Researchers evaluated 38 placentas from pregnant women with and without Covid-19 to assess the organ and look for explanations. Photo: Bigstock
Covid-19 affects pregnant women and babies, and a new Brazilian study is helping to clarify how it happens. Researchers from the PUCPR, UFPR and the Pelé Pequeno Príncipe Research Institute evaluated 38 placentas of women with or without Covid-19 to check for differences and possible alterations in these organs.
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Located between the baby and the pregnant woman, the placenta is responsible for supplying oxygen and nutrients to the fetus. Precisely because of this function, it is a very vascularized organ, and thus becomes an easy target for Covid-19, especially in the most severe forms of the disease.
“We already knew that patients with Covid-19, even non-pregnant, can have vascular disease. And in pregnant women, it can also be seen. -19 cause thrombotic events there “, details Lúcia de Noronha, pathologist, professor at the PUCPR faculty of medicine and one of the authors of the study.
As a result of these thrombi (or blood clots), there is a blockage in the passage of blood from the pregnant woman to the baby, interrupting the flow of oxygen or food. “This impairs the well-being of the fetus, and in some cases the decision was made to remove the baby, even prematurely. In other cases, they died,” says the researcher.
According to Noronha, the novelty of the study was to show how Covid-19 affects the placenta, and why some babies died or had to be born before the deadline. “What the study showed is that, in severe forms of Covid-19, pregnant women, in addition to having lung disease, also have vascular disease,” he said.
To arrive at the results, the researchers evaluated 19 placentas from patients with Covid-19 and 19 others from patients without the disease, to serve as a control group. Then the samples were separated according to certain characteristics, such as gestational age, maternal age, and comorbidities. Thus, the placenta of a pregnant woman without Covid-19 but diabetic for example was evaluated in comparison with the placenta of another diabetic pregnant woman as well, but with a diagnosis of Sars-CoV-2 infection.
The results were published in the scientific journal Frontiers of Immunology at the end of May.
Severe Covid-19 and placentas
According to the results found in the study, Noronha reinforces that all forms of Covid-19 are not more at risk of harming the health of the pregnant woman or the baby, but mainly the moderate and severe forms.
“We were only able to identify changes in cases of pregnant women who had moderate to severe Covid-19. need oxygen support or intensive care, these had no complications, “he explains.
In view of the results, the pathologist warns: “If you are pregnant and have respiratory symptoms and a positive test for Covid-19, you must seek the obstetrician. Who determines fetal well-being is the obstetrician.
Inflammation or viral action?
Asked whether the damage to the placenta is due to a direct action of the coronavirus, or the inflammatory reaction triggered by the disease, researcher Lúcia de Noronha replies: the condition results from a mixture of the two cases.
“The inflammatory reaction causes the vascular reaction and damages the placental vessels. But in some cases, although few in number, we have seen the presence of the virus in the inflammation of the vessels. We have had few cases where we have been able to prove the presence of the virus, but it passes [via placenta] and it’s there. We even had a baby born with the Covid. He was fine, but he was born with the virus, ”he explains.