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. 2022 Mar 18;22(5):277–282. doi: 10.1038/s41577-022-00703-6

Fig. 1. Direct versus indirect effects of SARS-CoV-2 infection on the fetus and placenta.

Fig. 1

Maternal SARS-CoV-2 infection can impact pregnancy in numerous ways. The need for intensive care associated with severe disease can necessitate delivering the infant, causing an increased rate of preterm delivery. Placental infection can be associated with SARS-CoV-2 placentitis, which is associated with an increased risk of stillbirth. Even in the absence of placental infection, inflammatory changes are observed in the decidua and placenta, and these may be linked to the increased risk of pre-eclampsia associated with SARS-CoV-2 infection in pregnancy. SARS-CoV-2 can also be vertically transmitted to infect the fetus, although this is uncommon. Blue indicates indirect outcomes on the fetus and placenta associated with maternal infection with SARS-CoV-2, whereas red indicates outcomes associated with direct fetal infection.