SARS-CoV-2 infection during pregnancy: Does fetal MRI show signs of disrupted brain development?

Zielsetzung The COVID-19 pandemic has resulted in a plethora of acute and long-term diseases. Pregnant women seem to be more vulnerable to a SARS-CoV-2 infection. The purpose of this study was to use fetal MRI to investigate, whether fetal brain development might be affected in cases of uncomplicated SARS-CoV-2 infection during pregnancy, depending on viral variant and timepoint of infection (trimester).

Material und Methoden We analyzed MRI data of 67 pregnant women with PCR-proven wildtype/alpha (n=42) and delta/omicron (n=25) variant infections of SARS-CoV-2. The variant prevailing in Germany was respectively considered as the infection variant. Fetal-MRI scans were acquired at a 1.5 Tesla. T2-, T1-, and diffusion-weighted brain images were evaluated in consensus with a board-certified radiologist with 6 years of experience in fetal MRI. Cortical folding and structures of the brain stem and posterior fossa were assessed quantitatively according to Dovjak et al.

Ergebnisse The mean gestational age (GA) was 29.7 weeks [range 19–40] with a mean onset of symptoms at 19.5 weeks GA [range 3-34]. The assessed opercularisation of the Sylvian fissure as a measure of the cortical folding and transverse cerebellar diameter were age-appropriate in all fetuses. Furthermore, a.p.-diameter and craniocaudal extent of pons, medulla oblongata, midbrain and cerebellar vermis were all within age-appropriate reference values, independent of viral variant, timepoint of infection and materal vaccination. No signs of hemorrhage, calcifications or edema were detected.

Schlussfolgerungen In 67 cases of mild SARS-CoV-2 infection during pregnancy all fetuses showed unremarkable brain development on fetal MRI, including cortical folding and brain stem segmentation. There were no findings indicative of infection of the fetal brain, independent of viral variant and timepoint of infection. Inclusion of further participants is warranted, especially to disentangle the effect of vaccination vs viral variant.

Publication History

Article published online:
13 April 2023