The COVID-19 pandemic has caused worry for people across the world, particularly among people in vulnerable populations, such as the immunocompromised and elderly. Pregnant women have understandably been among the most concerned, worrying about potential ramifications for themselves and their babies.
A new study published in the American Journal of Clinical Pathology sought to examine the potential impact of COVID-19 on placentas. They examined 16 placentas delivered by women with confirmed cases of COVID-19.
It is really important to remember that a sample size of 16 is very small. Unfortunately, because COVID-19 is still so new, most of the studies being done have very small sample sizes. This means that the results can add to our knowledge base but do not define it.
In this study, compared to the placentas of women without COVID-19, the placentas studied were more likely to exhibit at least one complication. These included:
- Maternal vascular malperfusion, a condition in which blood does not flow through the placenta properly
- Abnormal or injured blood vessels within the placenta
- Intervillous thrombi, or blood clots within the placenta
Rates of inflammation were not noticed to be different among the placentas.
These types of placental complications can negatively impact the way that the blood flows between the mother and fetus.
Despite these findings, only one of the women developed high blood pressure, which is a potential complication of the aforementioned placental abnormalities.
Dr. Sarah Bjorkman, Motherly's Medical Advisor explained that "of the 16 patients whose placentas were examined, all but two delivered full-term babies with excellent newborn exams and safe discharge from the hospital within four days. One of these mothers had a preterm delivery at 34 weeks, in which the baby also had an excellent newborn exam and is doing well in the NICU. None of the infants tested positive for COVID-19. (The 16th patient had a miscarriage at 16 weeks and it is unclear if this was related to COVID-19.)"
"So, while this new finding is certainly fascinating and perhaps a bit worrisome," she continued, "it is also reassuring that all of the babies born had healthy outcomes."
Because the sample size of this study is incredibly small, we need to take the results with a grain of salt and commit to more investigation before we can state definitively that the virus hurts the placenta.
Coauthor of the study, Dr. Emily Miller, stated, "We must discuss whether we should change how we monitor pregnant women right now." She wonders if these findings mean that providers might consider closer monitoring during pregnancy, via ultrasounds.
Not all providers agree. Dr. Denise Jamieson contributed to the American College of Obstetricians and Gynecologists' (ACOG) advisory statement for how to care for pregnant women during the pandemic. Dr. Jamieson told CNN that "there are all sorts of risks in doing additional screening and testing, which can result in unanticipated outcomes." In other words, increased monitoring during pregnancy could do more harm than good. Screening and tests can give false results that prompt interventions that are later deemed to be unwarranted and maybe even harmful.
She continues, "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."
Although it is possible for newborns to be infected with COVID-19, outcomes have been positive—babies tend to do very well.
The Centers for Disease Control has stated that while it does not appear that COVID-19 impacts pregnant women differently than others, pregnant women are more at risk of getting sick with respiratory infections in general. Dr. Bjorkman agrees, saying, "thankfully, the growing data that we have right now does not suggest that pregnant women are more at risk for disease or worse outcomes from COVID-19."
So what does this mean for you?
First and foremost, do not panic. Easier said than done, I know.
Remember that your provider should still be your primary source of information and guidance on the best plan of care for your particular situation because there are so many variables; your geographic region, specific health concerns, the presence of non-COVID-19 pregnancy complications, your risk of exposure and more.
That said, these findings do indicate that we need to continue to take the virus seriously, especially as the country moves towards re-opening.
It is (beyond) tempting to want to get back to our pre-pandemic lives, but we still need to maintain caution. This includes the following recommendations:
- Stay home when possible
- Avoid large groups, crowded places, and people with symptoms or confirmed cases of COVID-19
- Wear a mask when out and about
- Wash your hands frequently, or use an alcohol-based hand sanitizer when hand washing is not an option
- Avoid touching your face
- Disinfect frequently-touched areas in your home
- Report any concerning symptoms to your provider. As a reminder, the symptoms of COVID-19 can be:
- Fever and chills
- Shortness of breath or difficulty breathing
- Loss of taste or smell
- Sore throats
- Nasal congestion
- Diarrhea or vomiting
Mama, this is unbelievably stressful. Please know that while this all feels overwhelming and scary, it is still incredibly possible to have a healthy, beautiful pregnancy and birth during the pandemic.
You are so brave, and you can do this.