Perinatal outcomes and characteristics of placental disorders in term pregnancies among convalescents after novel coronavirus infection (COVID-19) experienced at different gestational ages
Kazachkova E.A., Voropaeva E.E., Ishchenko L.S., Kazachkov E.L., Kholopova A.Yu., Zatvornitskaya A.V., Shamaeva T.N.
Objective: To evaluate perinatal outcomes and the characteristics of placental disorders in term pregnancies among convalescents after COVID-19, experienced at different gestational ages.
Materials and methods: This study included 120 patients. The main group consisted of 80 women who gave birth at a gestational age of 370–416 weeks during the recovery period after COVID-19 and experienced various trimesters of pregnancy. The control group included 30 women without COVID-19 during their current pregnancy, who also gave birth at term. A retrospective analysis was conducted to assess obstetric and gynecological history, somatic pathology, course of pregnancy and childbirth, perinatal outcomes, and placental disorders.
Results: Convalescents after COVID-19, regardless of gestational age, who received low molecular weight heparin in prophylactic doses and vitamins C, E, and D in an extended regimen, exhibited favorable perinatal outcomes in term pregnancies. The most pronounced histological changes indicative of placental dysfunction were observed in cases in which COVID-19 was experienced during the second and third trimesters. In the placentas of convalescents at term, there was a statistically significant increase in the expression of the hypoxia markers HIF-1α and EPO compared to the control group. Additionally, a statistically significant increase in the apoptosis marker Caspase-3 was noted in the placentas of convalescents who experienced COVID-19 during the first and second trimesters.
Conclusion: Favorable perinatal outcomes were observed in convalescents with term pregnancies, regardless of the trimester in which the disease first manifested. However, pronounced histological and immunohistochemical changes in the placenta suggest the presence of placental insufficiency. Therefore, it is advisable to closely monitor this cohort of newborns from infancy to implement timely measures aimed at reducing the risk of potential long-term consequences.
Authors' contributions: Voropaeva E.E., Ishchenko L.S., Kazachkova E.A. – conception and design of the study; Voropaeva E.E., Ishchenko L.S. – data collection and processing; Ishchenko L.S., Kholopova A.Yu., Zatvornitskaya A.V., Shamaeva T.N. – data analysis; Kazachkova E.A., Ishchenko L.S. – drafting of the manuscript; Kazachkova E.A., Kazachkov E.L. – editing of the manuscript.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the South Ural State Medical University, Ministry of Health of the Russian Federation, Russia (Ref. No: 8 of 20.09.2021).
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Kazachkova E.A., Voropaeva E.E., Ishchenko L.S., Kazachkov E.L., Kholopova A.Yu., Zatvornitskaya A.V., Shamaeva T.N. Perinatal outcomes and characteristics
of placental disorders in term pregnancies among convalescents
after novel coronavirus infection (COVID-19) experienced at different gestational ages.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (8): 100-108 (in Russian)
https://dx.doi.org/10.18565/aig.2025.168
Keywords
pregnancy
COVID-19
convalescents
term delivery
histological and immunohistochemical changes in the placenta
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Received 24.06.2025
Accepted 01.07.2025
About the Authors
Ella A. Kazachkova, Dr. Med. Sci., Professor, Professor at the Department of Obstetrics and Gynecology, South Ural State Medical University, Ministry of Health of Russia,64 Vorovsky str., Chelyabinsk, 454000, Russia, +7(912)478-62-90, https://orcid.org/0000-0002-1672-7058
Ekaterina E. Voropaeva, Dr. Med. Sci., Professor, Professor at the Department of Pathological Anatomy and Forensic Medicine, South Ural State Medical University,
Ministry of Health of Russia, 64 Vorovsky str., Chelyabinsk, 454000, Russia; Chief Physician, Regional Perinatal Center, Chelyabinsk, Russia, +7(912)896-61-36,
https://orcid.org/0000-0002-9405-0134
Lyudmila S. Ishchenko, PhD, Associate Professor, Associate Professor at the Department of Obstetrics and Gynecology, South Ural State Medical University,
Ministry of Health of Russia, 64 Vorovsky str., Chelyabinsk, 454000, Russia; Obstetrician-Gynecologist, Regional Clinical Hospital No. 2, Chelyabinsk, Russia,
+7(919)352-91-14, lyudalyn@mail.ru, https://orcid.org/0000-0002-9405-0134
Evgeny L. Kazachkov, Dr. Med. Sci., Professor, Head of the Department of Pathological Anatomy and Forensic Medicine, South Ural State Medical University,
Ministry of Health of Russia, 64 Vorovsky str., Chelyabinsk, 454000, Russia, +7(912)323-39-74, https://orcid.org/0000-0002-4512-3421
Anna Yu. Kholopova, PhD student at the Department of Pathological Anatomy and Forensic Medicine, South Ural State Medical University, Ministry of Health of Russia,
64 Vorovsky str., Chelyabinsk, 454000, Russia, +7(922)231-63-66, https://orcid.org/0000-0001-5559-0069
Alexandra V. Zatvornitskaya, PhD, Teaching Assistant at the Department of Pathological Anatomy and Forensic Medicine, South Ural State Medical University,
Ministry of Health of Russia, 64 Vorovsky str., Chelyabinsk, 454000, Russia; Chief Physician, Regional Perinatal Center, Chelyabinsk, Russia, +7(919)400-75-35,
https://orcid.org/0000-0002-9245-3749
Tatiana N. Shamaeva, PhD, Associate Professor at the Department of Mathematics, Medical Informatics, Informatics and Statistics, South Ural State Medical University, Ministry of Health of Russia, 64 Vorovsky str., Chelyabinsk, 454000, Russia, +7(912)473-16-10, https://orcid.org/0000-0001-6327-2685
Corresponding author: Lyudmila S. Ishchenko, lyudalyn@mail.ru
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