背景:2019年爆发的严重急性呼吸综合征冠状病毒(SARS-CoV-2)有必要调查其对妊娠结局和胎儿发育的潜在不利影响。
目的:本研究旨在回顾妊娠期SARS-CoV-2感染对胎儿结局影响的证据。
方法:这篇叙述性综述总结了PubMed和WebofScience自COVID-19爆发以来的文献,显示母亲在怀孕期间感染SARS-CoV-2对胎儿发育的影响。
结果:妊娠期SARS-CoV-2感染可通过胎盘垂直传播,在子宫内和围产期,影响母胎免疫界面和胎盘功能。怀孕期间的病毒感染与中枢神经系统发育障碍和自闭症等疾病有关。呼吸道结构和功能的变化,免疫,和内脏系统也有报道。怀孕期间SARS-CoV-2感染与死产和早产风险增加有关。然而,所涉及的机制尚不清楚,可能包括细胞因子风暴,巨噬细胞介导,基因突变,甲基化,和其他表观遗传变化。在动物和临床研究中探索抗病毒治疗和其他干预措施的保护作用可能有助于改善结果。
结论:妊娠期SARS-CoV-2感染通过垂直传播激活母胎免疫界面,对胎儿发育有短期和长期影响,包括中枢神经系统.未来的长期研究可能有助于提供证据,为干预措施提供信息,以降低不良后果的风险。
BACKGROUND: The severe acute respiratory syndrome coronavirus (SARS-CoV-2) outbreak in 2019 has necessitated investigating its potential adverse effects on pregnancy outcomes and fetal development.
OBJECTIVE: This study aimed to review the evidence on the impact of SARS-CoV-2 infection during pregnancy on fetal outcomes.
METHODS: Literatures since the outbreak of COVID-19 from PubMed and Web of Science were summarized in this narrative review, to show the effects of maternal SARS-CoV-2 infection during pregnancy on fetal development.
RESULTS: SARS-CoV-2 infection during pregnancy can be transmitted vertically through the placenta, both in utero and perinatally, affecting the maternal-fetal immune interface and placental function. Viral infections during pregnancy have been linked to central nervous system development impairments and disorders such as autism. Changes in the structure and function of the respiratory, immune, and visceral systems have also been reported. SARS-CoV-2 infection during pregnancy has been linked with increased risks of stillbirth and preterm birth. However, the mechanisms involved remain unclear and may include cytokine storms, macrophage mediation, genetic mutations, methylation, and other epigenetic changes. Exploring the protective effects of antiviral treatment and other interventions in animal and clinical studies may help improve outcomes.
CONCLUSIONS: SARS-CoV-2 infection during pregnancy activates the maternal-fetal immune interface through vertical transmission, and has short- and long-term effects on fetal development, including the central nervous system. Future long-term studies may help provide evidence that can inform interventions to reduce the risk of adverse outcomes.