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Yao L, Zhang P, Zhou J, He T, Tan Z, Li C, Yin Y. Gestational weight gain during pregnancy is the risk factor for Omicron infection: a retrospective case-control study. BMC Pregnancy Childbirth 2024; 24:818. [PMID: 39695418 DOI: 10.1186/s12884-024-07025-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 12/02/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND It remains unclear whether gestational weight gain (GWG) during pregnancy is associated with Omicron infection in pregnant women. OBJECTIVE To investigate whether gestational weight gain during pregnancy is associated with an increased risk of Omicron infection. METHODS This is a retrospective case-control study of pregnant women from The Third Affiliated Hospital of Sun Yat-sen University from December 1 to 31, 2022. Pregnant women infected with Omicron were compared to those uninfected using chi-square statistics for categorical variables and t-tests or ANOVA for continuous variables. Multivariable logistic regression, along with subgroup analyses, was used to investigate the association between gestational weight gain during pregnancy and Omicron infection. RESULTS Our study included 369 pregnant women who met the eligibility criteria. The proportion of pregnant women in the term, infected and uninfected with Omicron was 113(30.6%) and 256(69.4%). Classified pregnant women according to GWG during pregnancy, GWG during pregnancy above IOM was significantly associated with an increased risk of Omicron infection (P = 0.006). After adjusting for demographic factors and pregnancy complications, this association was particularly notable (OR = 2.55, 95%CI = 1.35-4.85, P = 0.004). Classified pregnant women according to pregestational BMI, in normal-weight pregnant women, GWG during pregnancy above IOM was significantly associated with an increased risk of Omicron infection (P = 0.01). After adjusting for demographic factors and pregnancy complications, this association was particularly notable (OR = 2.56, 95%CI = 1.24-5.31, P = 0.01). CONCLUSION Among women with normal weight, gestational weight gain during pregnancy above IOM was an independent risk factor for Omicron infection.
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Affiliation(s)
- Lin Yao
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, 600#Tian He Road, Guangzhou, P. R. China
| | - Peizhen Zhang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, 600#Tian He Road, Guangzhou, P. R. China
| | - Jin Zhou
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, 600#Tian He Road, Guangzhou, P. R. China
| | - Tiantian He
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, 600#Tian He Road, Guangzhou, P. R. China
| | - Zhangmin Tan
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, 600#Tian He Road, Guangzhou, P. R. China
| | - Chuo Li
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, 600#Tian He Road, Guangzhou, P. R. China
| | - Yuzhu Yin
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, 600#Tian He Road, Guangzhou, P. R. China.
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Tan YS, Tsai CC, Cheng HH, Lai YJ, Lee PF, Hsu TY, Huang KL. Comparison of Modified Labor Induction Strategies for Pregnant Women at a Single Tertiary Center Before and During the COVID-19 Pandemic. Diagnostics (Basel) 2024; 14:2739. [PMID: 39682647 DOI: 10.3390/diagnostics14232739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Revised: 12/02/2024] [Accepted: 12/04/2024] [Indexed: 12/18/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has substantially impacted healthcare systems and obstetric practices worldwide. Labor induction is a common procedure for preventing obstetric complications in high-risk populations. This study evaluated perinatal outcomes of labor induction using a modified management protocol in a tertiary care center during the COVID-19 pandemic. METHODS We conducted a retrospective study by reviewing electronic structured delivery records of women who underwent elective labor induction between June 2020 and October 2022. We analyzed maternal characteristics, maternal outcomes, and neonatal outcomes during the pre-pandemic (June 2020 to May 2021) and pandemic periods (May 2021 to October 2022). RESULTS The study included 976 cases: 325 pregnancies in the pre-pandemic group and 651 in the pandemic group. The pandemic group showed earlier gestational age at delivery (39 vs. 40 weeks, p < 0.01) and lower body mass index (27.1 vs. 27.5 kg/m2, p = 0.03). During the pandemic period, we observed a significant increase in labor induction cases and a decrease in cesarean sections. Neonatal outcomes, including Apgar scores and intensive care admissions, showed no significant differences between groups. Subgroup analysis identified advanced maternal age (OR = 1.08; 95% CI = 1.03-1.14; p < 0.01) and primiparity (OR = 5.24; 95% CI = 2.75-9.99; p < 0.01) as independent risk factors for cesarean delivery. CONCLUSIONS Even under modified protocols for labor induction during the COVID-19 pandemic, more pregnancies underwent labor induction while achieving a significant reduction in cesarean sections. Advanced maternal age and primiparity were identified as independent risk factors associated with cesarean delivery.
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Affiliation(s)
- Yi-Sin Tan
- Department of Obstetrics and Gynecology, Kinmen Hospital, Ministry of Health and Welfare, Jinhu 891002, Taiwan
| | - Ching-Chang Tsai
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan
| | - Hsin-Hsin Cheng
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan
| | - Yun-Ju Lai
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan
| | - Pei-Fang Lee
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan
| | - Te-Yao Hsu
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan
| | - Kun-Long Huang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan
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Du T, Zhang Y, Zha X, Huang Q. Association of SARS-CoV-2 infection during late pregnancy with maternal and neonatal outcomes. BMC Pregnancy Childbirth 2024; 24:632. [PMID: 39354438 PMCID: PMC11446016 DOI: 10.1186/s12884-024-06816-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 09/10/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND Limited data on the impact of the coronavirus disease 2019 (COVID-19) during pregnancy on newborn outcomes are available. This study aimed to characterize and compare the clinical outcomes of newborns from women with and without the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during late pregnancy. METHOD This was a retrospective cohort study of women who were either infected or not infected with the SARS-CoV-2 virus during late pregnancy. The neonatal complications associated with COVID-19-positive pregnant women were investigated and analyzed. RESULTS Among 2063 pregnant women over 28 weeks of gestation, 1.2%, 3.3%, and 18.7% of patients with multiple pregnancies, abnormal fetal positions, and lack of maternal or neonatal follow-up data, respectively, were excluded. Patients who were COVID-19-negative (60.6%) and -positive (16.2%) remained for further analysis. SARS-CoV-2 infection was significantly associated with higher SARS-CoV-2 infection rates in newborns (0% vs. 1.49%, P < 0.01) and longer duration of hospital stay (6.39 ± 2.2 vs. 4.92 ± 1.6, P < 0.01). However, comparing neonatal complications, including Apgar score, preterm birth, low birth weight, cesarean section rate, newborn hearing, neonatal congenital heart defects, and height and weight compliance rate of 6-month-old children, between non-infected and infected participants did not reach statistical significance. CONCLUSION SARS-CoV-2 infection in late pregnancy has no significant impact on neonatal outcomes. After six months of follow-up of the neonates, we observed that SARS-CoV-2 infection in the third trimester of pregnancy did not affect their growth and development. Hopefully, these findings will guide management strategies and clinical practice.
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Affiliation(s)
- Ting Du
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China
| | - Yawen Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China
| | - Xueli Zha
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China
| | - Qin Huang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China.
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Bui MT, Nguyen Le CA, Duong KL, Hoang VT, Nguyen TK. Transplacental Transmission of SARS-CoV-2: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1517. [PMID: 39336558 PMCID: PMC11434576 DOI: 10.3390/medicina60091517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Revised: 09/12/2024] [Accepted: 09/14/2024] [Indexed: 09/30/2024]
Abstract
Background and Objectives: The study aims to explore the potential for transplacental transmission of SARS-CoV-2, focusing on its pathophysiology, placental defense mechanisms, and the clinical implications for maternal and neonatal health. Materials and Methods: A comprehensive review of the current literature was conducted, analyzing studies on SARS-CoV-2 infection in pregnancy, the expression of key viral receptors (ACE2 and TMPRSS2) in placental cells, and the immune responses involved in placental defense. The review also examined the clinical outcomes related to maternal and neonatal health, including adverse pregnancy outcomes and neonatal infection. Results: The expression of ACE2 and TMPRSS2 in the placenta supports the biological plausibility of SARS-CoV-2 transplacental transmission. Histopathological findings from the infected placentas reveal inflammation, vascular changes, and the evidence of viral particles in placental tissues. Clinical reports indicate an increased risk of preterm birth, intrauterine growth restriction, and neonatal infection in pregnancies affected by COVID-19. However, the frequency and mechanisms of vertical transmission remain variable across studies, highlighting the need for standardized research protocols. Conclusions: SARS-CoV-2 can potentially infect placental cells, leading to adverse pregnancy outcomes and neonatal infection. While evidence of transplacental transmission has been documented, the risk and mechanisms are not fully understood. Ongoing research is essential to clarify these aspects and inform obstetric care practices to improve maternal and neonatal outcomes during the COVID-19 pandemic.
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Affiliation(s)
| | | | | | | | - Trung Kien Nguyen
- Thai Binh University of Medicine and Pharmacy, Thai Binh 410000, Vietnam; (M.T.B.); (C.A.N.L.); (K.L.D.); (V.T.H.)
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Milostić-Srb A, Srb N, Talapko J, Meštrović T, Žiger T, Pačarić S, Fureš R, Makarović V, Škrlec I. The Effect of COVID-19 and COVID-19 Vaccination on Assisted Human Reproduction Outcomes: A Systematic Review and Meta-Analysis. Diseases 2024; 12:201. [PMID: 39329870 PMCID: PMC11431602 DOI: 10.3390/diseases12090201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 08/24/2024] [Accepted: 08/25/2024] [Indexed: 09/28/2024] Open
Abstract
The most discussed infectious disease is coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Many research endeavors have focused on the effects of the virus on reproductive organs, as these have also been shown to carry the receptors to which the virus attaches. The results of assisted reproductive technology (ART) have been significantly affected by the pandemic, with some in vitro fertilization (IVF) centers being closed due to the risk of further spread of the disease. According to World Health Organization statistics, 17.5% of adults worldwide suffered from fertility problems in 2023; in other words, one in six people in the world have reproductive health problems. As infertility is a growing problem in the modern world and new developments in assisted reproduction are always a topic of profound interest, it is important to understand the impact of SARS-CoV-2 on reproductive health. This systematic review aimed to examine studies describing patients undergoing ART procedures with a COVID-19-positive history and to shed light on the recent evidence on the safety of COVID-19 vaccination in the ART context. A meta-analysis was conducted to confirm the results of the systematic review. The results showed a significant difference in clinical pregnancy rates between the vaccinated and unvaccinated groups and an increased miscarriage rate in those with a COVID-19-positive history. However, no significant difference in clinical pregnancy and birth rates was found in participants with a previous COVID-19 infection. The results show that further studies and research are needed, even though the spread and impact of the virus have decreased. Evidence-based information for individuals and couples undergoing infertility treatment is vital to enable informed decision-making.
