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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2021№2
Etiology and pathogenesis of congenital...

Etiology and pathogenesis of congenital pneumonia. Characteristics in premature babies

DOI
https://dx.doi.org/10.18565/aig.2021.2.40-47

Shilova N.A., Andreev A.V., Kharlamova N.V., Sytova L.A., Pesenkina A.A.

V.N. Gorodkov Ivanovo Research Institute of Maternity and Childhood, Ministry of Health of the Russian Federation, Ivanovo, Russia
Congenital pneumonia is one of the main causes of high neonatal morbidity and mortality. The incidence of congenital pneumonia is about 1% among full-term infants and about 10% in premature infants and it is the cause of 10–38% of neonatal deaths. The etiological factor of this nosological entity can be bacteria, viruses, protozoa and fungi. The onset of clinical manifestations of congenital pneumonia depends on the period of action of the infectious agent (in utero, intranatally), as well as on the taxonomic characteristics of the pathogens. The lack of anti-infective protection in premature newborns, especially extremely and very premature ones, allows us to consider them as a specific group of immunocompromised patients, in whom congenital pneumonias occur more often and run a more severe course. In comparison with full-term babies, premature ones have some pathogens (ureaplasma, mycoplasma) that are often associated with the development of bronchopulmonary dysplasia in the outcome of congenital pneumonia. In addition, congenital infections caused by the same pathogen in premature infants can run a fulminant course, be accompanied by septic shock, respiratory distress syndrome, and death occurring within a few hours. This review of the literature presents an update on the etiology and pathogenesis of congenital pneumonia in newborn infants. Understanding the presented links of pathogenesis will be able to timely and correctly perform treatment in such babies.

Keywords

intrauterine infection
chorioamnionitis
congenital pneumonia
preterm neonatal infants
Full text (in Russian)

