Microbiology Section, Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, 00185 Rome, Italy.
Department of Maternal and Child Health and Urology, "Sapienza" University of Rome, 00161 Rome, Italy.
Int J Environ Res Public Health. 2023 Feb 1;20(3):2616. doi: 10.3390/ijerph20032616.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) represents one of the most threatening viral infections in the last decade. Amongst susceptible individuals, infected pregnant women might be predisposed to severe complications. Despite the extensive interest in SARS-CoV-2 research, the clinical course of maternal infection, the vertical transmission and the neonatal outcomes have not been completely understood yet. The aim of our study was to investigate the association between SARS-CoV-2 infection, obstetric outcomes and vertical transmission.
A prospective observational study was performed, enrolling unvaccinated pregnant patients positive for SARS-CoV-2 (cases) and matched with uninfected pregnant women (controls). Maternal and neonatal nasopharyngeal swabs, maternal and cord blood, amniotic fluid and placenta tissue samples were collected; blood samples were tested for anti-S and anti-N antibodies, and histologic examination of placental tissues was performed.
The cases showed a significant association with the development of some obstetric complications, such as intrauterine growth restriction and pregnancy-associated hypothyroidism and diabetes, as compared to controls; their newborns were more likely to have a low birth weight and an arterial umbilical pH less than 7. The viral genome was detected in maternal and cord blood and placental samples in six cases.
Pregnant women positive for SARS-CoV-2 infection are more likely to develop severe obstetric outcomes; their newborns could have a low birth weight and arterial pH. Vertical transmission seems a rare event, and further investigation is strongly needed.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）是过去十年中最具威胁性的病毒感染之一。在易感个体中，感染的孕妇可能更容易出现严重并发症。尽管人们对 SARS-CoV-2 研究非常感兴趣，但母体感染的临床过程、垂直传播和新生儿结局尚未完全了解。我们的研究旨在调查 SARS-CoV-2 感染、产科结局和垂直传播之间的关联。
进行了一项前瞻性观察性研究，纳入了 SARS-CoV-2 阳性（病例）的未接种疫苗的孕妇患者，并与未感染的孕妇进行了匹配（对照组）。采集了母体和新生儿的鼻咽拭子、母体和脐带血、羊水和胎盘组织样本；检测了血液样本中的抗-S 和抗-N 抗体，并对胎盘组织进行了组织学检查。
与对照组相比，病例组与一些产科并发症的发展显著相关，例如宫内生长受限以及妊娠相关的甲状腺功能减退症和糖尿病；其新生儿更有可能体重低，脐动脉 pH 值低于 7。在 6 例病例中检测到母体和脐带血以及胎盘样本中的病毒基因组。
SARS-CoV-2 感染的孕妇更有可能出现严重的产科结局；其新生儿可能体重低，脐动脉 pH 值低。垂直传播似乎是一个罕见事件，需要进一步调查。
