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孕妇感染 COVID-19 后的免疫反应和产科结局及其对后代可能的健康风险。

Maternal immune responses and obstetrical outcomes of pregnant women with COVID-19 and possible health risks of offspring.

机构信息

Department of Obstetrics and Gynecology, Fortaleza University (UNIFOR), Fortaleza, CE, 60.811-905, Brazil; CONCEPTUS - Reproductive Medicine, Fortaleza, CE, 60.170-240, Brazil.

Department of Pediatrics, Fortaleza University (UNIFOR), Fortaleza, CE, 60.811-905, Brazil.

出版信息

J Reprod Immunol. 2021 Feb;143:103250. doi: 10.1016/j.jri.2020.103250. Epub 2020 Nov 19.

Abstract

Coronavirus disease 2019 (COVID-19) pandemic has spread rapidly across the world. The vast majority of patients with COVID-19 manifest mild to moderate symptoms but may progress to severe cases or even mortalities. Young adults of reproductive age are the most affected population by SARS-CoV-2 infection. However, there is no consensus yet if pregnancy contributes to the severity of COVID-19. Initial studies of pregnant women have found that COVID-19 significantly increases the risk of preterm birth, intrauterine growth restriction, and low birth weight, which have been associated with non-communicable diseases in offspring. Besides, maternal viral infections with or without vertical transmission have been allied with neurological and behavioral disorders of the offspring. In this review, obstetrical outcomes of women with COVID-19 and possible risks for their offspring are discussed by reviewing maternal immune responses to COVID-19 based on the current evidence. Structural and systemic follow-up of offspring who are exposed to SARS-CoV-2 in-utero is suggested.

摘要

2019 年冠状病毒病(COVID-19)大流行在全球迅速蔓延。绝大多数 COVID-19 患者表现为轻症至中度症状,但可能进展为重症病例甚至死亡。处于生育年龄的年轻成年人是受 SARS-CoV-2 感染影响最严重的人群。然而,目前尚无共识认为妊娠是否会加重 COVID-19 的严重程度。对孕妇的初步研究发现,COVID-19 显著增加了早产、宫内生长受限和低出生体重的风险,这些与后代的非传染性疾病有关。此外,母体病毒感染(无论有无垂直传播)与后代的神经和行为障碍有关。在这篇综述中,我们根据现有证据,通过回顾 COVID-19 对母体免疫的反应,讨论了 COVID-19 孕妇的产科结局及其对后代的可能风险。建议对宫内暴露于 SARS-CoV-2 的后代进行结构和系统随访。

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