COVID-19 Infection in Pregnancy: PCR Cycle Thresholds, Placental Pathology, and Perinatal Outcomes

• Main Authors: Estibalitz Laresgoiti-Servitje, Jorge Arturo Cardona-Pérez, Rosa Gabriela Hernández-Cruz, Addy Cecilia Helguera-Repetto, María Yolotzin Valdespino-Vázquez, Elsa Romelia Moreno-Verduzco, Isabel Villegas-Mota, Sandra Acevedo-Gallegos, Mario Rodríguez-Bosch, Moisés León-Juárez, Mónica Aguinaga-Ríos, Irma Coronado-Zarco, Alejandro Ortiz-Calvillo, María Antonieta Rivera-Rueda, Carolina Valencia-Contreras, María de Lourdes Gómez-Sousa, Mario Solis-Paredes, Juan Carlos Rodriguez-Aldama, Rafael Galván-Contreras, Ricardo Figueroa-Damián, Manuel Cortés-Bonilla, Guadalupe Estrada-Gutierrez, Salvador Espino-y-Sosa, Claudine Irles
• Format: Article
• Language: English
• Published: MDPI AG 2021-09-01
• Series: Viruses
• Subjects: SARS-CoV-2; pregnancy; hypertensive disorder; placenta
• Online Access: https://www.mdpi.com/1999-4915/13/9/1884

(1) This study aimed to evaluate characteristics, perinatal outcomes, and placental pathology of pregnant women with or without SARS-CoV-2 infection in the context of maternal PCR cycle threshold (C_T) values. (2) This was a retrospective case-control study in a third-level health center in Mexico City with universal screening by RT-qPCR. The association of COVID-19 manifestations, preeclampsia, and preterm birth with maternal variables and C_T values were assessed by logistic regression models and decision trees. (3) Accordingly, 828 and 298 women had a negative and positive test, respectively. Of those positive, only 2.6% of them presented mild to moderate symptoms. Clinical characteristics between both groups of women were similar. No associations between C_T values were found for maternal features, such as pre-gestational BMI, age, and symptomatology. A significantly higher percentage of placental fibrinoid was seen with women with low C_Ts (<25; <i>p</i> < 0.01). Regarding perinatal outcomes, preeclampsia was found to be significantly associated with symptomatology but not with risk factors or C_T values (<i>p</i> < 0.01, aOR = 14.72). Moreover, 88.9% of women diagnosed with COVID-19 at <35 gestational weeks and symptomatic developed preeclampsia. (4) The data support strong guidance for pregnancies with SARS-CoV-2 infection, in particular preeclampsia and placental pathology, which need further investigation.