Features of Lymphocyte Subset Composition in Neonates Born to Mothers Suffered from Covid-19 at Different Stages of Pregnancy

The relationship between the incidence of COVID-19 in pregnant women who have had a coronavirus infection at different gestational ages and the health status of paired neonates is of great interest. However, no sufficient convincing data fully reflecting features of subsequent neonatal period, the state of the immune system in this category of children, affecting characteristics of postnatal period have been accumulated. Based on this, it underlies the relevance of the current study aimed at investigating parameters of clinical and immunological state of neonatal health after paired mothers recovered from COVID-19 at different gestational ages. The prospective study included 131 women and 132 children. The main group consisted of women (n = 61) who had COVID-19 during pregnancy and paired newborns (n = 62) at gestational age (GA) of 37-41 weeks, the comparison group - women without laboratory-confirmed COVID-19 during pregnancy (n = 70) and paired newborns (n = 70) of similar gestational age. While analyzing the anamnesis of the patients, no significant differences in somatic and obstetric-gynecological diseases were found. Analyzing course of pregnancy revealed that low molecular weight heparins were significantly more often applied in the main group. The term and frequency of delivery by caesarean section in pregnant women in the main group did not significant differ from that of the control group. No significant difference in the frequency of causes accounting for the severity of the condition of neonates in paired mothers with COVID-19 at different trimester of gestation was found. Investigating lymphocyte subset composition, neutrophil phagocytic activity, and IgG class antibodies specific to SARS-CoV-2 was carried out. It was found that lymphocyte subset profile in newborns from paired mothers with COVID-19 at different trimesters of gestation differed only in the level of NK cells (CD56+) in children born to mothers recovered from COVID-19 in the first trimester. In this study, in general, no severe perinatal outcomes in newborns from paired mothers with COVID-19 during pregnancy were documented. No cases of moderate or severe maternal COVID-19 were observed. Therefore, further prospective studies are needed to assess an impact of COVID-19 severity on maternal and fetal birth outcomes and clarify optimal management of pregnant women in such cases.

FEATURES OF LYMPHOCYTE SUBSET COMPOSITION IN NEONATES BORN TO MOTHERS SUFFERED FROM COVID-19 AT DIFFERENT STAGES OF PREGNANCY.

The relationship between the incidence of COVID-19 in pregnant women who have had a coronavirus infection at different gestational ages and the health status of paired neonates is of great interest. However, no sufficient convincing data fully reflecting features of subsequent neonatal period, the state of the immune system in this category of children, affecting characteristics of postnatal period have been accumulated. Based on this, it underlies the relevance of the current study aimed at investigating parameters of clinical and immunological state of neonatal health after paired mothers recovered from COVID-19 at different gestational ages. The prospective study included 131 women and 132 children. The main group consisted of women (n = 61) who had COVID-19 during pregnancy and paired newborns (n = 62) at gestational age (GA) of 37-41 weeks, the comparison group - women without laboratory-confirmed COVID-19 during pregnancy (n = 70) and paired newborns (n = 70) of similar gestational age. While analyzing the anamnesis of the patients, no significant differences in somatic and obstetric-gynecological diseases were found. Analyzing course of pregnancy revealed that low molecular weight heparins were significantly more often applied in the main group. The term and frequency of delivery by caesarean section in pregnant women in the main group did not significant differ from that of the control group. No significant difference in the frequency of causes accounting for the severity of the condition of neonates in paired mothers with COVID-19 at different trimester of gestation was found. Investigating lymphocyte subset composition, neutrophil phagocytic activity, and IgG class antibodies specific to SARS-CoV-2 was carried out. It was found that lymphocyte subset profile in newborns from paired mothers with COVID-19 at different trimesters of gestation differed only in the level of NK cells (CD56+) in children born to mothers recovered from COVID-19 in the first trimester. In this study, in general, no severe perinatal outcomes in newborns from paired mothers with COVID-19 during pregnancy were documented. No cases of moderate or severe maternal COVID-19 were observed. Therefore, further prospective studies are needed to assess an impact of COVID-19 severity on maternal and fetal birth outcomes and clarify optimal management of pregnant women in such cases.Copyright © 2023 Saint Petersburg Pasteur Institute. All rights reserved.

