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Am J Perinatol . Placental vascular and inflammatory findings from pregnancies diagnosed with coronavirus disease 2019 (COVID-19): A systematic rev

tetano

Editor, Senior Moderator
Am J Perinatol


. 2022 Mar 3.
doi: 10.1055/a-1787-7933. Online ahead of print.
Placental vascular and inflammatory findings from pregnancies diagnosed with coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis


Kamran Hessami, Kjersti Aagaard, Eumenia C Castro[SUP] 1 [/SUP], Sara E Arian, Ahmed Nassr[SUP] 2 [/SUP], Enrico Barrozo, Maxim D Seferovic, Alireza A Shamshirsaz[SUP] 3 [/SUP]



Affiliations

Abstract

Objective: We aimed to perform a meta-analysis of the literature concerning histopathologic findings in the placentas of women with SARS-CoV-2 infection during pregnancy. Methods and material Searches for articles in English included PubMed, Web of Science, Google Scholar and reference lists (up to April 2021). Studies presenting data on placental histopathology according to the Amsterdam consensus group criteria in SARS-CoV-2 positive and negative pregnancies were identified. Lesions were categorized into: maternal (MVM) and fetal (FVM) vascular malperfusion, acute placental inflammation with maternal (MIR) and fetal (FIR) inflammatory response, chronic inflammatory lesions (CILs) and increased perivillous fibrin deposition (PVFD). Results A total of 15 studies reporting on 19,025 placentas, n=699 of which were derived from women who were identified as being infected with SARS-CoV-2 and 18,326 as SARS-CoV-2 negative controls, were eligible for analysis. No significant difference in incidence of MVM (OR: 1.18, 95% CI 0.73-1.90), FVM (OR: 1.23, 95% CI 0.63-2.42), MIR (OR: 0.66, 95% CI 0.29-1.52) nor FIR (OR: 0.85, 95% CI 0.44-1.63), CILs (OR:0.97, 95% CI 0.55-1.72) was found between placentae from gravidae identified as being SARS-CoV-2 infected. However, placenta from gravidae identified as being infected with SARS-CoV-2 were associated with significantly increased occurrence of PVFD (OR: 2.77, 95% CI 1.06-7.27). After subgroup analyses based on clinical severity of COVID-19 infection, no significant difference was observed in terms of reported placental pathology between symptomatic or asymptomatic SARS-CoV-2 gravidae placenta.
Conclusions: Current evidence based on the available literature suggest that the only pathologic finding in the placentae of women who are pregnant identified as having been infected with SARS-CoV-2 was an increased prevalence of PVFD.
 
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