Coronavirus Disease 2019 (COVID-19) and Hypertensive Disorders of Pregnancy: Is the Placenta the Problem?

We hypothesized that COVID-19 exerts its effects of increasing the risk of hypertensive disorders of pregnancy through placental infection and inflammation. Placental pathology reports were analyzed from patients who tested positive for COVID-19 infection in pregnancy (n=70) and those who did not (n=210). Other factors including patient demographics and co-morbid conditions were obtained from the electronic medical record. Compared with pregnancies negative for COVID-19 infection, maternal COVID-19 infection was not associated with increased incidence of placental pathology including acute funisitis, acute chorioamnionitis, chronic villitis, chorionic pseudocysts, decidual necrosis, Tenney Parker changes, intervillous hemorrhage, infarcts, villous calcifications, meconium-stained amniotic fluid, inflammatory changes or vascular VTE changes. Based on the logistic regression analysis, after controlling for other variables in the model, the risk of developing HDP was 72.4% higher in patients who tested positive for COVID-19 versus those who did not (OR 1.72, 95% CI [1.09, 2.73], p=0.02).