Longo Carolina, Saito Mauricio, Castro Pedro Teixeira, Traina Evelyn, Werner Heron, Elito Júnior Julio, Araujo Júnior Edward
Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo 04023-062, SP, Brazil.
CONCEPTUS-Fetal Medicine Center, São Paulo 04001-084, SP, Brazil.
J Clin Med. 2024 Aug 21;13(16):4922. doi: 10.3390/jcm13164922.
Coxsackievirus group B (CVB), a member of the family and enterovirus genus, poses risks during pregnancy due to its potential to cause severe fetal and neonatal infections. Transmission primarily occurs through fecal-oral routes, with infections peaking mostly in warmer months. Vertical transmission to the fetus can lead to conditions such as myocarditis, encephalitis, and systemic neonatal disease, presenting clinically as severe myocardial syndromes and neurological deficits. Diagnostic challenges include detecting asymptomatic maternal infections and conducting in utero assessments using advanced techniques like RT-PCR from amniotic fluid samples. Morbidity and mortality associated with congenital CVB infections are notable, linked to preterm delivery, fetal growth restriction, and potential long-term health impacts such as type 1 diabetes mellitus and structural cardiac anomalies. Current treatments are limited to supportive care, with emerging therapies showing promise but requiring further study for efficacy in utero. Preventive measures focus on infection control and hygiene to mitigate transmission risks, which are crucial especially during pregnancy. Future research should aim to fill knowledge gaps in epidemiology, improve diagnostic capabilities, and develop targeted interventions to enhance maternal and fetal outcomes.
B组柯萨奇病毒(CVB)是肠道病毒属的成员,由于其有可能导致严重的胎儿和新生儿感染,在孕期存在风险。传播主要通过粪口途径发生,感染大多在温暖月份达到高峰。病毒垂直传播给胎儿可导致心肌炎、脑炎和新生儿全身性疾病等情况,临床上表现为严重的心肌综合征和神经功能缺损。诊断挑战包括检测无症状的母体感染以及使用羊水样本进行逆转录聚合酶链反应(RT-PCR)等先进技术进行宫内评估。与先天性CVB感染相关的发病率和死亡率值得关注,与早产、胎儿生长受限以及1型糖尿病和心脏结构异常等潜在的长期健康影响有关。目前的治疗仅限于支持性护理,新兴疗法显示出前景,但在宫内的疗效还需要进一步研究。预防措施侧重于感染控制和卫生,以降低传播风险,这在孕期尤为关键。未来的研究应旨在填补流行病学方面的知识空白,提高诊断能力,并制定有针对性的干预措施,以改善母婴结局。