tetano
Editor, Senior Moderator
Clin Microbiol Infect
. 2022 Feb 9;S1198-743X(22)00076-3.
doi: 10.1016/j.cmi.2022.02.003. Online ahead of print.
Low placental weight and altered metabolic scaling after severe acute respiratory syndrome coronavirus type 2 infection during pregnancy: a prospective multicentric study
Anda-Petronela Radan[SUP] 1 [/SUP], David Baud[SUP] 2 [/SUP], Guillaume Favre[SUP] 2 [/SUP], Andrea Papadia[SUP] 3 [/SUP], Daniel Surbek[SUP] 4 [/SUP], Marc Baumann[SUP] 4 [/SUP], Luigi Raio[SUP] 4 [/SUP]
Affiliations
Abstract
Objectives: A higher risk for adverse pregnancy outcome is associated with SARS-CoV-2 infection, which could be partially explained by an altered placental function. Since histopathology is often unspecific, we aimed to assess placental weight, birthweight/placental-weight (b/p) ratio and the metabolic scaling exponent ß, an indicator of a normal fetal-placental growth, in order to analyze the placental function.
Methods: We included 153 singleton pregnancies with SARS-CoV-2 positive PCR in our study, who delivered at three referring hospitals in Switzerland. Placental weight and b/p ratio were compared to published reference charts. Logistic regression analysis investigated the role of time of infection and other confounding factors on placental weight. The scaling exponent β was compared to the reference value of ¾.
Results: Placental weight was inferior or equal to the 10[SUP]th[/SUP] centile in 42.5%(65/153) and to the 3[SUP]rd[/SUP] centile in 19%(29/153) of the cases. The risk of low placental weight was not influenced by the trimester of infection. B/p ratio was >50[SUP]th[/SUP] centile in 80.4%(123/153) of the cases. Incidence of fetal growth restriction, preeclampsia and gestational diabetes was 11.8%(18/153), 3.3%(5/153) and 19.6%(30/153). Linear regression modelling revealed a pathologic metabolic scaling exponent β of 0.871±0.064 (R[SUP]2[/SUP]=0.56).
Conclusion: SARS-CoV-2 during pregnancy was associated with a higher incidence of low placental weight, an increased b/p ratio and an abnormal scaling exponent β in our cohort. This could be particularly relevant for the yet controversial issue of increased stillbirth rate in SARS-CoV-2 infection during pregnancy. In this regard, intensified fetal surveillance should be mandatory in these pregnancies.
Keywords: Birthweight/placental weight ratio; COVID-19; Metabolic scaling exponent β; SARS-CoV-2; gestational diabetes; placental weight.
. 2022 Feb 9;S1198-743X(22)00076-3.
doi: 10.1016/j.cmi.2022.02.003. Online ahead of print.
Low placental weight and altered metabolic scaling after severe acute respiratory syndrome coronavirus type 2 infection during pregnancy: a prospective multicentric study
Anda-Petronela Radan[SUP] 1 [/SUP], David Baud[SUP] 2 [/SUP], Guillaume Favre[SUP] 2 [/SUP], Andrea Papadia[SUP] 3 [/SUP], Daniel Surbek[SUP] 4 [/SUP], Marc Baumann[SUP] 4 [/SUP], Luigi Raio[SUP] 4 [/SUP]
Affiliations
- PMID: 35150886
- DOI: 10.1016/j.cmi.2022.02.003
Abstract
Objectives: A higher risk for adverse pregnancy outcome is associated with SARS-CoV-2 infection, which could be partially explained by an altered placental function. Since histopathology is often unspecific, we aimed to assess placental weight, birthweight/placental-weight (b/p) ratio and the metabolic scaling exponent ß, an indicator of a normal fetal-placental growth, in order to analyze the placental function.
Methods: We included 153 singleton pregnancies with SARS-CoV-2 positive PCR in our study, who delivered at three referring hospitals in Switzerland. Placental weight and b/p ratio were compared to published reference charts. Logistic regression analysis investigated the role of time of infection and other confounding factors on placental weight. The scaling exponent β was compared to the reference value of ¾.
Results: Placental weight was inferior or equal to the 10[SUP]th[/SUP] centile in 42.5%(65/153) and to the 3[SUP]rd[/SUP] centile in 19%(29/153) of the cases. The risk of low placental weight was not influenced by the trimester of infection. B/p ratio was >50[SUP]th[/SUP] centile in 80.4%(123/153) of the cases. Incidence of fetal growth restriction, preeclampsia and gestational diabetes was 11.8%(18/153), 3.3%(5/153) and 19.6%(30/153). Linear regression modelling revealed a pathologic metabolic scaling exponent β of 0.871±0.064 (R[SUP]2[/SUP]=0.56).
Conclusion: SARS-CoV-2 during pregnancy was associated with a higher incidence of low placental weight, an increased b/p ratio and an abnormal scaling exponent β in our cohort. This could be particularly relevant for the yet controversial issue of increased stillbirth rate in SARS-CoV-2 infection during pregnancy. In this regard, intensified fetal surveillance should be mandatory in these pregnancies.
Keywords: Birthweight/placental weight ratio; COVID-19; Metabolic scaling exponent β; SARS-CoV-2; gestational diabetes; placental weight.