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Multicenter Study Med (New York, N.Y.). 2024 Nov 8;5(11):1433-1441.e3. doi: 10.1016/j.medj.2024.07.009 N/A12.82024

Association between situs inversus and maternal SARS-CoV-2 infection at gestational age 4-6 weeks

母体妊娠4-6周新冠病毒感染与新生儿内脏转位关系的研究 翻译改进

Zhenming Guo  1, Yingchun Luo  2, Yan Bi  3, Liangjie Liu  4, Yuan Qi  1, Jin Yan  1, Chunhai Cai  1, Chenxiang Xi  1, Yihan Tan  2, Shifa Yao  5, Yanhui Qu  5, Ping Chen  5, Jiayu Chen  6, Yanlin Wang  7, Xiao Mao  8, Baoying Ye  9, Shaorong Gao  10, Guang He  11, Shan Bian  12

作者单位 +展开

作者单位

  • 1 Institute for Regenerative Medicine, State Key Laboratory of Cardiology and Medical Innovation Center, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, China.
  • 2 Department of Ultrasonography, Hunan Provincial Maternal and Child Health Care Hospital, University of South China, Changsha, China.
  • 3 Department of Prenatal Diagnosis Center, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • 4 Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China.
  • 5 Department of Ultrasonography, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • 6 Clinical and Translation Research Center of Shanghai First Maternity & Infant Hospital, Frontier Science Center for Stem Cell Research, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai, China.
  • 7 Department of Prenatal Diagnosis Center, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
  • 8 National Health Commission Key Laboratory of Birth Defect Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, University of South China, Changsha, China. Electronic address: gbtechies@outlook.com.
  • 9 Department of Ultrasonography, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: eyby99@126.com.
  • 10 Institute for Regenerative Medicine, State Key Laboratory of Cardiology and Medical Innovation Center, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, China; Clinical and Translation Research Center of Shanghai First Maternity & Infant Hospital, Frontier Science Center for Stem Cell Research, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai, China. Electronic address: gaoshaorong@tongji.edu.cn.
  • 11 Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China. Electronic address: heguang@sjtu.edu.cn.
  • 12 Institute for Regenerative Medicine, State Key Laboratory of Cardiology and Medical Innovation Center, Shanghai East Hospital, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai, China; National Health Commission Key Laboratory of Birth Defect Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, University of South China, Changsha, China; China Regional Research Center, International Center for Genetic Engineering and Biotechnology, Taizhou, China. Electronic address: shan_bian@tongji.edu.cn.

    • DOI: 10.1016/j.medj.2024.07.009 PMID: 39094582

    摘要 中英对照阅读

    Background: A dramatic increase in fetal situs inversus diagnoses by ultrasound in the months following the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surge of December 2022 in China led us to investigate whether maternal SARS-CoV-2 exposure could be associated with elevated risk of fetal situs inversus.

    Methods: In this multi-institutional, hospital-based, matched case-control study, we investigated pregnant women who underwent ultrasonographic fetal biometric assessment at gestational weeks 20-24 at our hospitals. Each pregnant woman carrying a situs inversus fetus was randomly matched with four controls based on the date of confinement. Relevant information, including SARS-CoV-2 infection, and other potential risk factors were collected. Conditional logistic regression was used to test possible associations between fetal situs inversus and SARS-CoV-2 infection at different gestational weeks as well as individual risk factors.

    Findings: A total of 52 pregnant women diagnosed with fetal situs inversus between January 1 and October 31, 2023 and 208 matched controls with normal fetuses were enrolled. We found no association between an increased risk of fetal situs inversus with gestational SARS-CoV-2 infection or with other risk factors. However, fetal situs inversus was significantly associated with SARS-CoV-2 infection specifically in gestational weeks 4-6 (adjusted odds ratio [aOR] 6.54 [95% confidence interval 1.76-24.34]), but not with infection at other gestational ages, after adjusting for covariates.

    Conclusions: Increased risk of fetal situs inversus is significantly associated with maternal SARS-CoV-2 infection at gestational weeks 4-6, corresponding to the fetal developmental window for visceral lateralization in humans.

    Funding: National Key R&D Program of China, etc.

    Keywords: SARS-CoV-2 infection; Translation to patients; human embryonic development; situs inversus; visceral lateralization.

    Keywords：situs inversus; maternal sars-cov-2 infection; gestational age

    背景：

    在2022年12月中国出现严重急性呼吸系统综合症冠状病毒2型（SARS-CoV-2）激增后几个月，通过超声检查诊断出胎儿内脏反位的情况显著增加，这促使我们调查母亲接触SARS-CoV-2是否与胎儿内脏反位的风险升高有关。

    方法：

    在这项多机构、基于医院的匹配病例对照研究中，我们调查了在我们的医院进行妊娠第20至24周超声胎儿生物测量评估的孕妇。每位携带内脏反位胎儿的孕妇都根据入院日期随机与四名对照组相匹配。收集包括SARS-CoV-2感染及其他潜在风险因素的相关信息。使用条件逻辑回归来测试胎儿内脏反位与不同妊娠周数的SARS-CoV-2感染及个体风险因素之间可能的关联。

    发现：

    共有52名在2023年1月1日至10月31日期间被诊断为胎儿内脏反位的孕妇和208名具有正常胎儿的匹配对照组纳入研究。我们未发现妊娠期间SARS-CoV-2感染或其他风险因素与胎儿内脏反位增加风险之间存在关联，但经过调整协变量后，在妊娠第4至6周时（校正比值比[aOR] 6.54 [95% 置信区间1.76-24.34]），SARS-CoV-2感染与胎儿内脏反位显著相关，而在其他妊娠年龄时则无此关联。

    结论：

    在妊娠第4至6周的SARS-CoV-2感染会显著增加胎儿内脏反位的风险，这对应于人类胚胎器官侧化的发育窗口期。

    资助：

    中国国家重点研发计划等。

    关键词：镜像反转症; 母体SARS-CoV-2感染; 孕周

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    Association between situs inversus and maternal SARS-CoV-2 infection at gestational age 4-6 weeks