Impact of COVID-19 and Vaccination During Pregnancy on Placenta-Mediated Complications (COVIGRO Study)

COVID-19 has been associated with preterm birth (PTB) and placental-mediated complications, including fetal growth restriction and preeclampsia (PE). This study aimed to estimate the impact of COVID-19 and vaccination on adverse pregnancy outcomes and markers of placental function. We performed a study on a prospective cohort of women recruited in the first trimester of pregnancy during the early COVID-19 pandemic period (December 2020 to December 2021). At each trimester of pregnancy, the assessment included a questionnaire on COVID-19 and vaccination status; serological tests for COVID-19 (for asymptomatic infection); measurement of placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt-1) in maternal blood; measurement of mean uterine artery pulsatility index (UtA-PI); and pregnancy outcomes (PTB, PE, birth weight below the fifth and the tenth percentile). Among 788 patients with complete data, we observed 101 (13%) cases of symptomatic infection and 74 (9%) cases of asymptomatic infection with SARS-CoV-2. Most cases (73%) of infection were among women with previous vaccination or COVID-19 infection before pregnancy. COVID-19 infection was not associated with adverse pregnancy outcomes, abnormal fetal growth, sFlt-1/PlGF ratio, or mean UtA-PI. Vaccination during pregnancy did not influence these outcomes either. We observed no case of severe COVID-19 infection requiring respiratory support. Mild symptomatic or asymptomatic COVID-19 during pregnancy did not influence the risk of adverse pregnancy outcomes and the markers of placental function in predominantly vaccinated women. Fetal growth monitoring is unlikely to be mandatory in women with mild symptoms of COVID-19. La COVID-19 est associée à l’accouchement prématuré et à des complications à médiation placentaire, notamment le retard de croissance intra-utérin et la pré-éclampsie. Estimer l’effet de la COVID-19 et de la vaccination sur les issues de grossesse défavorables et sur les marqueurs de la fonction placentaire. Nous avons réalisé une étude de cohorte prospective concernant des femmes recrutées au premier trimestre de grossesse en début de pandémie de COVID-19 (décembre 2020 à décembre 2021). Chaque trimestre, les évaluations suivantes ont été réalisées : questionnaire sur le statut vaccinal et infectieux; dépistage sérologique de la COVID-19 (pour détecter l’infection asymptomatique); dosage du facteur de croissance placentaire (PlGF) et de la forme soluble du récepteur de