Mother-to-child Transmission Research Articles

A case of congenital cytomegalovirus infection in a child with Prader–Willi syndrome

A possible manifestation of intrauterine infection with herpes viruses can be severe eye damage. Various visual disturbances with negative consequences have been described in Prader–Willi syndrome. The article describes bilateral chorioretinitis in a child with Prader–Willi syndrome, which developed against the background of congenital herpetic infection of CMV etiology.

Hepatitis A Seroprevalence Among HIV-Exposed and Unexposed Pediatric Populations in South Africa.

Background: There is limited evidence comparing hepatitis A seroprevalence among HIV-exposed uninfected (HEU), HIV-infected (HIV), and unexposed uninfected (HUU) children. This compromises rational vaccine decision-making. Methods: This study comprised a retrospective health facility-based population of children aged 1 month-12 years. Archival sera were tested for markers of acute (anti-HAV IgM) or past (total anti-HAV) HAV infection. Subgroup analysis was conducted based on perinatal HIV exposure or infection status. Results: Among 513 children, the median age was 10 (IQR: 4-25) months. The median maternal age was 29 (IQR: 25-34) years. An anti-HAV seropositivity of 95.1% (117/122 [95% CI 90.2-98.4]) was found among those ≤6 months of age, indicative of the rate of transplacental antibody transfer. Among 1-12-year-olds, hepatitis A seroprevalence was 19.3% (37/192 [95% CI 14.1-25.7]), while 1.1% (2/188 [95% CI 0.12-2.76]) had evidence of acute infection. Compared to HIV-exposed subgroups (HIV = 60%, 6/10 [95% CI 27.4-86.3] and HEU = 45%, 9/20 [95% CI 23.8-68]), hepatitis A seroprevalence among HUU children was low (29.2%, 47/161 [95% CI 22.4-37.0]). Conclusions: Natural immunity among HIV-exposed and unexposed children in South Africa is insufficient to protect against severe liver complications associated with HAV infection later in adulthood.

In utero human cytomegalovirus infection expands NK-like FcγRIII+ CD8+ T cells that mediate Fc antibody functions.

Human cytomegalovirus (HCMV) profoundly impacts host T and natural killer (NK) cells across the lifespan, yet how this common congenital infection modulates developing fetal immune cell compartments remains underexplored. Using cord blood from neonates with and without congenital HCMV (cCMV) infection, we identify an expansion of Fcγ receptor III (FcγRIII)-expressing CD8+ T cells following HCMV exposure in utero. Most FcγRIII+ CD8+ T cells express the canonical αβ T cell receptor (TCR) but a proportion express non-canonical γδ TCR. FcγRIII+ CD8+ T cells are highly differentiated and have increased expression of NK cell markers and cytolytic molecules. Transcriptional analysis reveals FcγRIII+ CD8+ T cells upregulate T-bet and downregulate BCL11B, known transcription factors that govern T/NK cell fate. We show that FcγRIII+ CD8+ T cells mediate antibody-dependent IFNγ production and degranulation against IgG-opsonized target cells, similar to NK cell antibody-dependent cellular cytotoxicity (ADCC). FcγRIII+ CD8+ T cell Fc effector functions were further enhanced by interleukin-15 (IL-15), as has been observed in neonatal NK cells. Our study reveals that FcγRIII+ CD8+ T cells elicited in utero by HCMV infection can execute Fc-mediated effector functions bridging cellular and humoral immunity and may be a promising target for antibody-based therapeutics and vaccination in early life.

Determinants of HIV infection at 18 months of age among HIV-exposed infants in the context of PMTCT interventions in southern Ethiopia.

