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. 2024 Apr 12;25(8):4298.
doi: 10.3390/ijms25084298.

Genital Dysbiosis and Different Systemic Immune Responses Based on the Trimester of Pregnancy in SARS-CoV-2 Infection

Giuseppina Campisciano  1 , Alice Sorz  2 , Carolina Cason  1 , Nunzia Zanotta  1 , Fabrizia Gionechetti  3 , Maria Piazza  2 , Petra Carli  1 , Francesca Maria Uliana  1 , Lisa Ballaminut  1 , Giuseppe Ricci  2   4 , Francesco De Seta  2   5 , Gianpaolo Maso  2 , Manola Comar  1   4
Affiliations

Genital Dysbiosis and Different Systemic Immune Responses Based on the Trimester of Pregnancy in SARS-CoV-2 Infection

Giuseppina Campisciano et al. Int J Mol Sci. .

Abstract

Respiratory infections are common in pregnancy with conflicting evidence supporting their association with neonatal congenital anomalies, especially during the first trimester. We profiled cytokine and chemokine systemic responses in 242 pregnant women and their newborns after SARS-CoV-2 infection, acquired in different trimesters. Also, we tested transplacental IgG passage and maternal vaginal-rectal microbiomes. IgG transplacental passage was evident, especially with infection acquired in the first trimester. G-CSF concentration-involved in immune cell recruitment-decreased in infected women compared to uninfected ones: a beneficial event for the reduction of inflammation but detrimental to ability to fight infections at birth. The later the infection was acquired, the higher the systemic concentration of IL-8, IP-10, and MCP-1, associated with COVID-19 disease severity. All infected women showed dysbiosis of vaginal and rectal microbiomes, compared to uninfected ones. Two newborns tested positive for SARS-CoV-2 within the first 48 h of life. Notably, their mothers had acute infection at delivery. Although respiratory infections in pregnancy are reported to affect babies' health, with SARS-CoV-2 acquired early during gestation this risk seems low because of the maternal immune response. The observed vaginal and rectal dysbiosis could be relevant for neonatal microbiome establishment, although in our series immediate neonatal outcomes were reassuring.

Keywords: COVID-19; SARS-CoV-2; dysbiosis; dysimmunity; pregnancy.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Results of the analysis of SARS-CoV-2-specific IgG in maternal blood and cord blood samples collected within 24 h from delivery. Some cord blood samples were not available or the quantity was not sufficient for the anti-SARS-CoV-2 IgG testing.
Figure 2
Figure 2
Immune soluble factors. The significantly modulated soluble factors in maternal and cord blood of the analyzed groups. Differences were calculated by means of a Mann–Whitney U test for pairwise comparisons (GraphPad Prism v. 5). * p < 0.05.
Figure 3
Figure 3
The maternal microbiome. The log-transformed (log10) mean relative abundances of the significantly modulated bacteria, as assessed using the ANCOM test, in rectal and vaginal samples. W values (shown in brackets) indicate the number of times the null hypothesis is rejected by the analysis. The higher the W, the more likely a feature differs statistically.
Figure 4
Figure 4
Lactobacilli species. The mean relative abundances of the species of lactobacilli in the vaginal and rectal swabs of the Spread-CoV, Late-CoV, and Early-CoV groups and in the vaginal swabs of uninfected pregnant women at the time of delivery.
Figure 5
Figure 5
Workflow of the study.
See this image and copyright information in PMC

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