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Histopathological evaluation of placentas after diagnosis of maternal SARS-CoV-2 infection.

Authors
  • Gulersen, Moti1
  • Prasannan, Lakha1
  • Tam, Hima Tam1
  • Metz, Christine N2
  • Rochelson, Burton1
  • Meirowitz, Natalie3
  • Shan, Weiwei4
  • Edelman, Morris5
  • Millington, Karmaine A5
  • 1 Department of Obstetrics and Gynecology, North Shore University Hospital - Northwell Health, Mahasset, NY.
  • 2 Institute of Molecular Medicine, Feinstein Institutes for Medical Research, Manhasset, NY.
  • 3 Department of Obstetrics and Gynecology, Long Island Jewish Medical Center - Northwell Health, Queens, NY.
  • 4 Biostatistics Unit, Feinstein Institutes for Medical Research, Manhasset, NY.
  • 5 Department of Anatomic and Clinical Pathology, Long Island Jewish Medical Center - Northwell Health, Queens, NY.
Type
Published Article
Journal
American journal of obstetrics & gynecology MFM
Publication Date
Aug 15, 2020
Pages
100211–100211
Identifiers
DOI: 10.1016/j.ajogmf.2020.100211
PMID: 32838277
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The impact of maternal SARS-CoV-2 infection on placental histopathology is not well known. 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. Retrospective cohort study of women diagnosed with SARS-CoV-2 infection who delivered at a single center from April 9th to April 27th, 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. 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. 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. © 2020 Elsevier Inc. All rights reserved.

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