Department of Gynecology and Obstetrics, Integrated Research Center for Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Division of Pediatric Infectious Diseases, Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Am J Reprod Immunol. 2020 Nov;84(5):e13306. doi: 10.1111/aji.13306. Epub 2020 Aug 15.
Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused over 12 million infections and more than 550 000 deaths. Morbidity and mortality appear partly due to host inflammatory response. Despite rapid, global research, the effect of SARS-CoV-2 on the developing fetus remains unclear. Case reports indicate that vertical transmission is uncommon; however, there is evidence that placental and fetal infection can occur. Placentas from infected patients show inflammatory, thrombotic, and vascular changes that have been found in other inflammatory conditions. This suggests that the inflammatory nature of SARS-CoV-2 infection during pregnancy could cause adverse obstetric and neonatal events. Exposure to intrauterine inflammation and placental changes could also potentially result in long-term, multisystemic defects in exposed infants. This review will summarize the known literature on the placenta in SARS-CoV-2 infection, evidence of vertical transmission, and possible outcomes of prenatal exposure to the virus.
自 2019 年 12 月以来，严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）已导致超过 1200 万人感染和超过 55 万人死亡。发病率和死亡率部分归因于宿主炎症反应。尽管全球研究进展迅速，但 SARS-CoV-2 对发育中胎儿的影响仍不清楚。病例报告表明，垂直传播并不常见；然而，有证据表明胎盘和胎儿感染可能发生。来自感染患者的胎盘显示出炎症、血栓形成和血管变化，这些变化在其他炎症情况下也有发现。这表明 SARS-CoV-2 感染在怀孕期间的炎症性质可能导致不良的产科和新生儿事件。宫内炎症和胎盘变化的暴露也可能导致暴露婴儿长期、多系统缺陷。这篇综述将总结 SARS-CoV-2 感染中胎盘的已知文献、垂直传播的证据以及产前暴露于该病毒的可能后果。
