UNASSIGNED: A comprehensive search of 4 databases was conducted to identify relevant studies. Inclusion criteria included studies measuring individual cytokines in pregnant women and/or their neonates. Studies were evaluated for quality, and data were extracted for analysis. Meta-analyses were performed using the random-effects model.
UNASSIGNED: Seventeen studies met the inclusion criteria, including data from 748 pregnant women and 287 infants. More than three of these studies evaluated data of 20 cytokines in maternal serum, and data of 10 cytokines was available from cord blood samples. Only the serum level of CXCL10 was significantly up-regulated in SARS-CoV-2 positive pregnant women (n = 339) compared to SARS-CoV-2 negative pregnant women (n = 409). Subset analysis of maternal samples (n = 183) collected during the acute phase of COVID-19 infection showed elevated CXCL10 and IFN-γ. No significant differences in cytokine levels were found between cord blood samples collected from infants born to mothers with (n = 97) and without (n = 190) COVID-19 during gestation. Subset analysis of cord blood samples collected during the acute phase of maternal infection was limited by insufficient data. The heterogeneity among the studies was substantial.
UNASSIGNED: The findings suggest that maternal cytokines responses to SARS-CoV-2 infection during pregnancy are not significantly dysregulated, except for CXCL10 and IFN-γ during the acute phase of illness. No evidence of increased cytokine levels in cord blood samples was observed, although this could be impacted by the time period between initial maternal infection and cord blood collection. These results provide some reassurance to parents and healthcare providers but should be interpreted cautiously due to study variations and limitations.
■对4个数据库进行了全面搜索,以确定相关研究。纳入标准包括测量孕妇和/或其新生儿中个体细胞因子的研究。研究进行了质量评估,并提取数据进行分析。采用随机效应模型进行Meta分析。
■17项研究符合纳入标准,包括748名孕妇和287名婴儿的数据。其中超过三项研究评估了母体血清中20种细胞因子的数据,10种细胞因子的数据可从脐带血样本中获得。与SARS-CoV-2阴性孕妇(n=409)相比,SARS-CoV-2阳性孕妇(n=339)中只有CXCL10的血清水平显着上调。在COVID-19感染急性期收集的母体样本(n=183)的子集分析显示CXCL10和IFN-γ升高。从妊娠期间有(n=97)和没有(n=190)COVID-19的母亲出生的婴儿收集的脐带血样本之间的细胞因子水平没有显着差异。在孕产妇感染急性期收集的脐带血样本的子集分析受到数据不足的限制。这些研究之间的异质性是巨大的。
■研究结果表明,母亲对SARS-CoV-2感染的反应在怀孕期间没有显著失调,在疾病的急性期,CXCL10和IFN-γ除外。未观察到脐带血样本中细胞因子水平升高的证据,尽管这可能受到从最初的母体感染到脐带血采集之间的时间段的影响。这些结果为父母和医疗保健提供者提供了一些保证,但由于研究的差异和局限性,应谨慎解释。