SARS‐CoV‐2 placentitis and severe pregnancy outcome after maternal infection: A Danish case series
Abstract Introduction SARS‐CoV‐2 infection during pregnancy may cause viral inflammation of the placenta, resulting in fetal demise even without fetal or newborn infection. The impact of timing of the infection and the mechanisms that cause fetal morbidity and mortality are not well understood. Mate...
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| Language: | English |
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Wiley
2023-05-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14541 |
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| author | Stine Y. Nielsen Lone E. Hvidman Anna J. M. Aabakke Tina E. Olsen Iben B. G. Johnsen Pauline W. Bogaard Astrid Petersen Hanne B. Westergaard Anne Sørensen Gitte Hedermann Elisabeth T. Rønneberg Dorthe Thisted Jane Boris Lise L. T. Andersen Anne G. H. Eggers Birgitte F. Lindved Tine B. Henriksen |
| author_facet | Stine Y. Nielsen Lone E. Hvidman Anna J. M. Aabakke Tina E. Olsen Iben B. G. Johnsen Pauline W. Bogaard Astrid Petersen Hanne B. Westergaard Anne Sørensen Gitte Hedermann Elisabeth T. Rønneberg Dorthe Thisted Jane Boris Lise L. T. Andersen Anne G. H. Eggers Birgitte F. Lindved Tine B. Henriksen |
| author_sort | Stine Y. Nielsen |
| collection | DOAJ |
| description | Abstract Introduction SARS‐CoV‐2 infection during pregnancy may cause viral inflammation of the placenta, resulting in fetal demise even without fetal or newborn infection. The impact of timing of the infection and the mechanisms that cause fetal morbidity and mortality are not well understood. Material and methods To describe placental pathology from women with confirmed SARS‐CoV‐2 infection during pregnancy, a SARS‐CoV‐2 immunohistochemistry‐positive placenta and late miscarriage, stillbirth, neonatal death, or medically indicated birth due to fetal distress. Results The triad of trophoblastic necrosis, inflammatory intervillous infiltrates, and increased perivillous fibrinoid deposition was present in all 17 placentas; the pregnancies resulted in eight stillbirths, two late miscarriages (19 and 21 weeks’ gestation), and seven liveborn children, two of which died shortly after delivery. The severity of maternal COVID‐19 was not reflected by the extent of the placental lesions. In only one case, SARS‐CoV‐2 was detected in lung tissue samples from the fetus. The majority events (miscarriage, stillbirth, fetal distress resulting in indicated birth, or livebirth, but neonatal death) happened shortly after maternal SARS‐CoV‐2 infection was diagnosed. Seven of eight sequenced cases were infected with the Delta (B.1.617.2) virus strain. Conclusion We consolidate findings from previous case series describing extensive SARS‐CoV‐2 placentitis and placental insufficiency leading to fetal hypoxia. We found sparse evidence to support the notion that SARS‐CoV‐2 virus had infected the fetus or newborn. |
| format | Article |
| id | doaj-art-1f981e48dd6b4082878abf5dfc0a3dfd |
| institution | OA Journals |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2023-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-1f981e48dd6b4082878abf5dfc0a3dfd2025-08-20T02:36:39ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-05-01102556757610.1111/aogs.14541SARS‐CoV‐2 placentitis and severe pregnancy outcome after maternal infection: A Danish case seriesStine Y. Nielsen0Lone E. Hvidman1Anna J. M. Aabakke2Tina E. Olsen3Iben B. G. Johnsen4Pauline W. Bogaard5Astrid Petersen6Hanne B. Westergaard7Anne Sørensen8Gitte Hedermann9Elisabeth T. Rønneberg10Dorthe Thisted11Jane Boris12Lise L. T. Andersen13Anne G. H. Eggers14Birgitte F. Lindved15Tine B. Henriksen16Department of Clinical Microbiology Lillebaelt University Hospital Vejle DenmarkDepartment of Obstetrics and Gynecology Aarhus University Hospital Aarhus DenmarkDepartment of Obstetrics and Gynecology University of Copenhagen, Nordsjælland Hillerød DenmarkDepartment of Pathology Copenhagen University Hospital Rigshospitalet Copenhagen DenmarkDepartment of Pathology Odense University Hospital