References

  1. Щеголев А.И., Туманова У.Н., Шувалова М.П., Фролова О.Г. Врожденная пневмония как причина перинатальной смертности в Российской Федерации. Неонатология: новости, мнения, обучение. 2016; 2: 61-6. [Shchegolev A.I., Tumanova U.N., Shuvalova M.P., Frolova O.G. Congenital pneumonia as a cause of perinatal mortality in the Russian Federation.Neonatologiya: novosti, mneniya, obuchenie/Neonatology: News, Opinions, Training. 2016; 2: 61-6. (in Russian)].
  2. Глуховец Б.И., Белоусова Н.А., Попов В.Г. Основные причины смерти новорожденных с экстремально низкой массой тела. Российский вестник перинатологии и педиатрии. 2004; 49(5): 61. [Glukhovets B.I., Belousova N.A., Popov V.G. The main causes of death of newborns with extremely low body weight. RossiyskiyVestnikPerinatologiiiPediatrii/Russian Bulletin of Perinatology and Pediatrics). 2004; 49(5): 61. (in Russian)].
  3. Nissen M.D. Congenital and neonatal pneumonia. Paediatr. Respir. Rev. 2007; 8(3): 195-203.
  4. GBD. 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013. Lancet. 2015; 385(9963): 117-71. https://dx.doi.org/10.1016/S0140-6736(14)61682-2.
  5. Антонов А.Г., Байбарина Е.Н., Балашова Е.Н., Дегтярев Д.Н., Зубков В.В., Иванов Д.О., Ионов О.В., Карпова А.Л., Киртбая А.Р., Крохина К.Н., Крючко Д.С., Ленюшкина А.А., Ли А.Г., Малютина Л.В., Мебелова И.И., Никитина И.В., Петренко Ю.В., Рындин А.Ю., Рюмина И.И., Романенко А.В. Врожденная пневмония (клинические рекомендации). Неонатология: новости, мнения, обучение. 2017; 4: 133-48. [Antonov A.G., Baibarina E.N., Balashova E.N., Degtyarev D.N., Zubkov V.V., Ivanov D.O. et al. Congenital pneumonia (clinical recommendations). Neonatology: news, opinions, training. 2017; 4: 133-48. (in Russian)].
  6. Hooven T., Polin R. Pneumonia. Semin. Fetal Neonatal Med. 2017; 4: 133-48. https://dx.doi.org/10.1016/j.siny.2017.03.002.
  7. Curfman A.L., Glissmeyer E.W., Ahmad F.A., Korgenski E.K., Blaschke A.J., Byington C.L. et al. Initial presentation of neonatal herpes simplex virus infection. J. Pediatr. 2016; 172: 121-6. https://dx.doi.org/10.1016/j.jpeds.2016.02.015.
  8. Самсыгина Г.А. Пневмонии у детей. М.: ГЭОТАР-Медиа; 2018. 176 с. [Samsygina G.A. Pneumonia in children. Moscow: GEOTAR-Media; 2018. 176 p. (in Russian)].
  9. Beck-Sague С., Robinson А. Sexually transmissible infections in infants, children and adolescents. In: Morse S.A., Ballard R.C., Holmes K.K., Moreland A.A., eds. Atlas of sexually transmitted diseases and AIDS. 4th ed. Elsevier Health Sciences; 2010: 187-324.
  10. Волянюк Е.В., Сафина А.И. Врожденная пневмония у недоношенных новорожденных: особенности этиологии, диагностики и лечения. Практическая медицина. 2011; 5: 55-9. [Volyanyuk E.V., Safina A.I. Congenital pneumonia in premature newborns: features of etiology, diagnosis and treatment. Practical medicine. 2011; 5: 55-9. (in Russian)].
  11. Кудашов H.H., Зубков В.В., Помелова В.Г., Ванько Л.В. Клинико-диагностическая характеристика пневмонии у новорожденных при герпетических инфекциях. Педиатрия. 2001; 3: 8-13. [Kudashov H.H., Zubkov V.V., Pomelova V.G., Vanko L.V. Clinical and diagnostic characteristics of pneumonia in newborns with herpetic infections. Pediatrics. 2001; 3: 8-13. (in Russian)].
  12. Mendz G.L., Kaakoush N.O., Quinlivan J.A. Bacterial aetiological agents of intraamniotic infections and preterm birth in pregnant women. Front. Cell. Infect. Microbiol. 2013; 3: 58. https://dx.doi.org/10.3389/ fcimb.2013.00058.
