Association of SARS-CoV-2 placental histopathology findings with maternal–fetal comorbidities and severity of COVID-19 hypoxia
Jessica A. Meyer, Ashley S. Roman, Meghana Limaye, Tracy B. Grossman, Abdallah Flaifel, Michelle Vaz, Kristen Thomas, Christina A. Penfield
Abstract
OBJECTIVE: SARS-CoV-2 is known to impact multiple organ systems, with growing data to suggest the potential for placental infection and resultant pathology. Understanding how maternal COVID-19 disease can affect placental histopathology has been limited by small study cohorts with mild disease, review by multiple pathologists, and potential confounding by maternal-fetal comorbidities that can also influence placental findings. This study aims to identify pathologic placental findings associated with COVID-19 disease and severity, as well as to distinguish them from changes related to coexisting maternal-fetal comorbidities. METHODS: < 0.05 considered significant. RESULTS: = 0.01). CONCLUSION: In pregnancies complicated by COVID-19 disease, there was a high prevalence of placental histopathologic changes identified, particularly features of maternal vascular malperfusion, which could not be attributed solely to the presence of maternal-fetal comorbidities. The significantly increased prevalence of villous trophoblast necrosis in women needing respiratory support suggests a connection to the severity of COVID-19 illness.