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Affiliation(s)
- Andrea Milostić-Srb
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Nika Srb
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Jasminka Talapko
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Tomislav Meštrović
- University Centre Varaždin, University North, 42000 Varaždin, Croatia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USA
- Department for Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA 98195, USA
| | - Tihomil Žiger
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Stana Pačarić
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Surgery, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Rajko Fureš
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Gynecology and Obstetrics, Zabok General Hospital and Croatian Veterans Hospital, 49210 Zabok, Croatia
| | - Vedrana Makarović
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- University Hospital Center Osijek, 31000 Osijek, Croatia
| | - Ivana Škrlec
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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6
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Sal-Sarria S, Conejo NM, González-Pardo H. Maternal immune activation and its multifaceted effects on learning and memory in rodent offspring: A systematic review. Neurosci Biobehav Rev 2024; 164:105844. [PMID: 39106940 DOI: 10.1016/j.neubiorev.2024.105844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/25/2024] [Accepted: 08/02/2024] [Indexed: 08/09/2024]
Abstract
This systematic review explored the impact of maternal immune activation (MIA) on learning and memory behavior in offspring, with a particular focus on sexual dimorphism. We analyzed 20 experimental studies involving rodent models (rats and mice) exposed to either lipopolysaccharide (LPS) or POLY I:C during gestation following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our findings reveal that most studies report a detrimental impact of MIA on the learning and memory performance of offspring, highlighting the significant role of prenatal environmental factors in neurodevelopment. Furthermore, this review underscores the complex effects of sex, with males often exhibiting more pronounced cognitive impairment compared to females. Notably, a small subset of studies report enhanced cognitive function following MIA, suggesting complex, context-dependent outcomes of prenatal immune challenges. This review also highlights sex differences caused by the effects of MIA in terms of cytokine responses, alterations in gene expression, and differences in microglial responses as factors that contribute to the cognitive outcomes observed.
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Affiliation(s)
- Saúl Sal-Sarria
- Laboratory of Neuroscience, Department of Psychology, University of Oviedo, Oviedo, Spain; Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain; Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain.
| | - Nélida M Conejo
- Laboratory of Neuroscience, Department of Psychology, University of Oviedo, Oviedo, Spain; Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain; Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain.
| | - Héctor González-Pardo
- Laboratory of Neuroscience, Department of Psychology, University of Oviedo, Oviedo, Spain; Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain; Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain.
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Abbasi F, Movahedi M, Seresht LM, Nazari F, Naeiji Z, Arbabzadeh T, Khanjani S. COVID-19's Effect in Pregnancy and Vertical Transmission: A Systematic Review. Int J Prev Med 2024; 15:25. [PMID: 39239304 PMCID: PMC11376542 DOI: 10.4103/ijpvm.ijpvm_245_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 02/20/2024] [Indexed: 09/07/2024] Open
Abstract
The COVID-19 pandemic has significantly impacted public health and the global economy. It has also been found to have potential effects on pregnancy, neonatal outcomes, and mother-to-infant transmission. This systematic review aims to provide an overview of the maternal and perinatal outcomes associated with pregnancy. A systematic review study was conducted by searching the PubMed, MEDLINE, Embase, and Web of Science databases according to PRISMA guidelines from December 1, 2019, to December 23, 2022. The results indicate that there was an increase in the rate of cesarean delivery among mothers infected with SARS-CoV-2. However, the study found that the mode of delivery for pregnant women infected with SARS-CoV-2 did not increase or decrease the risk of infection for newborns. During the COVID-19 pandemic, there has been an increase in maternal and infant mortality rates, as well as stillbirths and ruptured ectopic pregnancies. Research has shown that SARS-CoV-2 can potentially be transmitted during pregnancy, although vertical transmission is rare. However, additional data are needed to investigate this adverse effect, especially regarding reports of disease recurrence in mothers infected with SARS-CoV-2.
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Affiliation(s)
- Fatemeh Abbasi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Minoo Movahedi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Leila Mousavi Seresht
- Department of Obstetrics and Gynecology, Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Farzaneh Nazari
- Department of Obstetrics and Gynecology, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Zahra Naeiji
- Department of Obstetrics and Gynecology, School of Medicine, Mahdyieh Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Taraneh Arbabzadeh
- Department of Obstetrics and Gynecology, School of Medicine, Shohada Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Somayeh Khanjani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Isfahan University of Medical Science, Isfahan, Iran
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Soltani S, Mobarakabadi A, Hosseinpour Kohshahi M, Banaei M, Taheri M, Dashti S, Hosseini Teshnizi S, Roozbeh N. Identifying the Risk Factors of Adverse Pregnancy Outcomes among Women with COVID-19: A Population-Based Case-Control Study in Southern Iran. J Caring Sci 2024; 13:106-115. [PMID: 39318730 PMCID: PMC11417295 DOI: 10.34172/jcs.33156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/17/2023] [Indexed: 09/26/2024] Open
Abstract
Introduction Pregnant women and their fetuses are considered as high-risk groups during the COVID-19 pandemic. The aim of this study was to identify the risk factors of adverse pregnancy outcomes among women with COVID-19. Methods This case-control study was conducted among pregnant women who delivered live infants at least 60 days before data collection in Hormozgan Province, south of Iran, 2021. The case and control groups included women with and without the history of COVID-19, respectively. A 47-item checklist including demographic information of the mothers, maternal current and past medical history, maternal and fetal prenatal and post-natal outcomes; and other COVID-19 related outcomes was used. The logistic regression analysis was used for data analysis. Results A total of 1337 women (668 in case and 669 in control groups) participated in this study. The mean (SD) gestational age in the case and control groups were 32.83 (84.64) and 23.75 (6.93) weeks respectively. Maternal age and the incidence of abortion, obesity, and multiple pregnancies was higher in the COVID-19 group compared with the control group. The most common COVID-19 symptoms were myalgia (24.8%), cough (19.3%), fever (17.5%) and olfactory disorder (14.3%). The preventive factors against COVID-19 adverse pregnancy outcomes were low and normal body mass index, influenza vaccination history, and multivitamin consumption, while the risk factors were multiple pregnancies, abortion and preterm labor. Conclusion This study showed that pregnant women were to COVID-19. The identified risk factors for COVID-19 adverse pregnancy outcomes can be used to prioritized pregnant women in receiving COVID-19 related health services.
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Affiliation(s)
- Shirin Soltani
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Arezoo Mobarakabadi
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | - Mojdeh Banaei
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mahdiye Taheri
- Department of Midwifery and Reproductive Heath, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sareh Dashti
- Department of Public Health, Faculty of Paramedicine, Mashhad Medical sciences, Islamic Azad University, Mashhad, Iran
- Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
| | - Saeed Hosseini Teshnizi
- Department of Biostatistics, Paramedical School, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nasibeh Roozbeh
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Cruz-Calvente M, Rueda-Medina B, Gil-Gutiérrez R, Medina-Martínez I, Gómez-Urquiza JL, Correa-Rodríguez M. Impact of SARS-COV-2 Infection on Maternal, Obstetric and Neonatal Outcomes in a Cohort of Vaccinated Women: A Pilot Study. Biol Res Nurs 2024; 26:429-437. [PMID: 38429968 DOI: 10.1177/10998004241237134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
We aimed to investigate the impact of COVID-19 infection on maternal characteristics and obstetric and neonatal outcomes in a cohort of women in labor previously vaccinated who tested positive for SARS-CoV-2 infection, compared to aged-matched healthy controls. A retrospective case-control study was conducted among 66 women in labor. Clinical data were obtained from medical records. The attendance rates at childbirth and parenting classes, as well as the implementation of a birth plan, were significantly lower in the COVID-19 infection group (6.1% vs. 48.5%, <0.001; 6.1% vs. 33.3%, p = .005, respectively). Women with COVID-19 had a higher prevalence of prolonged postpartum hospital stay (33.3% vs. 9.1%, p = .016), and significantly higher prevalence of spontaneous preterm birth (27.3% vs. 1.09%, p = .006). Breastfeeding within the first 24 hr was also lower in women with COVID-19 (72.7% vs. 97.0%, p = .006). Maternal characteristics and neonatal outcomes are influenced by COVID-19 infection in vaccinated women. Complications include spontaneous preterm birth, prolonged postpartum hospital stay, and lack of breastfeeding within the first 24 hr. Childbirth education, parenting classes and implementing a birth plan may be associated with a decreased risk of COVID-19 infection.
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Affiliation(s)
| | - Blanca Rueda-Medina
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
| | - Rocío Gil-Gutiérrez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Irene Medina-Martínez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - José L Gómez-Urquiza
- Department of Nursing, Ceuta Faculty of Health Sciences, University of Granada, Ceuta, Spain
| | - María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
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Costa S, Giordano L, Bottoni A, Tiberi E, Fattore S, Pastorino R, Simone ND, Lanzone A, Buonsenso D, Valentini P, Cattani P, Santangelo R, Sanguinetti M, Scambia G, Vento G. Vertical Transmission of SARS-CoV-2 during Pregnancy: A Prospective Italian Cohort Study. Am J Perinatol 2024; 41:1077-1085. [PMID: 35263767 DOI: 10.1055/a-1792-4535] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The extent of vertical transmission (VT) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from mothers their fetuses or neonates is still uncertain. We aimed to determine the incidence of VT. STUDY DESIGN In this prospective cohort study. All mother diagnosed with SARS-CoV-2 infection at the time of delivery or up to 1 week prior and their neonates, managed in a tertiary referral hospital for pregnancy complicated by coronavirus disease 2019 (COVID-19) in Rome, from April 2 to December 22, 2020, were included. Maternal infection was defined as nasopharyngeal swab test results positive for SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR). Biological samples were collected before, at, and after delivery to test positivity for SARS-CoV-2 RT-PCR and anti-SARS-CoV-2-specific antibodies. RESULTS The cohort included 95 women and 96 neonates with documented SARS-CoV-2 test results. Four neonates (4.2%) tested positive. The incidence of VT, according to the guidance criteria for diagnosing perinatal SARS-CoV-2 infection, was 5.2%. Neonatal symptoms were due to prematurity or fetal distress: symptomatic infants had lower median (min-max) gestational age, 38.1 (29.3-40.6) versus 39.3 (33.9-41.9) weeks (p = 0.036), and 1-minute and 5-minute Apgar scores, 9 (3-9) versus 9 (7-10) (p = 0.036) and 10 (6-10) versus 10 (8-10) (p = 0.012), respectively, than asymptomatic infants and needed more frequent assistance in the delivery room (22.2 vs 2.5%; p = 0.008). Only six (7.1%) neonates had anti-SARS-CoV-2-specific antibodies, despite the ongoing maternal infection. CONCLUSION The incidence of VT is low as is the detection of specific anti-SARS-CoV-2 antibodies in cord blood when infection is contracted late in pregnancy. This would suggest poor protection of infants against horizontal transmission of the virus. KEY POINTS · VT of SARS-CoV-2 from pregnant mothers to fetuses or neonates can be possible.. · In this prospective cohort study, the incidence of VT is found to be 5.2%.. · VT is low but exists..