  13. Тирская Ю.И., Баринов С.В., Долгих Т.И., Овчинникова Е.М. Исследование лактоферина и ФНО в околоплодных водах и сыворотке крови, как возможность факторов риска развития хориоамнионита у рожениц высокого инфекционного риска. Мать и дитя в Кузбасcе. 2012; 4: 47-51. [Tirskaya Yu.I., Barinov S.V., Dolgikh T.I., Ovchinnikova E.M. Investigation of lactoferin and TNF in amniotic fluid and blood serum as a possibility of risk factors for chorioamnionitis in high-risk mothers. Mother and child in Kuzbass. 2012; 4: 47-51. (in Russian)].
  14. Kim C.J., Romero R., Chaemsaithong P., Chaiyasit N., Yoon B.H., Kim Y.M. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance. Am. J. Obstet. Gynecol. 2015; 213(4, Suppl.): S29-52. https://dx.doi.org/10.1016/j.ajog.2015.08.040.
  15. Семенова А.Л., Зарубина Е.Н., Павлович С.В. Современные взгляды на этиологию, диагностику и лечение хориоамнионита во II триместре беременности. Кремлевская медицина. Клинический вестник. 2008; 2: 63-6. [Semenova A.L., Zarubina E.N., Pavlovich S.V. Modern views on the etiology, diagnosis and treatment of chorioamnionitis in the second trimester of pregnancy. Kremlin medicine. Clinical Herald. 2008; 2: 63-6. (in Russian)].
  16. Han Y.W., Shen T., Chung P., Buhimschi I.A., Buhimschi C.S. Uncultivated bacteria as etiologic agents of intra-amniotic inflammation leading to preterm birth. J. Clin. Microbiol. 2009; 47(1): 38-47. https://dx.doi.org/10.1128/JCM.01206-08.
  17. Перепелица С.А. Этиологические и патогенетические перинатальные факторы развития внутриутробных инфекций у новорожденных (обзор). Общая реаниматология. 2018; 14(3): 54-67. [Perepelitsa S.A. Etiologic and Pathogenic Perinatal Factors for the Development of Intrauterine Infections in Newborns (Review). General reanimatology. 2018; 14(3): 54-67. (in Russian)]. https://dx.doi.org/10.15360/1813-9779-2018-3-54-67.
  18. Осипчук Д.О., Слабинская Т.В. Проблема амниорексиса при недоношенной беременности: предрасполагающие факторы, перспективы прогнозирования хориоамнионита (научный обзор). Вестник уральской академической медицинской науки. 2014; 1: 79-84. [Osipchuk D.O., Slabinskaya T.V. The problem of amniorexis in premature pregnancy: predisposing factors, prospects for predicting chorioamnionitis (scientific review). Bulletin of the Ural academic medical science. 2014; 1: 79-84. (in Russian)].
  19. Кузьмин В.Н., Арсланян К.Н., Харченко Э.И., Адамян Л.В. Роль стрептококка группы В в развитии внутрибольничных инфекций. Молекулярная генетика, микробиология и вирусология. 2016; 4: 142-8. [Kuzmin V.N., Arslanyan K.N., Kharchenko E.I., Adamyan L.V. The role of group B streptococcus in the development of nosocomial infections. Molecular Genetics, Microbiology and Virology. 2016; 4: 142-8 (in Russian)].
  20. Liu M.D., Xu F.L., Duan W.L., Liu J.X., Li X.N., Liu Y.X. et al. Risk factors for poor prognosis of neonatal bacterial meningitis. Zhongguo Dang Dai ErKeZaZhi. 2019; 21(11): 1064-8.
  21. Walker K.F., Morris E., Plumb J., Gray J., Thornton J.G., Daniels J. Universal testing for group B streptococcus during pregnancy: need for a randomised trial. BJOG. 2020; 127(6): 693. https://dx.doi.org/10.1111/1471-0528.16116.
  22. Remington J.S., Klein J.O., Wilson C.B., Nizet V., Maldonado Y. Infectious diseases of the fetus and newborn. 7th ed. Philadelphia: Elsevier Saunders; 2011. 1280p.
  23. Nader R., Tondeur S., Barrans A., Gevaudan A.R., Lamy B. Streptococcus pneumoniae neonatal infection. Ann. Biol. Clin. 2005; 63(6): 643-6.
  24. Samonini A., Grosse C., Aschero A., Boubred F., Ligi I. Congenital pneumonia owing to mycoplasma pneumonia. J. Pediatr. 2018; 203: 460. e1. https://dx.doi.org/10.1016/j.jpeds.2018.06.055.