IMPACT OF THE NOVEL CORONAVIRUS INFECTION (COVID-19) EXPERIENCED BY PREGNANT WOMEN ON THE HEALTH OF NEWBORNS

Background: Due to the high spread rate of SARS-CoV-2 and to the rapid increase in its incidence, including those among pregnant women, the novel coronavirus infection (COVID-19) has become a challenge in modern healthcare. Objective(s): To analyze the impact of the novel coronavirus infection experienced by pregnant women on the health of newborns in the early neonatal period. Material(s) and Method(s): A retrospective analysis was carried out of the birth records of 400 women who had experienced the novel coronavirus infection during pregnancy and the neonatal records of their newborns (n=500) who received health care in the clinical units of the V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia (Center), in July 2020 to July 2021. A comparison group consisted of randomly selected birth records of 495 pregnant women who had not been infected with COVID-19 and the neonatal records of their babies (n=500) born at the same Center at the same time. Result(s): The vast majority of women who had been infected with COVID-19 during pregnancy were found to have familial obstetric/gynecological and/or somatic histories. Among the factors aggravating pregnancy in the presence of COVID-19, chronic hypertension, hereditary thrombophilia, fat metabolism disorders, urogenital infections, and anemia are more common than those in the control group (p<0.05). This female group also tended to have miscarriage;however, no statistically significant differences could be detected (p=0.06). There were no statistically significant differences in the term and frequency of cesarean delivery in pregnant women in the study and control groups (p>0.05). Neonates born to women who had been infected with COVID-19 in the first trimester had its statistically significantly higher morbidity rates (p<0.05). The frequency of perinatal complications was higher in newborns whose mothers had experienced the novel coronavirus infection in the first trimester. Neonatal infants borns from women who had a new coronavirus infection in the third trimester, rhinitis and otitis media are statistically significantly more common in the early neonatal period. Among the factors leading to disruption of early neonatal adaptation of children whose mothers had a new coronavirus infection during pregnancy, the following were statistically significantly more common: infectious and inflammatory diseases (rhinitis, otitis media), hemorrhagic syndrome, and hypoglycemia (p<0.05). Neonates born to women who had been infected with COVID-19 in the first trimester were observed to have statistically significantly higher morbidity rates (p<0.05). The incidence of perinatal complications was higher in newborns whose mothers had experienced the novel coronavirus infection in the first trimester. Neonatal infants born to women who had the novel coronavirus infection in the third trimester were statistically significantly more commonly recorded to have rhinitis and otitis media in the early neonatal period. Among the factors leading to failure of early neonatal adaptation of babies whose mothers had the novel coronavirus infection during pregnancy, there were statistically significantly more often infectious and inflammatory diseases (rhinitis, otitis media), hemorrhagic syndrome, and hypoglycemia (p<0.05). Conclusion(s): The incidence of perinatal complications in babies born to women who had been infected with COVID-19 depended on their gestational age and was higher than that in newborns whose mothers had experienced the novel coronavirus infection in the first trimester. At the same time, the incidence of infectious and inflammatory diseases proved to be higher in infants whose mothers had a coronavirus infection in the third trimester. Failure of early neonatal adaptation of babies born to women who had an infection caused by SARS-CoV-2 during pregnancy may be due to both infectious and non-infectious factors that complicate the course of pregnancy and childbirth. Copyright © A group of authors, 2022.

Mild or Moderate COVID-19 during Pregnancy Does Not Affect the Content of CD34+ Hematopoietic Stem Cells in Umbilical Cord Blood of Newborns.

The study included umbilical cord blood samples (n=64) intended for cryogenic storage of hematopoietic stem cells and obtained from patients with a history of mild and moderate forms of COVID-19 during pregnancy. The control group was composed of samples (n=746) obtained from healthy women in labor. A comparative analysis of the volume of cord blood collected, the total leukocyte count, the relative and absolute content of cells with the CD34+/CD45+ phenotype revealed no significant differences between the groups.