Disturbance of the progesterone and its metabolites synthesis in the development of neurological disorders in children after cytomegalovirus infection during pregnancy
Cytomegalovirus (CMV) infection is one of the causes of congenital neurological disorders and the virus itself is the most common viral agent causing an imbalance in the production of placenta progesterone and its neuroactive metabolites - allopregnenolone and 5a-dihydroprogesterone. The aim was to evaluate the concentration of progesterone and its metabolites - 5a-dihydroprogesterone and allopregnenolone - in placenta during exacerbation of CMV infection in the first trimester of pregnancy, and the impact of these disturbances on the development of neurological disorders in children. We examined 30 pregnant women with exacerbation of CMV infection in the first trimester of pregnancy and 30 pregnant women with latent disease; and later their newborns. The enzyme immunoassay was used to determine concentration of progesterone in placenta; the histochemical method - to determine 5a-dihydroprogesterone and allopregnenolone. Newborns underwent neurosonography studies. Exacerbation of CMV infection in the first trimester of pregnancy decreased progesterone in placenta by 1.3 times, 5a-dihydroprogesterone - by 1.73 times and allopregnenolone - by 2 times. Ultrasound examination of the brain showed ventriculomegaly, periventricular ischemia, and pseudocysts in newborns up to oneyear from mothers with exacerbation of CMV during pregnancy. Later, minimal brain dysfunctions were manifested by motor disorders, increased general, vegetative excitability, and a tendency to digestive and sleep disorders. The data obtained indicate that the exacerbation of CMV infection in the first trimester of pregnancy is interrelated with a decrease in the concentration of progesterone and its metabolites (5a-dihydroprogesterone, allopregnenolone) in the placenta and development of neurological dysfunction in newborns.