Pregnant Women With COVID-19 Suffer From Placenta Damage, New Study Shows
"I think we need to be careful about jumping to what that means clinically in terms of care of pregnant women with COVID-19."
One of the pressing concerns for many pregnant mums, especially since the start of the COVID-19 pandemic is how the virus could affect her unborn baby.
In a new but small study of 16 pregnant women with COVID-19, published in the American Journal of Clinical Pathology, researchers found that all 16 women showed evidence of injury inflicted on the placenta during routine testing at a Chicago hospital.
Importance of the Placenta in Pregnancy
The placenta is the first organ that develops in the uterus during pregnancy, according to Mayoclinic, and is responsible for providing oxygen and nutrients to the developing foetus. Acting as the foetus’ lungs, gut, kidneys and liver, it also helps to remove waste products from the baby’s blood.
However, there are instances whereby the placenta’s health may be affected, such as during a break in an expectant mum’s water before labour, high blood pressure, multiple pregnancies, blood-clotting disorders among others.
Pathological exams were carried out on the mothers following their baby’s birth at Northwestern Medicine Prentice Women’s Hospital between March 18 and May 5.
COVID-19 Effects on Placenta: Impaired Blood Flow From Mum to Foetus
Out of the 16 pregnancies, one pregnancy was reported as a miscarriage which happened in the second trimester. All babies, however, were said to be born healthy and free from COVID-19.
“Most of these babies were delivered full-term after otherwise normal pregnancies, so you wouldn’t expect to find anything wrong with the placentas, but this virus appears to be inducing some injury in the placenta,” Dr Jeffrey Goldstein, assistant professor of pathology at Northwestern University and study author, said in a statement.
In addition, the study revealed that 12 of the women experienced impaired blood flow from mother to foetus (known as vascular malperfusion), as well as blood clots in the placenta.
“These findings support that there might be something clot-forming about coronavirus, and it’s happening in the placenta,” Goldstein told Reuters.
And in the face of placental blood flow issues, it could lead to growth issues in utero or in severe cases, central nervous system injury or even stillbirth.
Urged Close Monitoring of Pregnant Women
With regards to the miscarriage in one of the women, researchers were unable to ascertain if it is due to COVID-19 or how the damage to the placenta had caused it as she “was asymptomatic“, said Goldstein.
While “there are no known placental findings associated with the common coronaviruses”, the authors said it is the largest examination of placenta health till date despite the small study size.
But with these findings, it suggests that increased antenatal surveillance for women with COVID-19 may be warranted.
Coauthor of the study, Northwestern Medicine obstetrician Dr. Emily Miller, urged that changes should be made on how pregnant women are monitored today.
According to her, it could be “done by testing the oxygen delivery of the placenta during the pregnancy and following the growth of babies via ultrasounds”.
However, insights from the study does not mean that one should “jump the gun” in tackling this issues, said Jamieson who chairs the department of gynaecology and obstetrics at Emory University School of Medicine in Atlanta.
According to Jamieson, doing additional screening and testing involves “all sorts of risks”, which can result in unanticipated outcomes.
“This study raises more questions than it answers. Looking at the placenta will help us understand what’s going on in pregnancy, but I think we need to be careful about jumping to what that means clinically in terms of care of pregnant women with Covid-19.”
Encouraging Results for Mums
One positive finding that emerged from the research is the unlikelihood of COVID-19 positive mothers passing on coronavirus to their unborn baby, even though it appears to inflict damage onto the placenta.
Despite a blockage in blood flow and “many of the placentas were smaller than they should have been [sic]”, said Miller, newborns from the study were “healthy, full-term, beautifully normal babies”.
This is also consistent with Goldstein findings, who said: “It doesn’t appear to be inducing negative outcomes in live-born infants, based on our limited data.”
What Should Mums-to-be Take Note
The same precautionary measures recommended for everyone applies to pregnant mums, from washing hands regularly, wearing a mask when outdoors and to avoid touching the face.
Mums are also reminded to “stop worrying unnecessarily”, said Jamieson. It is a “better time than ever for pregnant women to ask and receive assistance,” she said.
According to her, there are many great reasons to pamper pregnant women, which could come in the form of asking family members to help with running errands, filling up the gas, getting groceries, among others.
Experts also advise pregnant mums to reach out to their ob-gyn to seek help or if there are any concerns.