TNF and viral pneumonia: Indirect mechanisms of fetal damage include hypoxia secondary to viral pneumonia in the mother, fever, changes in maternal pro-inflammatory tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6 and anti-inflammatory cytokines such as IL-10 and chemokines (CXCL8, CXCL10) compared to healthy pregnant women [9,10,52,53].