Maternal Obesity Modifies the Impact of Active SARS-CoV-2 Infection on Placental Pathology

Background: Obesity during pregnancy is associated with an elevated risk of severe COVID-19, including higher rates of maternal complications, intensive care admission, and adverse neonatal outcomes. The impact of combination of SARS-CoV-2 infection and maternal obesity in placental pathology has no...

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Main Authors: Francisca Carmo, Carla Ramalho, Susana Guimarães, Fátima Martel
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Viruses
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Online Access:https://www.mdpi.com/1999-4915/17/7/1013
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author Francisca Carmo
Carla Ramalho
Susana Guimarães
Fátima Martel
author_facet Francisca Carmo
Carla Ramalho
Susana Guimarães
Fátima Martel
author_sort Francisca Carmo
collection DOAJ
description Background: Obesity during pregnancy is associated with an elevated risk of severe COVID-19, including higher rates of maternal complications, intensive care admission, and adverse neonatal outcomes. The impact of combination of SARS-CoV-2 infection and maternal obesity in placental pathology has not been properly investigated. Aim: To compare the histopathological changes in the placenta induced by active SARS-CoV-2 infection in obese and non-obese patients. Methods: This retrospective cohort study included human placentas from non-obese women and pre-gestationally obese women with active SARS-CoV-2 infection (SARS and OB+SARS, respectively), and placentas from non-obese women and pre-gestationally obese women without SARS-CoV-2 infection (control and OB, collected in the post- and pre-pandemic periods, respectively). Results: A higher (50%) occurrence of ischemic injury and subchorionic fibrin deposits and a 15× higher risk of occurrence of these lesions were found in the OB+SARS group, in relation to control. In contrast, a 10% lower risk of developing chorangiosis in the OB+SARS group than the OB group was observed. Conclusions: An increased risk of lesions related to both maternal and fetal malperfusion and ischemic injury and a lower risk for chorangiosis exist in placentas from obese women affected by SARS-CoV-2 infection. Importantly, these differences were not observed in placentas from non-obese women.
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spelling doaj-art-560f8a3859ab4b8b9c8fec0ecb256f9a2025-08-20T02:47:14ZengMDPI AGViruses1999-49152025-07-01177101310.3390/v17071013Maternal Obesity Modifies the Impact of Active SARS-CoV-2 Infection on Placental PathologyFrancisca Carmo0Carla Ramalho1Susana Guimarães2Fátima Martel3Unit of Biochemistry, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, PortugalDepartment of Obstetrics, Unidade Local de Saúde de São João, 4200-319 Porto, PortugalDepartment of Pathology, Unidade Local de Saúde de São João, 4200-319 Porto, PortugalUnit of Biochemistry, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, PortugalBackground: Obesity during pregnancy is associated with an elevated risk of severe COVID-19, including higher rates of maternal complications, intensive care admission, and adverse neonatal outcomes. The impact of combination of SARS-CoV-2 infection and maternal obesity in placental pathology has not been properly investigated. Aim: To compare the histopathological changes in the placenta induced by active SARS-CoV-2 infection in obese and non-obese patients. Methods: This retrospective cohort study included human placentas from non-obese women and pre-gestationally obese women with active SARS-CoV-2 infection (SARS and OB+SARS, respectively), and placentas from non-obese women and pre-gestationally obese women without SARS-CoV-2 infection (control and OB, collected in the post- and pre-pandemic periods, respectively). Results: A higher (50%) occurrence of ischemic injury and subchorionic fibrin deposits and a 15× higher risk of occurrence of these lesions were found in the OB+SARS group, in relation to control. In contrast, a 10% lower risk of developing chorangiosis in the OB+SARS group than the OB group was observed. Conclusions: An increased risk of lesions related to both maternal and fetal malperfusion and ischemic injury and a lower risk for chorangiosis exist in placentas from obese women affected by SARS-CoV-2 infection. Importantly, these differences were not observed in placentas from non-obese women.https://www.mdpi.com/1999-4915/17/7/1013placentahistologySARS-CoV-2maternal COVID-19obesity
spellingShingle Francisca Carmo
Carla Ramalho
Susana Guimarães
Fátima Martel
Maternal Obesity Modifies the Impact of Active SARS-CoV-2 Infection on Placental Pathology
Viruses
placenta
histology
SARS-CoV-2
maternal COVID-19
obesity
title Maternal Obesity Modifies the Impact of Active SARS-CoV-2 Infection on Placental Pathology
title_full Maternal Obesity Modifies the Impact of Active SARS-CoV-2 Infection on Placental Pathology
title_fullStr Maternal Obesity Modifies the Impact of Active SARS-CoV-2 Infection on Placental Pathology
title_full_unstemmed Maternal Obesity Modifies the Impact of Active SARS-CoV-2 Infection on Placental Pathology
title_short Maternal Obesity Modifies the Impact of Active SARS-CoV-2 Infection on Placental Pathology
title_sort maternal obesity modifies the impact of active sars cov 2 infection on placental pathology
topic placenta
histology
SARS-CoV-2
maternal COVID-19
obesity
url https://www.mdpi.com/1999-4915/17/7/1013
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AT susanaguimaraes maternalobesitymodifiestheimpactofactivesarscov2infectiononplacentalpathology
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