Mother-to-child transmission (MTCT) of HIV accounts for over 90% of annual HIV infections among children under the age of 15. Despite the introduction of the Option B+ strategy in Ethiopia in 2013, the rate of MTCT of HIV at 18 months was 15% in 2020. This study aimed to identify determinants of HIV infection among HIV-exposed infants (HEIs) in the context of prevention of MTCT (PMTCT) care in southern Ethiopia. We conducted a retrospective facility-based study of 299 mother-baby pairs (HIV-infected women and their HEIs up to 18 months) enrolled in PMTCT care at three health facilities in Wolaita Sodo town, southern Ethiopia, from September 2015 to October 2021. Data was collected from medical charts and PMTCT registers. Logistic regression was used to identify determinants of HIV infection among HEIs. At enrolment into PMTCT care, most women were already on ART (75.3%) and in clinical stage I (89.6%) according to the World Health Organization's algorithm. Overall, 13 (4.3%, 95% CI: 2.5%-7.4%) HEIs were HIV-infected; the level was higher among HEIs born at home (17.9% (95% CI: 7.6%-36.5%). Being born to HIV-positive women with late WHO clinical stage (III and IV) of HIV (AOR = 9.1, 95%CI: 2.4, 34.5), being born at home (AOR = 4.8, 95%CI: 1.1-20.7), being born to women newly diagnosed with HIV (AOR = 4.8, 95%CI: 1.3-17.4), and low infant adherence to cotrimoxazole prophylaxis (AOR = 5.4, 95%CI: 1.4-20.4) increased the odds of MTCT. HIV infection levels among breastfeeding HEIs in PMTCT care was <5%, meeting the WHO transmission rate targets. Strengthening PMTCT care to expand community-based PMTCT interventions such as improving women's and communities' awareness of HIV, PMTCT and promoting male involvement would reduce reduce HIV infection among children to reach the 95-95-95 targets to end HIV in Ethiopia.

Cytomegalovirus-associated pancytopenia in a four-month-old infant: a case report

Cytomegalovirus (CMV) is a beta-herpes virus causing common infections, often asymptomatic in healthy individuals. However, it poses increased risks to immunocompromised individuals and can cause congenital infections, leading to severe disabilities. CMV infection can cause significant hematological abnormality. A four-month-old female infant was admitted for decreased feeding for two days. She was severely pale, without hepatosplenomegaly. In initial laboratory investigations hemoglobin, platelet count, and white blood cells were decreased. The patient was transfused with whole blood and referred to a tertiary care center. Further workup, including bone marrow biopsy, showed hypocellular marrow. The Urine CMV Polymerase Chain Reaction (PCR) test returned highly positive with a viral load of 1,700,000 copies/mL. This patient was diagnosed with CMV-associated bone marrow suppression, and she was prescribed valganciclovir at a dosage of 16 mg/kg/dose every 12 h for 6 months. She had shown significant hematologic parameter improvement during subsequent follow-up. Pancytopenia in infancy should include a differential diagnosis for CMV infection. The early recognition and correct infection management, including antiviral therapy and symptomatic treatment, yield a better prognosis.

Successful Management of High-Risk Pregnancy with TORCH Infection History and Chronic Hypertension

A 41-year-old pregnant woman of Javanese ethnicity attended the outpatient clinic of a private hospital, presented with fifth pregnancy and no living children due to a history of ectopic pregnancy, two times IUFD, and one time neonatal death. The patient also had a history of chronic hypertension and asthma. The examination showed positive IgG Toxoplasma and CMV antibody levels. The patient's blood pressure also never touched the normal limit since the beginning of pregnancy. At the end of pregnancy, she had very high blood pressure and proteinuria. According to WHO Maternal Mortality Rate (MMR) is still very high, where two of the five highest causes are infection and hypertension in pregnancy. High risk pregnancies require special attention in monitoring during pregnancy and management. In a history of bad obstetrical history it is necessary to screen for infection which can be done by antibody serology testing. A positive IgG indicates immunity to the virus, if possible it is necessary to check IgG Avidity to determine whether therapy is still needed or can rely on the immune system that has been formed. Chronic hypertension (Systolic Blood Pressure (SBP) &gt; 140 mmHg and / or Diastolic Blood Pressure (DBP) &gt; 90 mmHg since &lt; 20 Weeks Gestational Age (WGA) until 42 days after delivery). First-line Labetalol and Nifedipine or second-line Methyldopa and Hydrochlorothiazide should be considered depending on the condition and gestational age. If there are signs of preeclampsia, termination should be done if possible, along with antihypertensives and anticonvulsants such as MgSO4.