Odense DenmarkDepartment of Pathology Aalborg University Hospital Aalborg DenmarkDepartment of Pathology Aalborg University Hospital Aalborg DenmarkDepartment of Obstetrics and Gynecology University of Copenhagen, Nordsjælland Hillerød DenmarkDepartment of Obstetrics and Gynecology Aalborg University Hospital Aalborg DenmarkDepartment of Obstetrics and Gynecology Copenhagen University Hospital Rigshospitalet Copenhagen DenmarkDepartment of Obstetrics and Gynecology Herlev Hospital Herlev DenmarkDepartment of Obstetrics and Gynecology University of Copenhagen Holbæk DenmarkDepartment of Obstetrics and Gynecology Gødstrup Hospital Herning DenmarkDepartment of Obstetrics and Gynecology Odense University Hospital Odense DenmarkDepartment of Obstetrics and Gynecology Copenhagen University Hospital Rigshospitalet Copenhagen DenmarkDepartment of Obstetrics and Gynecology Regional Hospital Horsens Horsens DenmarkDepartment of Pediatric and Adolescent Medicine Aarhus University Hospital Aarhus DenmarkAbstract Introduction SARS‐CoV‐2 infection during pregnancy may cause viral inflammation of the placenta, resulting in fetal demise even without fetal or newborn infection. The impact of timing of the infection and the mechanisms that cause fetal morbidity and mortality are not well understood. Material and methods To describe placental pathology from women with confirmed SARS‐CoV‐2 infection during pregnancy, a SARS‐CoV‐2 immunohistochemistry‐positive placenta and late miscarriage, stillbirth, neonatal death, or medically indicated birth due to fetal distress. Results The triad of trophoblastic necrosis, inflammatory intervillous infiltrates, and increased perivillous fibrinoid deposition was present in all 17 placentas; the pregnancies resulted in eight stillbirths, two late miscarriages (19 and 21 weeks’ gestation), and seven liveborn children, two of which died shortly after delivery. The severity of maternal COVID‐19 was not reflected by the extent of the placental lesions. In only one case, SARS‐CoV‐2 was detected in lung tissue samples from the fetus. The majority events (miscarriage, stillbirth, fetal distress resulting in indicated birth, or livebirth, but neonatal death) happened shortly after maternal SARS‐CoV‐2 infection was diagnosed. Seven of eight sequenced cases were infected with the Delta (B.1.617.2) virus strain. Conclusion We consolidate findings from previous case series describing extensive SARS‐CoV‐2 placentitis and placental insufficiency leading to fetal hypoxia. We found sparse evidence to support the notion that SARS‐CoV‐2 virus had infected the fetus or newborn.https://doi.org/10.1111/aogs.14541COVID‐19placental insufficiencyplacentitispregnancySARS‐CoV‐2 |
| spellingShingle | Stine Y. Nielsen Lone E. Hvidman Anna J. M. Aabakke Tina E. Olsen Iben B. G. Johnsen Pauline W. Bogaard Astrid Petersen Hanne B. Westergaard Anne Sørensen Gitte Hedermann Elisabeth T. Rønneberg Dorthe Thisted Jane Boris Lise L. T. Andersen Anne G. H. Eggers Birgitte F. Lindved Tine B. Henriksen SARS‐CoV‐2 placentitis and severe pregnancy outcome after maternal infection: A Danish case series Acta Obstetricia et Gynecologica Scandinavica COVID‐19 placental insufficiency placentitis pregnancy SARS‐CoV‐2 |
| title | SARS‐CoV‐2 placentitis and severe pregnancy outcome after maternal infection: A Danish case series |
| title_full | SARS‐CoV‐2 placentitis and severe pregnancy outcome after maternal infection: A Danish case series |
| title_fullStr | SARS‐CoV‐2 placentitis and severe pregnancy outcome after maternal infection: A Danish case series |
| title_full_unstemmed | SARS‐CoV‐2 placentitis and severe pregnancy outcome after maternal infection: A Danish case series |
| title_short | SARS‐CoV‐2 placentitis and severe pregnancy outcome after maternal infection: A Danish case series |
| title_sort | sars cov 2 placentitis and severe pregnancy outcome after maternal infection a danish case series |
| topic | COVID‐19 placental insufficiency placentitis pregnancy SARS‐CoV‐2 |
| url | https://doi.org/10.1111/aogs.14541 |
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