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Affiliation(s)
- Simonetta Costa
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Lucia Giordano
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Anthea Bottoni
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Eloisa Tiberi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Simona Fattore
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Roberta Pastorino
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Nicoletta Di Simone
- Department of Biomedical Sciences, Humanitas University, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Antonio Lanzone
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Paola Cattani
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rosaria Santangelo
- Department of Laboratory and Infectivology Science, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Maurizio Sanguinetti
- Department of Laboratory and Infectivology Science, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Giovanni Scambia
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Vento
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Katsaras G, Gialamprinou D, Kontovazainitis CG, Psaroulaki E, Mitsiakos G. Neonatal hemostasis and the use of thromboelastography/rotational thromboelastometry in the neonatal period. Minerva Pediatr (Torino) 2024; 76:425-438. [PMID: 37166777 DOI: 10.23736/s2724-5276.23.07214-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Developmental hemostasis refers to age-related alterations related to the progressive maturation of the hemostatic system. Although the conventional coagulation tests, such as prothrombin time (PT) and activated partial thromboplastin time (aPTT), are indeed helpful in coagulation workup, they do not accurately delineate the hemostasis in vivo. The viscoelastic tests, namely thromboelastography (TEG) and rotational thromboelastometry (ROTEM), seem to reflect hemostasis more accurately since they measure various clot parameters without excluding the cellular coagulation components. TEG and ROTEM have shown redaction in blood product administration when used in therapeutic algorithms in older children and adults, but their use in neonates is limited. This review summarizes the current literature regarding using these tests in the neonatal population. Several studies tried to resolve the lack of neonatal reference values of the TEG/ROTEM parameters by publishing neonatal reference ranges for various gestational age groups. Moreover, few studies concerning therapeutic hypothermia, neonates undergoing surgery, and critically ill neonates have shown some predictive value of these tests regarding bleeding events. Even though their results seem promising, larger studies of higher quality are needed to clarify any discrepancies and point out whether these tests have significant predictive value. In conclusion, viscoelastic tests need to be increasingly part of the NICUs' clinical routine and should be used along with conventional coagulation tests in transfusion therapy.
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Affiliation(s)
- Georgios Katsaras
- Department of Pediatrics, Hospital Unit of Edessa, General Hospital of Pella, Edessa, Greece -
- Second Neonatal Department and Neonatal Intensive Care Unit (NICU), Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece -
| | - Dimitra Gialamprinou
- Second Neonatal Department and Neonatal Intensive Care Unit (NICU), Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Christos-Georgios Kontovazainitis
- Second Neonatal Department and Neonatal Intensive Care Unit (NICU), Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Evdokia Psaroulaki
- Department of Pediatrics, Hospital Unit of Edessa, General Hospital of Pella, Edessa, Greece
| | - Georgios Mitsiakos
- Second Neonatal Department and Neonatal Intensive Care Unit (NICU), Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
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12
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Soysal C, Ulaş Ö, Işıkalan MM, Bıyık İ, Taşçı Y, Keskin N. The changes in fear of childbirth in pregnancy during and before the COVID-19 pandemic. Sci Rep 2024; 14:11067. [PMID: 38744899 PMCID: PMC11093970 DOI: 10.1038/s41598-024-61307-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/03/2024] [Indexed: 05/16/2024] Open
Abstract
We aimed to investigate how factors such as age, education level, planned delivery method and fear of childbirth were affected in pregnant women before and during the pandemic. This cross-sectional study compared a pre-pandemic pregnant group (July 2019 and December 2019) and a pandemic group (November 2020 and May 2021) of patients at Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital. A total of 696 pregnant women in their second trimester were included in the study. All of them were literate and voluntarily agreed to participate in the study. Data were collected with the Wijma delivery expectancy/experience questionnaire (WDEQ-A), and the outpatient doctor asked the questions face-to-face. The mean age of the pregnant women participating in the study was 31.6 ± 6.8 years. While the total Wijma score was 62.1 ± 25.1 in the pre-pandemic group, it was 61.3 ± 26.4 in the pandemic group, and there was no significant difference between the two groups (p = 0.738). Upon analyzing the fear of childbirth among groups based on education level, no statistically significant differences were observed between the pre-pandemic and pandemic periods within any of the groups. While 25.7% (n = 179) of all participants had a normal fear of childbirth, 22% (n = 153) had a mild fear of childbirth, 27% (n = 188) had a moderate fear of childbirth, and 25.3% (n = 176) had a severe fear of childbirth (Wijma score of 85 and above). When the pre-pandemic and the pandemic period were compared, the fear of childbirth was unchanged in pregnant women at all education levels (p = 0.079, p = 0.957, p = 0.626, p = 0.539, p = 0.202). When comparing fear of childbirth before and after the pandemic, it was found that patients with a high school education level have a significantly higher fear of childbirth. To alleviate the fear of childbirth in pregnant women who have completed high school, training or psychosocial support interventions may be prioritized.
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Affiliation(s)
- Cenk Soysal
- Department of Obstetrics and Gynecology, Kütahya Health Sciences University, Kutahya, Turkey.
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kutahya Health Sciences University, Evliya Çelebi Campus on Tavşanlı Road 10. km, Kutahya, 43020, Turkey.
| | - Özlem Ulaş
- Department of Obstetrics and Gynecology, Kütahya Health Sciences University, Kutahya, Turkey
| | - Mehmet Murat Işıkalan
- Department of Obstetrics and Gynecology, Necmettin Erbakan University, Konya, Turkey
| | - İsmail Bıyık
- Department of Obstetrics and Gynecology, Kütahya Health Sciences University, Kutahya, Turkey
| | - Yasemin Taşçı
- Department of Obstetrics and Gynecology, Kütahya Health Sciences University, Kutahya, Turkey
| | - Nadi Keskin
- Department of Obstetrics and Gynecology, Kütahya Health Sciences University, Kutahya, Turkey
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Lv A, BianBaZhuoMa, DeQiong, DaWaZhuoMa, PuBuZhuoMa, Yao D, LangJiQuZhen, Lu Y, Cai L, DaZhen, Tang C, BianBaZhuoMa, Zhang Y, Yin J, Ding T, DaWaCang, Wu M, Chen Y, Li Y. Effect of COVID-19 infection on pregnant women in plateau regions. Public Health 2024; 229:57-62. [PMID: 38401193 DOI: 10.1016/j.puhe.2023.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/04/2023] [Accepted: 12/28/2023] [Indexed: 02/26/2024]
Abstract
OBJECTIVE The present study aims to explore the effect of COVID-19 infection on pregnant women in plateau regions. STUDY DESIGN Data from 381 pregnant women infected with COVID-19 who underwent prenatal examination or treatment at Women and Children's Hospital of Tibet Autonomous Region between January 2020 and December 2022 and 314 pregnant women not infected with COVID-19 were retrospectively collected. METHODS The study participants were divided into an infected and non-infected group according to whether they were infected with COVID-19. Basic information (ethnicity, age, body mass index and gestational age [GA]), vaccination status, intensive care unit (ICU) admission and delivery outcomes were compared. Binary logistic regression was used to analyse the influencing factors of ICU admission. RESULTS The results revealed significant differences in the GA, vaccination rate, blood pressure, partial pressure of oxygen, white blood cell (WBC) count, ICU admission rate, preeclampsia rate, forearm presentation rate, thrombocytopenia rate, syphilis infection rate and placental abruption rate between the two groups (P < 0.05). A univariate analysis showed that COVID-19 infection, hepatitis B virus infection, the WBC count and hypoproteinaemia were risk factors for ICU admission. The results of the multivariate analysis of the ICU admission of pregnant women showed that COVID-19 infection (odds ratio [OR] = 4.271, 95 % confidence interval [CI]: 3.572-5.820, P < 0.05) was a risk factor for ICU admission and the WBC count (OR = 0.935, 95 % CI: 0.874-0.947, P < 0.05) was a protective factor for ICU admission. CONCLUSION Pregnant women are vulnerable to the adverse consequences of COVID-19 infection, and public health measures such as vaccination are needed to protect this population subgroup.
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Affiliation(s)
- A Lv
- Department of Obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, NO. 1 DaHua Road, Dong Dan, Beijing, 100730, PR China; Women and Children's Hospital of Tibet Autonomous Region, NO. 10 Chagu Avenue, Doilungdêqên District, Liuwu New Area, Lhasa, Tibet Autonomous Region, 851414, PR China
| | - BianBaZhuoMa
- Lhasa People's Hospital, No. 1, Beijing Middle Road, Chengguan District, Lhasa, Tibet Autonomous Region, 850000, PR China
| | - DeQiong
- Women and Children's Hospital of Tibet Autonomous Region, NO. 10 Chagu Avenue, Doilungdêqên District, Liuwu New Area, Lhasa, Tibet Autonomous Region, 851414, PR China
| | - DaWaZhuoMa
- Women and Children's Hospital of Tibet Autonomous Region, NO. 10 Chagu Avenue, Doilungdêqên District, Liuwu New Area, Lhasa, Tibet Autonomous Region, 851414, PR China
| | - PuBuZhuoMa
- Lhasa People's Hospital, No. 1, Beijing Middle Road, Chengguan District, Lhasa, Tibet Autonomous Region, 850000, PR China
| | - D Yao
- Nyingchi People's Hospital, No. 11, Water Garden, Bayi Town, Bayi District, Nyingchi City, Tibet Autonomous Region, 860000, PR China
| | - LangJiQuZhen
- Women and Children's Hospital of Tibet Autonomous Region, NO. 10 Chagu Avenue, Doilungdêqên District, Liuwu New Area, Lhasa, Tibet Autonomous Region, 851414, PR China
| | - Y Lu
- Women and Children's Hospital of Tibet Autonomous Region, NO. 10 Chagu Avenue, Doilungdêqên District, Liuwu New Area, Lhasa, Tibet Autonomous Region, 851414, PR China
| | - L Cai
- Women and Children's Hospital of Tibet Autonomous Region, NO. 10 Chagu Avenue, Doilungdêqên District, Liuwu New Area, Lhasa, Tibet Autonomous Region, 851414, PR China
| | - DaZhen
- Women and Children's Hospital of Tibet Autonomous Region, NO. 10 Chagu Avenue, Doilungdêqên District, Liuwu New Area, Lhasa, Tibet Autonomous Region, 851414, PR China
| | - C Tang
- Women and Children's Hospital of Tibet Autonomous Region, NO. 10 Chagu Avenue, Doilungdêqên District, Liuwu New Area, Lhasa, Tibet Autonomous Region, 851414, PR China
| | - BianBaZhuoMa
- Women and Children's Hospital of Tibet Autonomous Region, NO. 10 Chagu Avenue, Doilungdêqên District, Liuwu New Area, Lhasa, Tibet Autonomous Region, 851414, PR China
| | - Y Zhang
- Women and Children's Hospital of Tibet Autonomous Region, NO. 10 Chagu Avenue, Doilungdêqên District, Liuwu New Area, Lhasa, Tibet Autonomous Region, 851414, PR China
| | - J Yin
- Women and Children's Hospital of Tibet Autonomous Region, NO. 10 Chagu Avenue, Doilungdêqên District, Liuwu New Area, Lhasa, Tibet Autonomous Region, 851414, PR China
| | - T Ding
- Women and Children's Hospital of Tibet Autonomous Region, NO. 10 Chagu Avenue, Doilungdêqên District, Liuwu New Area, Lhasa, Tibet Autonomous Region, 851414, PR China
| | - DaWaCang
- Tibet University Medical School, No. 10, Zangda East Road, Chengguan District, Lhasa, Tibet Autonomous Region, 850000, PR China
| | - M Wu
- Tibet University Medical School, No. 10, Zangda East Road, Chengguan District, Lhasa, Tibet Autonomous Region, 850000, PR China
| | - Y Chen
- Tibet University Medical School, No. 10, Zangda East Road, Chengguan District, Lhasa, Tibet Autonomous Region, 850000, PR China
| | - Y Li
- Department of Obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, NO. 1 DaHua Road, Dong Dan, Beijing, 100730, PR China.
