Maternal COVID-19 Exposure Risk during Pregnancy is Associated with Altered Placental Histopathology: An Exploratory Study from Kolkata, India
DOI:
https://doi.org/10.14738/bjhr.1304.12013Keywords:
COVID exposure risk, placental histopathology, vertical transmissionAbstract
Background: The impact of epidemiological exposure risk to COVID-19 remains unexplored, especially in pregnant women. This study, therefore, aims to investigate how exposure risk to COVID-19 during pregnancy influences the outcome and placental histopathology. Methods: A cohort of 60 pregnant women (30 control and 30 exposed) from Calcutta Medical Hospital and Calcutta National Medical College Hospital was studied. An exposure risk scoring system was assigned based on common COVID exposure routes such as contact frequency, clinical risk factors and symptom history. Clinical parameters were recorded and correlated with histopathological findings of haematoxylin-eosin-stained placental sections. Statistical analyses included Mann-Whitney U test, Chi-square test, Odds ratio estimation and Logistic regression. Findings: Higher pregnancy complications were observed in women with higher COVID-exposure risk women (odds ratio=4.5, p<0.05). Placental abnormalities were markedly elevated in the exposed-risk group with increased fibrin deposition (73.4% vs 13.15%, p<0.01), crowding of villi (9.4% vs 0%, p<0.01) and calcification (8.9% vs 2.1%, p<0.05). Normal histology was dramatically reduced among patients with higher exposure risk (7.83% vs 67%, p<0.01). Further, correlation analysis revealed that fibrin deposition, crowding of villi and syncytial knots were positively associated. While a higher exposure risk scores correlated with alterations in placental morphology, it did not serve as an independent predictor of overall clinical outcomes within this cohort. Conclusion: Even without active infection at delivery, maternal exposure risk to COVID-19 during pregnancy could be statistically associated with specific histopathological changes in the placenta, suggesting a potential subclinical impact. The innovative exposure risk scoring model developed here provides an effective framework for quantifying infection risk and its biological implications.
References
Duan L, Zheng Q, Zhang H, Niu Y, Lou Y. The SARS-CoV-2 Spike Glycoprotein Biosynthesis , Structure , Function , and Antigenicity : Implications for the Design of Spike-Based Vaccine Immunogens. 2020;11(October):1–12.
Sisman J, Jaleel MA, Moreno W, Rajaram V, Collins RRJ, Savani RC, et al. Intrauterine Transmission of SARS-COV-2 Infection in a Preterm Infant. Pediatr Infect Dis J. 2020 Sep;39(9):e265–7.
Ryan EE, Brar N, Allard G, Wang A, Winn VD, Folkins A, et al. Clinical Features of SARS-CoV-2 Infection During Pregnancy and Associated Placental Pathologies. Int J Gynecol Pathol. 2024 Jan
Peng Z, Wang J, Mo Y, Duan W, Xiang G, Yi M, et al. Unlikely SARS-CoV-2 vertical transmission from mother to child: A case report. J Infect Public Health. 2020 May;13(5):818–20.
Ponprabha R, Thiagarajan S, Balamurugesan K, Davis P. A Clinical Retrospective Study on the Transmission of COVID-19 From Mothers to Their Newborn and Its Outcome. Cureus.
Das ,Debajyoti, Das A. Statistics in Biology and Psychology. 6th ed. Academic Publishers;
Mutambudzi M, Niedzwiedz CL, Macdonald EB, Leyland AH, Mair FS, Anderson JJ, et al. Occupation and risk of severe COVID-19: prospective cohort study of 120,075 UK Biobank participants. 2021;78(5):307–14.
Mizukoshi A, Nakama C, Okumura J, Azuma K. Assessing the risk of COVID-19 from multiple pathways of exposure to SARS-CoV-2 : Modeling in health-care settings and effectiveness of nonpharmaceutical interventions. 2021;147.
Alghader MRM, Valvi D. Transmission and Risk Factors of COVID-19 among Health Care Workers.
Gaitens J, Condon M, Fernandes E, Mcdiarmid M. COVID-19 and Essential Workers : A Narrative Review of Health Outcomes and Moral Injury. Int J Environ Res Public Health [Internet]. 2021;18(1446). Available from: https://doi.org/10.3390/ijerph18041446
Wei C fu, Lan F yun, Hsu Y tien, Lowery N, Dibona L, Yang J. Risk of SARS-CoV-2 Infection Among Essential Workers in a Community-Based Cohort in the United States. Front Public Heal. 2022;10(May):10.878208.
Chatterjee S, Nalla LV, Sharma M, Sharma N, Singh AA, Malim FM, et al. Association of COVID-19 with Comorbidities: An Update. ACS Pharmacol Transl Sci. 2023;6(3):334–54.
Mukhra R. COVID-19 pandemic and “survival of the fittest.” J Infect Dev Ctries; 2021. p. 15(10):1384-1387.
Abdellatif Ibrahim N. Histological and Immunohistochemical Study on Human Placental Tissue in Normal Pregnancy and Preeclampsia. Cell Biol. 2014;2(6):72.
Kelehan P, Maes A, Mckay EM, Morgan TK, Nikkels PGJ. Sampling and Definitions of Placental Lesions. Arch Pathol Lab Med. 2016;140(July):698–713.
Indra S, Chalak K, Das P, Mukhopadhyay A. Placenta a potential gateway of prenatal SARS-CoV-2 infection: A review. Eur J Obstet Gynecol Reprod Biol. 2024;303(August):123–31.
Fredriksson L, Tidholm Qvist E, Sirotkina M, Pettersson K, Papadogiannakis N. Placental pathology in a large (Swedish) cohort of SARS-CoV-2 infected mothers. Placenta. 2024;145(December 2023):100–6.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Sulagna Mandal, Ruchira Mukherjee, Aditi Bhattacharyya, Sukumar Mitra, Pranab Kumar Biswas, Aparna Mukhopadhyay
This work is licensed under a Creative Commons Attribution 4.0 International License.
