OC15.04: Fetal cardiac remodelling after maternal SARS‐CoV‐2 infection during pregnancy

Abstract

To assess fetal cardiac structure and function in pregnancies with maternal COVID-19 infection, according to disease severity and gestational age at infection. Multicentric prospective cohort study including singleton pregnant women with confirmed SARS-CoV-2 infection (clinical, nasopharyngeal PCR or serologic test) at 5 hospitals in Spain, from April 2020 to April 2021. Pregnancies were subdivided according to the severity of maternal COVID-19 disease following NIH Classification. Fetal cardiac morphometry and function were evaluated in the third trimester, once COVID-19 symptoms ceased and at least 4 weeks after maternal infection. Echocardiography was performed in 269 fetuses including 70 asymptomatic patients (26.0%), 168 mild (62.5%) and 31 moderate/severe COVID-19 disease (one critical) (11.5%). Maternal infection occurred in the first trimester in 73 (27.1%) cases, in the second trimester in 158 (58.9%), and 38 (14.1%) cases during the third trimester. No significant differences were observed in fetal cardiac morphometric or functional parameters according to maternal severity of COVID-19 (table 1) or trimester of infection, except for increased septal thickness in fetuses of mothers with moderate/severe COVID-19. Fetal cardiac function was mostly preserved after severe maternal SARS-CoV-2 infection. Further studies are warranted to elucidate the implications of increased fetal septal thickness in cases of severe maternal COVID-19.