Influence of infection during pregnancy on fetal development.
Influence of infection during pregnancy on fetal development.
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DOI：
10.1530/rep-13-0232
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
McAdams RM
中科院分区：
文献类型：
--
作者：
Adams Waldorf KM;McAdams RM
被细菌、病毒和寄生虫感染可能会导致胎儿死亡、器官损伤或有限的后遗症，具体取决于病原体。在这里，我们考虑怀孕期间感染对胎儿发育的作用，包括胎盘发育和功能，这可能导致胎儿生长受限。典型的致畸病原体被称为TORCH(弓形虫，其他如梅毒螺旋体、风疹病毒、巨细胞病毒、单纯疱疹病毒)，但应包括更广泛的病原体组，包括细小病毒B19、水痘带状疱疹病毒和恶性疟原虫等。在这篇综述中，我们描述了不同的宫内感染对胎儿发育的影响以及对新生儿的短期和长期结局。在某些情况下，这些病原体用来扰乱胎儿发育的机制是众所周知的。发育中的胎儿肺和脑的细菌感染开始于炎症级联反应，导致细胞因子损伤和氧化应激。对于一些病原体，如恶性疟原虫，其机制涉及氧化应激和细胞凋亡，以扰乱胎盘和胎儿的生长。宫内感染也可能影响婴儿的长期健康；在许多情况下，宫内病毒感染会增加儿童患1型糖尿病的风险。了解这些病原体使用的不同机制可能使治疗能够减缓胎儿发育的变化，减少早产，并提高存活率。
Infection by bacteria, viruses and parasites may lead to fetal death, organ injury or limited sequelae depending on the pathogen. Here we consider the role of infection during pregnancy on fetal development including placental development and function, which can lead to fetal growth restriction. The classic group of teratogenic pathogens are referred to as “TORCH” (Toxoplasma gondii, Others like Treponema pallidum, Rubella virus, Cytomegalovirus, Herpes simplex virus), but should include a much broader group of pathogens including Parvovirus B19, Varicella zoster virus, and Plasmodium falciparum to name a few. In this review, we describe the influence of different infections in utero on fetal development and the short- and long-term outcomes for the neonate. In some cases, the mechanisms used by these pathogens to disrupt fetal development are well known. Bacterial infection of the developing fetal lungs and brain begins with inflammatory cascade resulting in cytokine injury and oxidative stress. For some pathogens like P. falciparum, the mechanisms involve oxidative stress and apoptosis to disrupt placental and fetal growth. An in utero infection may also impact the long-term health of the infant; in many cases, a viral infection in utero increases the risk of developing Type 1 diabetes in childhood. Understanding the varied mechanisms employed by these pathogens may enable therapies to attenuate changes in fetal development, decrease preterm birth, and improve survival.