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Viruses
Special Issues
Congenital Viral Infections: Mechanisms of Vertical Transmission and Pathology Findings
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Congenital Viral Infections: Mechanisms of Vertical Transmission and Pathology Findings

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Human Virology and Viral Diseases".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 8313

Special Issue Editor

Dr. Maria P. Bonasoni

E-Mail Website
Guest Editor
Pathology Unit, Azienda USL–IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
Interests: perinatal pathology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Congenital viral infections may affect the fetus at any time during pregnancy, passing from the mother to the baby through the placenta. Mothers may be asymptomatic or present aspecific flu-like symptoms. The main viruses in which vertical transmission is recognized are Cytomegalovirus, Parvovirus, Rubella, Herpes Viruses, Chickenpox, and Zika. COVID-19’s incidence of vertical transmission and its effects on the fetus are still unknown. Viruses present specific mechanisms of mother-to-fetus spread, passing or disrupting the placental barrier. Characteristic fetal damage may be detected by ultrasound and further investigated by magnetic resonance, especially encephalic malformations. Congenital viral damage may vary from mild to severe fetal damage, or lead to intrauterine death. Specific histological findings may be observed in the fetal or placental tissues.

This Special Issue will cover the main aspects of congenital viral infections, including the mechanisms of placental passage, the prenatal characteristics, and histopathological features in case of autopsy and/or placental examination.

Dr. Maria P. Bonasoni
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 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

  • fetal pathology
  • placental pathology
  • placental barrier disruption
  • viral infection in pregnancy
  • fetal/neonatal outcome in congenital viral infections

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Published Papers (4 papers)

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Review

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31 pages, 2919 KiB  
Review
Congenital and Perinatal Viral Infections: Consequences for the Mother and Fetus
by Mariam Al Beloushi, Huda Saleh, Badreldeen Ahmed and Justin C. Konje
Viruses 2024, 16(11), 1698; https://doi.org/10.3390/v16111698 - 30 Oct 2024
Viewed by 1286
Abstract
Viruses are the most common congenital infections in humans and an important cause of foetal malformations, neonatal morbidity, and mortality. The effects of these infections, which are transmitted in utero (transplacentally), during childbirth or in the puerperium depend on the timing of the [...] Read more.
Viruses are the most common congenital infections in humans and an important cause of foetal malformations, neonatal morbidity, and mortality. The effects of these infections, which are transmitted in utero (transplacentally), during childbirth or in the puerperium depend on the timing of the infections. These vary from miscarriages (usually with infections in very early pregnancy), congenital malformations (when the infections occur during organogenesis) and morbidity (with infections occurring late in pregnancy, during childbirth or after delivery). The most common of these viruses are cytomegalovirus, hepatitis, herpes simplex type-2, parvovirus B19, rubella, varicella zoster and zika viruses. There are currently very few efficacious antiviral agents licensed for use in pregnancy. For most of these infections, therefore, prevention is mainly by vaccination (where there is a vaccine). The administration of immunoglobulins to those exposed to the virus to offer passive immunity or appropriate measures to avoid being infected would be options to minimise the infections and their consequences. In this review, we discuss some of the congenital and perinatal infections and their consequences on both the mother and fetus and their management focusing mainly on prevention. Full article
(This article belongs to the Special Issue Congenital Viral Infections: Mechanisms of Vertical Transmission and Pathology Findings)
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Other

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16 pages, 804 KiB  
Systematic Review
Intrauterine Fetal Demise, Spontaneous Abortion and Congenital Cytomegalovirus: A Systematic Review of the Incidence and Histopathologic Features
by Megan H. Pesch, Jonathan Mowers, Anh Huynh and Mark R. Schleiss
Viruses 2024, 16(10), 1552; https://doi.org/10.3390/v16101552 - 30 Sep 2024
Viewed by 773
Abstract
The objective was to review the existing literature reporting on spontaneous abortion (SA) and intrauterine fetal demise (IUFD) associated with cytomegalovirus (CMV) infection. A review using standardized terminology such as ‘intrauterine fetal death’, ‘congenital cytomegalovirus’ and ‘CMV’ was performed using PubMed and Embase [...] Read more.
The objective was to review the existing literature reporting on spontaneous abortion (SA) and intrauterine fetal demise (IUFD) associated with cytomegalovirus (CMV) infection. A review using standardized terminology such as ‘intrauterine fetal death’, ‘congenital cytomegalovirus’ and ‘CMV’ was performed using PubMed and Embase (Medline) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Twenty-one studies met inclusion criteria. CMV was identified as a potential or likely factor in a median of 7.1% of SA or IUFD in study cohorts. Of the studies, 11 used fetal remains, 18 used placenta, 6 used serum, and 1 used post-mortem dried blood spot as specimens for testing for CMV. Features commonly observed were fetal thrombotic vasculopathy, hydrops fetalis and chronic villitis. CMV is frequently noted in studies evaluating viral etiologies of SA or IUFD. Large population-based studies are needed to estimate the incidence of CMV-associated SA or IUFD. CMV and congenital CMV should be included on the differential diagnosis in all cases of SA or IUFD of unknown etiology. Full article
(This article belongs to the Special Issue Congenital Viral Infections: Mechanisms of Vertical Transmission and Pathology Findings)
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Graphical abstract

