Early Life Inflammation and the Developing Hematopoietic and Immune Systems: The Cochlea as a Sensitive Indicator of Disruption

Emerging evidence indicates that perinatal infection and inflammation can influence the developing immune system and may ultimately affect long-term health and disease outcomes in offspring by perturbing tissue and immune homeostasis. We posit that perinatal inflammation influences immune outcomes in offspring by perturbing (1) the development and function of fetal-derived immune cells that regulate tissue development and homeostasis, and (2) the establishment and function of developing hematopoietic stem cells (HSCs) that continually generate immune cells across the lifespan. To disentangle the complexities of these interlinked systems, we propose the cochlea as an ideal model tissue to investigate how perinatal infection affects immune, tissue, and stem cell development. The cochlea contains complex tissue architecture and a rich immune milieu that is established during early life. A wide range of congenital infections cause cochlea dysfunction and sensorineural hearing loss (SNHL), likely attributable to early life inflammation. Furthermore, we show that both immune cells and bone marrow hematopoietic progenitors can be simultaneously analyzed within neonatal cochlear samples. Future work investigating the pathogenesis of SNHL in the context of congenital infection will therefore provide critical information on how perinatal inflammation drives disease susceptibility in offspring.

Neurological Outcome Following Newborn Encephalopathy With and Without Perinatal Infection: A Systematic Review

Background: Studies have suggested that neurological outcome may differ in newborns with encephalopathy with and without perinatal infection. We aimed to systematically review this association.Methods: We conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Studies were obtained from four databases including Pubmed, Embase, Web of Science, and The Cochrane Database. Newborns with encephalopathy with and without markers of perinatal infection were compared with regard to neurodevelopmental assessments, neurological disorders, and early biomarkers of brain damage. Risk of bias and quality of evidence were assessed by the Newcastle-Ottawa scale and Grading of Recommendations Assessment, Development and Evaluation (GRADE).Results: We screened 4,284 studies of which eight cohort studies and one case-control study met inclusion criteria. A narrative synthesis was composed due to heterogeneity between studies. Six studies were classified as having low risk of bias, while three studies were classified as having high risk of bias. Across all outcomes, the quality of evidence was very low. The neurological outcome was similar in newborns with encephalopathy with and without markers of perinatal infection.Conclusions: Further studies of higher quality are needed to clarify whether perinatal infection may affect neurological outcome following newborn encephalopathy.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42020185717.

Neurodevelopmental outcome of very low birth weight and extremely low birth weight newborn at 12 months of corrected age associated with prenatal risk factors

Background: Various neuro-developmental impairment (NDI) among very low birth weight babies (VLBW) and extremely low birth weight (ELBW) babies are common in Indian scenario. This study was designed to assess the impact between prenatal risk factors and neuro-developmental outcomes of premature infants.Methods: This descriptive study was conducted on 143 VLBW and ELBW babies admitted in SNCU of North Bengal Medical College, Darjeeling, West Bengal and discharged babies were followed up.Results: Total 143 neonates were studied among male 82 (57.3%) and female 61 (42.7%) and AGA: SGA ratio was 1.97. Birth weight ranged from 500 to 1500grams with mean was 1199.6±244.14 and the median was 1240 gm. The mean gestational age (Mean± SD) was 29.65±2.032 weeks with range 24-32 weeks and the median was 30 weeks. 28 (19.6%) had PIH, 39 (27.3%) had multiple gestation, 18 (12.6%) had perinatal infection and 25 (17.5%) had birth asphyxia. CRIB II score ranged from 3-18 with mean was 8.021±3.883 and median was 7. 73.4% (105/143) were discharged alive. Significant positive correlations were found among birth weight, gestational age, perinatal infection (p<0.001). Adverse neonatal outcome was associated with CRIB II score ≥10. Total CRIB II score with parameters of NDI like developmental delay, cerebral palsy, visual abnormality, absent ABR showed good correlation (p<0.001). Fisher Exact test revealed significant association between total score and Cerebral palsy (p=0.0005), visual abnormality (p=0.0005), absent ABR (p=0.0002).Conclusions: Perinatal risk factors influence future NDI in very low and extremely low birth weight babies. They should be identified and treated promptly to achieve good outcome.

Pandemic Stress and Its Correlates among Pregnant Women during the Second Wave of COVID-19 in Poland

Background: The ongoing COVID-19 pandemic has created numerous stressful conditions, especially for vulnerable populations such as pregnant women. Pandemic-related pregnancy stress consists of two dimensions: stress associated with feeling unprepared for birth due to the pandemic (Preparedness Stress), and stress related to fears of perinatal COVID-19 infection (Perinatal Infection Stress). The purpose of our study was to elucidate the association between various factors—sociodemographic, obstetric, pandemic-related, and situational—and pandemic stress in its two dimensions during the second wave of the COVID-19 pandemic in Polish pregnant women. Methods: A cross-sectional study with a total of 1119 pregnant women recruited during the second wave of the COVID-19 pandemic in Poland (between November 2020 and January 2021). Participants were recruited via social media to complete an online study questionnaire that included sociodemographic, obstetric, situational, and COVID-19 pandemic factors, as well as the Pandemic-Related Pregnancy Stress Scale (PREPS). Results: Nearly 38.5% of participants reported high Preparedness Stress; 26% reported high Perinatal Infection Stress. Multivariate analyses indicated that lack of COVID-19 diagnosis, higher compliance with safety rules and restrictions, and limited access to outdoor space were independently associated with moderate to severe levels of Infection Stress. Current emotional or psychiatric problems, nulliparity, limited access to outdoor space, and alterations to obstetric visits were independently associated with moderate to severe Preparedness Stress. Conclusion: Study findings suggest that particular attention should be focused on the groups of pregnant women who are most vulnerable to pandemic-related stress and therefore may be more prone to adverse outcomes associated with prenatal stress.

