Association between new coronavirus infection and fetal growth restriction
- Authors: Lipatov I.S.1, Tezikov Y.V.1, Kalinkina O.B.1, Tyutyunnik V.L.2, Kan N.E.2, Majorova M.O.1, Yakovleva M.A.1
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Affiliations:
- Samara State Medical University, Ministry of Health of Russia
- Academician V.I. Kulakov National Medical Research Centre of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
- Issue: No 2 (2023)
- Pages: 53-62
- Section: Original Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/337662
- DOI: https://doi.org/10.18565/aig.2022.260
- ID: 337662
Cite item
Open Access
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Abstract
Objective: To investigate the laboratory and instrumental characteristics of fetal growth restriction (FGR) secondary to novel coronavirus infection (NCI) to identify pathogenetically relevant predictive markers.
Materials and methods: During the epidemic activity of the NCI Delta strain, 140 high-risk pregnant women were tested at 18–21 weeks and 26–34 weeks of gestation. Retrospectively, taking into account the fact of NCI disease and the exclusion of severe somatic and obstetric comorbidities, 2 groups were formed. Group 1 (n=32) included pregnant women with FGR, without a history of NCI. Group 2 (n=41) included pregnant women with FGR who recovered from NCI by the end of the second and third trimesters. Thirty healthy pregnant women served as the controls. In addition to ultrasound assessment of the fetal placental unit, patients underwent testing for markers of inflammation, endothelial hemostasis dysfunction, decidualization, placental angiogenesis, and pathological insulin resistance.
Results: Pregnant women with a history of NCI had a higher incidence of FGR (1.3 times; OR 2.41 [95% CI 1.12–5.17]), more severe forms of FGR (2 times; OR 3.27 [95% CI 1.22–8.76]), more severe fetal-placental blood flow abnormalities (3.5-fold; OR 11.07 [95% CI 3.68-33.27]), and oligohydramnios (4.5-fold; OR 8.94 [95% CI 3.65–30.17]). The impact of NCI on the formation of placental insufficiency was expressed by an increase in systemic changes (thrombopoiesis, apoptosis), modulation of local processes (decidualization, placental angiogenesis), and the development of pathological insulin resistance and hyperinsulinemia, an immunopathological process of endotheliocytes. The identification of the most informative markers of FGR due to NCI allowed the development of a predictive index.
Conclusion: An in-depth study of the impact of NCI on the formation of FGR has important scientific and practical implications for the optimization of FGR prediction, which may help identify appropriate patient management strategies for high-risk pregnant women.
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About the authors
Igor S. Lipatov
Samara State Medical University, Ministry of Health of Russia
Email: i.lipatoff2012@yandex.ru
ORCID iD: 0000-0001-7277-7431
SPIN-code: 9625-2947
ResearcherId: С-5060-2018
Professor, Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology of the Institute of Clinical Medicine
Russian Federation, SamaraYurii V. Tezikov
Samara State Medical University, Ministry of Health of Russia
Author for correspondence.
Email: yra.75@inbox.ru
ORCID iD: 0000-0002-8946-501X
SPIN-code: 2896-6986
ResearcherId: С-6187-2018
Professor, Dr. Med. Sci., Head of the Department of Obstetrics and Gynecology of the Institute of Clinical Medicine
Russian Federation, SamaraOlga B. Kalinkina
Samara State Medical University, Ministry of Health of Russia
Email: maiorof@mail.ru
ORCID iD: 0000-0002-1828-3008
SPIN-code: 1260-6181
ResearcherId: I-3529-2014
Associate Professor, Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology of the Institute of Clinical Medicine
Russian Federation, SamaraVictor L. Tyutyunnik
Academician V.I. Kulakov National Medical Research Centre of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Email: tioutiounnik@mail.ru
ORCID iD: 0000-0002-5830-5099
SPIN-code: 1963-1359
Scopus Author ID: 56190621500
ResearcherId: B-2364-2015
Professor, Dr. Med. Sci., Leading Researcher of Research and Development Service
Russian Federation, MoscowNatalia E. Kan
Academician V.I. Kulakov National Medical Research Centre of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Email: kan-med@mail.ru
ORCID iD: 0000-0001-5087-5946
SPIN-code: 5378-8437
Scopus Author ID: 57008835600
ResearcherId: B-2370-2015
Professor, Dr. Med. Sci., Deputy Director for Science
Russian Federation, MoscowMariya O. Majorova
Samara State Medical University, Ministry of Health of Russia
Email: maria002507@mail.ru
ORCID iD: 0000-0002-1844-1838
5th year student at the Institute of Clinical Medicine
Russian Federation, SamaraMariya A. Yakovleva
Samara State Medical University, Ministry of Health of Russia
Email: mariayakovleva99@mail.ru
ORCID iD: 0000-0002-0137-5045
6th year student at the Institute of Clinical Medicine
Russian Federation, SamaraReferences
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