Morphofunctional characteristics of the liver in cerebral ischemia among full-term newborns of mothers with exacerbation of asthma during the acute phase of cytomegalovirus infection in pregnancy

Introduction. Despite the well-established association between virus-induced structural liver remodeling and serum endotoxin accumulation, to date no studies have examined the morphofunctional characteristics of the liver in offspring of women with chronic respiratory disease during the acute phase of viral infection.
Aim. To evaluate echogenic and functional changes in the liver in newborns with cerebral ischemia born to mothers who experienced exacerbation of mild bronchial asthma associated with reactivation of chronic cytomegalovirus (CMV) infection during the second trimester of pregnancy.
Materials and methods. Hepatic echogenic structure, as well as levels of medium-molecular-weight peptides and seromucoid in umbilical cord serum, were assessed in 42 full-term newborns of mothers with uncomplicated pregnancies (control group) and in 68 newborns with cerebral ischemia that developed against a background of mild bronchial asthma exacerbation associated with reactivation of chronic CMV infection in their mothers during the second trimester of gestation (main group). The main group was subdivided into two subgroups: 36 newborns with grade I cerebral ischemia (subgroup 1) and 32 newborns with grade II cerebral ischemia (subgroup 2).
Results. Compared with the control group, newborns in subgroup 1 showed significantly lower Apgar scores at 1 minute (p < 0.001) and 5 minutes (p < 0.001), as well as lower birth weight (p < 0.01). However, no differences were found in ultrasound liver parameters or in serum levels of medium-molecular-weight peptides and seromucoid. In subgroup 2, compared with both the control group and subgroup 1, further reductions in Apgar scores at 1 minute (p < 0.001) and 5 minutes (p < 0.001), as well as birth weight (p < 0.01 and p < 0.001, respectively), were observed. Moreover, compared with subgroup 1, subgroup 2 exhibited significantly higher hepatic parenchymal echogenicity (p < 0.01), structural alterations in portal tracts (p < 0.05), small inclusions (p < 0.01), and gallbladder deformation (p < 0.05). Concentrations of medium-molecular-weight peptides increased to 0.280 ± 0.003 optical density units (p < 0.05), and seromucoid levels rose to 0.094 ± 0.002 optical density units (p < 0.05).
Conclusion. In newborns with grade II cerebral ischemia born to mothers with exacerbation of mild bronchial asthma associated with reactivation of chronic CMV infection during the second trimester of pregnancy, more pronounced alterations in liver ultrasound morphology and elevated levels of medium-molecular-weight peptides and seromucoid were observed compared to newborns with grade I cerebral ischemia under similar maternal somatic conditions. These findings reflect intensified cytotoxic effects of hypoxia and endotoxemia on the central nervous system in newborns with an adverse antenatal infectious history.

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