{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:24:30Z","timestamp":1760149470301,"version":"build-2065373602"},"reference-count":36,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,6]],"date-time":"2023-08-06T00:00:00Z","timestamp":1691280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MMC Department of Pathology","award":["1R16GM145586","1R01HD092533"],"award-info":[{"award-number":["1R16GM145586","1R01HD092533"]}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["1R16GM145586","1R01HD092533"],"award-info":[{"award-number":["1R16GM145586","1R01HD092533"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIH","award":["1R16GM145586","1R01HD092533"],"award-info":[{"award-number":["1R16GM145586","1R01HD092533"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Babies born to severe acute respiratory syndrome corona virus-2 (SARS-CoV-2)-infected mothers are at greater risk for perinatal morbidity and more likely to receive a neurodevelopmental diagnosis in the first year of life. However, the effect of maternal infection on placental function and neonatal outcomes varies depending upon the patient population. We set out to test our hypothesis that maternal SARS-CoV-2 infection in our underserved, socioeconomically disadvantaged, mostly unvaccinated, predominantly African American and Latina population in the Bronx, NY would have effects evident at birth. Under IRB approval, 56 SARS-CoV-2-positive patients infected during the \u201cfirst wave\u201d of the pandemic with alpha and beta strains of the virus, 48 patients infected during the \u201csecond wave\u201d of the pandemic with delta and omicron strains and 61 negative third-trimester high-risk patients were randomly selected from Montefiore Medical Center (MMC), Bronx, NY. In addition, two positive cases from Yale New Haven Hospital, CT were included as controls. All 104 placentas delivered by SARS-CoV-2-positive mothers were uninfected by the virus, based on immunohistochemistry, in situ hybridization, and qPCR analysis. However, placental villous infarcts were significantly increased in first-wave cases compared to second-wave cases or negative controls. Significantly lower Apgar scores at 1 min and 5 min were observed in neonates born to infected mothers with severe symptoms. These findings suggest that even without entering the placenta, SARS-CoV-2 can affect various systemic pathways, culminating in altered placental development and function, which may adversely affect the fetus, especially in a high-risk patient population such as ours. These results underline the importance of vaccination among pregnant women, particularly in low-resource areas.<\/jats:p>","DOI":"10.3390\/biom13081224","type":"journal-article","created":{"date-parts":[[2023,8,6]],"date-time":"2023-08-06T10:01:53Z","timestamp":1691316113000},"page":"1224","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["SARS-CoV-2 Infection in Unvaccinated High-Risk Pregnant Women in the Bronx, NY, USA Is Associated with Decreased Apgar Scores and Placental Villous Infarcts"],"prefix":"10.3390","volume":"13","author":[{"given":"Sandra E.","family":"Reznik","sequence":"first","affiliation":[{"name":"Department of Pathology, Albert Einstein College of Medicine, Bronx, NY 10461, USA"},{"name":"Department of Obstetrics and Gynecology and Women\u2019s Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA"},{"name":"Department of Pharmaceutical Sciences, St. John\u2019s University, Queens, NY 11439, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia M.","family":"Vuguin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Columbia University Vagelos College of Physicians & Surgeons, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2430-1062","authenticated-orcid":false,"given":"Alexa","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology and Women\u2019s Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasha","family":"Khoury","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology and Divisions of Complex Family Planning and Maternal Fetal Medicine, Boston University School of Medicine, Boston, MA 02118, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5677-4716","authenticated-orcid":false,"given":"Olivier","family":"Loudig","sequence":"additional","affiliation":[{"name":"Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0042-9937","authenticated-orcid":false,"given":"Ridin","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Louisiana School of Medicine, LSU Health, New Orleans, LA 70112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan A.","family":"Fineberg","sequence":"additional","affiliation":[{"name":"Department of Pathology, Albert Einstein College of Medicine, Bronx, NY 10461, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francine","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malini","family":"Harigopal","sequence":"additional","affiliation":[{"name":"Department of Pathology, Yale University School of Medicine, New Haven, CT 06519, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen J.","family":"Charron","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology and Women\u2019s Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA"},{"name":"Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA"},{"name":"Department of Medicine and the Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, Bronx, NY 10461, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2301","DOI":"10.3390\/ijerph16132301","article-title":"Programming Effects of Prenatal Stress on Neural Development\u2014The Pitfall of Introducing a Self-fulfilling Prophecy","volume":"16","author":"Bleker","year":"2019","journal-title":"Int. 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