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Impact of COVID-19 disease on placental histopathology. PLAXAVID study.

Authors :: Montáns Araújo J
Suy Franch A
García Ruiz I
Maíz N
Garcia Aguilar E
Hidalgo Bermejo FJ
Source :: Histology and histopathology [Histol Histopathol] 2024 Mar; Vol. 39 (3), pp. 303-318. Date of Electronic Publication: 2023 Jun 08.
Publication Year :: 2024
Abstract: Background: The impact of COVID-19 on pregnancy has been analyzed suggesting an increased risk of placental lesions that might lead to maternal and neonatal complications. However, the current published evidence is not conclusive because contradictory results.<br />Methods: PLAXAVID is an observational, retrospective, histopathological, single-center study that aimed to evaluate the prevalence of vascular and inflammatory lesions in placental and umbilical cord samples of one hundred women infected by SARS-CoV-2 during pregnancy.<br />Results: The histopathological analysis showed that in most of the placentas (77.8%) there were signs of maternal vascular malperfusion (MVM; primary endpoint). The most common MVM features were an accelerated villous maturation (37.4%), central villous infarcts (33.3%), and villous agglutination (46.5%). Fetal vascular malperfusion (FVM) was identified in 57.6% of samples, and the most frequent features were hyalinized avascular villi (38.4%), fetal vascular thrombi (20.2%) and umbilical cord at risk of partial obstruction (14.1%). Acute and chronic inflammatory pathology were noticed in 22.2% and 49.5% of placentas, respectively. No significant correlations were found between MVM presence and the time, duration, and severity of infection, nor with the duration of pregnancy. However, in critically ill patients, the pregnancy duration ( p =0.008), newborn weight ( p =0.003), and APGAR test scores ( p <0.001) were significantly lower. The same trend was observed considering the presence of infection at the time of delivery and in preterm births.<br />Conclusion: A very high percentage of placentas with vascular and/or inflammatory lesions was found in the analyzed cohort. Therefore, PLAXAVID study results supported that COVID-19 should be considered a risk factor during gestation and requires close monitoring of pregnancy.<br /> (©The Author(s) 2024. Open Access. This article is licensed under a Creative Commons CC-BY International License.)