  25. Гладков С.А. Беременность и грипп: патоморфологические проявления инфекции, вызванной вирусом А/H1 N1. Журнал акушерства и женских болезней. 2014; 63(3): 26-35. [Gladkov S.A. Pregnancy and influenza: pathological manifestations of infection caused by the A/H1 N1 virus. Journal of Obstetrics and Women's Diseases. 2014; 63(3): 26-35.(in Russian)].
  26. Memoli M.J., Harvey H., Morens D.M., Taubenberger J.K. Influenza in pregnancy. Influenza Other Respir. Viruses. 2013; 7(6): 1033-9. https://dx.doi.org/10.1111/irv.12055.
  27. Englund J., Chu H. Respiratory virus infection during pregnancy: does it matter? J. Infect. Dis. 2018; 218(4): 512-5. https://dx.doi.org/10.1093/infdis/jiy169.
  28. Кошелева Н.Г., Зубжицкая Л.Б. Исходы беременности, иммуноморфологическое состояние плаценты после острой респираторно-вирусной инфекции, перенесенной беременной, профилактика, лечение. Журнал акушерства и женских болезней. 2005; 54(3): 12-8. [Kosheleva N.G., Zubzhitskaya L.B. Pregnancy outcomes, immunomorphological state of the placenta after an acute respiratory viral infection transferred by a pregnant woman, prevention, treatment. Journal of Obstetrics and Women's Diseases. 2005; 54(3): 12-8. (in Russian)].
  29. Schwartz D., Graham A. Potential maternal and infant outcomes from coronavirus 2019-nCoV (SARS-CoV-2) infecting pregnant women: lessons from SARS, MERS, and other human coronavirus infections. Viruses. 2020; 12(2): 194. https://dx.doi.org/10.3390/v12020194.
  30. Reiterer F. Neonatal pneumonia. Intech Open; 2013.106p. https://dx.doi.org/10.5772/54310.
  31. Piperaki E.T., Daikos G.L. Malaria in Europe: emerging threat or minor nuisance? Clin. Microbiol. Infect. 2016; 22(6): 487-93. https://dx.doi.org/10.1016/j.cmi.2016.04.023.
  32. Баранова А.М., Сергиев В.П., Гузеева Т.М., Токмалаев А.К. Клиническая настороженность к завозной малярии: прививные случаи и смертельные исходы в России. Инфекционные болезни: новости, мнения, обучение. 2018; 7(4): 97-101. [Baranova A.M., Sergiev V.P., Guzeeva T.M., Tokmalaev A.K. Clinical suspicion to imported malaria: transfusion cases and deaths in Russia. Infektsionnyye bolezni: novosti, mneniya, obucheniye/Infectious diseases: news, opinions, education. 2018; 7(4): 97-101. (in Russian)]. https://dx.doi.org/10.24411/2305-3496-2018-14015.
  33. Hangi M., Achan J., Saruti A., Quinlan J., Idro R. Congenital malaria in newborns presented at Tororo General Hospital in Uganda: a cross-sectional study. Am. J. Trop. Med. Hyg. 2019; 100(5): 1158-63. https://dx.doi.org/10.4269/Ёajtmh.17-0341.
  34. Chen S.N., Wang P.H., Hsieh M.F., Tsai H.W., Lin L.T., Tsui K.H. Maternal pregnancy-induced hypertension increases the subsequent risk of neonatal candidiasis: A nationwide population-based cohort study. Taiwan. J. Obstet. Gynecol. 2019; 58(2): 261-5. https://dx.doi.org/10.1016/j.tjog.2019.01.017.
  35. Barton M., Shen A., Obrien K., Robinson J.L., Davies H.D., Simpson K. Early onset invasive candidiasis in extremely low birth weight infants: perinatal acquisition predicts poor outcome. Clin. Infect. Dis. 2017; 64(7): 921-7. https://dx.doi.org/10.1093/cid/cix001.
  36. Никитина И.В., Ионов О.В, Приходько Н.А. Современные подходы к диагностике, терапии и профилактике инвазивных микозов у новорожденных. Неонатология: новости, мнения, обучение. 2014; 4: 64-72. [Nikitina I.V., Ionov O.V., Prikhodko N.A. Modern approaches to the diagnosis, therapy and prevention of invasive mycoses in newborns. Neonatologiya: novosti, mneniya, obuchenie/Neonatology: News, Opinions, Training. 2014; 4: 64-72. (in Russian)].
  37. Maki Y., Fujisaki M., Sato Y., Sameshima H. Candida chorioamnionitis leads to preterm birth and adverse fetal-neonatal outcome. Infect. Dis. Obstet. Gynecol. 2017; 2017: 9060138. https://dx.doi.org/10.1155/2017/9060138.
