Biochemical and morphological characteristics of umbilical vein endothelium in pregnancies complicated by cytomegalovirus infection

Background. Cytomegalovirus (CMV) infection triggers inflammation and endothelial damage in umbilical cord vessels, which is associated with impaired fetoplacental hemodynamics and adverse perinatal outcomes.

The aim. To identify biochemical and morphological characteristics of the umbilical vein endothelium in CMV infection.

Methods. The study included 117 newborns from mothers with CMV reactivation during the third trimester of pregnancy (main group) and 45 newborns from CMV-negative mothers (control group). In umbilical cord blood, TNF-α, IL-1β, IL-6, endothelin-1, and polymorphonuclear leukocyte (PMN) elastase were measured by enzyme-linked immunosorbent assay (ELISA). Umbilical cord tissue was examined histologically.

Results. In the main group, umbilical cord blood showed signifiantly elevated levels of TNF-α (2.6-fold, p < 0.001), IL-1β (2.5-fold, p < 0.001), IL-6 (1.6-fold, p < 0.001), endothelin-1 (3.2-fold, p < 0.001), and PMN elastase (1.3-fold, p < 0.001). Histological analysis revealed signs of inflammation and remodeling of the venous wall. A 1.14fold decrease in nuclear optical density of Wharton’s jelly cells (p < 0.05), a 1.2-fold reduction in the proportion (p < 0.001) and a 1.23-fold reduction in the thickness of amniotic epithelium (p < 0.001), and a 1.12-fold decrease in the proportion of intact Wharton’s jelly (p < 0.05) were observed, alongside a 1.1-fold increase in altered Wharton’s jelly (p < 0.05). Additionally, the proportion of the venous muscular layer and endothelium decreased by 1.23-fold (p < 0.001) and 1.24-fold (p < 0.001), respectively, and venous lumen narrowing by 1.1-fold (p < 0.05) was noted. Signifiant correlations were found between TNF-α, IL-1β, and IL-6 levels and the proportions of the muscular layer, endothelial layer, and venous lumen.

Conclusion. CMV reactivation during the third trimester of pregnancy is characterized by elevated levels of inflammatory, vasoconstrictive, and destructive factors in umbilical vein blood, which exert damaging effects on vascular endothelium.

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