The etiology of preeclampsia

American Journal of Obstetrics and Gynecology, Год журнала: 2022, Номер 226(2), С. S844 - S866

Опубликована: Фев. 1, 2022

Язык: Английский

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Preeclampsia and severe acute respiratory syndrome coronavirus 2 infection: a systematic review

Journal of Hypertension, Год журнала: 2022, Номер 40(9), С. 1629 - 1638

Опубликована: Июль 22, 2022

Objective: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of disease 2019 (COVID-19) that has rapidly spread worldwide, causing hundreds thousand deaths. Normal placentation characterized by many processes strictly regulated during pregnancy. If impaired, it can lead to gestational disorders, such as preeclampsia a multisystem disorder occurs in 2–8% pregnancies worldwide. Methods: We performed systematic search understand potential involvement SARS-CoV-2 onset using databases, PubMed and Web Science until 31 January 2022. Results: infection not only causes damage system but also infect human placenta cells impairing pivotal necessary for normal development. The inflammatory response trigged COVID-19 very similar one found suggesting possible link between Conclusion: Some studies showed affected had higher incidence compared with SARS-CoV-2-negative ones. However, increased blood pressure does allow associate hypertension common factor both conditions. At present, no diagnostic tools are available discriminate real from preeclampsia-like patients infection. Thus, new specific assure an appropriate diagnosis these patients, especially case severe disease.

Язык: Английский

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Pregnancy outcomes after SARS-CoV-2 infection by trimester: A large, population-based cohort study

PLoS ONE, Год журнала: 2022, Номер 17(7), С. e0270893 - e0270893

Опубликована: Июль 20, 2022

Data regarding women infected with SARS-CoV-2 during early trimesters are scarce. We aimed to assess preterm birth (PTB) and small-for-gestational-age (SGA) rates in a large unselected cohort by trimester at infection overall.A retrospective study including all positive RT-PCR test non-ectopic singleton pregnancy between February 21st 2020 July 2nd 2021 (N = 2753). Each woman was matched non-infected pregnant age, last menstruation date, sector, socioeconomic status.Logistic regression conducted the risks of PTB SGA an interaction group infection. Multivariable models included underlying diseases, previous abortions null parity. Subgroup analyses were on symptomatic women.A total 2753 /2789 (98.7%) eligible that could be matched, among them, 17.4% 48.4% first third trimesters, respectively. While second infections not associated (p>0.8), particular after 34 weeks gestation had greater risk adjusted ORs 2.76 (95% CI 1.63-4.67) 7.10 2.44-20.61), further heightened (OR 4.28, 95% 1.94-9.25). comparable groups across Pregnancy loss incidence similar both (adjusted OR 1.16; 0.90-1.50).SARS-CoV-2 increased only late pregnancy, particularly women.

Язык: Английский

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Differences and similarities in endothelial and angiogenic profiles of preeclampsia and COVID-19 in pregnancy

American Journal of Obstetrics and Gynecology, Год журнала: 2022, Номер 227(2), С. 277.e1 - 277.e16

Опубликована: Март 26, 2022

COVID-19 presents a spectrum of signs and symptoms in pregnant women that might resemble preeclampsia. Differentiation between severe preeclampsia is difficult some cases.To study biomarkers endothelial damage, coagulation, innate immune response, angiogenesis pregnancy addition to vitro alterations cells exposed sera from with COVID-19.Plasma samples were obtained infection classified into mild (n=10) or (n=9) normotensive pregnancies as controls patients (n=13). A panel plasmatic was assessed, including vascular cell adhesion molecule-1, soluble tumor necrosis factor-receptor I, heparan sulfate, von Willebrand factor antigen (activity multimeric pattern), α2-antiplasmin, C5b9, neutrophil extracellular traps, placental growth factor, fms-like tyrosine kinase-1, angiopoietin 2. In addition, microvascular patients' sera, changes the expression intercellular molecule 1 on membranes release matrix evaluated through immunofluorescence. Changes inflammation signaling pathways also assessed by p38 mitogen-activated protein kinase phosphorylation. Statistical analysis included univariate multivariate methods.Biomarker profiles similar those controls. Both showed significant most circulating distinctive profiles. Whereas exhibited higher concentrations factor-α receptor antigen, reduction compared controls, presented marked increase molecule-1 I (significantly increased COVID-19), striking activity, α2-antiplasmin. As expected, reduced kinase-1 2, very high ratio observed C5b9 traps detected Principal component demonstrated clear separation other groups (first second components explained 42.2% 13.5% variance), mainly differentiated variables related kinase-1. Von revealed absence high-molecular-weight multimers (similar profile disease type 2A), whereas healthy patients, pattern normal. Sera both induced an overexpression culture However, effect less pronounced than COVID-19. Immunoblots lysates Patients statistically different suggesting can activate inflammatory pathways.Although dysfunction, exhibit coagulopathy, angiogenic imbalance could aid differential diagnosis these entities.