HBV - infection in children with perinatal infection. Clinical report of familial hepatitis B

Hepatitis B, despite of being a controlled infection today, is one of the most common form of hepatitis in the world. According to the experts' evaluation there are about 3 million patients with chronic hepatitis B in our country. The global strategy of the World Health Organization includes the elimination of viral hepatitis by 2030.The program used in the North-West Federal District to eliminate acute hepatitis B has reduced the incidence rate due to the widespread vaccination coverage of children and the annual increase in adult immunization coverage.However, the relevance of HBV-infection in children still remains high which is associated with a high infection by hepatitis B virus in women of childbearing age and the possibility of the transmission of the infection from mother to her child. In case of perinatal infection the formation of chronic hepatitis B in children reaches up to 90%. The natural course of chronic hepatitis B is characterized by a change in pathogenetically determined phases, and HBsAg-negative infection, which is a latent (occult) form of hepatitis, was added to them in 2009. Occult hepatitis B is an epidemiological danger, for the child as well, if the mother suffers from this form of chronic hepatitis B. Monitoring of pregnant women is often limited to identifying only HBsAg, which is not enough to detect occult hepatitis B. Lately diagnosed occult HBV-infection can become a source of the infection for the baby, especially in cases when due to some reasons there are disorders in hepatitis B vaccination schedule after birth. The article presents an interesting clinical case of family hepatitis B.

AR APLINKOS VEIKSNIŲ POVEIKIS GALI BŪTI SIEJAMAS SU ŠIZOFRENIJOS IŠSIVYSTYMU?

Tyrimo tikslas. Apžvelgti ir apibendrinti įrodymais grįstos medicinos duomenis apie šizofrenijos proceso vystymosi eigą, išorinės aplinkos veiksnių tikėtiną poveikį, simptomų raišką ir ankstyvo ligos atpažinimo galimybes bendrosios praktikos gydytojo darbe. Metodika. Atlikta teminių straipsnių paieška Pubmed, Cochrane, SpringerLink duomenų bazėse, naudojant reikšminius žodžius: šizofrenija, rizikos veiksniai, kanapės, ankstyvos vaikystės traumos, urbanizacija, D vitaminas, perinatalinė infekcija, bendrosios praktikos gydytojas (angl. schizophrenia,risk factors, cannabis, childhood trauma, urbanisation, vitamin D, perinatal infection, general practitioner). Iš daugiau nei 100 mokslinių publikacijų, atrinkta 30 straipsnių. Rezultatai. Apžvelgti su šizofrenijos išsivystymu susiję pagrindiniai rizikos veiksniai, simptomų raiška ir ligos išsivystymo modelis. Įvertintas išorinės aplinkos veiksnių ryšys su šizofrenijos išsivystymu. Išvados. Nustatyta, jog išorinės aplinkos veiksniai susiję su šizofrenijos išsivystymu. Kanapių vartojimas, ankstyvosios vaikystės traumos, urbanizacija susiję su padidėjusia šizofrenijos išsivystymo rizika ar stipriau išreikštais ligos simptomais. Stebimas padidėjęs ligos pasireiškimo dažnis tarp tų pacientų, kuriems buvo nustatyta sumažėjusi D vitamino koncentracija organizme, ar perinataliniu laikotarpiu pasireiškė infekcija.

Dynamic changes of acquired maternal SARS-CoV-2 IgG in infants

At present, there are still ambiguous reports about the perinatal infection of infants born to mothers infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The dynamic characteristics of infantile serum antibodies born to mother with SARS-CoV-2 has not been well described. In this study, we analyzed the seroconversion of 27 newborns born to 26 pregnant women infected with SARS-CoV-2. The SARS-CoV-2 IgG positive rate of parturient was 80.8%, and half of their infants obtained maternal IgG. IgG transfer rates were 18.8% and 81.8% in those infants whose mother infected less and more than 2 weeks before delivery. In the first two months of life, the IgG level of infants dropped sharply to one tenth of that at birth. These results suggest that maternal SARS-CoV-2 IgG provides limited protection for infants.

Transmissibility: To be or not to be

Appraising SARS-CoV-2 virus under the taxonomy category of coronaviridae family, which has been responsible for more than two million fatalities across the globe. It not only jeopardizes the normal life, but also potentiating the evolutionary progress towards a more lethal form. The lethal form, albeit is a bit virulent, is likely to predominate, thereby causing cumulative damage in any cluster that cannot even combat the wide spectrum of genetic variation. The impact on the vertical COVID-19 transmissibility of antenatal population is still sketchy about “nosocomial transmission” and the measures crude. The paper has reviewed the placental pathological findings of pregnant women afflicted with SARS-CoV-2 including the information, gathered from the subsequent stages of gestational outcomes. The possibility of the vertical transmission of SARS-CoV-2 due to the probable placental barrier damage caused by the severe maternal hypoxia, Homo sapiens (human) angiotensin-converting enzyme-2 (hACE2) influenced transplacental migration of SARS-CoV-2 in advanced gestational age, the plausible presence of RNAemia (detection of SARS-CoV-2 in the blood) in hematogenous route was reviewed in this paper. Nevertheless, the probability of susceptible intrauterine or perinatal infection of fetus does not conclusively decide as chances of involving placental coexpression of hACE2 and transmembrane protease, serine 2 in cytoplasmic entry of SARS-CoV-2 remains insignificant, exhibiting the probable relative insensitivity to transplacental infection. The present paper will provide an important insight about the wider understanding of the SARS-CoV-2 pathogenesis in the placenta that canvassed across all trimesters of pregnancy in response to the indiscriminate spread across globe at the time of therapeutic interventions.