Abstract
(1) This study aimed to evaluate characteristics, perinatal outcomes, and placental pathology of pregnant women with or without SARS-CoV-2 infection in the context of maternal PCR cycle threshold (CT) values. (2) This was a retrospective case-control study in a third-level health center in Mexico City with universal screening by RT-qPCR. The association of COVID-19 manifestations, preeclampsia, and preterm birth with maternal variables and CT values were assessed by logistic regression models and decision trees. (3) Accordingly, 828 and 298 women had a negative and positive test, respectively. Of those positive, only 2.6% of them presented mild to moderate symptoms. Clinical characteristics between both groups of women were similar. No associations between CT values were found for maternal features, such as pre-gestational BMI, age, and symptomatology. A significantly higher percentage of placental fibrinoid was seen with women with low CTs (<25; p < 0.01). Regarding perinatal outcomes, preeclampsia was found to be significantly associated with symptomatology but not with risk factors or CT values (p < 0.01, aOR = 14.72). Moreover, 88.9% of women diagnosed with COVID-19 at <35 gestational weeks and symptomatic developed preeclampsia. (4) The data support strong guidance for pregnancies with SARS-CoV-2 infection, in particular preeclampsia and placental pathology, which need further investigation.
Highlights
In December 2019, an outbreak of a coronavirus that causes severe acute respiratory syndrome (SARS-CoV-2) was observed in Wuhan, China
All patients were attended at the National Institute of Perinatology and were tested for COVID-19 because they had a programmed visit for delivery (42.3%), an obstetric emergency (49.9%), or were hospitalized for pregnancy resolution and suspected to have COVID-19 (6.9%)
We found an association between COVID19 and preeclampsia but mainly in symptomatic patients and in women who were infected by SARS-CoV-2 before the 35th week of gestation
Summary
In December 2019, an outbreak of a coronavirus that causes severe acute respiratory syndrome (SARS-CoV-2) was observed in Wuhan, China. The virus causes the widely known Coronavirus disease (COVID-19) [1], with more than 123 million cases in 223 countries and more than 2 million deaths worldwide. Pregnant women are a high-risk population, especially vulnerable to infectious diseases due to the immune system’s delicate regulation during the gestational period [2] and the risk of vertical transmission of the infectious disease to the fetus [3]. During the COVID-19 pandemic, several research groups worldwide have reported the clinical characteristics of pregnant women infected with SARS-CoV-2 [5], the virus’s ability to infect the placenta and the presence of vertical transmission from mother to child [6,7,8]. The histopathological spectrum of placentas from maternal–neonatal dyads with SARS-CoV-2 infection showed histiocytic intervillositis and trophoblast necrosis [9,10]
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