Maternal SARS-CoV-2 Infection at Delivery Increases IL-6 Concentration in Umbilical Cord Blood.

BACKGROUND: SARS-CoV-2 infection in pregnant women may induce inflammation within the amniotic cavity and/or an increase in proinflammatory cytokines in fetal circulation. The aim was to investigate levels of IL-6 in maternal blood, umbilical cord blood, and amniotic fluid in pregnant women infected with SARS-CoV-2 at delivery. METHODS: A single-center prospective observational case-control study of pregnant women diagnosed with SARS-CoV-2 infection at delivery was conducted. A total of 48 infected and 42 healthy women had IL-6 concentrations measured in their blood, amniotic fluid, and umbilical cord blood. RESULTS: The concentrations of IL-6 in maternal blood and amniotic fluid were similar in the study and control groups, while umbilical cord blood concentrations were significantly higher in SARS-CoV-2-positive women. The umbilical cord blood IL-6 concentration was related to composite neonatal morbidity. CONCLUSIONS: Maternal SARS-CoV-2 infection in pregnant women at delivery increases umbilical cord blood IL-6 concentration. The correlation between maternal and umbilical blood concentrations indicates a possibility of passage of IL-6 through the placenta. Perinatal alterations resulting from maternal SARS-CoV-2 infection at delivery carry a risk of impacting the health of infants even in asymptomatic course of infection.

[Nemaline myopathy as a cause of neonatal hypotonia - with emphasis on personal experiences. Report of a family with two brothers affected]. / Miopatia nitkowata jako przyczyna wiotkosci u noworodka, z uwzglednieniem wlasnych badan. przypadek rodzinny u 2 braci.

Nemaline myopathy is a heterogenous form of congenital myopathy characterised by a variable spectrum of clinical features, predominated in the severe form by profound muscle hypotonia and weakness accompanied by respiratory insufficiency. The clinical variability, with differing age of onset and severity of symptoms makes the diagnosis of nemaline myopathy difficult in some cases. Severe forms of nemaline myopathy may be caused by mutation of a number of different genes: skeletal muscle actin (ACTA1), nebulin (NEB) and alpha-tropomyosin (TPM3), all of which encode components of the sarcomeric thin filaments of skeletal muscle. We describe the severe form of nemaline myopathy diagnosed in two brothers who died at the age of 12 days and 9 months, due to respiratory insufficiency caused by severe muscle weakness. Polyhydramnios and weakness of foetal movements in the IIIrd trimester of pregnancy, as well as variable clinical severity were noted in both cases. Microscopically visible significant immaturity of muscle fibers was found in the skeletal muscle biopsy performed in one of the brothers. The diagnosis of nemaline myopathy was confirmed by the presence of nemaline bodies (rods) in sections stained using the Gomori trichrome method. Molecular studies of DNA isolated from blood leucocytes showed no mutation in the ACTA1 or the TPM3 genes. Linkage analysis with polymorphic markers did not rule out linkage to part of the NEB gene locus. Results of the clinical evaluation and the investigations performed in the family members confirm that it is essential to consider congenital myopathies in the differential diagnosis of neonatal and infantile hypotonia with respiratory insufficiency. Molecular verification of the clinical diagnosis is also important for genetic counselling of the families.

[Risk factors of surgical site infection in newborn infants]. / Czynniki ryzyka zakazenia pooperacyjnego u noworodków.

AIM OF THE STUDY: Was to estimate the risk factors for surgical site infections (SSJ) in the newborn infants. MATERIALS AND METHODS: We retrospectively analyzed medical records of 381 operated newborn infants in order to estimate the rate of SSI and risk factors. All types of operations were divided according to contamination of surgical wound /CDC classification: clean, clean-contaminated, contaminated and dirty infected/. Additionally we evaluated risk factors such as: birth weight, gestational age, congenital infection, additional surgery, other congenital defect and invasive procedures like: mechanical ventilation and presence of central venous line. Descriptive statistics and odds ratios with 95% confidence intervals were applied in univariate statistical analysis. RESULTS: The mean incidence of SSI was 37%. According to CDC classification SSI rate were 27%, 35%, 46%, 71% respectively. The most important risk factors of SSI were: mechanical ventilation (IS:10.80), central line (IS:8.20), birth weight below 1500 g (IS:5.03) and congenital infection (IS:4.74). The risk of SSI depended on the type of surgery. The incidence of infections was significantly higher for contaminated and dirty-infected wounds than for clean and clean-contaminated. Risk factors for SSI were similar for clean and clean-contaminated wounds as for all study group. CONCLUSIONS: The premature newborns who underwent surgery, were mechanically ventilated, with venous access had the highest risk of SSI. The significance of risk factors was the same for the total study group for every type of surgery wound.