7 pages, 214 KiB  
Viewpoint
High Rates of Miscarriage and Stillbirth among Pregnant Women with Clade I Mpox (Monkeypox) Are Confirmed during 2023–2024 DR Congo Outbreak in South Kivu Province
by David A. Schwartz
Viruses 2024, 16(7), 1123; https://doi.org/10.3390/v16071123 - 13 Jul 2024
Cited by 8 | Viewed by 2551
Abstract
Mpox (monkeypox) is a neglected tropical disease that has received increased attention since the multi-nation outbreak that began in 2022. The virus is endemic in West and Central Africa, where the Democratic Republic of the Congo (DRC) is the most affected country. Clade [...] Read more.
Mpox (monkeypox) is a neglected tropical disease that has received increased attention since the multi-nation outbreak that began in 2022. The virus is endemic in West and Central Africa, where the Democratic Republic of the Congo (DRC) is the most affected country. Clade I monkeypox virus (MPXV) infection is endemic in the DRC and has an overall case fatality rate of 10.6% among children and adults. A study conducted in Sankuru Province, DRC, from 2007 to 2011 demonstrated that 75% of pregnant women with mpox had miscarriages or stillbirth. Further analysis of a stillborn fetus showed that MPXV could infect both the placenta and fetus, causing congenital infection. No additional cases of Clade I MPXV in pregnant women were reported until a new outbreak occurred in South Kivu Province during 2023 and 2024. Eight pregnant women having Clade I MPXV infection were identified, of whom four had either miscarriages or stillbirth, representing a 50% fetal mortality rate. These reports confirm previous data from the DRC that indicate the capability of Clade I MPXV to affect the fetus, causing congenital infection and fetal loss in a high percentage of cases. In this article, we review both past and new data from the DRC on the effects of Clade I MPXV during pregnancy and discuss the association of mpox with fetal loss. Full article
(This article belongs to the Special Issue Congenital Viral Infections: Mechanisms of Vertical Transmission and Pathology Findings)
19 pages, 1568 KiB  
Systematic Review
Maternal Fever and Reduced Fetal Movement as Predictive Risk Factors for Adverse Neonatal Outcome in Cases of Congenital SARS-CoV-2 Infection: A Meta-Analysis of Individual Participant Data from Case Reports and Case Series
by Elena S. Bernad, Florentina Duica, Panagiotis Antoniadis, Andreea Moza, Diana Lungeanu, Marius Craina, Brenda C. Bernad, Edida Maghet, Ingrid-Andrada Vasilache, Anca Laura Maghiari, Diana-Aurora Arnautu and Daniela Iacob
Viruses 2023, 15(7), 1615; https://doi.org/10.3390/v15071615 - 24 Jul 2023
Cited by 1 | Viewed by 2989
Abstract
Objectives: To determine risk factors for primary and secondary adverse neonatal outcomes in newborns with congenital SARS-CoV-2 infection. Data sources: PubMed/MEDLINE and Google Scholar from January 2020 to January 2022. Study eligibility criteria: newborns delivered after 24 weeks of gestation with confirmed/possible congenital [...] Read more.
Objectives: To determine risk factors for primary and secondary adverse neonatal outcomes in newborns with congenital SARS-CoV-2 infection. Data sources: PubMed/MEDLINE and Google Scholar from January 2020 to January 2022. Study eligibility criteria: newborns delivered after 24 weeks of gestation with confirmed/possible congenital SARS-CoV-2 infection, according to standard classification criteria. Methods: Execution of the IPD analyses followed the PRISMA-IPD statement. Univariate non-parametric tests compared numerical data distributions. Fisher’s exact or Chi-square test determined categorical variables’ statistical significance. Multivariate logistic regression revealed risk factors for adverse neonatal outcome. Results: Maternal fever was associated with symptomatic congenital infection (OR: 4.55, 95% CI: 1.33–15.57). Two-thirds of women that reported decreased fetal movements were diagnosed with IUFD (p-value = 0.001). Reduced fetal movement increased the risk of intrauterine fetal death by 7.84 times (p-value = 0.016, 95% CI: 2.23–27.5). The risk of stillbirth decreased with gestational age at the time of maternal infection (p-value < 0.05, OR: 0.87, 95% CI: 0.79–0.97). Conclusions: Maternal fever and perception of reduced fetal movement may be predictive risk factors for adverse pregnancy outcome in cases with congenital SARS-CoV-2 infection. Full article
(This article belongs to the Special Issue Congenital Viral Infections: Mechanisms of Vertical Transmission and Pathology Findings)
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