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Khodavandi P, Khodavandi A, Alizadeh F, Gholizadeh L. Possibility of intrauterine transmission from mother to fetus/newborn: Systematic review and meta-analysis of diagnostic methods to detect SARS-CoV-2 infection. Eur J Obstet Gynecol Reprod Biol 2024; 295:181-200. [PMID: 38367392 DOI: 10.1016/j.ejogrb.2024.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/03/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
Several studies have reported vertical transmission of SARS-CoV-2; however, information regarding intrauterine transmission based on diagnostic methods to detect SARS-CoV-2 infection is scarce. A systematic review and meta-analysis was conducted to identify and explore the studies that attempt to ascertain the possibility of intrauterine transmission of SARS-CoV-2 infection according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement. The results demonstrate that SARS-CoV-2 can be transmitted intrauterine, as detected by clinical manifestations (1.00, 95 % CI: 1.00 - 1.00, 0.51, 95 % CI: 0.22 - 0.80), imaging (0.50, 95 % CI: 0.24 - 0.76, 0.03, 95 % CI: 0.00 - 0.17), molecular (1. 00, 95 % CI: 1.00 - 1.00, 0.92, 95 % CI: 0.77 - 1.00), immunological (0.32, 95 % CI: 0.10 - 0.57, 0.34, 95 % CI: 0.11 - 0.61), and histological approaches (0.79, 95 % CI: 0.52 - 0.98) in maternal and fetal/neonatal specimens, respectively. The possibility of intrauterine transmission of SARS-CoV-2 from mother to fetus/newborn was 41 % (95 % CI 0.37 - 0.45). We might confirm/verify the intrauterine transmission of SARS-CoCV-2 from mother to fetus/newborn.
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Affiliation(s)
| | - Alireza Khodavandi
- Department of Biology, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran.
| | - Fahimeh Alizadeh
- Department of Biology, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran
| | - Lida Gholizadeh
- Department of Nursing and Midwifery, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran
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Fang Y, Fang D. Mendelian randomization analysis reveals causal relationship between obstetric-related diseases and COVID-19. Virol J 2024; 21:73. [PMID: 38528518 PMCID: PMC10964700 DOI: 10.1186/s12985-024-02348-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/19/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Several observational studies demonstrated that pregnant individuals with COVID-19 had a higher risk of preeclampsia and preterm birth. We aimed to determine whether women with COVID-19 diagnosis had adverse pregnancy outcomes. METHODS A two-sample Mendelian randomization (MR) analysis in this study was used to evaluate the casual relationships between COVID-19 infection and obstetric-related diseases based on genome-wide association studies (GWAS) dataset. Inverse-variance weighted (IVW), MR-Egger and MR-PRESSO were used to infer the connection and estimate the pleiotropy respectively. RESULTS The significant connection was observed between COVID-19 and placental disorders with betaIVW of 1.57 and odds ratio (OR) of 4.81 (95% confidence interval [CI]: 1.05-22.05, p = 0.04). However, there were no associations between COVID-19 infection and gestational diabetes mellitus (GDM) (OR = 1.12; 95% CI: 0.85-1.45, p = 0.41), other disorders of amniotic fluid and membranes (OR = 0.90; 95% CI: 0.61-1.32, p = 0.59), Intrahepatic Cholestasis of Pregnancy (ICP) (OR = 1.42; 95% CI: 0.85-2.36, p = 0.18), birth weight (OR = 1.02; 95% CI: 0.99-1.05, p = 0.19), gestational hypertension (OR = 1.00; 95% CI: 1.00-1.00, p = 0.85), spontaneous miscarriages (OR = 1.00; 95% CI: 0.96-1.04, p = 0.90) and stillbirth (OR = 1.00; 95% CI: 0.98-1.01, p = 0.62). CONCLUSION There was no direct causal relationship between COVID-19 infection and maternal and neonatal poor outcomes. Our study could alleviate the anxiety of pregnant women under the COVID-19 pandemic conditions partly.
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Affiliation(s)
- Yan Fang
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No 9 Jinsui Road, Tianhe District, Guangzhou, Guangdong Province, 510623, People's Republic of China
| | - Dajun Fang
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No 9 Jinsui Road, Tianhe District, Guangzhou, Guangdong Province, 510623, People's Republic of China.
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16
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Jamali Z, Mohammadpour N, Sinaei R, Jafari M, Sabzevari F, Hasannejad M. The footprint of SARS-COV-2 infection in neonatal late sepsis. BMC Pediatr 2024; 24:184. [PMID: 38491449 PMCID: PMC10943770 DOI: 10.1186/s12887-024-04665-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 02/22/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Predicting and finding the viral agents responsible for neonatal late-sepsis has always been challenging. METHOD In this cross-sectional study, which has been done from September 2020 to December 2022, 145 hospitalized neonates suspected to late-onset sepsis alongside routine sepsis workup, were also evaluated for severe acute respiratory syndrome-coronavirus-2 (SARS-COV-2) infection, by nasopharyngeal real-time polymerase chain reaction (RT-PCR) or serological tests. RESULT 145 neonates including 81 girls and 64 boys with a mean age of 12.3 ± 5.9 days and an average hospitalization stay of 23.1 ± 15.4 days were enrolled in the study. While 76.6% of them had negative bacterial culture, 63 patients (43.4%) showed evidence of SARS-COV-2 infection in RT-PCR or serology tests. None of the underlying factors including gender, age, and laboratory investigation had a significant relationship with SARS-COV-2 infection. Similarly, the outcomes of death and length of hospitalization were not different between the two groups with positive and negative SARS-COV-2 RT-PCR (P < 0.05). There was only a significant relationship between radiological changes including reticulonodular pattern, consolidation, pleural effusion, and different types of infiltrations and SARS-COV2 infection. CONCLUSION Considering the widespread of coronavirus disease 2019 (COVID-19) in newborns, it seems logical to investigate the SARS-COV-2 infection in late-sepsis.
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Affiliation(s)
- Zahra Jamali
- Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Najmeh Mohammadpour
- Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Sinaei
- Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
| | - Maedeh Jafari
- Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Sabzevari
- Department of Pediatrics, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Hasannejad
- Department of Laboratory Sciences, School of Medicine, Bam University of Medical Sciences, Bam, Iran
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Palaska E, Golia E, Zacharogianni E, Bothou A, Tziriridou-Chatzopoulou M, Dagla M, Antoniou E, Orovou E. Risk of Transmission of COVID-19 from the Mother to the Foetus: A Systematic Review. JOURNAL OF MOTHER AND CHILD 2024; 28:94-101. [PMID: 39561303 PMCID: PMC11575933 DOI: 10.34763/jmotherandchild.20242801.d-24-00032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Accepted: 10/17/2024] [Indexed: 11/21/2024]
Abstract
INTRODUCTION People's lives have been impacted in every way by the COVID-19 pandemic and it had a variety of effects on pregnancy and childbirth, including decreased access to healthcare providers who can attend to the needs of expectant mothers and their foetuses. These effects can be attributed to the infection's effects on the mother and foetus. AIM The aim of this research was to investigate the probability of vertical transmission of COVID-19 from the pregnant mother to the foetus. METHODS A comprehensive systematic search was conducted on the PubMed, SCOPUS, and Web of Science databases to identify original research articles published from 2019 to 2021. The search aimed to locate cohort studies, case series, and reports focusing on pregnant individuals with COVID-19, specifically those containing information on COVID-19 testing for foetuses or newborns. RESULTS In this systematic review, studies showed that the possibility of vertical transmission from a COVID-19-infected mother to the foetus or neonate is rare. CONCLUSION With regards to the theoretical framework proposed regarding the vertical transmission of COVID-19 from the pregnant woman to the foetus or neonate, there exists a potential risk of transmission. Nevertheless, documented instances of confirmed vertical transmission are limited and inadequately documented in the available literature.
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Affiliation(s)
- Ermioni Palaska
- Department of Midwifery, University of West Attica, Egaleo, Greece
| | - Eleni Golia
- Department of Midwifery, University of West Attica, Egaleo, Greece
| | | | - Anastasia Bothou
- Department of Midwifery, University of West Attica, Egaleo, Greece
| | | | - Maria Dagla
- Department of Midwifery, University of West Attica, Egaleo, Greece
| | | | - Eirini Orovou
- Department of Midwifery, University of West Attica, Egaleo, Greece
- Department of Midwifery, University of Western Macedonia, Ptolemaida, Greece
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El-Atawi K, Abdul Wahab MG, Elsayed Y, Saleh M. Perinatal Outcomes of Newborns of COVID-19-Infected Pregnant Women: An Updated Systematic Review and Meta-Analysis. Cureus 2024; 16:e54306. [PMID: 38496078 PMCID: PMC10944650 DOI: 10.7759/cureus.54306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2024] [Indexed: 03/19/2024] Open
Abstract
In this systematic review and meta-analysis, we aimed to review the characteristics and outcomes of the newborns of Coronavirus disease 2019 (COVID-19) infected pregnant women. We conducted an online bibliographic search using the following electronic databases: MEDLINE via PubMed, Scopus, Web of Science, and Cochrane Central. Studies were deemed eligible if they recruited newborns from mothers with confirmed COVID-19 and reported the perinatal outcomes of neonatal COVID-19 cases. A total of 20 studies were included. Neonates born to mothers with positive COVID-19 results have been shown to have significantly lower birth weights (mean difference, MD = -48.54 g, p = 0.04), increased risks of fetal distress (odds ratio, OR = 1.76, p < 0.00001), respiratory distress (OR = 1.96, p = 0.006), premature birth (OR = 2.08, p < 0.00001), neonatal death (OR = 2.20, p = 0.004), and a lower 5-minute Apgar score (OR = 1.44, p = 0.02). Additionally, they were more likely to be admitted to the neonatal intensive care unit (NICU) (OR = 2.25, p = 0.007) and test positive for COVID-19 themselves (OR = 9.88, p = 0.03). However, other parameters, such as risks for malformations, mechanical ventilation, hypoglycemia, and sepsis, appeared to be comparable between the two groups. Maternal infection with COVID-19 during pregnancy is associated with several neonatal outcomes, some of which are adverse and others that do not show significant deviation from norms. While our meta-analysis clearly illustrates heightened risks associated with premature birth, reduced neonatal weight, and other challenges, it also emphasizes that not all neonatal outcomes can be directly attributed to maternal SARS-CoV-2 infection.
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Affiliation(s)
- Khaled El-Atawi
- Pediatrics/Neonatal Intensive Care Unit, Latifa Women and Children Hospital, Dubai, ARE
| | | | - Yasser Elsayed
- Pediatrics and Neonatology, Health Sciences Centre-Winnipeg, Max Rady College of Medicine, University of Manitoba, Manitoba, CAN
| | - Maysa Saleh
- Pediatrics and Child Health, Al Jalila Children's Hospital, Dubai, ARE
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Man OM, Azamor T, Cambou MC, Fuller TL, Kerin T, Paiola SG, Cranston JS, Mok T, Rao R, Chen W, Jung JU, Martinez VF, Foo SS, Nielsen-Saines K. Respiratory distress in SARS-CoV-2 exposed uninfected neonates followed in the COVID Outcomes in Mother-Infant Pairs (COMP) Study. Nat Commun 2024; 15:399. [PMID: 38267411 PMCID: PMC10808093 DOI: 10.1038/s41467-023-44549-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024] Open
Abstract
Respiratory distress (RD) has been reported in SARS-CoV-2 exposed uninfected (SEU) term neonates. Prior studies suggest that prenatal exposure to Coronavirus Disease 19 (COVID-19) may activate an inflammatory cascade in the newborn airway. In this study, we examine the relationship between maternal COVID-19 vaccination and neonatal RD using a longitudinal cohort of mother-infant pairs in Los Angeles, CA. Two-hundred and twenty-one mothers with laboratory confirmed SARS-CoV-2 during pregnancy and 227 exposed fetuses are enrolled in our study. Maternal disease severity and neonatal RD variables were defined based on current accepted clinical criteria. To explore the multifactorial associations between maternal COVID-19 parameters and infant RD, we utilize a multivariable logistic regression model and a proteomic sub-analysis to propose a pathway for the development of RD following in utero exposure to SARS-CoV-2. Unusually high rates of RD are observed in SEU infants (17%). The odds ratio of RD is 3.06 (95% CI:1.08-10.21) in term neonates born to unvaccinated individuals versus those born to individuals vaccinated prior to maternal infection. Proteomic analysis reveals a robust inflammatory response associated with ciliary dysregulation and enhanced IgE production among SEU neonates with RD. Maternal vaccination against COVID-19 reduces the frequency of neonatal RD.
