SARS-CoV-2 Placentitis Associated With B.1.617.2 (Delta) Variant and Fetal Distress or Demise

In this brief report, we present 2 cases of fetal demise and 1 case of severe fetal distress in maternal delta-variant SARS-CoV-2 infection. SARS-CoV-2 placentitis may be a potential mechanism for the increased stillbirth risk observed in delta-variant COVID-19. There is limited information on the specific impact of maternal infection with the SARS-CoV-2 B.1.617.2 (delta) variant on pregnancy outcomes. We present 2 cases of intrauterine fetal demise and 1 case of severe fetal distress in the setting of maternal infection with delta-variant SARS-CoV-2. In all cases, fetal demise or distress occurred within 14 days of COVID-19 diagnosis. Evaluation revealed maternal viremia, high nasopharyngeal viral load, evidence of placental infection with delta-variant SARS-CoV-2, and hallmark features of SARS-CoV-2 placentitis. We suggest that delta-variant SARS-CoV-2 infection during pregnancy warrants vigilance for placental dysfunction and fetal compromise regardless of disease severity.

Automated summary

In this brief report, 2 cases of fetal demise and 1 case of severe fetal distress in maternal delta-variant SARS-CoV-2 infection are presented. SARS-CoV-2 placentitis may be a potential mechanism for the increased risk of stillbirth observed in delta-variant COVID-19. Limited information is available on the specific impact of maternal infection with the SARS-CoV-2 B.1.617.2 (delta) variant on pregnancy outcomes.