Язык: Английский

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Maternal and neonatal outcomes following SARS-CoV-2 infection

Seminars in Fetal and Neonatal Medicine, Год журнала: 2023, Номер 28(1), С. 101428 - 101428

Опубликована: Фев. 1, 2023

Язык: Английский

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First- or second-trimester SARS-CoV-2 infection and subsequent pregnancy outcomes

American Journal of Obstetrics and Gynecology, Год журнала: 2022, Номер 228(2), С. 226.e1 - 226.e9

Опубликована: Авг. 13, 2022

Язык: Английский

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Pre-Eclampsia: From Etiology and Molecular Mechanisms to Clinical Tools—A Review of the Literature

Current Issues in Molecular Biology, Год журнала: 2023, Номер 45(8), С. 6202 - 6215

Опубликована: Июль 25, 2023

Pre-eclampsia is a severe pregnancy-related complication that manifests as syndrome with multisystem involvement and damage. It has significantly grown in frequency during the past 30 years could be considered one of major causes maternal fetal morbidity mortality. However, specific etiology molecular mechanisms pre-eclampsia are still poorly known have variety causes, such altered angiogenesis, inflammations, infections, obesity, metabolic disorders, gestational diabetes, autoimmune diseases. Perhaps most promising area under investigation imbalance angiogenic factors its effects on vascular function, though studies placental oxidative stress immune response demonstrated intriguing findings. to determine relative importance each cause impact actions aiming reduce incidence this illness, more research needed. Moreover, it necessary better understand etiologies subtype well pathophysiology other obstetrical syndromes identify clinical tool able recognize patients at risk early.

Язык: Английский

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Pregnancy-specific responses to COVID-19 revealed by high-throughput proteomics of human plasma

Communications Medicine, Год журнала: 2023, Номер 3(1)

Опубликована: Апрель 4, 2023

Pregnant women are at greater risk of adverse outcomes, including mortality, as well obstetrical complications resulting from COVID-19. However, pregnancy-specific changes that underlie such worsened outcomes remain unclear.Plasma samples were collected pregnant and non-pregnant individuals (male female) with (n = 72 pregnant, 52 non-pregnant) without 29 41 COVID-19 patients grouped asymptomatic, mild, moderate, severe, or critically ill according to NIH classifications. Proteomic profiling 7,288 analytes corresponding 6,596 unique protein targets was performed using the SOMAmer platform.Herein, we profile plasma proteome controls show alterations display a dose-response relationship disease severity; yet, proteomic perturbations dampened during pregnancy. In both state, response induced by shows enrichment mediators implicated in cytokine storm, endothelial dysfunction, angiogenesis. Shared identified: tailored may protect conceptus heightened inflammation, while stronger repel infection. Furthermore, can accurately identify patients, even when asymptomatic mild symptoms.This study represents most comprehensive characterization patients. Our findings emphasize distinct immune modulation between states, providing insight into pathogenesis potential explanation for more severe observed women.Pregnant increased experiencing compared general population. reasons this still unclear. We measured proteins present blood these healthy individuals. found some COVID-19-associated lower levels women, which could help fetus harmful body’s natural While affected shared others distinctly only group.

Язык: Английский

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Maternal infection with COVID-19 and increased risk of adverse pregnancy outcomes: a meta-analysis

The Journal of Maternal-Fetal & Neonatal Medicine, Год журнала: 2022, Номер 35(25), С. 9368 - 9375

Опубликована: Фев. 13, 2022

Background: The Coronavirus disease 2019 (COVID-19) pandemic has become worldwide, posing particularly severe challenges. Pregnancy brings changes that might make individuals more vulnerable to this viral infection. To date, the impact of COVID-19 infection on pregnancy outcomes remains controversial.Method: We performed a meta-analysis address outcomes. searched PubMed and China National Knowledge infrastructure (CNKI) databases for related articles. odds ratio (OR) corresponding 95% confidence interval (95% CI) was used define INFECTION severity statistical heterogeneity among studies batched with Q-test I2 statistics.Results: collected 38 including 127,805 women. Our revealed pregnant women have been linked an increased risk premature birth (OR = 1.66, CI 1.41–1.96), stillbirth 1.98, 1.22–3.21), pre-eclampsia 1.46, 1.18–1.80), PROM 1.39, 1.07–1.81).Conclusions: showed increases preterm birth, stillbirth, pre-eclampsia, PROM. Screening early care intervene is important, given adverse

Язык: Английский

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Distinct Cellular Immune Responses to SARS-CoV-2 in Pregnant Women

The Journal of Immunology, Год журнала: 2022, Номер 208(8), С. 1857 - 1872

Опубликована: Апрель 4, 2022

Pregnant women are at increased risk of adverse outcomes, including preeclampsia and preterm birth, that may result from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Pregnancy imprints specific maternal immune responses can modulate host susceptibility to microbial infection; therefore, recent studies have focused on the humoral response against SARS-CoV-2 in pregnant women. However, pregnancy-specific cellular triggered by infection poorly understood. In this study, we undertook an extensive vitro investigation determine particles proteins/peptides First, show do not alter oxidative burst neutrophils monocytes. Yet, particles/proteins shift monocyte activation classical intermediate states pregnant, but nonpregnant, Furthermore, proteins, or peptide pools, mildly enhance T cell during pregnancy. As expected, B phenotypes heavily modulated all women; yet, pregnancy itself further modified such these adaptive cells. Lastly, report governs cytokine circulation, which IFN-β IL-8 were diminished upon challenge. Collectively, findings highlight differential nonpregnant shed light mechanisms implicated disease 2019

Язык: Английский

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