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Affiliation(s)
- Olivia M Man
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
| | - Tamiris Azamor
- Department of Cancer Biology, Infection Biology Program, Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Mary Catherine Cambou
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
| | - Trevon L Fuller
- Department of Pediatrics, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Tara Kerin
- Department of Pediatrics, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Sophia G Paiola
- Department of Pediatrics, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Jessica S Cranston
- Department of Pediatrics, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Thalia Mok
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Rashmi Rao
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Weiqiang Chen
- Department of Cancer Biology, Infection Biology Program, Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Jae U Jung
- Department of Cancer Biology, Infection Biology Program, Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Viviana Fajardo Martinez
- Department of Pediatrics, Division of Neonatology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Suan-Sin Foo
- Department of Cancer Biology, Infection Biology Program, Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Karin Nielsen-Saines
- Department of Pediatrics, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
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Robinson AA, Feder S, Krishna S, Brustman L. Likely Vertical Transmission of Neonatal SARS CoV-2 Infection. AJP Rep 2024; 14:e62-e65. [PMID: 38370331 PMCID: PMC10874692 DOI: 10.1055/s-0044-1779030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/22/2023] [Indexed: 02/20/2024] Open
Abstract
Maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can affect placental function, but the possibility of intrauterine transmission has been debated. Several authors have published inclusion criteria for vertical transmission, but few reports exist that are able to meet the suggested requirements. Despite the fact that the majority of fetuses born to infected mothers do well, others become critically ill. We present a case of likely intrauterine transmission of a neonate born to a mother who was recently symptomatic with a positive SARS CoV-2 polymerase chain reaction (PCR). The parturient complained of decreased fetal movement and presented at 31 2/7 weeks' gestation with a biophysical profile score of 2/10 and required an emergency cesarean delivery. The neonate went on to develop severe leukopenia with signs of sepsis with a positive SARS CoV-2 PCR on day 4 of life and an otherwise pan-negative workup. Meeting criteria for transplacental transmission requires timely collection of several diagnostic studies that are not standard of care. Further research is needed to support the notion that intrauterine/transplacental infection is possible. Collection swabs should be obtained soon after delivery to help diagnose neonatal infection because early diagnosis is crucial to help identify opportunities for intervention.
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Affiliation(s)
- Andre A. Robinson
- Department of Obstetrics and Gynecology, Mount Sinai West, New York, New York
| | - Samantha Feder
- Department of Obstetrics and Gynecology, NewYork-Presbyterian/Weill Cornell Medical Center, New York, New York
| | - Sushma Krishna
- Department of Neonatology, Mount Sinai West, New York, New York
| | - Lois Brustman
- Department of Maternal-Fetal Medicine, Mount Sinai West, New York, New York
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21
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Brandibur TE, Kundnani NR, Boia M, Nistor D, Velimirovici DM, Mada L, Manea AM, Boia ER, Neagu MN, Popoiu CM. Does COVID-19 Infection during Pregnancy Increase the Appearance of Congenital Gastrointestinal Malformations in Neonates? Biomedicines 2023; 11:3105. [PMID: 38137326 PMCID: PMC10740856 DOI: 10.3390/biomedicines11123105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND COVID-19 was an infection that was capable of bringing the entire world to a standstill position within a period of days to months. Despite the advancements in the medical sector, the contagion was difficult to control and costed the lives of millions of people worldwide. Many short- and long-term effects are witnessed even to date in people that contracted the disease. Pregnant females had to suffer not only the devastating effects of the virus, but also the psycho-social impact of the lockdown. The impact of COVID-19 infection during pregnancy causing decreased antenatal care or hypoxemic episodes due to severe respiratory distress and whether it could lead to the appearance of congenital gastrointestinal malformation in neonates is still unclear. The aim of our study was to analyze if COVID-19 infection during pregnancy could increase the incidence of gastric malformations in neonates born from these women. MATERIALS AND METHODS We sifted the files of all neonates admitted into our hospital between January 2022 and December 2022, and based on inclusion and exclusion criteria, we included the cases having gastrointestinal congenital malformations during the COVID-19 pandemic. We performed a single-center, retrospective, observational descriptive study. We further divided the patients based on the anatomical location of the malformation. We also took down details of the evolution of pregnancy and whether the mother had contracted a SARS-CoV-2 infection during the pregnancy. Details regarding the Apgar score, days of intensive care admission, sex, and nutrition were the key findings studied. RESULTS A total of 47 neonates were found to have digestive anomalies, among which, based on the anatomical locations, the number of malformation cases found at the level of the esophagus were 15, while 16 occurred at the level of the pylorus; we found 12 cases of malformation of the duodenum, and four cases had malformation of the rectum. Out of these 47 neonates, 38.3% were females and 61.7% were males. A total of 58% were preemies, among which 9% had intra-uterine growth retardation (IUGR), and 42% were full-term newborns, among which 4% had intra-uterine growth retardation (IUGR). A total of 45% of the births were primiparous pregnancies and 55% were from multiparous females. A total of 14 mothers were found to have tested positive for COVID-19 during the course of pregnancy (p-value = 0.23); many had mild symptoms but were not tested. CONCLUSIONS COVID-19 can affect the wellbeing of the pregnant female and their fetus. Larger studies can help gain extensive knowledge as to whether COVID-19 also has the potential to result in congenital gastrointestinal anomalies in children born from COVID-19 positive mothers. In our study, only a few infants born with this pathology were found to be born from COVID-19 positive mothers. Hence, it is difficult to conclude or exclude a direct correlation between the infection and the congenital malformations.
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Affiliation(s)
- Timea Elisabeta Brandibur
- Department of Neonatology and Puericulture, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Neonatology and Puericulture, “Louis Ţurcanu” Children Emergency Hospital, 300011 Timisoara, Romania
| | - Nilima Rajpal Kundnani
- Discipline of Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Marioara Boia
- Department of Neonatology and Puericulture, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Neonatology and Puericulture, “Louis Ţurcanu” Children Emergency Hospital, 300011 Timisoara, Romania
| | - Daciana Nistor
- Discipline of Physiology, Department of Functional Sciences, Physiology, Center of Immuno-Physiology and Biotechnologies (CIFBIOTEH), “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Centre for Gene and Cellular Therapies in Cancer, 300723 Timisoara, Romania
| | - Daniel Milan Velimirovici
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania (L.M.)
| | - Leonard Mada
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania (L.M.)
- Syonic SRL, 300254 Timisoara, Romania
| | - Aniko Maria Manea
- Department of Neonatology and Puericulture, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Neonatology and Puericulture, “Louis Ţurcanu” Children Emergency Hospital, 300011 Timisoara, Romania
| | - Eugen Radu Boia
- Department of Oto-Rhino-Laryngology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marioara Nicula Neagu
- Discipline of Physiology, Faculty of Bioengineering of Animal Resources, University of Life Sciences “King Mihai I”, 300645 Timisoara, Romania
| | - Calin Marius Popoiu
- Department XI of Pediatric Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
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22
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Cross JH, Bohne C, Ngwala SK, Shabani J, Wainaina J, Dosunmu O, Kassim I, Penzias RE, Tillya R, Gathara D, Zimba E, Ezeaka VC, Odedere O, Chiume M, Salim N, Kawaza K, Lufesi N, Irimu G, Tongo OO, Malla L, Paton C, Day LT, Oden M, Richards-Kortum R, Molyneux EM, Ohuma EO, Lawn JE. Neonatal inpatient dataset for small and sick newborn care in low- and middle-income countries: systematic development and multi-country operationalisation with NEST360. BMC Pediatr 2023; 23:567. [PMID: 37968588 PMCID: PMC10652643 DOI: 10.1186/s12887-023-04341-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 10/02/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Every Newborn Action Plan (ENAP) coverage target 4 necessitates national scale-up of Level-2 Small and Sick Newborn Care (SSNC) (with Continuous Positive Airway Pressure (CPAP)) in 80% of districts by 2025. Routine neonatal inpatient data is important for improving quality of care, targeting equity gaps, and enabling data-driven decision-making at individual, district, and national-levels. Existing neonatal inpatient datasets vary in purpose, size, definitions, and collection processes. We describe the co-design and operationalisation of a core inpatient dataset for use to track outcomes and improve quality of care for small and sick newborns in high-mortality settings. METHODS A three-step systematic framework was used to review, co-design, and operationalise this novel neonatal inpatient dataset in four countries (Malawi, Kenya, Tanzania, and Nigeria) implementing with the Newborn Essential Solutions and Technologies (NEST360) Alliance. Existing global and national datasets were identified, and variables were mapped according to categories. A priori considerations for variable inclusion were determined by clinicians and policymakers from the four African governments by facilitated group discussions. These included prioritising clinical care and newborn outcomes data, a parsimonious variable list, and electronic data entry. The tool was designed and refined by > 40 implementers and policymakers during a multi-stakeholder workshop and online interactions. RESULTS Identified national and international datasets (n = 6) contained a median of 89 (IQR:61-154) variables, with many relating to research-specific initiatives. Maternal antenatal/intrapartum history was the largest variable category (21, 23.3%). The Neonatal Inpatient Dataset (NID) includes 60 core variables organised in six categories: (1) birth details/maternal history; (2) admission details/identifiers; (3) clinical complications/observations; (4) interventions/investigations; (5) discharge outcomes; and (6) diagnosis/cause-of-death. Categories were informed through the mapping process. The NID has been implemented at 69 neonatal units in four African countries and links to a facility-level quality improvement (QI) dashboard used in real-time by facility staff. CONCLUSION The NEST360 NID is a novel, parsimonious tool for use in routine information systems to inform inpatient SSNC quality. Available on the NEST360/United Nations Children's Fund (UNICEF) Implementation Toolkit for SSNC, this adaptable tool enables facility and country-level comparisons to accelerate progress toward ENAP targets. Additional linked modules could include neonatal at-risk follow-up, retinopathy of prematurity, and Level-3 intensive care.
