Evaluating gestational stage of maternal SARS-CoV-2 infection on immune and inflammatory response & fetal outcomes
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Citation
Abstract
Despite the surge of research since the onset of the coronavirus disease 2019 (COVID-19) pandemic, the pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the placental microenvironment during pregnancy is still unclear. The indirect effect of the virus via maternal immune and inflammatory activation is implicated in adverse outcomes. This study aims to characterize the viral response in light of the fluctuating inflammatory states natural to pregnancy.
OBJECTIVE: To evaluate the impact of timing of maternal SARS-CoV-2 infection on systemic and placental immune and inflammatory response, and assess the risks and effects of infection at each gestational stage throughout pregnancy.
DESIGN, SETTING, AND PARTICIPANTS: Longitudinal prospective cohort study across 12 Boston area hospitals taking place over 5 years involving a study group divided into pregnant people infected with SARS-CoV-2 during different trimesters, matched with control group of non-infected pregnant people.
EXPOSURES: Maternal SARS-CoV-2 infection, as confirmed by polymerase chain reaction tests and antigen tests, during pregnancy.
MAIN OUTCOME MEASURES: immune and inflammatory systemic biomarkers, placental pathology at delivery and at dilation and curettage, pregnancy complications and mortality, maternal health (gestational diabetes, preeclampsia, HELLP - Hemolysis, Elevated Liver Enzymes, Low Platelets – syndrome), fetal mortality and health (size according to gestational age, birth weight, Apgar score, congenital abnormalities, neurodevelopmental disorders.)
IMPLICATIONS: pregnancy risk assessment, obstetrics clinical management, therapeutic targets, maternal health, fetal growth and development, public and mental health resources.