SARS-CoV-2 in the first trimester of pregnancy: potential interference in placentation

Silva, João Victor Farias da; Silva, Katheryne Suellen Cavalcante; Santos, Valdeci Elias dos

doi:10.1080/14767058.2020.1792879

The Journal of Maternal-Fetal & Neonatal Medicine

2020

DOI: 10.1080/14767058.2020.1792879

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SARS-CoV-2 in the first trimester of pregnancy: potential interference in placentation

João Victor Farias da Silva

Katheryne Suellen Cavalcante Silva²,

Valdeci Elias dos Santos

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Cited by 3 publications

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“…disorders since placentation, with consequent damage to uteroplacental circulation and fetal development [11]. In those in the second or third trimester of pregnancy, on the other hand, there may be a greater risk of adverse events, such as those already identified in mothers infected with SARS-CoV-2: Prematurity, low birth weight, neonatal asphyxia, fetal death, neonatal death and newborn with a diagnosis of COVID-19 (even without knowledge about vertical transmission) [12].…”

mentioning

confidence: 99%

Imbalances Caused by SARS-CoV-2 during Pregnancy: Considerations for Long-Term Obstetric and Gynecological Care

da¹,

Santos²

2021

Int J Women's Health Wellness

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SARS-CoV-2, responsible for the outbreak of severe acute respiratory syndrome corona virus 2 and the current pandemic, is one of seven species of coronavirus that infect humans and is among the three that are potentially fatal. Its pathophysiology, although not fully understood, has been characterized by causing immunological imbalance, inflammatory storm, tissue damage with pulmonary impairment and potential dysfunction of multiple organs and disorders in the coagulation system. Even after the cure of COVID-19, in pregnant or postpartum women, add to the physiological changes characteristic of the period and may be exacerbated and/or responsible for a higher risk of complications or long-term gynecological or obstetric diseases.

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mentioning

confidence: 99%

Imbalances Caused by SARS-CoV-2 during Pregnancy: Considerations for Long-Term Obstetric and Gynecological Care

da¹,

Santos²

2021

Int J Women's Health Wellness

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“…There are a few case reports of miscarriage with SARS-CoV-2 infection in early pregnancy, but there are also reports of women with infection early in gestation who recover and have healthy, term infants. [23][24][25] Data on the effects of maternal SARS-CoV-2 infection on the fetus/neonate are limited, partly because of the lack of collection of appropriate laboratory specimens. In utero mother-to-child transmission of SARS-CoV-2 appears rare.…”

mentioning

confidence: 99%

Effect of SARS-CoV-2 Infection in Pregnancy on Maternal and Neonatal Outcomes in Africa: An AFREhealth Call for Evidence through Multicountry Research Collaboration

Nachega

Sam-Agudu

Budhram

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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. In the African context, there is a paucity of data on SARS-CoV-2 infection and associated COVID-19 in pregnancy. Given the endemicity of infections such as malaria, HIV, and tuberculosis (TB) in sub-Saharan Africa (SSA), it is important to evaluate coinfections with SARS-CoV-2 and their impact on maternal/infant outcomes. Robust research is critically needed to evaluate the effects of the added burden of COVID-19 in pregnancy, to help develop evidence-based policies toward improving maternal and infant outcomes. In this perspective, we briefly review current knowledge on the clinical features of COVID-19 in pregnancy; the risks of preterm birth and cesarean delivery secondary to comorbid severity; the effects of maternal SARS-CoV-2 infection on the fetus/neonate; and in utero mother-to-child SARS-CoV-2 transmission. We further highlight the need to conduct multicountry surveillance as well as retrospective and prospective cohort studies across SSA. This will enable assessments of SARS-CoV-2 burden among pregnant African women and improve the understanding of the spectrum of COVID-19 manifestations in this population, which may be living with or without HIV, TB, and/or other coinfections/comorbidities. In addition, multicountry studies will allow a better understanding of risk factors and outcomes to be compared across countries and subregions. Such an approach will encourage and strengthen much-needed intra-African, south-to-south multidisciplinary and interprofessional research collaborations. The African Forum for Research and Education in Health’s COVID-19 Research Working Group has embarked upon such a collaboration across Western, Central, Eastern and Southern Africa.

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First-Trimester SARS-CoV-2 Infection: Clinical Presentation, Inflammatory Markers, and Obstetric Outcomes

Trilla¹,

Móra²,

Crovetto³

et al. 2022

Fetal Diagn Ther

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Objective: Second and third trimester SARS-CoV-2 infections may have an increased risk of obstetric complications. However, data on first-trimester infections are scarce. We sought to characterize the clinical and inflammatory presentation, and pregnancy outcomes of first-trimester infections. Methods: A population-based multicenter study including 817 singleton pregnancies with SARS-CoV-2 serologic testing at 8-14 weeks between March and May 2020. Blood count, uterine artery Doppler and pregnancy-associated plasma protein A (PAPP-A) were performed in all women. Placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), IL-6 and ferritin were determined in positive women. Obstetric outcomes were evaluated. Results: The prevalence of first-trimester infection was 15.2% (n=124). 72.6% of positive women were asymptomatic. Symptomatic women had higher rates of lymphopenia (1.91x109/L vs 2.16x109/L, P=0.017), and increased levels of IL-6 (9.1% vs 1.2%, P=0.051), but lower rates of decreased ferritin (6.3% vs 19.8%, P=0.015). PAPP-A was higher in symptomatic women compared with asymptomatic and negative women (1.44 (IQR 0.90-1.82) vs 1.08 (IQR 0.66-1.61) P=0.014, vs 1.08 (IQR 0.77-1.55) P=0.019, respectively). Obstetric outcomes were not increased. Conclusions: First-trimester SARS-CoV-2 infections are mostly asymptomatic, with a mild increase of inflammatory markers in symptomatic women. Obstetric complications were not increased, but PAPP-A levels were higher in symptomatic women.

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SARS-CoV-2 in the first trimester of pregnancy: potential interference in placentation

Cited by 3 publications

References 5 publications

Imbalances Caused by SARS-CoV-2 during Pregnancy: Considerations for Long-Term Obstetric and Gynecological Care

Imbalances Caused by SARS-CoV-2 during Pregnancy: Considerations for Long-Term Obstetric and Gynecological Care

Effect of SARS-CoV-2 Infection in Pregnancy on Maternal and Neonatal Outcomes in Africa: An AFREhealth Call for Evidence through Multicountry Research Collaboration

First-Trimester SARS-CoV-2 Infection: Clinical Presentation, Inflammatory Markers, and Obstetric Outcomes

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