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妊娠期、胎盘、胎儿和新生儿的冠状病毒病。

Coronavirus Diseases in Pregnant Women, the Placenta, Fetus, and Neonate.

机构信息

Department of Pathology, Medical College of Georgia, Augusta University, Augusta, GA, USA.

Boston University School of Medicine, Boston, MA, USA.

出版信息

Adv Exp Med Biol. 2021;1318:223-241. doi: 10.1007/978-3-030-63761-3_14.

Abstract

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the etiological agent of coronavirus disease 2019 (COVID-19), is similar to two other coronaviruses, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), in causing life-threatening respiratory infections and systemic complications in both children and adults. As the COVID-19 pandemic has continued to spread globally, increasing numbers of pregnant women have become infected, raising concern not only for their health but also for the health of their infants. This chapter discusses the effects of coronavirus infections, e.g., MERS, SARS, and COVID 19, on pregnancy and describes the evolving knowledge of COVID 19 among pregnant women. The physiological changes that occur in pregnancy, especially changes in the immune system, are reviewed in terms of their effect on susceptibility to infectious diseases. The effects of COVID-19 on the placenta, fetus, and neonate are also reviewed, including potential clinical outcomes and issues relating to testing and diagnosis. The potential mechanisms of vertical transmission of the virus between pregnant women and their infants are analyzed, including intrauterine, intrapartum, and postpartum infections. Several recent studies have reported the detection of SARS-CoV-2 in tissues from the fetal side of the placenta, permitting the diagnosis of transplacental infection of the fetus by SARS-CoV-2. Placentas from infected mothers in which intrauterine transplacental transmission of SARS-CoV-2 has occurred demonstrate an unusual combination of pathology findings which may represent risk factors for placental as well as fetal infection.

摘要

严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)是导致 2019 年冠状病毒病(COVID-19)的病原体,它与另外两种冠状病毒,即严重急性呼吸综合征冠状病毒(SARS-CoV)和中东呼吸综合征冠状病毒(MERS-CoV)在导致儿童和成人威胁生命的呼吸道感染和全身并发症方面相似。随着 COVID-19 大流行在全球范围内持续蔓延,越来越多的孕妇感染了这种病毒,这不仅引起了人们对她们健康的关注,也引起了对她们婴儿健康的关注。本章讨论了冠状病毒感染,如 MERS、SARS 和 COVID-19 对妊娠的影响,并描述了 COVID-19 在孕妇中的不断发展的知识。从易感性的角度,对妊娠期间发生的生理变化,特别是免疫系统的变化,进行了综述。还综述了 COVID-19 对胎盘、胎儿和新生儿的影响,包括潜在的临床结局以及与检测和诊断有关的问题。分析了病毒在孕妇及其婴儿之间垂直传播的潜在机制,包括宫内、产时和产后感染。最近的几项研究报告了在胎盘胎儿侧组织中检测到 SARS-CoV-2,这允许诊断胎儿通过 SARS-CoV-2 的宫内感染。感染母亲的胎盘显示出不寻常的病理发现组合,这可能代表胎盘以及胎儿感染的风险因素。

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