Poster Session 3
Lindsay B. Howard, MD (she/her/hers)
Resident Physician
Lehigh Valley Health Network
Allentown, Pennsylvania, United States
.jpg "Vincent Tang, MD (he/him/his) photo")
Vincent Tang, MD (he/him/his)
Fellow, Maternal Fetal Medicine
Lehigh Valley Health Network
Allentown, PA, United States
Shekinah Dosunmu, MD
Lehigh Valley Health Network
Allentown, Pennsylvania, United States
Joanne N. Quiñones, MD, MSCE (she/her/hers)
Program Director, Maternal Fetal Medicine Fellowship; VC Research, Dept OBGYN
Lehigh Valley Health Network
Allentown, Pennsylvania, United States
Kyle Shaak, BA, MPH
Biostatistician
Network Office of Research and Innovation, Lehigh Valley Health Network
Allentown, Pennsylvania, United States
Janae Cornwall, BS
Medical Student
University of South Florida Morsani College of Medicine, SELECT Program
Tampa, Florida, United States
Aishwarya Pattnaik
University of South Florida Morsani College of Medicine, SELECT Program
Tampa, Florida, United States
Victoria Loven, MD
Lehigh Valley Health Network
Allentown, Pennsylvania, United States
Albert Sarno, MD, MPH
Lehigh Valley Health Network
Allentown, Pennsylvania, United States
Matthew P. Romagano, DO
MFM fellow
Lehigh Valley Health Network
Allentown, Pennsylvania, United States
To compare placental histologic findings to perinatal outcomes from pregnant patients with COVID-19 based on predominant SARS-CoV-2 variant at time of infection.
Study Design:
Retrospective cohort study of pregnant patients between March 1, 2020 to February 28, 2023 with confirmed PCR-positive COVID-19 in singleton pregnancy > 6 weeks and available placental pathology. Exclusion criteria: patients with preexisting risk factors for abnormal placentation. Exposures: COVID-19 wild-type, Delta and Omicron strains. Primary outcomes: placental findings [maternal vascular malperfusion (MVM), fetal vascular malperfusion (FVM), and infectious/inflammatory findings], development of hypertensive disorders of pregnancy (HDP), and spontaneous or indicated preterm birth. Placental findings were categorized by strain, infection severity, trimester. Delivery timing was categorized by placental findings. Univariate techniques were utilized.
Results:
708 out of 1536 patients met inclusion criteria. COVID symptoms and placental findings were similar across strains (Table 1). The three cases of severe placental findings were seen in patients with Omicron that were asymptomatic or had mild symptoms. Four patients with severe/critical symptoms had non severe placental findings. HDP after COVID infection was similar across all strains (Table 1). The proportion of patients with placental findings was similar across all trimesters (Table 2). MVM was more common in full-term deliveries, likely explained by the common finding of villous infarction < 5%. Placental inflammatory/infectious findings were significantly associated with spontaneous preterm birth (45.9% vs. 24.5% full-term, 20.0% indicated preterm; p=0.01).
Conclusion:
Our data does not suggest a difference in placental findings based on COVID strain, infection severity, or trimester. Placental inflammatory/ infectious findings were most common in patients who experienced spontaneous preterm birth.
