-CoV-2 amniotic fluid testing was performed. Neonatal surveillance of infection status comprised RT-PCR testing of a nasopharyngeal swab and the measuring of levels of anti-SARS-CoV-2 in blood serum. In the initial study group were 161 pregnant women with positive test results. From that group, women who delivered during the hospital stay were selected for further analysis. Clinical data, laboratory results, placental histomorphology results, and neonatal outcomes were compared in women with immunohistochemistry (IHC)-con SARS-CoV-2-positive and IHC SARS-CoV-2-negative placentas (26 cases). A positive placental immunoprofile was noted in 8% of cases (n = 2), whereas 92% of cases were negative (n = 24). Women with placental infection proven by IHC had significantly different pathological findings from those without. One infected neonate was noted (n = 1; 4%). Infection was confirmed in perinatal autopsy, as there was the intrauterine fetal demise. The potential course of the infection with the risk of vertical transmission and implications for fetal–neonatal condition is critical for proper clinical management, which will involve comprehensive, multidisciplinary perinatal care for SARS-CoV-2-positive patients.

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