{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:30:28Z","timestamp":1753878628333,"version":"3.41.2"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T00:00:00Z","timestamp":1728259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cell Proliferation"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The coronavirus disease 2019 (COVID\u201019) pandemic increases the risk of adverse fetal outcomes during pregnancy. Maternal infection during pregnancy, particularly with cytomegalovirus (CMV), hepatitis B and C virus, and human immunodeficiency virus can have detrimental effects on both mother and fetus, potentially leading to adverse outcomes such as spontaneous abortion or neonatal infection. However, the impact of severe acute respiratory syndrome coronavirus (SARS\u2010CoV\u20102) infection on the maternal\u2013fetal interface remains poorly understood. In this study, we initially utilised immunofluorescence and immunohistochemical to investigate placental samples from pregnant women who were infected with SARS\u2010CoV\u20102 during the first trimester. Our data indicate that infection in the first trimester induces an upregulation of hypoxia inducible factor (HIF) levels at the maternal\u2013fetal interface. Subsequently, single\u2010cell RNA sequencing and metabolomics sequencing analyses reveal alterations in maternal\u2013fetal interface. Remarkably, immune cells exhibited low expression levels of HIF possibly associated with immune activation. Furthermore, our findings demonstrate a gradual reduction in transcriptome and metabolic changes as gestation progressed beyond 12\u201316\u2009weeks compared to samples obtained at 6\u20138\u2009weeks gestation. Overall, our study suggests that early\u2010stage SARS\u2010CoV\u20102 infection during the first trimester leads to severe hypoxia and aberrant cell metabolism at the maternal\u2013fetal interface which gradually resolves as pregnancy progresses. Nevertheless, these abnormal changes may have long\u2010term implications for maternal\u2013fetal interface development.<\/jats:p>","DOI":"10.1111\/cpr.13749","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T05:45:43Z","timestamp":1728366343000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal infection with <scp>SARS<\/scp>\u2010<scp>CoV<\/scp>\u20102 during early pregnancy induces hypoxia at the maternal\u2013fetal interface"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2025-9674","authenticated-orcid":false,"given":"Xiaohui","family":"Shi","sequence":"first","affiliation":[{"name":"Center for Reproductive Medicine of The Second Affiliated Hospital, Center for Regeneration and Cell Therapy of Zhejiang University\u2010University of Edinburgh Institute (ZJU\u2010UoE Institute), Zhejiang University School of Medicine Zhejiang University  Hangzhou Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7038-7840","authenticated-orcid":false,"given":"Chenxiang","family":"Xi","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Maternal Fetal Medicine, Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Institute of Maternal\u2010Fetal Medicine and Gynecologic Oncology, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology Tongji University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baoxing","family":"Dong","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Maternal Fetal Medicine, Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Institute of Maternal\u2010Fetal Medicine and Gynecologic Oncology, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology Tongji University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5491-6810","authenticated-orcid":false,"given":"Zihui","family":"Yan","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Maternal Fetal Medicine, Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Institute of Maternal\u2010Fetal Medicine and Gynecologic Oncology, Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology Tongji University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5974-9900","authenticated-orcid":false,"given":"Wenqiang","family":"Liu","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Maternal Fetal Medicine, Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, 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