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Impact of SARS-CoV-2 infection during pregnancy on the placenta and fetus
Amanda Li1, David A Schwartz2, Andrew Vo1
1Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, United States of America.
Insights
Pregnant individuals and fetuses face risks from COVID-19, including maternal mortality and stillbirth. SARS-CoV-2 infection can cause placental injury and may affect fetal neurodevelopment, with emerging variants posing ongoing risks.
Area of Science:
- Perinatal health
- Infectious disease pathology
- Immunology
Background:
- Coronavirus 2019 disease (COVID-19) poses significant risks to pregnant individuals and fetuses.
- COVID-19 is linked to increased maternal mortality, preterm birth, and stillbirth.
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) placental infection and vertical transmission are rare but concerning.
Purpose of the Study:
- To review the impact of COVID-19 on placental and fetal health.
- To identify knowledge gaps regarding SARS-CoV-2 variants and perinatal outcomes.
- To highlight concerns for maternal and perinatal health.
Main Methods:
- Literature review and synthesis of existing research on COVID-19's effects on pregnancy.
- Analysis of placental pathology in SARS-CoV-2 associated stillbirths.
- Discussion of immunological impacts on fetal development.
Main Results:
- COVID-19 is associated with placental injuries such as fibrin deposition and trophoblast necrosis.
- Maternal SARS-CoV-2 infection can alter fetal immunity, potentially impacting neurodevelopment.
- Emerging SARS-CoV-2 variants present continued threats to placental and perinatal health.
Conclusions:
- COVID-19 significantly impacts placental integrity and fetal outcomes.
- Further research is needed to understand the long-term effects of SARS-CoV-2 on fetal neurodevelopment.
- Ongoing vigilance regarding SARS-CoV-2 variants is crucial for maternal and perinatal health protection.
Abstract:
Pregnant people and their fetuses are vulnerable to adverse health outcomes from coronavirus 2019 disease (COVID-19) due to infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has been associated with higher rates of maternal mortality, preterm birth, and stillbirth. While SARS-CoV-2 infection of the placenta and vertical transmission is rare, this may be due to the typically longer time interval between maternal infection and testing of the placenta and neonate. Placental injury is evident in cases of SARS-CoV-2-associated stillbirth with massive perivillous fibrin deposition, chronic histiocytic intervillositis, and trophoblast necrosis. Maternal COVID-19 can also polarize fetal immunity, which may have long-term effects on neurodevelopment. Although the COVID-19 pandemic continues to evolve, the impact of emerging SARS-CoV-2 variants on placental and perinatal injury/mortality remains concerning for maternal and perinatal health. Here, we highlight the impact of COVID-19 on the placenta and fetus and remaining knowledge gaps.
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