Human papillomavirus (HPV) is the most common sexually transmitted viral infection worldwide, which may result in the development in benign lesions or malignant tumors. The prevalence of HPV infection is twice as high in pregnancy as in non-pregnant women. Additionally, there is a risk of vertical transmission of HPV from mother to fetus during pregnancy or childbirth. Various studies have reported an increased risk of adverse pregnancy outcomes in HPV-positive women, including miscarriage, preterm birth, premature rupture of membranes, preeclampsia, fetal growth restriction, and fetal death. HPV vaccination is not currently recommended during pregnancy. On the other hand, there is no evidence linking HPV vaccination during pregnancy with adverse pregnancy outcomes and termination of pregnancy is not justified in this case.

• Klíčová slova
• HPV, adverse pregnancy outcomes, human papillomavirus, human papillomavirus– pregnancy complications, vaccination in pregnancy,
• MeSH
• infekce papilomavirem * přenos   diagnóza   prevence a kontrola   MeSH
• infekční komplikace v těhotenství * epidemiologie   virologie   MeSH
• lidé MeSH
• těhotenství MeSH
• vakcíny proti papilomavirům MeSH
• vertikální přenos infekce * MeSH
• výsledek těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• vakcíny proti papilomavirům MeSH

PURPOSE: Group B streptococcus (GBS) remains a leading cause of invasive disease, mainly sepsis and meningitis, in infants < 3 months of age and of mortality among neonates. This study, a major component of the European DEVANI project (Design of a Vaccine Against Neonatal Infections) describes clinical and important microbiological characteristics of neonatal GBS diseases. It quantifies the rate of antenatal screening and intrapartum antibiotic prophylaxis among cases and identifies risk factors associated with an adverse outcome. METHODS: Clinical and microbiological data from 153 invasive neonatal cases (82 early-onset [EOD], 71 late-onset disease [LOD] cases) were collected in eight European countries from mid-2008 to end-2010. RESULTS: Respiratory distress was the most frequent clinical sign at onset of EOD, while meningitis is found in > 30% of LOD. The study revealed that 59% of mothers of EOD cases had not received antenatal screening, whilst GBS was detected in 48.5% of screened cases. Meningitis was associated with an adverse outcome in LOD cases, while prematurity and the presence of cardiocirculatory symptoms were associated with an adverse outcome in EOD cases. Capsular-polysaccharide type III was the most frequent in both EOD and LOD cases with regional differences in the clonal complex distribution. CONCLUSIONS: Standardizing recommendations related to neonatal GBS disease and increasing compliance might improve clinical care and the prevention of GBS EOD. But even full adherence to antenatal screening would miss a relevant number of EOD cases, thus, the most promising prophylactic approach against GBS EOD and LOD would be a vaccine for maternal immunization.

• Klíčová slova
• Early-onset disease, Group B streptococcal vaccine, Group B streptococcus, Late-onset disease, Neonatal infection, Streptococcus agalactiae,
• MeSH
• antibiotická profylaxe škodlivé účinky   MeSH
• infekční komplikace v těhotenství * diagnóza   epidemiologie   MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• Streptococcus agalactiae MeSH
• streptokokové infekce * diagnóza   epidemiologie   prevence a kontrola   MeSH
• těhotenství MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

OBJECTIVE: To assess perinatal outcomes for pregnancies affected by suspected or confirmed SARS-CoV-2 infection. METHODS: Prospective, web-based registry. Pregnant women were invited to participate if they had suspected or confirmed SARS-CoV-2 infection between 1st January 2020 and 31st March 2021 to assess the impact of infection on maternal and perinatal outcomes including miscarriage, stillbirth, fetal growth restriction, pre-term birth and transmission to the infant. RESULTS: Between April 2020 and March 2021, the study recruited 8239 participants who had suspected or confirmed SARs-CoV-2 infection episodes in pregnancy between January 2020 and March 2021. Maternal death affected 14/8197 (0.2%) participants, 176/8187 (2.2%) of participants required ventilatory support. Pre-eclampsia affected 389/8189 (4.8%) participants, eclampsia was reported in 40/ 8024 (0.5%) of all participants. Stillbirth affected 35/8187 (0.4 %) participants. In participants delivering within 2 weeks of delivery 21/2686 (0.8 %) were affected by stillbirth compared with 8/4596 (0.2 %) delivering ≥ 2 weeks after infection (95 % CI 0.3-1.0). SGA affected 744/7696 (9.3 %) of livebirths, FGR affected 360/8175 (4.4 %) of all pregnancies. Pre-term birth occurred in 922/8066 (11.5%), the majority of these were indicated pre-term births, 220/7987 (2.8%) participants experienced spontaneous pre-term births. Early neonatal deaths affected 11/8050 livebirths. Of all neonates, 80/7993 (1.0%) tested positive for SARS-CoV-2. CONCLUSIONS: Infection was associated with indicated pre-term birth, most commonly for fetal compromise. The overall proportions of women affected by SGA and FGR were not higher than expected, however there was the proportion affected by stillbirth in participants delivering within 2 weeks of infection was significantly higher than those delivering ≥ 2 weeks after infection. We suggest that clinicians' threshold for delivery should be low if there are concerns with fetal movements or fetal heart rate monitoring in the time around infection. The proportion affected by pre-eclampsia amongst participants was not higher than would be expected, although we report a higher than expected proportion affected by eclampsia. There appears to be no effect on birthweight or congenital malformations in women affected by SARS-CoV-2 infection in pregnancy and neonatal infection is uncommon. This study reflects a population with a range of infection severity for SARS-COV-2 in pregnancy, generalisable to whole obstetric populations.