Auditory Development of Young Children with Profound Hearing Loss, Cochlear Implants, and Congenital CMV Infection.

Background/Objectives: The aim of this study was to assess auditory development in young children with profound hearing loss, cochlear implants (CIs), and congenital cytomegalovirus (cCMV) infection and to determine the effect of comorbidities on their development. Methods: The study group (cCMV group) consisted of 47 CI children-18 girls and 29 boys-who had been diagnosed as having prelingual hearing loss due to cCMV infection (with or without comorbidities); the mean age at CI activation was 15.2 months (range: 9.7-23.8; SD = 3.5). The reference group (no cCMV) consisted of 117 similar children (57 girls and 60 boys) who had profound sensorineural hearing loss not caused by cCMV infection; they had no comorbidities. The mean age at CI activation in the second group was 14.3 months (range: 7.9-23.5; SD = 4.0). Auditory development in all children was assessed with the LittlEARS Auditory Questionnaire (LEAQ) at CI activation and at about 1, 5, 9, 14, and 24 months of CI use. Results: The mean LEAQ total score increased over a similar time frame from 9.8 pts to 28.9 pts in the cCMV group without comorbidities, from 4.5 pts to 18.5 pts in the cCMV group with comorbidities, and from 9.2 to 31.6 pts in the reference group with no cCMV infection. Conclusions: Early cochlear implantation in children with sensorineural hearing loss due to congenital CMV infection and no comorbidities promotes their early auditory development in a similar way to children without cCMV infection.

The Impact of Climate Change on Maternal and Fetal Health: An Emerging Crisis

The health risks posed by climate change have extended into maternal and fetal health, with evidence linking changing environmental factors to a rise in conditions such as pregnancy-induced hypertension (PIH), cerebral venous thrombosis (CVT), and physiological jaundice, particularly in winter months. Additionally, post-viral infections and intrauterine infections have become more prominent in the post- COVID era, contributing to an increased risk of congenital anomalies, preterm labor, and intrauterine growth restriction (IUGR). The article also highlights the higher incidence of postpartum cardiomyopathy in African women and the challenges posed by long-distance travel during pregnancy. This article examines these trends and calls for more targeted research and interventions to mitigate these risks.

Aanpak van congenitaal cataract: een actueel overzicht

Current management of congenital cataract: an overview Congenital cataract, a congenital clouding of the lens of the eye, annually affects 20,000 to 40,000 neonates worldwide. An important clinical sign is complete or partial leukocoria, a white pupillary reflex, detected on a screening examination of the newborn in primary care or otherwise noticed by the parents. Congenital cataracts can occur uni- or bilaterally. Unilateral cataract is mostly due to a developmental disorder of the lens. Bilateral cataract is often isolated and caused by a genetic mutation, but can also be seen in an underlying syndrome, a metabolic disorder, a chromosomal disorder or a congenital infection, requiring further investigation by the pediatrician. It is crucial to recognize the condition and to refer the patient to a specialized center for pediatric cataract as early as possible to initiate an appropriate investigation and treatment. The mainstay of the therapy is cataract surgery. Its ideal timing varies individually, but in most cases the procedure is planned very early: ideally at the age of 6 to 8 weeks. Afterwards, an intensive and long-term treatment with contact lenses, glasses and often occlusion therapy is needed to stimulate the visual development. Lifelong follow-up is indicated. This literature review provides a comprehensive overview of the epidemiology, classification, diagnosis, treatment and prognosis of congenital cataract.

IL-36 Gamma: A Novel Adjuvant Cytokine Enhancing Protective Immunity Induced by DNA Immunization with TGIST and TGNSM Against Toxoplasma gondii Infection in Mice.