  38. Zemans R., Henson P.,Henson J., Janssen W. Conceptual approaches to lung injury and repair. Ann. Am. Thorac. Soc. 2015; 12(Suppl. 1): S9-15. https://dx.doi.org/10.1513/AnnalsATS.201408-402MG.
  39. Whidbey С., Vornhagen J., Gendrin C., Boldenow E., Samson J., Doering K. et al. A streptococcal lipid toxin induces membrane permeabilization and pyroptosis leading to fetal injury. EMBO Mol. Med. 2015; 7: 488-505. https://dx.doi.org/10.15252/emmm.201404883.
  40. Massler A., Kolodkin-Gal D., Meir K., Khalaileh A., Falk H., Izhar U. et al. Infant lungs are preferentially infected by adenovirus and herpes simplex virus type 1 vectors: role of the tissue mesenchymal cells. J. Gene Med. 2011; 13(2): 101-13. https://dx.doi.org/10.1002 / jgm.1544.
  41. Han S., Mallampalli R.K. The role of surfactant in lung disease and host defense against pulmonary infections. Ann. Am. Thorac. Soc. 2015; 12(5): 765-74. https://dx.doi.org/10.1513/AnnalsATS.201411-507FR.
  42. Kuang Z., Hao Y., Walling B., Jeffries J., Ohman D., Lau G. Pseudomonas aeruginosa elastase provides an escape from phagocytosis by degrading the pulmonary surfactant protein-A. PLoS One. 2011; 6(11): e27091.https://dx.doi.org/10.1371/journal.pone.0027091.
  43. Bernhard W. Lung surfactant: Function and composition in the context of development and respiratory physiology. Ann. Anat. 2016; 208: 146-50. https://dx.doi.org/10.1016/j.aanat.2016.08.003.
  44. Collins A., Weitkamp J.H., Wynn J.L. Why are preterm newborns at increased risk of infection? Arch. Dis. Child Fetal Neonatal Ed. 2018; 103(4): F391-4. https://dx.doi.org/10.1136/archdischild-2017-313595.
  45. Никитина И.В., Жукова А.С., Ванько Л.В., Вторушина В.В., Матвеева Н.К., Кречетова Л.В., Крючко Д.С., Ионов О.В., Зубков В.В., Дегтярев Д.Н. Особенности цитокинового статуса у недоношенных новорожденных с заболеваниями легких инфекционного и неинфекционного генеза. Неонатология: новости, мнения, обучение. 2018; 6(4): 16-23. [Nikitina I.V., Zhukova A.S., Vanko L.V., Vtorushina V.V., Matveeva N.K., Krechetova L.V. et al. Cytokine status of preterm newborns with infectious and noninfectious diseases. Neonatologiya: novosti, mneniya, obuchenie/Neonatology: News, Opinions, Training. 2018; 6(4): 16-23. (in Russian)]. https://dx.doi.org/10.24411/2308-2402-2018-14002.
  46. Овсянников Д.Ю., Кравчук Д.А., Николаева Д.Ю. Клиническая патофизиология органов дыхания недоношенных детей. Неонатология: новости, мнения, обучение. 2018; 6(3): 74-98. [Ovsyannikov D.Yu., Kravchuk D.A., Nikolaeva D.Yu. Clinical pathophysiology of the respiratory system in preterm infant. Neonatologiya: novosti, mneniya, obuchenie/Neonatology: News, Opinions, Training. 2018; 6(3): 74-98. (in Russian)]. https://dx.doi.org/10.24411/2308-2402-2018-13003.
  47. Derscheid R.J., Ackermann M.R. The innate immune system of the perinatal lung and responses to respiratory syncytial virus infection. Vet. Pathol. 2013; 50(5): 827-41. https://dx.doi.org/10.1177/0300985813480216.
  48. Köhl J. Anaphylatox in sand infectious and non-infectious inflammatory diseases. Mol. Immunol. 2001; 38(23):175-87. https://dx.doi.org/10.1016/s0161-5890 (01) 00041-4.
  49. Siauw C., Kobsar A., Dornieden C., Beyrich C., Schinke B., Schubert-Unkmeir A. et al. Group B streptococcus isolates from septic patients and healthy carriers differentially activate platelet signaling cascades. Thromb. Haemost. 2006; 95: 836-49. https://dx.doi.org/10.1160 / th05-08-0534.
  50. Kollmann T.R., Kampmann B., Mazmanian S.K., Marchant A., Levy O. Protecting the newborn and young infant from infectious diseases: lessons from immune ontogeny. Immunity. 2017; 46: 350-63. https://dx.doi.org/10.1016/j.immuni.2017.03.009.

