Placenta, the Key Witness of COVID-19 Infection in Premature Births.

Adverse perinatal outcomes, such as increased risks of pre-eclampsia, miscarriage, premature birth, and stillbirth have been reported in SARS-CoV-2 infection. For a better understanding of COVID-19 complications in pregnancy, histopathological changes in the placenta, which is the interface between mother and foetus, could be the place to look at. The aim of this study was to determine placental histopathological changes and their role in preterm birth in pregnant women with SARS-CoV-2 infection. We performed a prospective, observational study in a COVID-only hospital, which included 39 pregnant women with SARS-CoV-2 infection and preterm birth compared with a control group of 39 women COVID-19 negative with preterm birth and a placental pathology exam available. The microscopic examination of all placentas revealed placental infarction (64.1% vs. 30.8%), decidual arteriopathy (66.7% vs. 23.1%), intervillous thrombi (53.8% vs. 38.5%), perivillous fibrin deposits (59% vs. 46.2%), inflammatory infiltrate (69.2% vs. 46.2%), chorangiosis (17.9% vs. 10.3%), and accelerated maturation of the villi (23.1% vs. 28.2%).

The Impact of SARS-CoV-2 Infection on Premature Birth-Our Experience as COVID Center.

Information about the impact of SARS-CoV-2 infection on pregnant women is still limited and raises challenges, even as publications are increasing rapidly. The aim of the present study was to determine the impact of SARS-CoV-2 infection on preterm birth pregnancies. We performed a prospective, observational study in a COVID-only hospital, which included 34 pregnant women with SARS-CoV-2 infection and preterm birth compared with a control group of 48 healthy women with preterm birth. The rate of cesarean delivery was 82% in the study group versus 6% for the control group. We observed a strong correlation between premature birth and the presence of COVID-19 symptoms (cough p = 0.029, fever p = 0.001, and chills p = 0.001). The risk for premature birth is correlated to a lower value of oxygen saturation (p = 0.001) and extensive radiologic pulmonary lesions (p = 0.025). The COVID-19 pregnant women with preterm delivery were older, and experienced an exacerbation of severe respiratory symptoms, decreased saturation of oxygen, increased inflammatory markers, severe pulmonary lesions and decreased lymphocytes.