懷孕期間,免疫系統處於一個特殊的狀態,免疫系統必須包容胎兒這個「抗原」,同時又要保護母親對抗其他病原的感染。懷孕婦女本身即較容易受到呼吸道感染,因此,他們可能較一般族群容易感染武漢肺炎。此外,因懷孕本身即有的免疫反應及感染武漢肺炎可能引起的cytokine storm,懷孕婦女感染武漢肺炎可能引起較嚴重的疾病甚至死亡率。對這些婦女,應根據其疾病的嚴重度及妊娠期給予及時且個人化的治療,尤其是第一及第二妊娠期的婦女。目前雖無證據顯示武漢肺炎會經由垂直傳染感染胎兒,但感染武漢肺炎引起的發炎反應可能會影響胎兒發展。抗病毒藥物的給予,必須仔細評估得失,若效果可超過對胎兒的風險,則可進行抗病毒藥物的治療。即使病毒感染已控制,仍必須仔細監測胎兒的發展,因胎盤發炎可能會持續一段時間;然目前仍缺乏相關資料。

(財團法人國家衛生研究院 莊淑鈞博士摘要整理)

Highlights:

  • The COVID-19 may alter the maternal symmetrical and local immune responses, and affect the well-being of mothers and infants.
  • Pregnant women are more susceptible to respiratory pathogens; hence, they may be more susceptible to SARS-CoV-2 than the general population.
  • We focused on the immunological factor of the susceptibility of pregnant women to COVID-19 and the potential damages to mother and fetus.

Abstract: The 2019 novel coronavirus disease (COVID-19) was first detected in December 2019 and became epidemic in Wuhan, Hubei Province, China. COVID-19 has been rapidly spreading out in China and all over the world. The virus causing COVID-19, SARS-CoV-2 has been known to be genetically similar to severe acute respiratory syndrome coronavirus (SARS-CoV) but distinct from it. Clinical manifestation of COVID-19 can be characterized by mild upper respiratory tract infection, lower respiratory tract infection involving non-life threatening pneumonia, and life-threatening pneumonia with acute respiratory distress syndrome. It affects all age groups, including newborns, to the elders. Particularly, pregnant women may be more susceptible to COVID-19 since pregnant women, in general, are vulnerable to respiratory infection. In pregnant women with COVID-19, there is no evidence for vertical transmission of the virus, but an increased prevalence of preterm deliveries has been noticed. The COVID-19 may alter immune responses at the maternal-fetal interface, and affect the well-being of mothers and infants. In this review, we focused on the reason why pregnant women are more susceptible to COVID-19 and the potential maternal and fetal complications from an immunological viewpoint.

Author:Liu H, Wang LL, Zhao SJ, et al.
原文連結:https://www.sciencedirect.com/science/article/pii/S0165037820300437?via%3Dihub