Toxoplasma gondii can cause congenital infections and abortions in humans. TgIST and TgNSM play critical roles in intracellular cyst formation and chronic infection. However, no studies have explored their potential to induce protective immunity against T. gondii infection. To evaluate the immune efficacy of DNA vaccines encoding TgNSM and TgIST genes against T. gondii infection, using the acute and chronic ME49 strain (Type II). DNA vaccines, including eukaryotic plasmids pVAX-IST and pVAX-NSM, were constructed. A cocktail DNA vaccine combining these two genes was formulated. The expression and immunogenicity were determined using the indirect immunofluorescence assay (IFA). Mice were immunized with DNA vaccines encoding either TgIST or TgNSM, as well as with the cocktail DNA vaccine. Humoral and cellular immune responses were analyzed by detecting antibody levels, cytotoxic T cell (CTL) responses, cytokines, and lymphocyte surface markers. Mouse survival and brain cyst counts were assessed 1 to 2 months post-vaccination in experimental toxoplasmosis models. The adjuvant efficacy of plasmid pVAX-IL-36γ in enhancing DNA vaccine-induced protective immunity was also evaluated. DNA immunization with pVAX-IST and pVAX-NSM elicited strong humoral and cellular immune responses, characterized by increased Toxoplasma-specific IgG2a titers, Th1 responses (including production of IFN-γ, IL-2, IL-12p40, and IL-12p70), and cell-mediated activity with elevated frequencies of CD8+ and CD4+ T cells, and CTL responses. This provided significant protective efficacy against acute and chronic T. gondii infection. Mice immunized with the two-gene cocktail (pVAX-IST + pVAX-NSM) showed greater protection than those immunized with single-gene vaccines. Co-administration of the molecular adjuvant pVAX-IL-36γ further enhanced the protective immunity induced by the cocktail DNA vaccine. TgIST and TgNSM induce effective immunity against T. gondii infection, making them promising vaccine candidates against toxoplasmosis. Additionally, IL-36γ is a promising genetic adjuvant that enhances protective immunity in a vaccine setting against T. gondii, and it should be evaluated in strategies against other apicomplexan parasites.

Intrauterine Infections and Preterm Birth: Literature Review

Objective: Premature birth is involved in the worldwide health sector problem and an important part challenge. This incidence rate continues to increase and currently, premature births occur in developing countries at 12.5% of all births. Infections within the uterus are associated with at least 40% of births occurring prematurely. Genitourinary tract infections can affect around 41% of women in their reproductive years worldwide may be affected, with 60-80% of these pregnancy-related infections being symptom-free. This article attempts to review the link relating intrauterine infections to premature birth. Data source: This study was taken from six electronic bibliographic databases, namely PubMed, Science Direct. ProQuest, Scopus, EBSCO and DOAJ employing the terms "intrauterine infection", or "premature delivery". Data from all journal articles, summarized according to the categories of the framework of concepts. The following summarization involves the compilation, analysis, and understanding of study data. Results: 10- 12% of intrauterine infections were found in pregnant women, and 20% of premature births were caused by intrauterine infections. The risk factors for this infection are known to be nullipara, lifestyle, and generally women of reproductive age who frequently change partners. There are several types of intrauterine infections, including Bacterial vaginosis, Chlamydia, Asymptomatic bacteriuria, Trihcomonas, and Syphilis. Conclusion: preterm birth has several risk factors, one of which is intrauterine infection that occurs during pregnancy. A quick and accurate diagnosis will help the process of treating intrauterine events in pregnant women to prevent preterm birth.

Challenges of Congenital HHV6 Infection Diagnosis and Treatment: Two Case Reports and Literature Review

Introduction: Congenital human herpesvirus 6 (HHV6) infection occurs in 1% of the general population and may result from the transmission of an inherited chromosomally integrated HHV6 (iciHHV6) or transplacental infection. It is mostly asymptomatic. Case reports: Case 1: a 29th-week-old female preterm newborn, admitted to the neonatal intensive care unit, became clinically unstable and irritable on the 20th day of hospitalization. Cranial ultrasound, revealed a significant posthemorrhagic tetraventricular dilation, with signs of ventriculitis. Investigations revealed HHV6 positivity on cerebrospinal fluid polymerase chain reaction multiplex panel testing and HHV6-DNA high viral loads in plasma samples. Case 2: a female late preterm newborn was admitted to the neonatal intensive care unit due to early-onset sepsis. Investigations revealed group B streptococcus positive blood cultures and cerebrospinal fluid HHV6 positivity on polymerase chain reaction multiplex panel testing, with negative bacterial culture. After 3 days of adequate antibiotic treatment, she maintained persistent moaning, which motivated a cranial ultrasound, revealing mild brain edema. Clinical improvement was observed only after beginning antiviral treatment in both newborns. Due to the persistency of high viral loads in both cases, despite antiviral treatment and clinical improvement, an iciHHV6 was suspected and posteriorly confirmed. Discussion/conclusion: Congenital iciHHV6 infection diagnosis is challenging because the presence of an iciHHV6 results in persistently high viral loads, even in the absence of active infection. Only a few diagnostic techniques can confirm active replication; unfortunately, these are not available in most countries. The decision to initiate antiviral treatment should be based on clinical judgment. Better ways for the diagnosis of active infection are needed.

