Echocardiographic characteristics of the heart in full-term newborns of mothers who experienced exacerbation of asthma associated with reactivation of cytomegalovirus infection during pregnancy

   Introduction. Exacerbation of bronchial asthma during pregnancy in the context of acute-phase reactivation of chronic viral infection in women is frequently associated with the development of cerebral and cardiac pathology in their offspring.

   Aim. To provide an echocardiographic characterization of cardiac structure and function in full-term newborns of mothers who experienced exacerbation of bronchial asthma associated with reactivation of chronic cytomeg-alovirus (CMV) infection during pregnancy.

   Materials and methods. Echocardiography was performed in 42 newborns of mothers with uncomplicated pregnancies (control group) and in 68 newborns with cerebral ischemia whose intrauterine development was complicated by mild bronchial asthma exacerbation associated with CMV reactivation in 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 with grade II cerebral ischemia (subgroup 2).

   Results. Compared with the control group, newborns in subgroup 1 had 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 significant differences were found in echocardiographic parameters: end-diastolic dimension (EDD, p > 0.05), end-systolic dimension (ESD, p > 0.05), stroke volume (SV, p > 0.05), ejection fraction (EF, p > 0.05), or fractional shortening (FS, p > 0.05). In contrast, newborns in subgroup 2 showed significantly lower Apgar scores at 1 and 5 minutes (p < 0.001) and reduced birth weight compared with both the control group (p < 0.01) and subgroup 1 (p < 0.001). Echocardiographically, subgroup 2 exhibited significantly decreased EDD (p < 0.01), ESD (p < 0.01), SV (p < 0.05), EF (p < 0.01), and FS (p < 0.001) compared to subgroup 1.

   Conclusion. Newborns with grade II cerebral ischemia and an antenatal history of mild maternal bronchial asthma exacerbated by CMV reactivation in the second trimester demonstrate significantly greater cardiovascular burden in the early neonatal period compared to those with grade I ischemia under similar antenatal conditions. This is likely due to the adverse impact of antenatal hypoxia on fetal cardiac organogenesis and histogenesis.

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