For people of reproductive age right now, one of the consistent questions about the novel coronavirus and the illnesses it can cause (like COVID-19) is what does it mean for pregnant people and those trying to conceive? As new information develops every day, researchers are beginning to get a better picture of the different ways the virus affects different bodies. And, according to a recent study published in American Journal of Clinical Pathology, researchers at Northwestern University’s Feinberg School of Medicine have found evidence of the virus “inducing some injury in the placenta” of pregnant people.
“There is an emerging consensus that there are problems with coagulation and blood vessel injury in COVID-19 patients,” senior author Dr. Jeffrey Goldstein, assistant professor of pathology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine pathologist, said. “Our finding support that there might be something clot-forming about coronavirus, and it’s happening in the placenta.”
According to a release about the study, researchers looked at a small group (16) of pregnant women who tested positive for COVID-19 and gave birth at Northwestern Medicine Prentice Women’s Hospita in early April. Of the group, four of the patients had flu-like symptoms three to five weeks before delivery, five patients never developed symptoms and the rest tested positive when they came in for delivery with some showing symptoms at the time of delivery.
— Jeff Goldstein (@JefferyAGoldst1) May 23, 2020
The release notes that “fourteen of the live-born infants in the study were born full term and with normal weights and Apgar scores. One live-born infant was premature.”
“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,” Goldstein said. “It doesn’t appear to be inducing negative outcomes in live-born infants, based on our limited data, but it does validate the idea that women with COVID should be monitored more closely.”
The release on the study cites previous research on pregnancies from the 1918-19 flu pandemic and the kids born out of them, which found trends of “lifelong lower incomes and higher rates of cardiovascular disease.” However, Goldstein notes that as flu doesn’t cross the placenta these issues were likely caused by “immune activity and injury to the placenta.”
“Not to paint a scary picture, but these findings worry me,” co-author Dr. Emily Miller, assistant professor of obstetrics and gynecology at Feinber, adds. “I don’t want to draw sweeping conclusions from a small study, but this preliminary glimpse into how COVID-19 might cause changes in the placenta carries some pretty significant implications for the health of a pregnancy. We must discuss whether we should change how we monitor pregnant women right now…“They were healthy, full-term, beautifully normal babies, but our findings indicate a lot of the blood flow was blocked off and many of the placentas were smaller than they should have been. Placentas get built with an enormous amount of redundancy. Even with only half of it working, babies are often completely fine. Still, while most babies will be fine, there’s a risk that some pregnancies could be compromised.”
Goldstein says that this study and others like it are key to helping researchers find the right questions to ask as more pregnant patients give birth during this pandemic.
“If you get the flu and you’re pregnant, we know nothing about what that looks like in your placenta, so I began thinking how we’d study this flu-like epidemic if it came through Chicago,” Goldstein said. “We started setting things up and then lo and behold, the epidemic came here, so we were ready.”
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