Risk factors for and short-term prognosis of intrauterine infection in preterm infants.

To identify the risk factors for and short-term prognosis of intrauterine infection (IUI) in preterm infants. We retrospectively collected clinical data regarding preterm infants (28+0-36+6 weeks of gestational age) with IUI from the neonatal intensive care unit of our hospital between June 2017 and June 2022. The pathologic characteristics of the infants were classified using the Redline criteria, and the resulting groups were compared with respect to their clinical characteristics, indicators of infection, complications, and mortality rates. Three hundred thirty (78.1%) of the 422 enrolled neonates showed signs of histologic IUI; 51.8% showed histologic chorioamnionitis alone, and 48.2% showed both histologic chorioamnionitis and funisitis. The independent risk factors identified for IUI were maternal prenatal invasive manipulation, premature rupture of membranes (>18 hours before labor), and prenatal C-reactive protein concentration. The infants with IUI showed higher incidences of respiratory distress syndrome, bronchopulmonary dysplasia, retinopathy of prematurity, and prolonged mechanical ventilation. Low gestational age and low birth weight of preterm infants were significantly associated with a higher incidence of histologic IUI, more severe inflammation, and a higher incidence of complications. Histologic IUI is associated with high complication and mortality rates in preterm infants, as is an increasing severity of inflammation.

Real-world clinical data-driven modelling on the initiation time of antiviral prophylaxis among pregnant women with chronic hepatitis B infection

Background & AimsThe risk of mother-to-child transmission (MTCT) for pregnant women with chronic hepatitis B (CHB) infection still exists, especially for those with high HBV DNA level. The guidelines for initiating prophylaxis for pregnant women with CHB vary across countries. We aimed to explore the latest prophylaxis initiation time for these women. MethodsWe collected the real-world clinical data of 328 pregnant women with CHB infection aged 20-49 treated by telbivudine (LdT) or tenofovir disoproxil fumarate (TDF) from July 2010 to December 2020 in China. A mathematical model was developed to describe the viral kinetics of HBV after prophylaxis. We calculated the time required to reduce viral load below the threshold value of 5.3 log10 IU/mL. We derived the prophylaxis initiation time by subtracting the required time to threshold from the childbirth gestational week. ResultsThe median time for 328 women to reduce HBV DNA levels below the threshold of 5.3 log10 IU/mL was 4.2 (range: 0.2-12.8) weeks, corresponding to prophylaxis initiation time of no later than 35.1 (25.2-41.4) weeks. Specifically, for women with viral loads > 8.0 log10 IU/mL, prophylaxis should be initiated before 33.9 (25.2-39.5) weeks, and particularly before the lower bound of 25.2 weeks, to maximize clinical safety. For women with viral load >7.0 to 8.0 log10 IU/mL, prophylaxis should be initiated before 35.5 (28.6-39.8) weeks, and for women with viral load >5.3 to 7.0 log10 IU/mL, prophylaxis should be initiated before 36.2 (28.3-41.4) weeks. ConclusionPregnant women with HBV DNA levels >5.3 to 8.0 log10 IU/mL can initiate prophylaxis before 28 gestational weeks. However, women with HBV DNA >8.0 log10 IU/mL could consider initiating prophylaxis before 25 weeks. Impact and implicationsThis study investigates how long it takes to decrease maternal viral load below a threshold·(5.3 log10 IU/mL) after receiving antiviral prophylaxis in pregnant women with different HBV DNA levels based on real-world clinical data and mathematical modelling, which provides quantitative evidence on the initiation time of antiviral prophylaxis. The results show that pregnant women with CHB infection at high HBV DNA levels (>8 log10 IU/mL) should initiate antiviral prophylaxis earlier to decrease the risk of mother-to-child transmission of HBV. Physicians can determine when to begin antiviral prophylaxis for those women according to their maternal HBV DNA levels. Our findings justify the initiation time of antiviral prophylaxis recommended by the Chinese guidelines and will offer new insights for other international guidelines.