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Affiliation(s)
- James H Cross
- Maternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK.
| | - Christine Bohne
- Rice360 Institute for Global Health Technologies, Rice University, Texas, USA
- Ifakara Health Institute, Ifakara, Tanzania
| | - Samuel K Ngwala
- Research Support Center, School of Public Health and Family Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | - John Wainaina
- Kenya Medical Research Institute, Wellcome Trust Research Program, Nairobi, Kenya
| | | | | | - Rebecca E Penzias
- Maternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | | | - David Gathara
- Maternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
- Kenya Medical Research Institute, Wellcome Trust Research Program, Nairobi, Kenya
| | - Evelyn Zimba
- Rice360 Institute for Global Health Technologies, Rice University, Texas, USA
| | | | - Opeyemi Odedere
- Rice360 Institute for Global Health Technologies, Rice University, Texas, USA
- APIN Public Health Initiatives, Abuja, Nigeria
| | - Msandeni Chiume
- Department of Paediatrics, Kamuzu University of Health Sciences (Formerly College of Medicine, University of Malawi), Blantyre, Malawi
- Kamuzu Central Hospital, Lilongwe, Malawi
| | - Nahya Salim
- Ifakara Health Institute, Ifakara, Tanzania
- Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Kondwani Kawaza
- Department of Paediatrics, Kamuzu University of Health Sciences (Formerly College of Medicine, University of Malawi), Blantyre, Malawi
| | - Norman Lufesi
- Department of Curative and Medical Rehabilitation, Ministry of Health, Lilongwe, Malawi
| | - Grace Irimu
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Olukemi O Tongo
- Department of Paediatrics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Lucas Malla
- Maternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Chris Paton
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Information Science, University of Otago, Dunedin, New Zealand
| | - Louise T Day
- Maternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
- Maternal and Newborn Health Group, Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Maria Oden
- Rice360 Institute for Global Health Technologies, Rice University, Texas, USA
| | | | - Elizabeth M Molyneux
- Department of Paediatrics, Kamuzu University of Health Sciences (Formerly College of Medicine, University of Malawi), Blantyre, Malawi
| | - Eric O Ohuma
- Maternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK
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Conde TC, de Sá RAM, Portari EA, Velarde LGC, de Ávila LM, Araujo E. Clinical and serological findings in pregnant women and newborns: patterns of coronavirus disease 2019 placental histopathology. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230616. [PMID: 37971121 PMCID: PMC10645172 DOI: 10.1590/1806-9282.20230616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate the correlation between clinical and serological findings of pregnant women and newborns with patterns of histopathologic changes of the placenta diagnosed with coronavirus disease 2019. METHODS A prospective descriptive study was conducted with pregnant women who were positive for SARS-CoV-2 by reverse transcription polymerase chain reaction or serology (IgG and IgM). Clinical analyses were performed using ELISA to detect anti-SARS-CoV-2 IgG and IgA antibodies using the S1 spike protein domain with the Euroimmun kit. Histopathologic analyses of placentas were performed by two expert pathologists. RESULTS Maternal SARS-CoV-2 infection was associated with increased neonatal hospital length of stay (p=0.03), increased preterm birth (p=0.04), and Apgar score<7 at 1st min (p=0.00) and 5th min (p=0.02). Pregnant women with positive IgG and/or IgA at delivery had a higher incidence of placental histopathologic changes in addition to a greater likelihood of having an IgG-positive fetus (p<0.0001). Placentas with positive reverse transcription polymerase chain reaction for SARS-CoV-2 had a higher incidence of histopathologic changes such as maternal vascular hypoperfusion changes (p=0.00). CONCLUSION Maternal SARS-CoV-2 infection was associated with adverse perinatal outcomes. Pregnant women with positive IgG at delivery had a higher incidence of placental histopathologic changes. Placentas with positive reverse transcription polymerase chain reaction for SARS-CoV-2 had a higher incidence of histopathologic changes such as maternal vascular hypoperfusion.
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Affiliation(s)
- Thayana Camara Conde
- Universidade Federal Fluminense, Department of Obstetrics – Niterói (RJ), Brazil
- Perinatal Rede D'or, Obstetrics Service – Rio de Janeiro (RJ), Brazil
| | - Renato Augusto Moreira de Sá
- Universidade Federal Fluminense, Department of Obstetrics – Niterói (RJ), Brazil
- Perinatal Rede D'or, Obstetrics Service – Rio de Janeiro (RJ), Brazil
| | - Elyzabeth Avvad Portari
- National Institute of Women, Children and Adolescents Health Fernandes Figueira/Oswaldo Cruz Foundation, Pathology Service – Rio de Janeiro (RJ), Brazil
| | | | | | - Edward Araujo
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Obstetrics – São Paulo (SP), Brazil
- Universidade Municipal de São Caetano do Sul, Medical Course – São Paulo (SP), Brazil
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24
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Lee SH, Jin JH, Yoo JH, Yoon SW. Association between maternal coronavirus disease 2019 and transient tachypnea of the newborn: a single-center study. Clin Exp Pediatr 2023; 66:493-500. [PMID: 37873564 PMCID: PMC10626023 DOI: 10.3345/cep.2023.00563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Limited clinical reports have investigated the effects of maternal coronavirus disease 2019 (COVID-19) on fetuses and neonates. PURPOSE This retrospective study aimed to assess the impact of maternal COVID-19 on neonates during the perinatal period, including neonatal clinical outcomes, versus the outcomes of neonates of mothers without COVID-19. METHODS Neonates born to COVID-19-infected mothers at the National Health Insurance Service Ilsan Hospital between February 2021 and March 2022 were included. Those with gestational age (GA) ≥35+0 weeks who were born within 2 weeks of the maternal infection were matched 1:2 with a control group based on GA. The main outcomes were respiratory diseases, including transient tachypnea of the newborn (TTN), respiratory distress syndrome, meconium aspiration syndrome, the need for respiratory support, and length of hospital stay. Uni- and multivariate logistic regression analyses were performed and adjusted for relevant covariates, including maternal age, obstetric complications (hypertension and gestational diabetes), delivery mode, birth weight, sex, and small-for-gestational-age status. RESULTS The case group comprised 103 neonates (mean GA, 38.5±1.3 weeks; mean birth weight, 3,121±397 g), while the control group included 206 neonates (mean GA, 38.4±1.2 weeks; mean birth weight, 3088±428 g). In the case and control groups, the proportion of cesarean sections was 91% and 40%, respectively, while the proportion of male infants was 56% and 47%, respectively. After adjusting for covariates, the case group had a higher risk of TTN (adjusted odd ratio [AOR], 3.69; 95% confidence interval [CI], 1.69-8.07), noninvasive respiratory ventilator use (AOR, 2.28; 95% CI, 1.05-4.97), and oxygen support (AOR, 4.83; 95% CI, 1.46-15.95). CONCLUSION Newborns born to COVID-19-infected mothers are at increased risk of TTN and may require respiratory support. Close monitoring of respiratory symptoms is crucial in neonates.
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Affiliation(s)
- Sung Hee Lee
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Ju Hyun Jin
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jong Ha Yoo
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Shin Won Yoon
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea
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25
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Yasa B, Memur S, Ozturk DY, Bagci O, Uslu SI, Cetinkaya M. Neonatal Outcomes of Premature Infants Born to Women with the Novel Coronavirus (SARS-CoV-2) Infection: A Case Control Study. Am J Perinatol 2023; 40:1715-1724. [PMID: 34839474 DOI: 10.1055/s-0041-1740177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Novel coronavirus disease 2019 (COVID-19) is a disease associated with atypical pneumonia caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The first cases of COVID-19 were reported in Wuhan at the end of 2019. Transmission usually occurs via infected droplets and close personal contact; the possibility of vertical transmission is still under debate. This retrospective study aimed to analyze clinical characteristics of premature infants born to mothers with symptomatic COVID-19 disease. STUDY DESIGN This case control study compared the clinical and laboratory data of 20 premature infants born to mothers infected with SARS-CoV-2 with sex and gestational age-matched historical controls. RESULTS The median gestational age and birth weight in both groups were similar. Respiratory distress developed in 11 (55.5%) infants in study group and 19 (47.5%) infants in control group. Mechanical ventilation and endotracheal surfactant administration rates were similar. Median duration of hospitalization was 8.5 (2-76) days in study group and 12 days in historical controls. Real-time reverse-transcription polymerase chain reaction tests (RT-PCR) of nasopharyngeal swab samples for SARS-CoV-2 were found to be negative twice, in the first 24 hours and later at 24 to 48 hours of life. No neutropenia or thrombocytopenia was detected in the study group. Patent ductus arteriosus, bronchopulmonary dysplasia, and necrotizing enterocolitis rates were similar between groups. No mortality was observed in both groups. CONCLUSION To the best of our knowledge, this is one of the few studies evaluating the clinical outcomes of premature infants born to SARS-CoV-2 infected mothers. There was no evidence of vertical transmission of SARS-CoV-2 from symptomatic SARS-CoV-2-infected women to the neonate in our cohort. The neonatal outcomes also seem to be favorable with no mortality in preterm infants. KEY POINTS · SARS-CoV-2 pandemic is a challenge for pregnant women.. · Neonatal outcomes of premature infants born to mothers infected with SARS-CoV-2 not well defined.. · SARS-CoV-2 infection seems to have no adverse effect on mortality and morbidity in premature infants..
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Affiliation(s)
- Beril Yasa
- Neonatology Department, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Seyma Memur
- Neonatology Department, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Dilek Y Ozturk
- Neonatology Department, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Onur Bagci
- Neonatology Department, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Sait I Uslu
- Neonatology Department, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Merih Cetinkaya
- Neonatology Department, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
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26
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Alanya Tosun S, Celikkalkan K, Tosun A, Bulut A, Ozkaya E, Senel I, Bulut M, Ordu G. Role of Lactate Dehydrogenase and Lymphocyte Count as Predictors of Poor Perinatal Outcomes in COVID-19-Infected Pregnancies Requiring Hospitalization and Delivery: A Retrospective Cohort Study. Cureus 2023; 15:e46463. [PMID: 37927663 PMCID: PMC10624150 DOI: 10.7759/cureus.46463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
INTRODUCTION Physiological, hormonal, or biochemical changes may be related to the increased morbidity of COVID-19 during pregnancy. Our knowledge remains limited about which pregnant women will worsen and develop complications. The aim was to evaluate the maternal, fetal, and neonatal outcomes in hospitalized pregnant women who delivered while infected with acute COVID-19 and to investigate the possible predictors of poor prognosis in a tertiary pandemic center. METHODS A retrospective cohort study was conducted on pregnant women who required termination or delivery during a COVID-19 infection in a tertiary hospital. Serum markers were analyzed to determine any possible association and the predictive value of these markers to show poor maternal, fetal, and/or neonatal outcomes. RESULTS Out of 45 patients, 12 had maternal complications (Group 1) and 33 had no maternal complications (Group 2). The mean lymphocyte at hospital admission was measured as 1,175.83 ± 362.0 and 1,735.30 ± 746.1 in Groups 1 and 2, respectively (p=0.02). The lymphocyte count measured at hospital admission showed significance in predicting poor maternal outcome, with an area under the curve (AUC) of 0.737 (95% CI:0.578 to 0.897) and a cut-off value of 1,110 mcL with 82% sensitivity and 67% specificity. Nineteen of the 45 women had fetal complications. Receiver operating characteristic analysis showed maternal lactate dehydrogenase as a significant predictor for poor fetal outcome with a cut-off value of 213 U/L (AUC:0.719; 95% CI:0.566 to 0.872) with 85% sensitivity and 60% specificity. CONCLUSION The lymphocyte count can be used as a predictor of poor maternal outcome and lactate dehydrogenase demonstrates poor fetal outcome during hospitalization.
