SARS-CoV-2 placentitis, and how maternal COVID-19 vaccination could prevent stillbirth

Drucilla J. Roberts, MD, from the Mass General Department of Pathology and colleagues recently published a literature review in the American Journal of Obstetrics & Gynecology, titled SARS-CoV-2 Placentitis, Stillbirth and Maternal COVID-19 Vaccination: Clinical-Pathological Correlations.

What was the question you set out to answer with this review?

Stillbirth is a recognized complication of COVID-19 in pregnant women that has recently been demonstrated to be caused by SARS-CoV-2 infection of the placenta.

This infection caused by the virus has been termed SARS-CoV-2 placentitis, and can negatively impact more than 75% of the placenta, effectively rendering it incapable of performing its function of providing oxygen to the fetus.

To combat this occurrence, we wanted to know if vaccination against SARS-CoV-2 protects against stillbirth that is caused by SARS-COV-2 placentitis.

What are two or three key takeaways?

• In all reported cases of SARS-CoV-2 placentitis causing stillbirth and neonatal death, the mothers were unvaccinated.
• The development of SARS-CoV-2 placentitis likely involves both viral and immunological factors.
• Maternal COVID-19 vaccination may be life-saving for the fetus as well as the mother.

What were your conclusions?

After reviewing the relationship between stillbirth and vaccination of mothers, we have found that vaccination appears to protect against COVID-19 related stillbirth.

Pregnant women with COVID-19 have an increased risk for stillbirth compared to uninfected women, and those who vaccinate can more effectively prevent adverse conditions such as SARS-CoV-2 placentitis, infant death, preterm birth, and stillbirth.

What are the potential clinical implications of your work?

As far as clinical implications of this review, it is evident that pregnant people should be encouraged to get vaccinated against SARS-CoV-2, to prevent adverse health events. 

Paper cited:

Schwartz, D. A., Mulkey, S. B., & Roberts, D. J. (2022). SARS-CoV-2 Placentitis, Stillbirth and Maternal COVID-19 Vaccination: Clinical-Pathological Correlations. American journal of obstetrics and gynecology, S0002-9378(22)00800-6. Advance online publication. https://doi.org/10.1016/j.ajog.2022.10.001

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