Differential contributions of fetal mononuclear phagocytes to Zika virus neuroinvasion versus neuroprotection during congenital infection.

Fetal immune cell functions during congenital infections are poorly understood. Zika virus (ZIKV) can vertically transmit from mother to fetus, causing nervous system infection and congenital ZIKV syndrome (CZS). We identified differential functional roles for fetal monocyte/macrophage cell types and microglia in ZIKV dissemination versus clearance using mouse models. Trafficking of ZIKV-infected primitive macrophages from the yolk sac allowed initial fetal virus inoculation, while recruited monocytes promoted non-productive neuroinflammation. Conversely, brain-resident differentiated microglia were protective, limiting infection and neuronal death. Single-cell RNA sequencing identified transcriptional profiles linked to the protective versus detrimental contributions of mononuclear phagocyte subsets. In human brain organoids, microglia also promoted neuroprotective transcriptional changes and infection clearance. Thus, microglia are protective before birth, contrasting with the disease-enhancing roles of primitive macrophages and monocytes. Differential modulation of myeloid cell phenotypes by genetically divergent ZIKVs underscores the potential of immune cells to regulate diverse outcomes during fetal infections.

Hearing loss and vestibular dysfunction in congenital CMV infection: could it be due to endolymphatic pressure anomaly? A preliminary study

ObjectivesTo describe the inner ear sectors after an inner ear MRI protocol and search for the presence of endolymphatic pressure anomaly in patients presenting with a congenital CMV infection and audio-vestibular dysfunction. MethodsA 3D FLAIR MRI sequence, 4 hours after gadolinium injection, was performed in patients with sensory-neural hearing loss secondary to a congenital CMV infection in order to analyse the morphology of the endolymphatic space. ResultsTwo patients presented with a unilateral SNHL and 4 patients a bilateral SNHL. Seven ears with SNHL demonstrated an endolymphatic hydrops on MRI images and 2 showed a membranous labyrinth atelectasis. All ears but two had a marked enhancement in the perilymph of the basal turn of the cochlea. One ear, with a normal hearing threshold but altered vestibular function, demonstrated cochlear and saccular hydrops. Two ears with normal or near normal hearing and normal vestibular function were radiologically normal on the MRI. ConclusionThe compartmental endolymphatic study using delayed contrast-enhanced MRI sequences in children with cCMV infection suggests a relationship between inner ear involvement and endolymphatic pressure anomaly.

Improving the detection of congenital syphilis: reviewing test utility and adherence to recommendations

Western Australia (WA) has experienced a resurgence of congenital syphilis. Appropriate microbiology testing of the neonate is recommended to confirm infection, including syphilis immunoglobulin M (IgM), rapid plasma reagin (RPR) paired with a maternal sample, and polymerase chain reaction (PCR) on placenta and nasal swabs. We examined the performance of microbiology tests in confirmed congenital syphilis cases and the adherence to testing recommendations in those assessed as high risk. We reviewed the microbiology results of confirmed congenital syphilis cases in WA between 1 January 2018 and 31 December 2023. In addition, microbiology testing of neonates from metropolitan Perth identified as being at a high risk of congenital syphilis between 1 January 2021 and 31 October 2023 was reviewed. Eighteen congenital syphilis cases were identified; data were unavailable for a case born interstate. Of the 17 included cases, the case fatality rate was 35% (6/17; five stillbirths and one perinatal death). Placenta tissue PCR was positive in all stillbirths. Of the 12 live births, 83% were symptomatic at delivery. Perinatal testing was performed in 11 live births (11/12); IgM was detected in 55% (6/11). Placenta tissue PCR was positive in 88% (7/8 tested). Nasal swab PCR was positive in 57% (4/7 tested) of cases. There were 22 neonates classified as being at a high risk for congenital syphilis infection; all had IgM and RPR testing. Syphilis PCR was performed on placenta tissue samples in 64% (14/22) and on nasal swabs in 64% (14/22) of cases. Comprehensive microbiological testing, including syphilis IgM and placenta tissue PCR, is required to confirm congenital syphilis infection. Continuous evaluation of testing will be crucial for individual case detection and monitoring of the ongoing outbreak. Given the risk of incomplete specimen collection, our data support ​the adoption of a risk-based approach for neonates at risk of congenital syphilis, with management guided by maternal serology and treatment history.

