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Q&A

Infectious Diseases

Poster Session 2

(628) Association of disease severity and placental pathology changes in pregnant patients with SARS-CoV-2

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

    Primary & Presenting Author(s)

  • Juliann Wang, BS

    University of Alabama at Birmingham School of Medicine
    Birmingham, AL, United States

    • Coauthor(s)

  • CB

    Christina T. Blanchard, MS

    Statistician
    Center for Women’s Reproductive Health, University of Alabama at Birmingham
    Birmingham, AL, United States

  • Angela R. Seasely, MD, MS

    Fellow
    Center for Women’s Reproductive Health, University of Alabama at Birmingham
    Birmingham, AL, United States

  • VD

    Virginia E. Duncan, MD, MS

    University of Alabama at Birmingham
    Birmingham, AL, United States

  • JD

    Jodie A. Dionne, MD

    Assistant Professor
    Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham
    BIRMINGHAM, AL, United States

  • Akila Subramaniam, MD, MPH (she/her/hers)

    Associate Professor
    Center for Women’s Reproductive Health, University of Alabama at Birmingham
    Birmingham, AL, United States

  • NA

    Nitin Arora, MD, MPH

    University of Alabama at Birmingham
    Birmingham, AL, United States

Objective:

Pregnant people infected with SARS CoV-2 are at increased risk for greater disease severity and complications. Prior studies have shown an unusual pathologic group of COVID placentitis in some patients diagnosed with SARS CoV-2 in pregnancy. We sought to investigate the association between disease severity and placental pathology in pregnant patients with confirmed SARS CoV-2.

Study Design:

This was a retrospective cohort study of all pregnant patients with PCR confirmed SARS CoV-2 (3/2020-4/2022) at a single institution. Disease severity was based on the NIH standard definitions and grouped into asymptomatic, mild/moderate, and severe/critical disease. Primary outcome evaluated by a trained placental pathologist were findings characteristic for SARS CoV-2 placentitis: chronic histiocytic intervillositis, massive perivillous fibrinoid deposition, and trophoblast necrosis. Secondary outcomes included additional descriptors of placental pathology and infant variables.

Results:

A total of 530 women delivered at our institution and were included in the study: 406 (77%) had placental pathology available. Among patients with placental pathology available, 46% were asymptomatic, 42% had mild/moderate disease, and 12% had severe/critical disease. Pregnant women with severe disease had an older age, higher BMI, and lower gestational age at delivery (all p< 0.05). SARS CoV-2 placentitis was observed in four patients (0.01%) with no association with disease severity. Higher disease severity was associated with chronic villous ischemic changes (p< 0.01), infant head circumferences < 10th percentile (p< 0.01), and decreased acute chorionic vasculitis (p< 0.01). All other placental pathology descriptors and infant variables were similar across groups.

Conclusion:

Overall, we found no association between disease severity and risk of SARS CoV-2 placentitis.