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BMC Pregnancy Childbirth . Peripartum outcomes and immune responses after SARS-CoV-2 infection in the third trimester of pregnancy

tetano

Editor, Senior Moderator
BMC Pregnancy Childbirth


. 2024 Jul 24;24(1):498.
doi: 10.1186/s12884-024-06707-5. Peripartum outcomes and immune responses after SARS-CoV-2 infection in the third trimester of pregnancy

Qi Shen[SUP] #[/SUP][SUP] 1 [/SUP], Shuai Dong[SUP] #[/SUP][SUP] 1 [/SUP], Neelam Kumari Shah[SUP] 1 [/SUP], Yuan Liang[SUP] 1 [/SUP], Jie Wang[SUP] 1 [/SUP], Yan-Hong Shan[SUP] 2 [/SUP], Jin He[SUP] 3 [/SUP]



Affiliations
Abstract

Background: SARS-CoV-2 infection in pregnant women during the third trimester resulted in overall adverse pregnancy outcomes compared to non-infected controls and a unique humoral and cellular response at delivery. In this study we aimed to assess the impact of SARS-CoV-2 infection on maternal/neonatal peripartum outcomes andimmunological profiles.
Method: In this study, we recruited 304 SARS-CoV-2 infected pregnant women and 910 SARS-CoV-2 non-infected pregnant women who were admitted for delivery. Peripartum and neonates' outcomes response to SARS-CoV-2 infection were analyzed. Furthermore, we characterized the antibody and cytokines profile in SARS-CoV-2 infected maternal blood (MB) and cord blood (CB). We also assessed routine laboratory tests and liver function tests in MB before labor. Unpaired T test, Mann-Whitney test and Spearman test were used to analyze the data.
Results: SARS-CoV-2 infected pregnant women were significantly associated with increased risk of adverse pregnancy outcomes, including preterm labor (13.8% vs. 9.5%, p = 0.033) and meconium-stained amniotic fluid (8.9% vs. 5.5%, p = 0.039). The risk of low birth weight (< 2500 g) (10.5% vs. 6.5%, p = 0.021) and Apgar score < 8 at 1-minute (9.2% vs. 5.8%, p = 0.049) significantly increased in newborns from COVID-19 positive mothers than their counterparts. Our results showed that antibodies were increased in adverse-outcome SARS-CoV-2 infected mothers and their neonates, and abnormal proportion of immune cells were detected in SARS-CoV-2 infected mothers. While the immune response showed no difference between adverse-outcome infected pregnant women and normal-outcome infected pregnant women. Thus, SARS-CoV-2 infection during the third trimester of pregnancy induced a unique humoral and cellular response at delivery.
Conclusion: SARS-CoV-2 infection closer to delivery could incline to adverse pregnancy outcomes. Therefore, the utmost care is required for SARS-CoV-2 infected pregnant women and their newborns.
Trial registration: The study protocol was approved by the Institutional Review Board of the First Hospital of Jilin University with the approval code number 23K170-001, and informed consent was obtained from all enrolled patients prior to sample collection.

Keywords: COVID-19; Immune response; Peripartum outcomes; Pregnancy.

 
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