title: Viral infections during pregnancy.
abstract: Viral infections during pregnancy have long been considered benign conditions with a few notable exceptions, such as herpes virus. The recent Ebola outbreak and other viral epidemics and pandemics show how pregnant women suffer worse outcomes (such as preterm labor and adverse fetal outcomes) than the general population and non-pregnant women. New knowledge about the ways the maternal-fetal interface and placenta interact with the maternal immune system may explain these findings. Once thought to be 'immunosuppressed', the pregnant woman actually undergoes an immunological transformation, where the immune system is necessary to promote and support the pregnancy and growing fetus. When this protection is breached, as in a viral infection, this security is weakened and infection with other microorganisms can then propagate and lead to outcomes, such as preterm labor. In this manuscript, we review the major viral infections relevant to pregnancy and offer potential mechanisms for the associated adverse pregnancy outcomes.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Silasi
authors.forename: Ingrid
authors.initials: I
authors.lastname: Cardenas
authors.forename: Ja-Young
authors.initials: JY
authors.lastname: Kwon
authors.forename: Karen
authors.initials: K
authors.lastname: Racicot
authors.forename: Paula
authors.initials: P
authors.lastname: Aldo
authors.forename: Gil
authors.initials: G
authors.lastname: Mor
mesh_terms: D000818:Animals; D060085:Coinfection; D000013:Congenital Abnormalities / Q000209:etiology; D005260:Female; D005315:Fetal Diseases / Q000276:immunology; D015658:HIV Infections / Q000151:congenital / Q000196:embryology / Q000276:immunology / Q000635:transmission; D006525:Hepatitis, Viral, Human / Q000196:embryology / Q000276:immunology / Q000635:transmission; D006566:Herpesviridae Infections / Q000196:embryology / Q000276:immunology / Q000635:transmission; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007251:Influenza, Human / Q000196:embryology / Q000276:immunology; D008431:Maternal-Fetal Exchange / Q000276:immunology; D007752:Obstetric Labor, Premature / Q000209:etiology; D010920:Placenta / Q000276:immunology / Q000821:virology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology* / Q000821:virology; D011256:Pregnancy Outcome; D012306:Risk; D012409:Rubella / Q000196:embryology / Q000276:immunology / Q000635:transmission; D014777:Virus Diseases / Q000276:immunology* / Q000635:transmission
keywords: Infection; placenta; polymicrobial; pregnancy; trophoblast; virus