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Ferreira G, Blasina F, Rodríguez Rey M, Anesetti G, Sapiro R, Chavarría L, Cardozo R, Rey G, Sobrevia L, Nicolson GL. Pathophysiological and molecular considerations of viral and bacterial infections during maternal-fetal and -neonatal interactions of SARS-CoV-2, Zika, and Mycoplasma infectious diseases. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166285. [PMID: 34624499 PMCID: PMC8492386 DOI: 10.1016/j.bbadis.2021.166285] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 09/14/2021] [Accepted: 10/01/2021] [Indexed: 01/04/2023]
Abstract
During pregnancy, a series of physiological changes are determined at the molecular, cellular and macroscopic level that make the mother and fetus more susceptible to certain viral and bacterial infections, especially the infections in this and the companion review. Particular situations increase susceptibility to infection in neonates. The enhanced susceptibility to certain infections increases the risk of developing particular diseases that can progress to become morbidly severe. For example, during the current pandemic caused by the SARS-CoV-2 virus, epidemiological studies have established that pregnant women with COVID-19 disease are more likely to be hospitalized. However, the risk for intensive care unit admission and mechanical ventilation is not increased compared with nonpregnant women. Although much remains unknown with this particular infection, the elevated risk of progression during pregnancy towards more severe manifestations of COVID-19 disease is not associated with an increased risk of death. In addition, the epidemiological data available in neonates suggest that their risk of acquiring COVID-19 is low compared with infants (<12 months of age). However, they might be at higher risk for progression to severe COVID-19 disease compared with older children. The data on clinical presentation and disease severity among neonates are limited and based on case reports and small case series. It is well documented the importance of the Zika virus infection as the main cause of several congenital anomalies and birth defects such as microcephaly, and also adverse pregnancy outcomes. Mycoplasma infections also increase adverse pregnancy outcomes. This review will focus on the molecular, pathophysiological and biophysical characteristics of the mother/placental-fetal/neonatal interactions and the possible mechanisms of these pathogens (SARS-CoV-2, ZIKV, and Mycoplasmas) for promoting disease at this level.
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Affiliation(s)
- Gonzalo Ferreira
- Laboratory of Ion Channels, Biological Membranes and Cell Signaling, Dept. of Biophysics, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay,Corresponding author
| | - Fernanda Blasina
- Dept. of Neonatology, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Marianela Rodríguez Rey
- Dept. of Neonatology, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Gabriel Anesetti
- Dept. of Histology and Development, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Rosana Sapiro
- Dept. of Histology and Development, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Luisina Chavarría
- Laboratory of Ion Channels, Biological Membranes and Cell Signaling, Dept. of Biophysics, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Romina Cardozo
- Laboratory of Ion Channels, Biological Membranes and Cell Signaling, Dept. of Biophysics, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Grazzia Rey
- Dept. of Clinical Ginecology and Obstetrics B, Facultad de Medicina, Universidad de la Republica, Uruguay
| | - Luis Sobrevia
- Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrics, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile,Department of Physiology, Faculty of Pharmacy, Universidad de Sevilla, Seville E-41012, Spain,Medical School, Faculty of Medicine, Sao Paulo State University (UNESP), Brazil,University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston, QLD 4029, Australia,Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, 9713GZ Groningen, The Netherlands
| | - Garth L. Nicolson
- Department of Molecular Pathology, The Institute for Molecular Medicine, Huntington Beach, CA, USA
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Ospina ML, Tong VT, Gonzalez M, Valencia D, Mercado M, Gilboa SM, Rodriguez AJ, Tinker SC, Rico A, Winfield CM, Pardo L, Thomas JD, Avila G, Villanueva JM, Gomez S, Jamieson DJ, Prieto F, Meaney-Delman D, Pacheco O, Honein MA. Zika Virus Disease and Pregnancy Outcomes in Colombia. N Engl J Med 2020; 383:537-545. [PMID: 32757522 PMCID: PMC7480270 DOI: 10.1056/nejmoa1911023] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND In 2015 and 2016, Colombia had a widespread outbreak of Zika virus. Data from two national population-based surveillance systems for symptomatic Zika virus disease (ZVD) and birth defects provided complementary information on the effect of the Zika virus outbreak on pregnancies and infant outcomes. METHODS We collected national surveillance data regarding cases of pregnant women with ZVD that were reported during the period from June 2015 through July 2016. The presence of Zika virus RNA was identified in a subgroup of these women on real-time reverse-transcriptase-polymerase-chain-reaction (rRT-PCR) assay. Brain or eye defects in infants and fetuses and other adverse pregnancy outcomes were identified among the women who had laboratory-confirmed ZVD and for whom data were available regarding pregnancy outcomes. We compared the nationwide prevalence of brain and eye defects during the outbreak with the prevalence both before and after the outbreak period. RESULTS Of 18,117 pregnant women with ZVD, the presence of Zika virus was confirmed in 5926 (33%) on rRT-PCR. Of the 5673 pregnancies with laboratory-confirmed ZVD for which outcomes had been reported, 93 infants or fetuses (2%) had brain or eye defects. The incidence of brain or eye defects was higher among pregnancies in which the mother had an onset of ZVD symptoms in the first trimester than in those with an onset during the second or third trimester (3% vs. 1%). A total of 172 of 5673 pregnancies (3%) resulted in pregnancy loss; after the exclusion of pregnancies affected by birth defects, 409 of 5426 (8%) resulted in preterm birth and 333 of 5426 (6%) in low birth weight. The prevalence of brain or eye defects during the outbreak was 13 per 10,000 live births, as compared with a prevalence of 8 per 10,000 live births before the outbreak and 11 per 10,000 live births after the outbreak. CONCLUSIONS In pregnant women with laboratory-confirmed ZVD, brain or eye defects in infants or fetuses were more common during the Zika virus outbreak than during the periods immediately before and after the outbreak. The frequency of such defects was increased among women with a symptom onset early in pregnancy. (Funded by the Colombian Instituto Nacional de Salud and the Centers for Disease Control and Prevention.).
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Affiliation(s)
- Martha L Ospina
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Van T Tong
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Maritza Gonzalez
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Diana Valencia
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Marcela Mercado
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Suzanne M Gilboa
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Andrea J Rodriguez
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Sarah C Tinker
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Angelica Rico
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Christina M Winfield
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Lissethe Pardo
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Jennifer D Thomas
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Greace Avila
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Julie M Villanueva
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Sara Gomez
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Denise J Jamieson
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Franklyn Prieto
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Dana Meaney-Delman
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Oscar Pacheco
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
| | - Margaret A Honein
- From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
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