Pandemic stress and SARS-CoV-2 infection are associated with pathological changes at the maternal-fetal interface. (November 2021)

• Record Type: Journal Article
• Authors: Brien, Marie-Eve; Bouron-Dal Soglio, Dorothée; Dal Soglio, Solenn; Couture, Camille; Boucoiran, Isabelle; Nasr, Youssef; Widdows, Kate; Sharps, Megan C.; El Demellawy, Dina; EP Heazell, Alexander; Menzies, Didier; Girard, Sylvie
• Is Part Of: Placenta. Volume 115(2021)
• Page Start: 37
• Page End: 44
• Publication Date: 2021-11
• Subjects: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) -- Coronavirus disease 2019 (COVID-19) -- Infection -- Pandemic stress -- Pregnancy -- Placenta; Placenta -- Periodicals; Reproduction -- Periodicals; Placenta -- Periodicals; Placenta -- Périodiques; Reproduction -- Périodiques; 612.63
• DOI: 10.1016/j.placenta.2021.09.007
• Languages: English
• ISSNs: 0143-4004

Abstract

Abstract: Introduction: The reported effects of SARS-CoV-2 on pregnancy outcomes are conflicting; studies frequently overlook the placenta, which is critical for the health of the mother and infant(s). This study aimed to determine the effect of pandemic stress ± SARS CoV-2 infection on placental histopathology. Methods: Women were recruited in Canada (n = 69); France (n = 21) or in the UK (n = 25), between March and October 2020. Historic controls (N = 20) were also included. Placenta and fetal membrane samples were collected rapidly after delivery and were fixed and stained for histopathological analysis. Maternal demographical data and obstetric outcomes were recorded. Results: Over 80% of the placentas from SARS-CoV-2+ pregnancies had histopathological abnormalities: predominantly structural (71–86%) or inflammatory (9–22%), depending on geographical location. Excessive fibrin was seen in all sites, whereas deciduitis (Canada), calcifications (UK), agglutinations and chorangiosis (France) predominated in different locations. The frequency of abnormalities was significantly higher than in SARS-CoV-2 negative women (50%, p < 0.05). Demographic and obstetric data were similar in the SARS-CoV-2+ women across all sites - characterised by predominantly Black/Middle Eastern women, and women with elevated body mass index. Discussion: Overall, the frequency of placental abnormalities is increased in SARS-CoV-2+ women, but the incidence of placental abnormalities is also higher in SARS-CoV-2- women that gave birth during the pandemic, which highlights the importance of appropriate control groups to ascertain the roles of pandemic stress and SARS-CoV-2 infection on the placenta and pregnancy outcomes. Highlights: Impact of stress ± SARS CoV-2 infection in a multi-sites international study. Prevalence of placental abnormalities in SARS-CoV-2+ and negative (stress only) cases. Over 80% of placentas from SARS-CoV2+ pregnancies presented abnormalities. 50% of the placentas exposed to pandemic stress alone presented abnormalities.