Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands.
Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
J Reprod Immunol. 2024 Jun;163:104243. doi: 10.1016/j.jri.2024.104243. Epub 2024 Mar 18.
Associations between antenatal SARS-CoV-2 infection and pregnancy outcomes have been conflicting and the role of the immune system is currently unclear. This prospective cohort study investigated the interaction of antenatal SARS-CoV-2 infection, changes in cytokine and HS-CRP levels, birthweight and gestational age at birth. 2352 pregnant participants from New York City (2020-2022) were included. Plasma levels of interleukin (IL)-1β, IL-6, IL-17A and high-sensitivity C-reactive protein (HS-CRP) were quantified in blood specimens obtained across pregnancy. Quantile and linear regression models were conducted to 1) assess the impact of antenatal SARS-CoV-2 infection, overall and by timing of detection of SARS-CoV-2 positivity (< 20 weeks versus ≥ 20 weeks), on birthweight and gestational age at delivery; 2) examine the relationship between SARS-CoV-2 infection and maternal immune changes during pregnancy. All models were adjusted for maternal demographic and obstetric factors and pandemic timing. Birthweight models were additionally adjusted for gestational age at delivery and fetal sex. Immune marker models were also adjusted for gestational age at specimen collection and multiplex assay batch. 371 (15.8%) participants were infected with SARS-CoV-2 during pregnancy, of which 98 (26.4%) were infected at < 20 weeks gestation. Neither SARS-CoV-2 infection in general nor in early or late pregnancy was associated with lower birthweight nor earlier gestational age at delivery. Further, we did not observe cytokine or HS-CRP changes in response to SARS-CoV-2 infection and thus found no evidence to support a potential association between immune dysregulation and the diversity in pregnancy outcomes following infection.
产前 SARS-CoV-2 感染与妊娠结局的关系一直存在争议，目前免疫系统的作用尚不清楚。本前瞻性队列研究调查了产前 SARS-CoV-2 感染、细胞因子和 HS-CRP 水平变化、出生体重和出生时的胎龄之间的相互作用。纳入了来自纽约市的 2352 名孕妇（2020-2022 年）。在整个妊娠期间采集的血液样本中定量检测白细胞介素 (IL)-1β、IL-6、IL-17A 和高敏 C 反应蛋白 (HS-CRP) 的水平。采用分位数和线性回归模型来：1）评估产前 SARS-CoV-2 感染（总体以及 SARS-CoV-2 阳性检测时间[<20 周与≥20 周]）对出生体重和分娩时胎龄的影响；2）检查 SARS-CoV-2 感染与孕妇妊娠期间免疫变化的关系。所有模型均调整了产妇人口统计学和产科因素以及大流行时间。出生体重模型还调整了分娩时的胎龄和胎儿性别。免疫标志物模型还调整了标本采集时的胎龄和多重分析试剂盒批次。371 名（15.8%）参与者在妊娠期间感染了 SARS-CoV-2，其中 98 名（26.4%）在妊娠<20 周时感染。一般来说，产前 SARS-CoV-2 感染，无论是早期还是晚期妊娠感染，都与较低的出生体重或更早的分娩胎龄无关。此外，我们没有观察到针对 SARS-CoV-2 感染的细胞因子或 HS-CRP 变化，因此没有证据支持免疫失调与感染后妊娠结局的多样性之间存在潜在关联。