Galectin-1 Elicits a Tissue-Specific Anti-Inflammatory and Anti-Degradative Effect Upon LPS-Induced Response in an Ex Vivo Model of Human Fetal Membranes Modeling an Intraamniotic Inflammation.

Intrauterine infection is one of the most jeopardizing conditions associated with adverse outcomes, including preterm birth; however, multiple tolerance mechanisms operate at the maternal-fetal interface to avoid the rejection of the fetus. Among the factors that maintain the uterus as an immunoprivileged site, Galectin-1 (Gal-1), an immunomodulatory glycan-binding protein secreted by the maternal-fetal unit, is pivotal in promoting immune cell homeostasis. This work aimed to evaluate the role of Gal-1 during a lipopolysaccharide(LPS)-induced-inflammatory milieu. Using an ex vivo culture with two independent compartments, human fetal membranes at term were pretreated with 40 and 80ng/mL of Gal-1, then to reproduce an intraamniotic inflammation, the fetal side of membranes was stimulated with 500ng/mL of LPS for 24h. The concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, monocyte chemoattractant protein (MCP1), macrophage inflammatory protein (MIP1) α, regulated upon activation normal T cell expressed and secreted (RANTES), and matrix metalloproteinase (MMP)-9 were measured in both amnion and choriodecidua compartments. In a tissue-specific fashion profile, pretreatment with the physiologic concentration of Gal-1 significantly diminished the LPS-dependent secretion of TNF-α, IL-1β, Il-6, MCP1, MIP1α, RANTES, and MMP-9. Gal-1 elicits an anti-inflammatory effect on the human fetal membranes stimulated with LPS, which supports the hypothesis that Gal-1 is part of the immunomodulatory mechanisms intended to stop the harmful effect of inflammation of the maternal-fetal interface.

Perinatal infection: a case report

Perinatal infection: a case report

Prevalence of Trypanosoma cruzi Infection in Pregnant Women and Risk of Vertical Transmission in Newborns in Chiapas, Mexico.

The Mexican state of Chiapas is considered epidemiologically significant for Chagas disease due to the coexistence of infected reservoirs and vectors, including migratory populations from Central and South America. However, there is a lack of monitoring programs for the timely detection of this disease. The objective of this study was to elucidate the prevalence of Trypanosoma cruzi infection in pregnant women and the risk of vertical transmission in newborns at two hospitals located in the Metropolitan Region of Tuxtla Gutierrez, the capital of Chiapas State Mexico. A cross-sectional study was carried out with 193 pregnant women with gestational ages between 32 and 40 weeks, who underwent immunological testing to diagnose Chagas disease. Conventional PCR testing on cord blood revealed the presence of T. cruzi in newborns. The prevalence of T. cruzi infection in pregnant women was 32.12% (95% confidence interval (CI): 0.25, 0.38). The 62 pregnant women who tested positive for Chagas disease gave birth to 63 children, and in 5 newborns (8% (5/62), 95% confidence interval (CI): 0.02, 0.19), PCR tests on umbilical cord blood were positive for T. cruzi. In conclusion, the dataset showed a high prevalence of Chagas disease in the sample of pregnant women studied and a maternal-fetal transmission rate of 8%.