SARS-CoV-2 Infection in Unvaccinated High-Risk Pregnant Women in the Bronx, NY, USA Is Associated with Decreased Apgar Scores and Placental Villous Infarcts.
SARS-CoV-2 Infection in Unvaccinated High-Risk Pregnant Women in the Bronx, NY, USA Is Associated with Decreased Apgar Scores and Placental Villous Infarcts.
复制标题
DOI：
10.3390/biom13081224
复制
发表时间：
2023-08-06
期刊：
影响因子：
5.5
通讯作者：
中科院分区：
文献类型：
--
作者：
严重急性呼吸道综合征冠状病毒2型（SARS-CoV-2）感染的母亲所生的婴儿患围产期疾病的风险更大，更有可能在生命的第一年接受神经发育诊断。然而，母体感染对胎盘功能和新生儿结局的影响因患者人群而异。我们开始测试我们的假设，即在我们的服务不足，社会经济上处于不利地位，大多数未接种疫苗，主要是非洲裔美国人和拉丁裔人口在布朗克斯，纽约州的母亲SARS-CoV-2感染将在出生时有明显的影响。在IRB批准下，从纽约州布朗克斯的蒙蒂菲奥里医疗中心（MMC）随机选择了56名在大流行“第一波”期间感染α和β病毒株的SARS-CoV-2阳性患者、48名在大流行“第二波”期间感染δ和Omicron病毒株的患者以及61名阴性的妊娠晚期高危患者。此外，来自耶鲁纽黑文医院的两例阳性病例作为对照。基于免疫组织化学、原位杂交和qPCR分析，所有104个由SARS-CoV-2阳性母亲分娩的胎盘均未被病毒感染。然而，与第二波病例或阴性对照相比，第一波病例中胎盘绒毛梗死显著增加。感染母亲有严重症状的新生儿在1分钟和5分钟时的Apgar评分明显较低。这些发现表明，即使没有进入胎盘，SARS-CoV-2也会影响各种全身途径，最终改变胎盘发育和功能，这可能会对胎儿产生不利影响，特别是在像我们这样的高危患者群体中。这些结果强调了孕妇接种疫苗的重要性，特别是在资源匮乏的地区。
Babies born to severe acute respiratory syndrome corona virus-2 (SARS-CoV-2)-infected mothers are at greater risk for perinatal morbidity and more likely to receive a neurodevelopmental diagnosis in the first year of life. However, the effect of maternal infection on placental function and neonatal outcomes varies depending upon the patient population. We set out to test our hypothesis that maternal SARS-CoV-2 infection in our underserved, socioeconomically disadvantaged, mostly unvaccinated, predominantly African American and Latina population in the Bronx, NY would have effects evident at birth. Under IRB approval, 56 SARS-CoV-2-positive patients infected during the “first wave” of the pandemic with alpha and beta strains of the virus, 48 patients infected during the “second wave” of the pandemic with delta and omicron strains and 61 negative third-trimester high-risk patients were randomly selected from Montefiore Medical Center (MMC), Bronx, NY. In addition, two positive cases from Yale New Haven Hospital, CT were included as controls. All 104 placentas delivered by SARS-CoV-2-positive mothers were uninfected by the virus, based on immunohistochemistry, in situ hybridization, and qPCR analysis. However, placental villous infarcts were significantly increased in first-wave cases compared to second-wave cases or negative controls. Significantly lower Apgar scores at 1 min and 5 min were observed in neonates born to infected mothers with severe symptoms. These findings suggest that even without entering the placenta, SARS-CoV-2 can affect various systemic pathways, culminating in altered placental development and function, which may adversely affect the fetus, especially in a high-risk patient population such as ours. These results underline the importance of vaccination among pregnant women, particularly in low-resource areas.
登录
查看更多内容
影响因子：
4
作者：
Tamanna S;Clifton VL;Rae K;van Helden DF;Lumbers ER;Pringle KG
通讯作者：
Pringle KG
影响因子：
1.7
作者：
Ko, Christine J.;Harigopal, Malini;McNiff, Jennifer M.
通讯作者：
McNiff, Jennifer M.
DOI：
10.3390/ijerph16132301
发表时间：
2019-07-01
影响因子：
--
作者：
Bleker, Laura S.;De Rooij, Susanne R.;Roseboom, Tessa J.
通讯作者：
Roseboom, Tessa J.
影响因子：
9.8
作者：
通讯作者：
--
影响因子：
7.8
作者：
Vimercati A;De Nola R;Battaglia S;Di Mussi R;Cazzato G;Resta L;Chironna M;Loconsole D;Vinci L;Chiarello G;Marucci M;Cicinelli E
通讯作者：
Cicinelli E