Placental findings in SARS-CoV-2 maternal infection by severity and timing of maternal disease

Pregnant women who are infected with SARS-CoV-2 are at an increased risk of adverse perinatal outcomes. With this study, we aimed to better understand the relationship between maternal infection and perinatal outcomes, especially preterm births, and the underlying medical and interventionist factors. This was a prospective observational study carried out in 78 centers (Spanish Obstetric Emergency Group) with a cohort of 1347 SARS-CoV-2 PCR-positive pregnant women registered consecutively between 26 February and 5 November 2020, and a concurrent sample of PCR-negative mothers. The patients’ information was collected from their medical records, and the association of SARS-CoV-2 and perinatal outcomes was evaluated by univariable and multivariate analyses. The data from 1347 SARS-CoV-2-positive pregnancies were compared with those from 1607 SARS-CoV-2-negative pregnancies. Differences were observed between both groups in premature rupture of membranes (15.5% vs. 11.1%, p < 0.001); venous thrombotic events (1.5% vs. 0.2%, p < 0.001); and severe pre-eclampsia incidence (40.6 vs. 15.6%, p = 0.001), which could have been overestimated in the infected cohort due to the shared analytical signs between this hypertensive disorder and COVID-19. In addition, more preterm deliveries were observed in infected patients (11.1% vs. 5.8%, p < 0.001) mainly due to an increase in iatrogenic preterm births. The prematurity in SARS-CoV-2-affected pregnancies results from a predisposition to end the pregnancy because of maternal disease (pneumonia and pre-eclampsia, with or without COVID-19 symptoms).

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P16: Guinea pig cytomegalovirus elicits distinct placental responses after maternal infection early versus late in pregnancy

American Journal of Reproductive Immunology ◽

10.1111/aji.15_13420 ◽

2021 ◽

Vol 85 (S1) ◽

pp. 70-71

Keyword(s):

Guinea Pig ◽

Maternal Infection ◽

Guinea Pig Cytomegalovirus ◽

In Pregnancy

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Effects of Environmental Conditions on Nephron Number: Modeling Maternal Disease and Epigenetic Regulation in Renal Development

International Journal of Molecular Sciences ◽

10.3390/ijms22084157 ◽

2021 ◽

Vol 22 (8) ◽

pp. 4157

Author(s):

Lars Fuhrmann ◽

Saskia Lindner ◽

Alexander-Thomas Hauser ◽

Clemens Höse ◽

Oliver Kretz ◽

...

Keyword(s):

Environmental Conditions ◽

High Glucose ◽

Culture Conditions ◽

Renal Development ◽

Organ Cultures ◽

Renal Growth ◽

Epigenetic Modifiers ◽

Metabolic Conditions ◽

Renal Size ◽

Maternal Disease

A growing body of evidence suggests that low nephron numbers at birth can increase the risk of chronic kidney disease or hypertension later in life. Environmental stressors, such as maternal malnutrition, medication and smoking, can influence renal size at birth. Using metanephric organ cultures to model single-variable environmental conditions, models of maternal disease were evaluated for patterns of developmental impairment. While hyperthermia had limited effects on renal development, fetal iron deficiency was associated with severe impairment of renal growth and nephrogenesis with an all-proximal phenotype. Culturing kidney explants under high glucose conditions led to cellular and transcriptomic changes resembling human diabetic nephropathy. Short-term high glucose culture conditions were sufficient for long-term alterations in DNA methylation-associated epigenetic memory. Finally, the role of epigenetic modifiers in renal development was tested using a small compound library. Among the selected epigenetic inhibitors, various compounds elicited an effect on renal growth, such as HDAC (entinostat, TH39), histone demethylase (deferasirox, deferoxamine) and histone methyltransferase (cyproheptadine) inhibitors. Thus, metanephric organ cultures provide a valuable system for studying metabolic conditions and a tool for screening for epigenetic modifiers in renal development.

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Persistent Pulmonary Hypertension of the Newborn

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462300012538 ◽

1991 ◽

Vol 7 (S1) ◽

pp. 66-69

Author(s):

George Lister

Keyword(s):

Pulmonary Hypertension ◽

Diaphragmatic Hernia ◽

Vascular Development ◽

Clinical Syndrome ◽

Persistent Pulmonary Hypertension ◽

Maternal Infection ◽

Fetal Circulation ◽

Cns Disease ◽

Persistent Fetal Circulation

Persistent pulmonary hypertension of the newborn or persistent fetal circulation is a clinical syndrome that is usually apparent within the first 2 days after birth because of the presence of hypoxemia (2;12;19). The syndrome was first described in an abstract by Gersony, Due, and Sinclair (6) in 1969. Two infants were reported who had “RV decompensation, cyanosis and clear lung fields… in the absence of recognizable cardiac, pulmonary, hematologic or CNS disease.” The syndrome has been associated with aspiration of meconium, diaphragmatic hernia, asphyxia, hemorrhage, shock, and maternal infection (4;18). In other cases, there is no clear antecedent event. Despite considerable interest in the problem and a wealth of research related to pulmonary vasoregulation and vascular development in the fetus and newborn, the etiology of the syndrome remains obscure 20 years since its recognition.

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Severe Brain Damage in a Moderate Preterm Infant as Complication of Post-COVID-19 Response during Pregnancy

Neonatology ◽

10.1159/000516846 ◽

2021 ◽

pp. 1-4

Author(s):

Viktoria Engert ◽

Celine Siauw ◽

Annika Stock ◽

Monika Rehn ◽

Achim Wöckel ◽

...

Keyword(s):

Preterm Infant ◽

Brain Damage ◽

Fetal Development ◽

Periventricular Leukomalacia ◽

Intracranial Bleeding ◽

Current Evidence ◽

Potential Consequence ◽

Maternal Infection ◽

Sars Coronavirus ◽

Unique Case

Current evidence from the COVID-19 pandemic suggests that neonatal SARS-coronavirus-2 infections usually have a mild course. Data on how maternal infection during pregnancy affects fetal development are scarce. We present the unique case of a moderate preterm infant with intracranial bleeding and periventricular leukomalacia as a potential consequence of post-COVID-19 hyperinflammation during pregnancy.

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