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KMID : 1101620230340030114
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Perinatology
2023 Volume.34 No. 3 p.114 ~ p.121
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Placental Infection and Perinatal Outcomes in Neonates Born to Mothers with COVID- 19: A Single-Center Retrospective Study
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Andrew W. Browne
Lee Ha-Na
Kim Soo-Hyun
Park Sung-Hyeon
Jeong Ji-Yoon
Lee Byong-Sop
Nam Soo-Jung
Jung Eui-Seok
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Abstract
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Objective: The angiotensin converting enzyme 2 (ACE2) has been established as the receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and placental ACE2 expression has led to a few cases of vertical transmission via the placenta. In this study, we aimed to investigate placental infection in pregnant women with coronavirus disease 2019 (COVID-19) and the perinatal outcomes of neonates.
Methods: We retrospectively reviewed the data of newborn infants and their mothers infected with SARS-CoV-2 at the Asan Medical Center from December 2021 to April 2022. We collected data on maternal and neonatal characteristics, histopathological and immunohistochemical results of placenta. Placental infection of SARS-CoV-2 was confirmed by positive immunohistochemical staining with antibodies bind to viral proteins. Nasopharyngeal polymerase chain reaction (PCR) tests with 24-hour intervals for newborns
Results: Overall, 59 infants were born to mothers with confirmed COVID-19. The mean gestational age was 38.5±1.5 weeks, and the mean birth weight was 3,185.6±497.3 g. The median Apgar score was 8 and 9 at 1 and 5 minutes, respectively. The placenta showed various placental pathologies, such as placental inflammation (53.4%), and maternal vascular malperfusion (27.5%). SARS-CoV-2 antigen was detected in 55 cases of 58 (94.8%) placental tissues, mainly on the syncytiotrophoblast (89.7%). However, all newborn infants tested negative for nasopharyngeal SARS-CoV-2 PCR.
Conclusion: In this single-center study, majority of pregnant women with COVID-19 also had evidence of placental infection during the Omicron wave in Korea. Nevertheless, none of the newborn infants were infected with SARS-CoV-2, and their perinatal outcomes were favorable.
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KEYWORD
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COVID-19, SARS-CoV-2, Neonatal morbidity, Infant mortality, Placenta
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