• Klíčová slova
• COVID, Fetal, Fetal growth restriction, Infection, Neonatal, Perinatal, Pregnancy, SARS-CoV-2, Stillbirth,
• MeSH
• COVID-19 * komplikace   epidemiologie   MeSH
• eklampsie * MeSH
• infekční komplikace v těhotenství * epidemiologie   MeSH
• kojenec MeSH
• lidé MeSH
• narození mrtvého plodu epidemiologie   MeSH
• novorozenec MeSH
• předčasný porod * epidemiologie   MeSH
• preeklampsie * epidemiologie   MeSH
• prospektivní studie MeSH
• SARS-CoV-2 MeSH
• těhotenství MeSH
• výsledek těhotenství epidemiologie   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The placenta provides a significant physical and physiological barrier to prevent fetal infection during pregnancy. Nevertheless, it is at times breached by pathogens and leads to vertical transmission of infection from mother to fetus. This review will focus specifically on the Zika flavivirus, the HIV retrovirus and the emerging SARS-CoV2 coronavirus, which have affected pregnant women and their offspring in recent epidemics. In particular, we will address how viral infections affect the immune response at the maternal-fetal interface and how the placental barrier is physically breached and discuss the consequences of infection on various aspects of placental function to support fetal growth and development. Improved understanding of how the placenta responds to viral infections will lay the foundation for developing therapeutics to these and emergent viruses, to minimise the harms of infection to the offspring.

• Klíčová slova
• Barrier function, Human immunodeficiency virus, Immune cells, Placenta, Pregnancy, Severe acute respiratory syndrome coronavirus 2, Syncytiotrophoblast, Viral infections, Zika virus,
• MeSH
• COVID-19 metabolismus   MeSH
• HIV infekce metabolismus   MeSH
• HIV-1 patogenita   MeSH
• infekce virem zika metabolismus   MeSH
• infekční komplikace v těhotenství epidemiologie   virologie   MeSH
• lidé MeSH
• placenta metabolismus   virologie   MeSH
• plod virologie   MeSH
• SARS-CoV-2 patogenita   MeSH
• těhotenství MeSH
• vertikální přenos infekce statistika a číselné údaje   MeSH
• virové nemoci patofyziologie   MeSH
• virus zika patogenita   MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6±9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8-0.9 per week increase; p<0.001), birthweight (OR: 1.17, 95% CI 1.09-1.12.7 per 100 g decrease; p=0.012) and maternal ventilatory support, including either need for oxygen or CPAP (OR: 4.12, 95% CI 2.3-7.9; p=0.001) were independently associated with composite adverse fetal outcome. Conclusions Early gestational age at infection, maternal ventilatory supports and low birthweight are the main determinants of adverse perinatal outcomes in fetuses with maternal COVID-19 infection. Conversely, the risk of vertical transmission seems negligible.

