ISGlobal, Barcelona, Spain.
Centro de Investigaçao em Saude de Manhiça (CISM), Manhiça, Mozambique.
BMC Pregnancy Childbirth. 2024 Sep 19;24(1):609. doi: 10.1186/s12884-024-06800-9.
SARS-CoV-2 infection during pregnancy is known to be associated with poor pregnancy outcomes, including pre-eclampsia (PE), prematurity, perinatal and maternal mortality. Data on the burden of SARS-CoV-2 infection among pregnant women and their offspring in Sub-Saharan Africa is limited. We aimed to estimate SARS-CoV-2 seroprevalence and determine PE biomarkers in Mozambican pregnant women with perinatal loss.
A cross-sectional study was conducted among women who had a fetal or an early neonatal death at the Maputo Central Hospital (MCH), Mozambique. Anti-SARS-CoV-2 IgG/IgM were determined in maternal and umbilical cord blood and PE biomarkers (sFlt-1 and PIGF) in maternal blood. SARS-CoV-2 RT-PCR was performed in placenta and fetal lung biopsies from participants found to be SARS-CoV-2 seropositive.
A total of 100 COVID-19 unvaccinated women were included in the study from March 2021 to April 2022. Total SARS-CoV-2 antibodies were detected in 68 [68%; 95CI (58 - 76)] maternal and 55 [55%; 95CI (54 - 74)] cord blood samples. SARS-CoV-2 IgM was detected in 18 cord blood samples and a positive placental RT-PCR in three of these participants. The proportion of women with moderate to high sFlt-1/PIGF ratio was higher in SARS-CoV-2 seropositive women than in those seronegative (71.2% vs 28.8%, p = 0.339), although the difference was not statistically significant.
SARS-CoV-2 seroprevalence among Mozambican women with perinatal loss was high during the second pandemic year, and there was evidence of vertical transmission in stillbirths. Findings also suggest that maternal SARS-CoV-2 infection may increase the risk of developing PE.
已知 SARS-CoV-2 感染与妊娠不良结局相关，包括子痫前期（PE）、早产、围产儿和孕产妇死亡。撒哈拉以南非洲地区关于孕妇及其后代 SARS-CoV-2 感染负担的数据有限。我们旨在评估莫桑比克妊娠期间发生围产儿死亡的孕妇的 SARS-CoV-2 血清阳性率，并确定 PE 生物标志物。
本横断面研究于 2021 年 3 月至 2022 年 4 月在莫桑比克马普托中央医院（MCH）进行，研究对象为胎儿或新生儿早期死亡的女性。在母血和脐血中检测抗 SARS-CoV-2 IgG/IgM，在母血中检测 PE 生物标志物（sFlt-1 和 PIGF）。对 SARS-CoV-2 血清阳性的参与者的胎盘和胎儿肺活检标本进行 SARS-CoV-2 RT-PCR 检测。
本研究共纳入了 100 名未接种 COVID-19 疫苗的莫桑比克女性，研究时间为 2021 年 3 月至 2022 年 4 月。在 68 份[68%；95%置信区间（CI）（58-76）]母血和 55 份[55%；95%CI（54-74）]脐血样本中检测到总 SARS-CoV-2 抗体。在 18 份脐血样本中检测到 SARS-CoV-2 IgM，其中 3 份样本的胎盘 RT-PCR 为阳性。在 SARS-CoV-2 血清阳性的女性中，中度至高度 sFlt-1/PIGF 比值的女性比例高于血清阴性的女性（71.2% vs 28.8%，p=0.339），尽管差异无统计学意义。
在第二个大流行年，莫桑比克发生围产儿死亡的女性中 SARS-CoV-2 血清阳性率较高，死产中存在垂直传播的证据。研究结果还表明，母体 SARS-CoV-2 感染可能增加发生 PE 的风险。
