Şahin Orhan, Altay Ali Yılmaz, Aydın Emine, Bağcı Helin, Yalçın Özben
Sarıyer Hamidiye Etfal Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.
University of Health Sciences Turkey, Prof. Dr. Cemil Taşcıoğlu City Hospital, Clinic of Pathology, İstanbul, Turkey.
Turk J Obstet Gynecol. 2022 Sep 23;19(3):178-186. doi: 10.4274/tjod.galenos.2022.94984.
To clarify the effect of asymptomatic coronaviruse disease-2019 (COVID-19) positivity on the placenta in the third trimester of pregnancy.
This prospective, case-control study included 30 pregnant women diagnosed with asymptomatic COVID-19 between April 30, 2021 and July 20, 2021 who delivered after the 34 gestational week, and a control group of 30 pregnant women without COVID-19, who delivered between April 2021 and July 2021, matched to the study group regarding age, gestational age and body mass index. Outcomes were compared in terms of demographic characteristics, serum blood outcomes, neonatal results, complications and placental histopathological findings.
The mean age of the study population was 28.8 years and the mean gestational week was 38.2 weeks. The C-reactive protein levels (38.2 mg/L vs 5.8 mg/L, p=0.001) and ferritin levels (266.4 μg/L and 40.5 μg/L, p=0.001) were significantly higher in the COVID-19-positive pregnant women. The lymphocyte level was significantly higher in the non-COVID-19 pregnant women (p=0.040). Mural hypertrophy was determined at a significantly higher rate in COVID-positive pregnant women (83.3% vs 30.0%, p=0.001). Multivariate regression analysis showed that only COVID-19 positivity increased the presence of mural hypertrophy in pregnant women with asymptomatic COVID-19 (4.716-fold, 95% confidence interval=1.012-22.251).
The results of this study demonstrated that asymptomatic COVID-19 had no significant effect on pregnancy and neonatal complications. However, mural hypertrophy in the placenta was found at a significantly higher rate in pregnant women with asymptomatic COVID-19.
为阐明2019冠状病毒病(COVID-19)无症状阳性对妊娠晚期胎盘的影响。
这项前瞻性病例对照研究纳入了2021年4月30日至2021年7月20日期间诊断为无症状COVID-19且在孕34周后分娩的30名孕妇,以及2021年4月至7月期间分娩的30名无COVID-19的孕妇作为对照组,对照组在年龄、孕周和体重指数方面与研究组匹配。比较了两组在人口统计学特征、血清学指标、新生儿结果、并发症和胎盘组织病理学发现等方面的情况。
研究人群的平均年龄为28.8岁,平均孕周为38.2周。COVID-19阳性孕妇的C反应蛋白水平(38.2mg/L对5.8mg/L,p=0.001)和铁蛋白水平(266.4μg/L对40.5μg/L,p=0.001)显著更高。非COVID-19孕妇的淋巴细胞水平显著更高(p=0.040)。COVID阳性孕妇中确定有壁层肥大的比例显著更高(83.3%对30.0%,p=0.001)。多因素回归分析显示,在无症状COVID-19孕妇中,只有COVID-19阳性会增加壁层肥大的发生率(4.716倍,95%置信区间=1.012-22.251)。
本研究结果表明,无症状COVID-19对妊娠和新生儿并发症无显著影响。然而,无症状COVID-19孕妇中胎盘壁层肥大的发生率显著更高。