• Klíčová slova
• Coronavirus, perinatal morbidity, perinatal mortality,
• MeSH
• Betacoronavirus * genetika   izolace a purifikace   MeSH
• COVID-19 MeSH
• gestační stáří MeSH
• infekční komplikace v těhotenství epidemiologie   virologie   MeSH
• klinické laboratorní techniky MeSH
• kohortové studie MeSH
• koronavirové infekce komplikace   diagnóza   epidemiologie   MeSH
• lidé MeSH
• novorozenec nedonošený MeSH
• novorozenec MeSH
• odumření plodu * MeSH
• pandemie MeSH
• perinatální smrt * MeSH
• polymerázová řetězová reakce s reverzní transkripcí MeSH
• rizikové faktory MeSH
• samovolný potrat epidemiologie   MeSH
• SARS-CoV-2 MeSH
• těhotenství MeSH
• testování na COVID-19 MeSH
• vakcíny proti COVID-19 MeSH
• vertikální přenos infekce statistika a číselné údaje   MeSH
• virová pneumonie komplikace   diagnóza   epidemiologie   MeSH
• výsledek těhotenství MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Immunization during pregnancy has been recommended in an increasing number of countries. The aim of this strategy is to protect pregnant women and infants from severe infectious disease, morbidity and mortality and is currently limited to tetanus, inactivated influenza, and pertussis-containing vaccines. There have been recent advancements in the development of vaccines designed primarily for use in pregnant women (respiratory syncytial virus and group B Streptococcus vaccines). Although there is increasing evidence to support vaccination in pregnancy, important gaps in knowledge still exist and need to be addressed by future studies. This collaborative consensus paper provides a review of the current literature on immunization during pregnancy and highlights the gaps in knowledge and a consensus of priorities for future research initiatives, in order to optimize protection for both the mother and the infant.

• Klíčová slova
• group B Streptococcus vaccines, influenza, maternal immunization, pertussis, pregnant women, respiratory syncytial virus, tetanus,
• MeSH
• celosvětové zdraví MeSH
• hodnocení rizik MeSH
• hodnocení vlivů na zdraví MeSH
• imunizace * škodlivé účinky   etika   metody   trendy   MeSH
• imunogenicita vakcíny MeSH
• infekční komplikace v těhotenství epidemiologie   prevence a kontrola   MeSH
• klinické zkoušky jako téma etika   MeSH
• konsensus MeSH
• lékařská etika MeSH
• lidé MeSH
• matka - expozice noxám MeSH
• rizikové faktory MeSH
• těhotenství MeSH
• vakcinace MeSH
• vakcíny aplikace a dávkování   škodlivé účinky   imunologie   MeSH
• výzkum MeSH
• zdravotní priority MeSH
• zpožděný efekt prenatální expozice MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• vakcíny MeSH

Toxoplasmosis affects about one third of human population worldwide. It has a wide range of effects on the health, immunity, behaviour, and both prenatal and postnatal outcomes of infected hosts, including humans. Among these effects, stage of infection-specific shifts in secondary sex ratio were described about ten years ago both in humans and in artificially infected mice. In both women and female mice, in the early stage of infection the probability of giving birth of sons significantly increases, up to 260 sons to every 100 daughters. In the late stages of infection, the probability of giving birth to sons markedly decreases to as low as 78 to every 100 daughters. An ecological correlation study shows that the effect of latent toxoplasmosis on human population biology and demography can be large. In fact, the effect of prevalence of toxoplasmosis on a nationwide sex ratio was the third strongest effect from the effects of 15 factors included in the analysis. It has been suggested that toxoplasmosis-associated concentration of steroid hormones or glucose may be the proximal cause in the sex ratio shift. A more parsimonious explanation of the upward secondary sex ratio shift is found in a lower stringency of quality control of embryos, whose side-effect is increased survival rate of the more immunogenic male embryos in immunosuppressed infected females. The most parsimonious explanation of the downward secondary sex ratio shift relies on the Trivers-Willard hypothesis, which predicts an adaptive shift to more daughters in females with impaired health or lower socioeconomic status.

• Klíčová slova
• Manipulation hypothesis, Sex ratio, Steroid hormones, Toxoplasmosis, Trivers-Willard hypothesis,
• MeSH
• infekční komplikace v těhotenství epidemiologie   MeSH
• lidé MeSH
• novorozenec MeSH
• poměr pohlaví * MeSH
• těhotenství MeSH
• toxoplazmóza epidemiologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

OBJECTIVE: The aim of the study was to evaluate the epidemiological trends in the incidence rates of mother-to-child transmission of syphilis, syphilis in women of reproductive age and pregnant women in the antenatal care program over the period 1991-2014, in order to find a basis for preventive measures. MATERIAL AND METHOD: Case series data of confirmed syphilis was used to evaluate the incidence rates over the period 1991-2014 in Slovakia. RESULTS: During the monitored period, 101 cases of mother-to-child transmitted syphilis were detected. The rate increased in 1996, corresponding to 33.3 per 100,000 live births and discovered discordance in antenatal care program. The rates of syphilis in women of reproductive age showed increased rate in 2001, corresponding to 10.44 per 100 000 population. Pregnant women reported the highest rate in 2000, corresponding to 3.24 per 1,000 pregnant women population. Syphilis notification rates in all three groups showed increased trend in the first decade following with decreased trend in the second decade. The high decrease in rate notification among pregnant women in 2011 (0.37) decreasing up to 0.11 in 2014 was followed with decreasing of mother-to-child transmission. CONCLUSION: Mother-to-child transmission of syphilis poses a public health problem and requires comprehensive surveillance in all countries. These data result in the requirement of effective improvement of antenatal care program in pregnant women. The last years 2011-2014 showed improvement in antenatal care program corresponding with decrease rate of mother-to-child transmission of syphilis.

