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The clinical impact of maternal COVID-19 on mothers, their infants, and placentas with an analysis of vertical transfer of maternal SARS-CoV-2-specific IgG antibodies.
Ward, J D; Cornaby, C; Kato, T; Gilmore, R C; Bunch, D; Miller, M B; Boucher, R C; Schmitz, J L; Askin, F A; Scanga, L R.
  • Ward JD; University of North Carolina School of Medicine, Department of Pathology and Laboratory Medicine, Chapel Hill, NC, USA. Electronic address: jeremy.ward@unchealth.unc.edu.
  • Cornaby C; Immunology, Histocompatibility and Immunogenetics Laboratories/McLendon Clinical Laboratories UNC Hospitals, Chapel Hill, NC, USA.
  • Kato T; University of North Carolina School of Medicine, Marisco Lung Institute/UNC Cystic Fibrosis Center, Chapel Hill, NC, USA.
  • Gilmore RC; University of North Carolina School of Medicine, Marisco Lung Institute/UNC Cystic Fibrosis Center, Chapel Hill, NC, USA.
  • Bunch D; University of North Carolina School of Medicine, Department of Medicine, Division of Nephrology and Hypertension, Chapel Hill, NC, USA.
  • Miller MB; University of North Carolina School of Medicine, Department of Pathology and Laboratory Medicine, Chapel Hill, NC, USA; Clinical Microbiology and Molecular Microbiology Laboratories, University of North Carolina Health Care, Chapel Hill, NC, USA.
  • Boucher RC; University of North Carolina School of Medicine, Marisco Lung Institute/UNC Cystic Fibrosis Center, Chapel Hill, NC, USA.
  • Schmitz JL; University of North Carolina School of Medicine, Department of Pathology and Laboratory Medicine, Chapel Hill, NC, USA; Immunology, Histocompatibility and Immunogenetics Laboratories/McLendon Clinical Laboratories UNC Hospitals, Chapel Hill, NC, USA.
  • Askin FA; University of North Carolina School of Medicine, Department of Pathology and Laboratory Medicine, Chapel Hill, NC, USA.
  • Scanga LR; University of North Carolina School of Medicine, Department of Pathology and Laboratory Medicine, Chapel Hill, NC, USA. Electronic address: lori.scanga@unchealth.unc.edu.
Placenta ; 123: 12-23, 2022 06 01.
Article in English | MEDLINE | ID: covidwho-1815047
ABSTRACT

INTRODUCTION:

The effect of SARS-CoV-2 severity or the trimester of infection in pregnant mothers, placentas, and infants is not fully understood.

METHODS:

A retrospective, observational cohort study in Chapel Hill, NC of 115 mothers with SARS-CoV-2 and singleton pregnancies from December 1, 2019 to May 31, 2021 via chart review to document the infants' weight, length, head circumference, survival, congenital abnormalities, hearing loss, maternal complications, and placental pathology classified by the Amsterdam criteria.

RESULTS:

Of the 115 mothers, 85.2% were asymptomatic (n = 37) or had mild (n = 61) symptoms, 13.0% had moderate (n = 9) or severe (n = 6) COVID-19, and 1.74% (n = 2) did not have symptoms recorded. Moderate and severe maternal infections were associated with increased C-section, premature delivery, infant NICU admission, and were more likely to occur in Type 1 (p = 0.0055) and Type 2 (p = 0.0285) diabetic mothers. Only one infant (0.870%) became infected with SARS-CoV-2, which was not via the placenta. Most placentas (n = 63, 54.8%) did not show specific histologic findings; however, a subset showed mild maternal vascular malperfusion (n = 26, 22.6%) and/or mild microscopic ascending intrauterine infection (n = 28, 24.3%). The infants had no identifiable congenital abnormalities, and all infants and mothers survived.

DISCUSSION:

Most mothers and their infants had a routine clinical course; however, moderate and severe COVID-19 maternal infections were associated with pregnancy complications and premature delivery. Mothers with pre-existing, non-gestational diabetes were at greatest risk of developing moderate or severe COVID-19. The placental injury patterns of maternal vascular malperfusion and/or microscopic ascending intrauterine infection were not associated with maternal COVID-19 severity.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / Premature Birth / COVID-19 Type of study: Observational study / Prognostic study / Risk factors Limits: Female / Humans / Infant / Pregnancy Language: English Journal: Placenta Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications, Infectious / Premature Birth / COVID-19 Type of study: Observational study / Prognostic study / Risk factors Limits: Female / Humans / Infant / Pregnancy Language: English Journal: Placenta Year: 2022 Document Type: Article