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Affiliation(s)
- Sebnem Alanya Tosun
- Department of Obstetrics and Gynecology, Giresun University Faculty of Medicine, Giresun, TUR
| | - Kivanc Celikkalkan
- Department of Pediatrics, Giresun University Faculty of Medicine, Giresun, TUR
| | - Alptekin Tosun
- Department of Radiology, Giresun University Faculty of Medicine, Giresun, TUR
| | - Azime Bulut
- Department of Anesthesiology, Giresun University Faculty of Medicine, Giresun, TUR
| | - Enis Ozkaya
- Department of Obstetrics and Gynecology, Zeynep Kamil Maternity and Children Education and Research Hospital, Istanbul, TUR
| | - Ilknur Senel
- Department of Infectious Diseases, Giresun University Faculty of Medicine, Giresun, TUR
| | - Muhammet Bulut
- Department of Pediatrics, Giresun University Faculty of Medicine, Giresun, TUR
| | - Gokhan Ordu
- Department of Obstetrics and Gynecology, Giresun Maternity and Children Education and Research Hospital, Giresun, TUR
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27
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Amiel Castro RT, Schaal NK, Meyerhoff H, Preis H, Mahaffey B, Lobel M, La Marca-Ghaemmaghami P. Investigating Factors Influencing Prenatal Stress, Anxiety, and Fear of Childbirth During the COVID-19 Pandemic in Germany and Switzerland: An Online Survey. Matern Child Health J 2023; 27:1864-1875. [PMID: 37470899 DOI: 10.1007/s10995-023-03758-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVES Pregnant women are likely to experience high levels of stress during the COVID-19 pandemic. However, the factors that might influence the extent of experienced emotional distress are poorly understood. Therefore, we aimed to investigate potential correlates of prenatal emotional distress during the COVID-19 pandemic. METHODS In total, N = 1437 pregnant women from Germany and Switzerland participated in an online study during the first wave of the COVID-19 pandemic (May-August 2020). The survey assessed prenatal distress, pandemic-related pregnancy stress, general anxiety, fear of childbirth, and several socio-demographic, pregnancy- and COVID-19-related factors. Linear multivariate regression models were the main analytical strategy. RESULTS The results highlight that several factors such as full-time employment, nulliparity, high-risk pregnancy, emotional problems, cancelled prenatal appointments, and stating that COVID-19 affected the choice of birth mode were significantly associated with elevated prenatal distress, anxiety, pandemic-related pregnancy stress, and fear of childbirth. Conversely, access to an outdoor space was a protective factor for pandemic-related pregnancy stress and prenatal distress. CONCLUSIONS FOR PRACTICE Overall, the study highlights significant correlates influencing the levels of emotional distress pregnant women experienced during the COVID-19 pandemic. These findings may contribute to the improvement of maternal prenatal medical and psychological care during a public health crisis of international concern, such as the COVID-19 pandemic.
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Affiliation(s)
- Rita T Amiel Castro
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Nora K Schaal
- Institute of Experimental Psychology, Heinrich-Heine-University, Dusseldorf, Germany
| | - Hannah Meyerhoff
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Heidi Preis
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Brittain Mahaffey
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Pearl La Marca-Ghaemmaghami
- Psychology Counselling and Research Institute for Sexuality, Marriage and the Family, International Academy for Human Sciences and Culture, Staadweg 3, P.O. Box 57, 8880, Walenstadt, Switzerland.
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Sekulovski M, Mileva N, Chervenkov L, Peshevska-Sekulovska M, Vasilev GV, Vasilev GH, Miteva D, Tomov L, Lazova S, Gulinac M, Velikova T. Endothelial Dysfunction and Pregnant COVID-19 Patients with Thrombophilia: A Narrative Review. Biomedicines 2023; 11:2458. [PMID: 37760899 PMCID: PMC10525846 DOI: 10.3390/biomedicines11092458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/22/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023] Open
Abstract
Pregnancy with SARS-CoV-2 infection can raise the risk of many complications, including severe COVID-19 and maternal-fetal adverse outcomes. Additionally, endothelial damage occurs as a result of direct SARS-CoV-2 infection, as well as immune system, cardiovascular, and thrombo-inflammatory reactions. In this narrative review, we focus on endothelial dysfunction (ED) in pregnancy, associated with obstetric complications, such as preeclampsia, fetal growth retardation, gestational diabetes, etc., and SARS-CoV-2 infection in pregnant women that can cause ED itself and overlap with other pregnancy complications. We also discuss some shared mechanisms of SARS-CoV-2 pathophysiology and ED.
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Affiliation(s)
- Metodija Sekulovski
- Department of Anesthesiology and Intensive Care, University Hospital Lozenetz, 1 Kozyak Str., 1407 Sofia, Bulgaria
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
| | - Niya Mileva
- Medical Faculty, Medical University of Sofia, 1 Georgi Sofiiski Str., 1431 Sofia, Bulgaria;
| | - Lyubomir Chervenkov
- Department of Diagnostic Imaging, Medical University Plovdiv, Bul. Vasil Aprilov 15A, 4000 Plovdiv, Bulgaria;
| | - Monika Peshevska-Sekulovska
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Department of Gastroenterology, University Hospital Lozenetz, 1407 Sofia, Bulgaria
| | - Georgi Vasilev Vasilev
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Clinic of Endocrinology and Metabolic Disorders, UMHAT “Sv. Georgi”, 4000 Plovdiv, Bulgaria
| | - Georgi Hristov Vasilev
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Laboratory of Hematopathology and Immunology, National Specialized Hospital for Active Treatment of Hematological Diseases, “Plovdivsko Pole“ Str., 6, 1756 Sofia, Bulgaria
| | - Dimitrina Miteva
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Department of Genetics, Faculty of Biology, Sofia University “St. Kliment Ohridski”, 8 Dragan Tzankov Str., 1164 Sofia, Bulgaria
| | - Latchezar Tomov
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Department of Informatics, New Bulgarian University, Montevideo 21 Str., 1618 Sofia, Bulgaria
| | - Snezhina Lazova
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Pediatric Clinic, University Hospital “N. I. Pirogov,” 21 “General Eduard I. Totleben” Blvd; 1606 Sofia, Bulgaria
- Department of Healthcare, Faculty of Public Health “Prof. Tsekomir Vodenicharov, MD, DSc”, Medical University of Sofia, Bialo More 8 Str., 1527 Sofia, Bulgaria
| | - Milena Gulinac
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Department of General and Clinical Pathology, Medical University of Plovdiv, Bul. Vasil Aprilov 15A, 4000 Plovdiv, Bulgaria
| | - Tsvetelina Velikova
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
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Eltayeb MM, Mohamad RMA, Alhawiti IS, Alsulami GM, Buraei SSEM, Mohammed SSH, Awaji HH. Neonatal Outcome of Mothers With COVID-19 in King Salman Armed Forces Hospital, Tabuk, Kingdom of Saudi Arabia. Cureus 2023; 15:e45257. [PMID: 37842358 PMCID: PMC10576630 DOI: 10.7759/cureus.45257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES This study was conducted to assess the neonatal outcome of mothers with COVID-19 in King Salman Armed Forces Hospital, Tabuk, Saudi Arabia. METHODS This was a hospital record-based, retrospective cohort study. The case group included neonates born to mothers who were positive for the COVID-19 virus during pregnancy, whereas the control group included neonates born to mothers who were not infected with the COVID-19 virus during pregnancy. The data were collected from the records and were analyzed using the Statistical Package for the Social Sciences software (IBM Corp., Armonk, NY, USA). RESULTS This study covered the hospital records of 342 women (114 cases and 228 control). The rates of cesarean sections and small for gestational age were significantly higher among the cases compared to the controls (71.1% versus 43.4%, p < 0.001 and 24.6% versus 11.8%, p = 0.003; respectively). The mean birth weight was significantly lower among the cases group (3.0 ± 0.6 versus 3.3 ± 0.6 kg, p = 0.022). Only the case group reported the occurrence of neonatal COVID-19 infection (7.9%, p < 0.001). The study reported only a single case of intrauterine fetal death and one stillbirth in the cases group, but no neonatal deaths (p > 0.05). CONCLUSIONS Maternal COVID-19 may be associated with undesirable neonatal outcomes. There is a possibility of vertical transmission of COVID-19 from the mother to the neonate, but this cannot be confirmed.
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Affiliation(s)
| | | | | | | | | | | | - Hosam Hadi Awaji
- Preventive Medicine Department, King Salman Armed Forces Hospital, Tabuk, SAU
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Bisen AC, Agrawal S, Sanap SN, Ravi Kumar HG, Kumar N, Gupta R, Bhatta RS. COVID-19 retreats and world recovers: A silver lining in the dark cloud. HEALTH CARE SCIENCE 2023; 2:264-285. [PMID: 38939523 PMCID: PMC11080794 DOI: 10.1002/hcs2.57] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2024]
Abstract
The coronavirus disease (COVID-19), which the World Health Organization classified as the Sixth Public Health Emergency Of International Concern (PHEIC) on January 30, 2020, is no longer a PHEIC. Millions were affected due to unawareness. The increase in fatalities and shortage of medicine was the first outrage of COVID-19. As per the Johns Hopkins COVID-19 resource center database, it was observed that the disease has spread dynamically across 200+ nations worldwide affecting more than 600 million people from 2019 to 2023, and over thousands of people were victimized regularly at a 2% mortality rate (approx.). In the midway, the mutant variants of concern like omicron, and delta have also created havoc and caused significant impact on public health, global economy, and lifestyle. Since 2019, 3 years now passed and the dynamic disease statistics seem decelerated; moreover, the prevalence of COVID-19 is also fading. The Johns Hopkins resource center has also stopped recording the data of the global pandemic recently from March 10, 2023. Hence, based on the facts, we are presenting a concise report on the pandemic from 2019 to 2023, which includes a brief discussion of the global pandemic. We have highlighted global epidemiology, emphasizing the Indian COVID scenario, vaccination across the globe, and the psychosocial and geopolitical consequences of COVID-19 with a brief background to pathology, clinical management, and the worldwide response against triage. A lot has changed and still needs to change after three tough years of COVID-19. Even though science has progressed and advanced research in medicine is pointing toward future generations, there is no standard care supplied for COVID-19-like calamities. COVID-19 cases might have declined but its influence on the society is still stagnant. This COVID experience has taught us that, despite our bleak beginnings, there is always hope for the future and that we must act with foresight to improve things for future generations.
