Abstract
Background: As the COVID-19 pandemic continues, there is an increasing number of pregnant women that contract SARS CoV-2. Maternal and neonatal clinical courses are typically mild, with low mortality rates. However, preterm births occurred in 29.7% of those recorded within case studies (Bellos et al., 2021). While there are no pathognomonic histological patterns of the placenta, some commonalities associated with COVID-19 maternal infection have been reported. However, there are no current studies that indicate the significance of these patterns and their effect on neonatal health. In third trimester women, there have been reports of an increased frequency of maternal vascular malperfusion (MVM) to the placenta, fetal vascular malperfusion (FVM), and increased intervillous macrophage infiltration which may negatively impact neonatal outcomes. Placental differences could be used as a predictor for neonatal health outcomes, thus indicating the importance of a comprehensive study that identifies placental abnormalities associated with COVID-19 maternal infection.
Objective: We aim to determine if there is a relationship between the placental abnormalities seen due to maternal COVID-19 infection and neonatal outcomes.
Methods: Medline, CINAHL, and Web of Science databases were searched in November 2021 using MeSH terms for COVID-19, infant or newborn, and placenta. Our initial search yielded 502 articles. After deleting duplicates, 266 articles were assessed for meeting inclusion criteria, and 5 articles were selected that met our stringent criteria as most studies were excluded due to maternal comorbidities. A scoping review was compiled on maternal pathology occurring in COVID-19 patients, and its effect on neonatal outcomes.
Results: Symptomatology of newborns born to COVID-19 positive mothers varied with the most severe complications including intrauterine fetal demise while other newborns were seemingly unaffected. CNS difficulties including an absent sucking reflex, GI conditions such as GERD, preterm births, low birth weight, and intrauterine growth restrictions were all seen with low prevalence across the different studies. Placental specimens consistently showed abnormalities including MVM, FVM, fibrin deposition, syncytial knotting, and thrombi formation.
Conclusion: Neonatal health outcomes and placental pathologies varied greatly across the five articles that met inclusion criteria. Insufficient evidence has been gathered regarding mothers who do not have other health comorbidities complicating their pregnancy. More research is needed to determine whether the abnormalities seen in pregnancies complicated by COVID-19 infection create statistically significant differences in neonatal outcomes compared to the general population born to otherwise healthy mothers.
