1116 Microstructural & functional changes in the placenta during the COVID-19 pandemic

Abstract

To study the impact of the COVID-19 pandemic on in vivo microstructural and functional placental development using intra-voxel incoherent motion (IVIM) and blood oxygen level dependent (BOLD) MRI, respectively. This is prospective, observational study of pregnant women with singleton gestations during the COVID-19 pandemic (May 2020-present), compared to pre-pandemic historical controls (July 2014-February 2020). Placental imaging was identical for pandemic and pre-pandemic cohorts: including T2W anatomic images, PGSE sequences for IVIM [TE/TR=53.8/8000ms with 9 b-values (0-900s/mm2)], gradient-echo planar imaging sequences for BOLD imaging (TE/TR=60/2000ms) using a 6 minute maternal hyperoxia design, followed by 6 minutes of normoxia as return to baseline. 28 pregnant women during COVID-19 were included and compared to 100 pre-pandemic healthy controls (IVIM) and 57 pre-pandemic healthy controls (BOLD). The average gestational age (GA) was 28.6±6.0, 29.2±5.8 and 30.1±3.9, respectively. IVIM metrics trended higher for placental diffusion and lower for placental perfusion compared to pre-pandemic controls (Table 1). BOLD functional MRI revealed significantly lower placental oxygenation during minutes 2-6 of maternal hyperoxia and during minutes 1-3 of return to resting state (post hyperoxia) compared to pre-pandemic controls (Figure 1). Respiratory pandemics have been associated with altered intrauterine programing that can result in fetal onset of adult diseases. While the mechanisms are unclear, the placenta is a critical organ that mediates maternal well-being with fetal development. We report altered microstructural and functional placental development during the COVID-19 pandemic in COVID-19 negative women. Neurodevelopmental assessments of these infants are ongoing to determine the short- and long-term effects of these changes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)