1. Low placental weight and altered metabolic scaling after severe acute respiratory syndrome coronavirus type 2 infection during pregnancy: a prospective multicentric study.
- Author
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Radan AP, Baud D, Favre G, Papadia A, Surbek D, Baumann M, and Raio L
- Subjects
- Female, Humans, Placenta, Pregnancy, Pregnancy Outcome, Prospective Studies, SARS-CoV-2, COVID-19 epidemiology, Diabetes Mellitus, Type 2, Pregnancy Complications, Infectious epidemiology, Pregnancy Complications, Infectious pathology
- Abstract
Objectives: A higher risk of adverse pregnancy outcomes is associated with SARS-CoV-2 infection; this could be partially explained by an altered placental function. Because histopathology is often unspecific, we aimed to assess placental weight, birthweight/placental weight (b/p) ratio, and the metabolic scaling exponent ß, an indicator of normal fetal-placental growth, to analyze placental function., Methods: We included 153 singleton pregnancies with SARS-CoV-2-positive PCR result who delivered at three referring hospitals in Switzerland. Placental weight and b/p ratio were compared to published reference charts. Logistic regression analysis investigated the role of time of infection and other confounding factors on placental weight. The scaling exponent β was compared to the reference value of 0.75., Results: Placental weight was inferior or equal to the tenth centile in 42.5% (65 of 153) and to the third centile in 19% (29 of 153) of the cases. The risk of low placental weight was not influenced by the trimester in which infection occurred. The b/p ratio was >50th centile in 80.4% (123 of 153) of the cases. The incidence of foetal growth restriction, preeclampsia, and gestational diabetes was 11.8% (18 of 153), 3.3% (5 of 153), and 19.6% (30 of 153). Linear regression modelling revealed a pathologic metabolic scaling exponent β of 0.871 ± 0.064 (R
2 = 0.56)., Discussion: SARS-CoV-2 infection during pregnancy was associated with a higher incidence of low placental weight, an increased b/p ratio, and an abnormal scaling exponent β in our cohort. This could be particularly relevant for the still controversial issue of an increased stillbirth rate in SARS-CoV-2 infection during pregnancy. In this regard, intensified foetal surveillance should be mandatory in these pregnancies., (Copyright © 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)- Published
- 2022
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