Ferraz Thaina, Benton Samantha J, Zareef Israa, Aribaloye Oluwatomike, Bloise Enrrico, Connor Kristin L
Health Sciences, Carleton University, Ottawa, ON K1S 5B6, Canada.
Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil.
Pathogens. 2023 Mar 27;12(4):524. doi: 10.3390/pathogens12040524.
Obesity is a risk factor for severe COVID-19 disease during pregnancy. We hypothesized that the co-occurrence of high maternal body mass index (BMI) and gestational SARS-CoV-2 infection are detrimental to fetoplacental development. We conducted a systematic review following PRISMA/SWiM guidelines and 13 studies were eligible. In the case series studies ( = 7), the most frequent placental lesions reported in SARS-CoV-2(+) pregnancies with high maternal BMI were chronic inflammation (71.4%, 5/7 studies), fetal vascular malperfusion (FVM) (71.4%, 5/7 studies), maternal vascular malperfusion (MVM) (85.7%, 6/7 studies) and fibrinoids (100%, 7/7 studies). In the cohort studies ( = 4), three studies reported higher rates of chronic inflammation, MVM, FVM and fibrinoids in SARS-CoV-2(+) pregnancies with high maternal BMI (72%, = 107/149; mean BMI of 30 kg/m) compared to SARS-CoV-2(-) pregnancies with high BMI (7.4%, = 10/135). In the fourth cohort study, common lesions observed in placentae from SARS-CoV-2(+) pregnancies with high BMI ( = 187 pregnancies; mean BMI of 30 kg/m) were chronic inflammation (99%, 186/187), MVM (40%, = 74/187) and FVM (26%, = 48/187). BMI and SARS-CoV-2 infection had no effect on birth anthropometry. SARS-CoV-2 infection during pregnancy associates with increased prevalence of placental pathologies, and high BMI in these pregnancies could further affect fetoplacental trajectories.
肥胖是孕期发生重症 COVID-19 疾病的一个风险因素。我们假设，高母体体重指数（BMI）与妊娠期 SARS-CoV-2 感染同时存在对胎儿胎盘发育有害。我们按照 PRISMA/SWiM 指南进行了一项系统评价，有 13 项研究符合条件。在病例系列研究（n = 7）中，母体 BMI 高的 SARS-CoV-2 阳性妊娠中报告的最常见胎盘病变为慢性炎症（71.4%，5/7 项研究）、胎儿血管灌注不良（FVM）（71.4%，5/7 项研究）、母体血管灌注不良（MVM）（85.7%，6/7 项研究）和纤维素样物（100%，7/7 项研究）。在队列研究（n = 4）中，三项研究报告称，与高 BMI 的 SARS-CoV-2 阴性妊娠（7.4%，n = 10/135）相比，母体 BMI 高的 SARS-CoV-2 阳性妊娠（72%，n = 107/149；平均 BMI 为 30 kg/m²）中慢性炎症、MVM、FVM 和纤维素样物的发生率更高。在第四项队列研究中，母体 BMI 高的 SARS-CoV-2 阳性妊娠（n = 187 例妊娠；平均 BMI 为 30 kg/m²）胎盘观察到的常见病变为慢性炎症（99%，186/187）、MVM（40%，n = 74/187）和 FVM（26%，n = 48/187）。BMI 和 SARS-CoV-2 感染对出生人体测量学无影响。孕期 SARS-CoV-2 感染与胎盘病变患病率增加相关，这些妊娠中的高 BMI 可能会进一步影响胎儿胎盘发育进程。