• Klíčová slova
• mother-to-child transmission - syphilis in pregnant women - syphilis in women of reproductive age - maternal health.,
• MeSH
• dítě MeSH
• infekční komplikace v těhotenství * epidemiologie   MeSH
• lidé MeSH
• prenatální péče MeSH
• syfilis * epidemiologie   MeSH
• těhotenství MeSH
• vertikální přenos infekce statistika a číselné údaje   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH

UNLABELLED: Pertussis is a respiratory disease caused by the Gram-negative encapsulated bacterium Bordetella pertussis. Despite the high vaccination coverage rate and addition of new booster doses to the immunisation scheme (in response to the epidemiological situation), pertussis is on the rise not only in the Czech Republic but also in many other countries. The age groups at highest risk are infants and, to a lower extent, newborns who can get infected before receiving the first dose of vaccine and develop a severe course of the disease, often requiring admission to hospital. The most common source of infection are adults or adolescents from the childs close environment who experience a mild course of the disease because of the previous vaccination. The immune response induced by the currently available acellular vaccines does not last. It can be reasonably assumed that pertussis has been underreported. Multiple studies have shown mutations in the causative bacterium that confer higher pathogenicity to it, either as a result of enhanced production of pertussis toxin or loss of some antigens. Possible strategies to control these negative trends are to develop novel more effective vaccines using new adjuvants or to use whole-cell vaccines. Maternal vaccination in pregnancy trimester 3 also turned out to be effective. KEY WORDS: pertussis - vaccination - epidemiology - diagnosis - newborns.

• MeSH
• Bordetella pertussis * MeSH
• dítě MeSH
• dospělí MeSH
• infekční komplikace v těhotenství epidemiologie   imunologie   prevence a kontrola   MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• pertuse * epidemiologie   imunologie   prevence a kontrola   MeSH
• pertusová vakcína * MeSH
• předškolní dítě MeSH
• těhotenství MeSH
• vakcinace MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• pertusová vakcína * MeSH

OBJECTIVE: The main aim of this study was to evaluate the presence of Streptococcus agalactiae (S. agalactiae) in the vagina and the amniotic fluid in pregnancies complicated by preterm prelabor rupture of membranes (PPROM). The next aim was to evaluate the incidence of S. agalactiae early onset sepsis in newborns from PPROM pregnancies, with respect to the presence of S. agalactiae in the vagina and the amniotic fluid. METHODS: Singleton gestations with PPROM between 24 + 0 and 36 + 6 were included. A vaginal swab was obtained, and amniocentesis was performed at admission. The presence of S. agalactiae in the vagina and in the amniotic fluid was assessed by culture and by real-time polymerase chain reaction, respectively. RESULTS: In total, 336 women were included. The presence of S. agalactiae in the vaginal and amniotic fluid was found in 9% (31/336) and 1% (3/336) of women. One woman had S. agalactiae in the amniotic fluid but was negative for the presence of S. agalactiae in the vaginal fluid. Early onset neonatal sepsis developed in one newborn from pregnancies complicated by the presence of S. agalactiae in the amniotic fluid. CONCLUSION: The presence of S. agalactiae in the vagina and amniotic fluid complicated approximately each 10th and each 100th PPROM pregnancy. Cultivation-negative findings of S. agalactiae in the vagina did not exclude the positivity of the amniotic fluid for S. agalactiae and the development of early onset sepsis in newborns.

• Klíčová slova
• Amniocentesis, amniotic fluid, group B streptococcus, sepsis, vaginal swab,
• MeSH
• dospělí MeSH
• incidence MeSH
• infekční komplikace v těhotenství epidemiologie   mikrobiologie   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nemoci novorozenců epidemiologie   mikrobiologie   MeSH
• novorozenec MeSH
• plodová voda mikrobiologie   MeSH
• předčasný odtok plodové vody mikrobiologie   MeSH
• retrospektivní studie MeSH
• sepse epidemiologie   mikrobiologie   MeSH
• Streptococcus agalactiae izolace a purifikace   MeSH
• streptokokové infekce epidemiologie   MeSH
• těhotenství MeSH
• vagina mikrobiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH