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Pathogens
Special Issues
Impact of Viruses on Maternal and Fetal Outcome
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Impact of Viruses on Maternal and Fetal Outcome

A special issue of Pathogens (ISSN 2076-0817). This special issue belongs to the section "Viral Pathogens".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 6703

Special Issue Editors

Dr. Lynne Sykes

E-Mail Website
Guest Editor
Department of Metabolism Digestion and Reproduction, Imperial College London, London W12 0HS, UK
Interests: inflammation; neutrophils; complement; preterm birth; vaginal microbiota
Prof. Dr. Graham Taylor

E-Mail Website
Guest Editor
Department of Infectious Disease, Imperial College London, London W2 1PG, UK
Interests: pre-term birth; inflammation; human retroviral infection

Special Issue Information

Dear Colleagues,

A healthy pregnancy outcome relies on a robust maternal immune response and protection of the fetus and neonate against adverse effects of infection. There are many viruses such as CMV, HIV, Zika, SARS-CoV-2, Influenza, Hepatitis and HPV that can lead to adverse pregnancy outcomes by impacting maternal, fetal and neonatal health. Epidemiological, in vitro and ex vivo studies, including animal studies, have demonstrated associative and causal effects of many viruses on adverse maternal and fetal outcome. This Special Issue is focused on describing the role of viruses on adverse outcome, including mechanistic and observational studies, and explores the therapeutic options. 

Research articles, review articles, short communications and case reports with literature reviews are welcomed for submission. For planned papers, it is recommended that a title and short abstract (approx. 100 words) is sent to the Editorial Office to confirm that the subject is within our scope.

Dr. Lynne Sykes
Prof. Dr. Graham Taylor
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pathogens is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • HIV
  • SARS-CoV-2
  • CMV
  • hepatitis
  • viruses
  • preterm birth
  • intrauterine growth restriction
  • congenital infection
  • antivirals
  • inflammation

Published Papers (5 papers)

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12 pages, 793 KiB  
Article
Pregnancy Management in HIV Viral Controllers: Twenty Years of Experience
by Charlotte-Eve S. Short, Laura Byrne, Aishah Hagan-Bezgin, Rachael A. Quinlan, Jane Anderson, Gary Brook, Okavas De Alwis, Annemiek de Ruiter, Pippa Farrugia, Sarah Fidler, Eleanor Hamlyn, Anna Hartley, Siobhan Murphy, Heather Noble, Soonita Oomeer, Sherie Roedling, Melanie Rosenvinge, Luciana Rubinstein, Rimi Shah, Selena Singh, Elizabeth Thorne, Martina Toby, Brenton Wait, Liat Sarner and Graham P. Tayloradd Show full author list remove Hide full author list
Pathogens 2024, 13(4), 308; https://doi.org/10.3390/pathogens13040308 - 10 Apr 2024
Viewed by 582
Abstract
(1) Background: The evidence base for the management of spontaneous viral controllers in pregnancy is lacking. We describe the management outcomes of pregnancies in a series of UK women with spontaneous HIV viral control (<100 copies/mL 2 occasions before or after pregnancy off [...] Read more.
(1) Background: The evidence base for the management of spontaneous viral controllers in pregnancy is lacking. We describe the management outcomes of pregnancies in a series of UK women with spontaneous HIV viral control (<100 copies/mL 2 occasions before or after pregnancy off ART). (2) Methods: A multi-centre, retrospective case series (1999–2021) comparing pre- and post-2012 when guidelines departed from zidovudine-monotherapy (ZDVm) as a first-line option. Demographic, virologic, obstetric and neonatal information were anonymised, collated and analysed in SPSS. (3) Results: A total of 49 live births were recorded in 29 women, 35 pre-2012 and 14 post. HIV infection was more commonly diagnosed in first reported pregnancy pre-2012 (15/35) compared to post (2/14), p = 0.10. Pre-2012 pregnancies were predominantly managed with ZDVm (28/35) with pre-labour caesarean section (PLCS) (24/35). Post-2012 4/14 received ZDVm and 10/14 triple ART, p = 0.002. Post-2012 mode of delivery was varied (5 vaginal, 6 PLCS and 3 emergency CS). No intrapartum ZDV infusions were given post-2012 compared to 11/35 deliveries pre-2012. During pregnancy, HIV was detected (> 50 copies/mL) in 14/49 pregnancies (29%) (median 92, range 51–6084). Neonatal ZDV post-exposure prophylaxis was recorded for 45/49 infants. No transmissions were reported. (4) Conclusion: UK practice has been influenced by the change in guidelines, but this has had little impact on CS rates. Full article
(This article belongs to the Special Issue Impact of Viruses on Maternal and Fetal Outcome)
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11 pages, 521 KiB  
Article
Normocephalic Children Exposed to Maternal Zika Virus Infection Do Not Have a Higher Risk of Neurodevelopmental Abnormalities around 24 Months of Age than Unexposed Children: A Controlled Study
by Juannicelle T. A. M. Godoi, Silvia F. B. M. Negrini, Davi C. Aragon, Paulo R. H. Rocha, Fabiana R. Amaral, Bento V. M. Negrini, Sara R. Teixeira, Aparecida Y. Yamamoto, Heloisa Bettiol and Marisa M. Mussi-Pinhata
Pathogens 2023, 12(10), 1219; https://doi.org/10.3390/pathogens12101219 - 06 Oct 2023
Viewed by 901
Abstract
Although very few controlled studies are available, in utero Zika virus (ZIKV)-exposed children are considered at risk for neurodevelopmental abnormalities. We aimed to identify whether there is an excess risk of abnormalities in non-microcephalic children born to mothers with confirmed ZIKV infection compared [...] Read more.
Although very few controlled studies are available, in utero Zika virus (ZIKV)-exposed children are considered at risk for neurodevelopmental abnormalities. We aimed to identify whether there is an excess risk of abnormalities in non-microcephalic children born to mothers with confirmed ZIKV infection compared with ZIKV-unexposed children from the same population. In a cross-sectional study nested in two larger cohorts, we compared 324 ZIKV-exposed children with 984 unexposed controls. Outcomes were assessed using the Bayley Screening Test III applied around 24 months of age. Relative risks for classifying children as emergent or at-risk for neurodevelopmental delay in at least one of five domains were calculated, adjusting for covariates. In four of the five domains, few children were classified as emergent (4–12%) or at-risk (0.3–2.16%) but for the expressive communication domain it was higher for emergent (19.1–42.9%). ZIKV-exposed children were half as frequently classified as emergent, including after adjusting for covariates [RR = 0.52 (CI 95% 0.40; 0.66)]. However, no difference was detected in the at-risk category [RR = 0.83 (CI 95% 0.48; 1.44)]. Normocephalic children exposed to the Zika virus during pregnancy do not have a higher risk of being classified as at risk for neurodevelopmental abnormalities at two years of age. Full article
(This article belongs to the Special Issue Impact of Viruses on Maternal and Fetal Outcome)
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9 pages, 893 KiB  
Communication
Histological Alterations in Placentas of Pregnant Women with SARS-CoV-2 Infection: A Single-Center Case Series
by Jesus Enrique Patiño Escarcina, Ana Keila Carvalho Vieira da Silva, Malú Oliveira de Araújo Medeiros, Stephanie Santos Santana Fernandes, Luiza Andrade Agareno, Louise Andrade Garboggini, Marcela de Sá Gouveia, Vanessa Campos Duarte, Diogo Lago Morbeck and Lícia Maria Oliveira Moreira
Pathogens 2023, 12(10), 1197; https://doi.org/10.3390/pathogens12101197 - 26 Sep 2023
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Abstract
This study aimed to investigate the histopathological changes associated with SARS-CoV-2 infection in placentas. A case series of anatomopathological analysis was conducted on the placentas of pregnant women with SARS-CoV-2 who delivered between March and December 2020 at Santo Amaro Hospital (HSA) in [...] Read more.
This study aimed to investigate the histopathological changes associated with SARS-CoV-2 infection in placentas. A case series of anatomopathological analysis was conducted on the placentas of pregnant women with SARS-CoV-2 who delivered between March and December 2020 at Santo Amaro Hospital (HSA) in Salvador, Brazil. Out of the 29 placentas examined, the median weight was 423.0 (IQR: 385.0–521.0) g. Among them, 58.3% (n = 14) had inadequate weight relative to the newborn’s weight. The histopathological findings revealed that 86.2% (n = 25) of the placentas had poorly defined lobes, and the fetal and maternal surface color was normal in 89.7% (n = 26) and 93.1% (n = 27), respectively. Additionally, 51.7% (n = 15) of the umbilical cords displayed hypercoiling. The most frequent microscopic finding was infarction, present in 35.3% (n = 6) of the cases, followed by 11.8% (n = 2) for each of chorioamnionitis, chronic villitis, focal perivillositis, and laminar necrosis. Analysis of the umbilical cords identified 23.5% (n = 4) cases of intervillous thrombosis, while amnion analysis showed 13.8% (n = 4) cases of squamous metaplasia. Extraplacental membrane examination revealed fibrin deposition in 93.1% (n = 27) of the cases, necrosis in 62.0% (n = 18), calcifications in 51.7% (n = 15), cysts in 37.9% (n = 11), neutrophilic exudate in 17.2% (n = 5), thrombosis in 13.7% (n = 4), and delayed placental maturation in 6.9% (n = 2). All analyzed placentas exhibited histopathological changes, primarily vascular and inflammatory, which indicate SARS-CoV-2 infection in term pregnancies. These alterations could be associated with impaired placental function, fetal growth restriction, preeclampsia, and prematurity. However, further prospective studies are required to validate the type, prevalence, and prognosis of each of these changes. Full article
(This article belongs to the Special Issue Impact of Viruses on Maternal and Fetal Outcome)
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11 pages, 915 KiB  
Article
Maternal–Fetal Infections (Cytomegalovirus, Toxoplasma, Syphilis): Short-Term and Long-Term Neurodevelopmental Outcomes in Children Infected and Uninfected at Birth
by Cinzia Auriti, Silvia Bucci, Domenico Umberto De Rose, Luana Coltella, Alessandra Santisi, Ludovica Martini, Chiara Maddaloni, Iliana Bersani, Simona Lozzi, Francesca Campi, Concettina Pacifico, Martina Balestri, Daniela Longo and Teresa Grimaldi
Pathogens 2022, 11(11), 1278; https://doi.org/10.3390/pathogens11111278 - 31 Oct 2022
Cited by 4 | Viewed by 1698
Abstract
(1) Background: Infections in pregnancy can lead to miscarriage, premature birth, infections in newborns, and developmental disabilities in babies. Infected infants, symptomatic at birth, can have long-term sequelae, and asymptomatic babies are also at increased risk of developing long-term sensorineural outcomes. Targeted therapy [...] Read more.
(1) Background: Infections in pregnancy can lead to miscarriage, premature birth, infections in newborns, and developmental disabilities in babies. Infected infants, symptomatic at birth, can have long-term sequelae, and asymptomatic babies are also at increased risk of developing long-term sensorineural outcomes. Targeted therapy of the pregnant mother can reduce fetal and neonatal harm. (2) Aim of the study: To explore the association between symptoms and time of onset of long-term sequelae in infected children born from mothers who contracted an infection during pregnancy, by a long-term multidisciplinary follow-up. (3) Methods: For up to 2–4 years, we evaluated cognitive, motor, audiological, visual, and language outcomes in infants with symptomatic and asymptomatic congenital infections and in uninfected infants. (4) Results: 186 infants born from women who acquired Cytomegalovirus infection (n = 103), Toxoplasma infection (n = 50), and Syphilis (n = 33) during pregnancy were observed. Among them, 119 infants acquired the infection in utero. Infected infants, symptomatic at birth, obtained lower scores on the Cognitive and Motor Scale on Bayley-III compared to asymptomatic and uninfected infants (p = 0.026; p = 0.049). Many severe or moderate sequelae rose up within the first year of life. At 24 months, we observed sequelae in 24.6% (14/57) of infected children classified as asymptomatic at birth, compared to 68.6% (24/35) of symptomatic ones (χ2 = 15.56; p < 0.001); (5) Conclusions: Infected babies symptomatic at birth have a worse prognosis than asymptomatic ones. Long-term sequelae may occur in infected children asymptomatic at birth after the first year of life. Multidisciplinary follow-up until 4–6 years of age should be performed in all infected children, regardless of the presence of symptoms at birth. Full article
(This article belongs to the Special Issue Impact of Viruses on Maternal and Fetal Outcome)
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26 pages, 5639 KiB  
Systematic Review
Impact of Co-Occurrence of Obesity and SARS-CoV-2 Infection during Pregnancy on Placental Pathologies and Adverse Birth Outcomes: A Systematic Review and Narrative Synthesis
by Thaina Ferraz, Samantha J. Benton, Israa Zareef, Oluwatomike Aribaloye, Enrrico Bloise and Kristin L. Connor
Pathogens 2023, 12(4), 524; https://doi.org/10.3390/pathogens12040524 - 27 Mar 2023
Cited by 3 | Viewed by 1682
Abstract
Obesity is a risk factor for severe COVID-19 disease during pregnancy. We hypothesized that the co-occurrence of high maternal body mass index (BMI) and gestational SARS-CoV-2 infection are detrimental to fetoplacental development. We conducted a systematic review following PRISMA/SWiM guidelines and 13 studies [...] Read more.
Obesity is a risk factor for severe COVID-19 disease during pregnancy. We hypothesized that the co-occurrence of high maternal body mass index (BMI) and gestational SARS-CoV-2 infection are detrimental to fetoplacental development. We conducted a systematic review following PRISMA/SWiM guidelines and 13 studies were eligible. In the case series studies (n = 7), the most frequent placental lesions reported in SARS-CoV-2(+) pregnancies with high maternal BMI were chronic inflammation (71.4%, 5/7 studies), fetal vascular malperfusion (FVM) (71.4%, 5/7 studies), maternal vascular malperfusion (MVM) (85.7%, 6/7 studies) and fibrinoids (100%, 7/7 studies). In the cohort studies (n = 4), three studies reported higher rates of chronic inflammation, MVM, FVM and fibrinoids in SARS-CoV-2(+) pregnancies with high maternal BMI (72%, n = 107/149; mean BMI of 30 kg/m2) compared to SARS-CoV-2(−) pregnancies with high BMI (7.4%, n = 10/135). In the fourth cohort study, common lesions observed in placentae from SARS-CoV-2(+) pregnancies with high BMI (n = 187 pregnancies; mean BMI of 30 kg/m2) were chronic inflammation (99%, 186/187), MVM (40%, n = 74/187) and FVM (26%, n = 48/187). BMI and SARS-CoV-2 infection had no effect on birth anthropometry. SARS-CoV-2 infection during pregnancy associates with increased prevalence of placental pathologies, and high BMI in these pregnancies could further affect fetoplacental trajectories. Full article
(This article belongs to the Special Issue Impact of Viruses on Maternal and Fetal Outcome)
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