Nanomedicine in maternal viral infections: advancing prenatal therapies for fetal protection

Viral infections during pregnancy can lead to several adverse outcomes, including miscarriage, stillbirth, intrauterine growth restriction, and neonatal complications, which may manifest congenital malformations and organ dysfunction. Infants who exhibit symptoms following maternal infection tend to have poorer health outcomes compared to their asymptomatic counterparts. Various viruses are known to cause birth defects, with the most common being cytomegalovirus (CMV), rubella virus, hepatitis B and C viruses, herpes simplex viruses 1 and 2, human herpesvirus 6 (HHV-6), Zika virus, and human immunodeficiency virus. In this review article, we examined the most prevalent maternal viral infections that can cross the placental barrier and affect the fetus, potentially resulting in severe damage. Nanomedicine emerges as a promising candidate capable of traversing the placenta to mitigate viral infections in the fetus, thereby minimizing damage. We explored several classes of nanoparticle-based clinical approaches, along with their associated complications and success rates in various trials targeting different types of maternal viral infections. Additionally, we discussed several nanomedicines that can effectively combat viral infections during pregnancy, serving as potential safeguards for both the mother and the fetus.