Skip to main content
SMFM 2024 Pregnancy Meeting Main banner
Final Program


Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Poster Icons
Foundation Awardee
Foundation Awardee
No Social Media
No Social Media
Back
Q&A

Basic Science

Poster Session 3

(686) Histopathologic placental findings in SARS-CoV-2 exposed gravida compared to unexposed controls

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

    Primary & Presenting Author(s)

  • Burk Schaible, DO

    Dr. Burk Schaible
    Atrium Wake Forest Baptist Health
    Winston-Salem, NC, United States

    • Coauthor(s)

  • David M. Stamilio, MD, MSCE

    Professor, Maternal and Fetal Medicine
    Wake Forest University School of Medicine
    Winston-Salem, NC, United States

  • JS

    Jeffrey Shenberger, MD

    Atrium Wake Forest Baptist Health, Connecticut Children's Specialty Group
    Hartford, CT, United States

  • AM

    Anna McDonald, MD

    Atrium Wake Forest Baptist Health
    Winston-Salem, NC, United States

  • IT

    Ingrid Tablason, MD

    Atrium Wake Forest Baptist Health
    Columbus, OH, United States

  • MS

    Megan Seger, MD

    Atrium Wake Forest Baptist Health
    Winston-Salem, NC, United States

Objective: To estimate if SARS-CoV-2 maternal infection during pregnancy is associated with higher rates of placental abnormalities compared to unexposed controls.

Study Design: We designed a single center retrospective cohort study of delivered patients with placental histopathologic results in exposed and unexposed to prenatal SARS-CoV-2 infection. Primary outcomes included select placental malperfusion abnormalities. Secondary outcomes included desired pregnancy outcomes. Data was obtained through automated chart extraction and verified manually. Bivariate and multivariable logistic regression analyses were performed. Subanalyses examined the effect of gestational timing and disease severity of SARS-CoV-2 infection on placental outcomes. Sensitivity analyses were performed to assess for confounding by indication.

Results: Among the 1,923 pregnant patients in the cohort, 490 (25.5%) had prenatal SARS-CoV-2 infection. Study groups differed on several baseline characteristics, including higher rates of preterm birth, obesity, hypertension, fetal growth restriction, and fetal congenital anomalies in the unexposed group. In the unadjusted analysis, placental abnormalities, including MVM, FVM and inflammation, were similar between SARS-CoV-2 exposed and unexposed pregnant individuals. Findings were largely confirmed in the multivariable analyses adjusting for relevant confounding variables. Gestational timing and severity of infection did not appear to impact placental injury. However, a sub-cohort sensitivity analysis restricting to patients without potential confounding variables related to indications for ordering placental pathology revealed a higher rate of MVM in the SARS-CoV-2 exposed group.

Conclusion: Rates of specified placental histopathologic abnormalities were not increased in SARS-CoV-2 infection during pregnancy in this high-risk cohort. However, there is evidence of confounding by indication that may be masking an association between SARS-CoV-2 prenatal exposure and increased placental pathology.