Received 03.06.2020

Accepted 17.09.2020

About the Authors

Nataliya A. Shilova, PhD in Medicine, Senior Researcher of the Department of Neonatology and Clinical Neurology of Children's Age, Professor of the Department of Obstetrics and Gynecology, Neonatology, Anesthesiology and Resuscitation, V.N. Gorodkov Ivanovo Research Institute of Motherhood and Childhood, Ministry of Health of Russia. Tel.: +7(910)988-86-27. E-mail: shilova37@gmail.com. ORCID: 0000-0001-9623-2575. 153000, Russia, Ivanovo, Pobedy sqr., 20.
Artyom V. Andreev, anesthesiologist-resuscitator of the Department of Resuscitation and Intensive Care of the Newborn, Post-graduate student of the Department of Obstetrics and Gynecology, Neonatology, Anesthesiology and Resuscitation, V.N. Gorodkov Ivanovo Research Institute of Motherhood and Childhood, Ministry of Health of Russia. Tel.: +7(906)618-20-94. E-mail: andreyevar@gmail.com. ORCID: 0000-0002-3380-3980. 153000, Russia, Ivanovo, Pobedy sqr., 20.
Natalya V. Kharlamova, MD, PhD, Dr. Med. Sci., Head of the Department of Neonatology and Clinical Neurology of Children, Professor of the Department of Obstetrics and Gynecology, Neonatology, Anesthesiology and Resuscitation, V.N. Gorodkov Ivanovo Research Institute of Motherhood and Childhood, Ministry of Health of Russia. Tel.: +7(910)981-57-05. E-mail: nataliakhar13@yandex.ru. ORCID: 0000-0003-2867-1693. 153000, Russia, Ivanovo, Pobedy sqr., 20.
Lyudmila A. Sytova, PhD in Medicine, associate Professor of the Department of Obstetrics and Gynecology, Neonatology, Anesthesiology and Resuscitation. V.N. Gorodkov Ivanovo Research Institute of Motherhood and Childhood, Ministry of Health of Russia. Tel.: +7(910)994-81-48. E-mail: lusytta@mail.ru. ORCID: 0000-0002-5441-6090.
153000, Russia, Ivanovo, Pobedy sqr., 20.
Anna A. Pesenkina, student, Ivanovo State Medical Academy, Ministry of Health of Russia; Department of Obstetrics and Gynecology, Neonatology, Anesthesiology and Resuscitation. V.N. Gorodkov Ivanovo Research Institute of Motherhood and Childhood, Ministry of Health of Russia. Tel.: +7(901)280-49-20. E-mail: anna.pesenkina@gmail.com. ORCID: 0000-0002-4989-0732. 153000, Russia, Ivanovo, Pobedy sqr., 20.

For citation: Shilova N A., Andreev A.V., Kharlamova N.V., Sytova L.A., Pesenkina A.A. Etiology and pathogenesis of congenital pneumonia. Characteristics in premature babies.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 2: 40-47 (in Russian)
https://dx.doi.org/10.18565/aig.2021.2.40-47

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