COVID in pregnant women manifests by variant in developing offspring: MRI study
Prenatal MRI is adept at revealing potentially damaging placental lesions affecting fetuses whose mothers were infected with COVID-19 while carrying.
So report researchers who conducted a prospective, case-control study in Austria and published their findings in The Lancet Regional Health–Europe [1].
The team further found changes of concern are more conspicuous in pre-Omicron strains of the virus than in Omicron variants.
This may help explain previously identified abnormalities associated with maternal COVID infection, such as stunted fetal size, the authors suggest.
For the study, Gregor Kasprian, MD, MBA, and colleagues at the Medical University of Vienna worked with two obstetric centers that consecutively referred pregnant women for prenatal MRI after confirmed SARS-CoV-2 infection.
The project included 38 prenatal MRI scans of women with confirmed COVID infection and 38 uninfected controls matched for MRI field strength and gestational age.
The team found 20 of the 38 COVID-positive cases had pre-Omicron variants while the other 18 had Omicron.
Further, performing prenatal MRI an average of 83 days after the first positive polymerase chain reaction (PCR) test, Kasprian and co-researchers found:
- Both pre-Omicron and Omicron groups showed abnormalities in the form of a globular placenta compared to control cases.
- Placentas in the pre-Omicron group were significantly thickened and showed significantly more frequent lobules and hemorrhages.
- Fetal growth restriction (FGR) was observed in five of 20 cases (25%) in the pre-Omicron group.
In their discussion the authors note the reliance of previous research in this area on histopathologic studies, suggesting their study may be the first to substitute prenatal MRI.
“SARS-CoV-2 infections in pregnancy can lead to placental lesions based on vascular events, which can be well visualized on prenatal MRI,” Kasprian et al. conclude. “Pre-Omicron variants cause greater damage than Omicron sub-lineages in this regard.”
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In possible upcoming future variants with similar pathogenetic mechanisms as, for instance, the Delta variant, the placenta should be monitored closely with respect to vascular lesions and potential fetal impairment.”
The study is available in full for free.