COVID-19 and placenta-associated pregnancy complications: is there any connection?
Introduction. Women during pregnancy may be particularly susceptible to SARS-CoV-2 infection as physiological changes affect the cardiovascular, respiratory and immune systems. Several studies suggest that pregnant women who have had COVID-19 are not only at high risk for developing a severe infection, they also have an increased incidence of placental-associated pregnancy complications. The objective of this literature review was to establish pathogenetic relationships between COVID-19 and placenta-associated pregnancy complications. Materials and methods. International and Russian scientometric databases Google Sholar, ResearchGate, Pubmed, and Elibrary were used to analyze the scientific literature. Results and discussion. Severe COVID-19 is closely associated with preeclampsia, preterm birth, and other adverse perinatal outcomes. Pregnant women with SARS-CoV-2 infection are at higher risk of: maternal death, intensive care unit hospitalization, preterm birth and stillbirth. However, in some cases, the increased incidence of preeclampsia observed in mothers with SARS-CoV-2 may be related to misdiagnosis and iatrogenic preterm birth, as preeclampsia and COVID-19 may have similar symptoms. COVID-19 vaccination is recommended during pregnancy in high-risk groups to prevent severe maternal morbidity and adverse pregnancy and childbirth outcomes. Conclusion. COVID-19 increases the risk of placental-associated pregnancy complications. In some cases, COVID-19 mimics the clinical picture of preeclampsia, so careful differential diagnosis is required to reduce the incidence of iatrogenic preterm labor. Vaccination in pregnant women is a preventive measure against COVID-19 infection and its severe forms and may indirectly reduce in the incidence of major obstetric syndromes.