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Affiliation(s)
- Amol Chhatrapati Bisen
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Academy of Scientific and Innovative Research (AcSIR)GhaziabadUttar PradeshIndia
| | - Sristi Agrawal
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Academy of Scientific and Innovative Research (AcSIR)GhaziabadUttar PradeshIndia
| | - Sachin Nashik Sanap
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Academy of Scientific and Innovative Research (AcSIR)GhaziabadUttar PradeshIndia
| | | | - Nelam Kumar
- Biochemistry and Structural Biology DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Present address:
International Centre for Translational Eye Research (ICTER)Institute of Physical Chemistry (IChF)Marcina Kasprzaka 44/5201‐224WarsawPoland
| | - Rajdeep Gupta
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
| | - Rabi Sankar Bhatta
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Academy of Scientific and Innovative Research (AcSIR)GhaziabadUttar PradeshIndia
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Berger DS, Galyean A, Nguyen K, Alshak N, Blumenthal E. A Case of Significant Transaminitis with Liver Biopsy in a Pregnant Patient with COVID-19. AJP Rep 2023; 13:e78-e81. [PMID: 38033600 PMCID: PMC10684339 DOI: 10.1055/s-0043-1777099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 08/30/2023] [Indexed: 12/02/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has led to a global health crisis. The virus can cause varying severity of liver injury, but the mechanism has not yet been elucidated, especially in pregnancy. We present a morbidly obese 30-year-old woman with COVID-19 at 28 weeks' gestation complicated by significant transaminitis with peak liver enzymes levels of 501/1,313 (aspartate aminotransferase/alanine aminotransferase). Liver biopsy showed reactive changes consistent with medication effect and mild steatosis. Significant transaminitis has been found in both pregnant and nonpregnant patients with COVID-19. Our case demonstrates the multifactorial nature of liver injury in COVID-19 patients including mild underlying liver steatosis combined with possible viral potentiation of medication effect.
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Affiliation(s)
- Dana Senderoff Berger
- Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California
| | - Anna Galyean
- Department of Obstetrics and Gynecology, Southern California Permanente Medical Group, Pasadena, California
| | - Kelvin Nguyen
- Department of Gastroenterology, Southern California Permanente Medical Group, Pasadena, California
| | - Najeeb Alshak
- Department of Pathology, Southern California Permanente Medical Group, Pasadena, California
| | - Elizabeth Blumenthal
- Department of Obstetrics and Gynecology, Southern California Permanente Medical Group, Pasadena, California
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32
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Chanda BM, Chen XQ. Breastfeeding during the COVID-19 pandemic. Front Pediatr 2023; 11:1120763. [PMID: 37342530 PMCID: PMC10277472 DOI: 10.3389/fped.2023.1120763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 05/10/2023] [Indexed: 06/23/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused many significant changes to all aspects of day to day life. The disease has spread and reached pandemic proportions. The principle route of transmission is the respiratory route. Infants, pregnant women and breastfeeding mothers have all been affected. Many interventions and guidelines from important societies have been instituted in order to curb the transmission of the disease. These have involved both pharmacological and non-pharmacological methods. COVID-19 vaccines have also emerged as important methods of primary prevention of the disease. But several questions have been raised concerning the safety and efficacy of their use in pregnant and breastfeeding mothers. It has also not been clear if the vaccines are effective in generating a robust immune response in the pregnant women and breastfeeding mothers to confer passive immunity to the fetuses and infants, respectively. And they have not been tested in infants. The aspect of infant feeding has equally been affected. Although breast milk has not been known to serve as the vehicle of transmission of the virus, there is still some lack of uniformity of practice regarding breastfeeding when a mother has SARS-CoV-2 infection. This has led to infant feeding being done by the use of commercial formula feeds, pasteurized human donor breast milk, feeding on the mother's own expressed breast milk by a care giver and directly breastfeeding with skin to skin contact. This is despite breast milk being the most physiologically appropriate type of feed for infants. Therefore the pertinent question remains; should breastfeeding continue during the pandemic continue? This review also seeks to analyse the vast amount of scientific information regarding the subject and to synthesize science-based information.
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Affiliation(s)
- Bwalya Mpelwa Chanda
- Department of Pediatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Qing Chen
- Department of Pediatrics, First Affiliation Hospital of Nanjing Medical University, Nanjing, China
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Pryshliak OY, Marynchak OV, Kondryn OY, Hryzhak IH, Henyk NI, Makarchuk OM, Golovchak IS, Boichuk OP, Protsyk AL, Prokofiev MV. Clinical and laboratory characteristics of COVID-19 in pregnant women. J Med Life 2023; 16:766-772. [PMID: 37520486 PMCID: PMC10375343 DOI: 10.25122/jml-2023-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/13/2023] [Indexed: 08/01/2023] Open
Abstract
This article discusses the distinct characteristics of COVID-19 in pregnant women and investigates potential early predictors of disease severity in this specific patient population. The study included 116 pregnant women with a confirmed diagnosis of COVID-19 in different trimesters of pregnancy. In addition to clinical features, we evaluated general clinical research methods, biochemical parameters (procalcitonin, C-reactive protein, D-dimer), and the leukocyte index of endogenous intoxication and lymphocytic index to identify potential early predictors of disease severity. All pregnant women were divided into two study groups: Group I - pregnant women with mild course, and Group II - pregnant women with moderate and severe course of COVID-19. Most pregnant women (72.4%) experienced a non-severe course characterized by catarrhal symptoms and moderate intoxication. However, pulmonary manifestations and pregnancy-related complications were detected in pregnant women from Group 2. The levels of C-reactive protein and procalcitonin in both study groups were significantly increased compared to the control group. In pregnant women with moderate and severe COVID-19, indicators of endogenous intoxication were significantly pronounced. Establishing associations between leukocyte indices and biomarkers, such as procalcitonin and C-reactive protein, enables the utilization of routine complete blood counts as a primary screening tool for predicting the severity of COVID-19 in pregnant women.
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Affiliation(s)
| | - Oleksandra Vasulivna Marynchak
- Department of Infectious Diseases and Epidemiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Oksana Yevgenivna Kondryn
- Department of Infectious Diseases and Epidemiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Ihor Hnatovych Hryzhak
- Department of Infectious Diseases and Epidemiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Natalia Ivanivna Henyk
- Department of Obstetrics and Gynecology named after I.D. Lanovyi Ivano-Frankivsk, National Medical University, Ivano-Frankivsk, Ukraine
| | - Oksana Mykhailivna Makarchuk
- Department of Obstetrics and Gynecology named after I.D. Lanovyi Ivano-Frankivsk, National Medical University, Ivano-Frankivsk, Ukraine
| | | | - Oleksandr Petrovych Boichuk
- Department of Infectious Diseases and Epidemiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Andriy Liubomyrovych Protsyk
- Department of Infectious Diseases and Epidemiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Mykola Valeriiovych Prokofiev
- Department of Infectious Diseases and Epidemiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
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Ardila Pereira L, Meléndres Vidal Ó. [COVID-19 in maternal, perinatal and neonatal mortality in four locations in Bogotá. Descriptive study.]. Rev Esp Salud Publica 2023; 97:e202304034. [PMID: 37114485 PMCID: PMC10541262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE The multiple effects of the COVID-19 pandemic are beginning to be seen from the alteration of vital statistics figures. This is summarized in changes in the usual causes of death and excess attributable mortality, which can finally be seen in structural changes in the populations of the countries. For this reason, this research was created with the objective of determining the impact of the COVID-19 pandemic on maternal, perinatal and neonatal mortality in four locations in Bogotá D.C. (Colombia). METHODS A retrospective longitudinal investigation was carried out in which 217,419 mortality data were analyzed in the towns of Kennedy, Fontibón, Bosa and Puente Aranda in the city of Bogotá - Colombia that occurred between the years 2018 to 2021, of which maternal (54), perinatal (1,370) and neonatal (483) deaths in order to identify a history of SARS-CoV-2 infection that could be related to the excess mortality associated with COVID-19. The data were collected from the open records of vital statistics of the National Statistics Department (DANE), where they were analyzed from frequency measures or central tendency and dispersion according to the types of variables. The specific mortality indicators related to maternal, perinatal and neonatal death events were calculated. RESULTS A decrease in perinatal and neonatal mortality was evidenced since 2020, which was associated with the progressive decrease in pregnancies in those same years; Additionally, a considerable increase in maternal deaths was observed for 2021 compared to the other years analyzed. The proportion of maternal deaths in 2020 and 2021 by 10% and 17%, respectively, were attributed to COVID-19. CONCLUSIONS It is observed that the trend of maternal mortality is related to the increase in mortality from COVID-19, maternal deaths associated with COVID-19 occurred specifically in the zonal planning units that registered more than 160 cases of COVID-19 for the year 2021.
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Affiliation(s)
- Laura Ardila Pereira
- Programa de Maestría en Epidemiologia, Facultad de Ciencias de la Salud, Fundación Universitaria del Área Andina. Fundación Universitaria del Área AndinaBogotá D.C.Colombia
| | - Óscar Meléndres Vidal
- Universidad Militar Nueva Granada. Universidad Militar Nueva Granada. Bogotá D.C.Colombia
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Tesarik J. Editorial: COVID-19 and human reproduction. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1202180. [PMID: 37180490 PMCID: PMC10169819 DOI: 10.3389/frph.2023.1202180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 05/16/2023] Open
Affiliation(s)
- Jan Tesarik
- MARGen Clinic, Molecular Assisted Reproduction and Genetics, Granada, Spain
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Zamaniyan M, Rahmani Z, Ghasemian R, Karimi Z, Arab RK, Ebadi A, Moradi S, Shahrjerdi S, Aghajanpour Mir S, Azizi S. Maternal and Neonatal Outcomes in Pregnant Women With COVID-19 Admitted to Imam Khomeini Hospital of Sari, Iran, 2019 - 2020. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2023; 18. [DOI: 10.5812/archcid-119394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 03/11/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2025]
Abstract
Background: The COVID-19 infection may adversely affect both the mother and baby. Evaluation and identification of aggravating factors can help prevent adverse outcomes. Objectives: The present study aimed to examine pregnant women with COVID-19 infection and evaluate the disease outcomes in Sari, Iran. Methods: The present case series study was performed on 17 pregnant women hospitalized for COVID-19 in Sari. A convenience sampling method was used. First, the researcher took the demographic information and medical history and obtained informed consent from all participants. Then, the selected subjects were examined for inclusion and exclusion criteria, and a throat swab sample was taken from eligible ones for PCR. The PCR was performed for amniotic fluid and neonatal throat samples at pregnancy termination. Six weeks after delivery, the status of rehospitalization of the baby, breastfeeding status, rehospitalization of the mother due to COVID-19, and the state of depression of the mother were evaluated by a 21-item questionnaire over the phone. The collected data were analyzed in SPSS version 23 using the chi-square test. Results: Out of 19 participants, 17 (68%) had positive results for COVID-19 laboratory tests. The prevalence of preterm labor, admission to the neonatal intensive care unit, and vertical transmission were significantly high in pregnant women with COVID-19 and positive PCR results for amniotic fluid (P < 0.050). The frequency of admission to the ICU was significantly higher in pregnant women with diabetes infected with COVID-19 (P = 0.025). There was no rehospitalization of the mother and newborn due to COVID-19, but one case of postpartum depression (9.5%) and two cases of formula feeding (11.8%) were reported. Conclusions: Due to the high risk of maternal and neonatal outcomes of COVID-19 during pregnancy and the high probability of vertical transmission, it is recommended to take special precautions to prevent the disease during this period.
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Kaveh M, Sadatinejad SM. Management of neonatal sepsis with COVID-19 infection in a premature newborn - A case report. JOURNAL OF NEONATAL NURSING : JNN 2023; 29:409-412. [PMID: 35935164 PMCID: PMC9343744 DOI: 10.1016/j.jnn.2022.07.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 11/20/2022]
Abstract
Introduction Neonates appear to be less affected by COVID-19 than adults, yet COVID-19 has been a challenge for all medical specialties, including neonatal intensive care unit (NICU) specialists. Unfortunately, current knowledge about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is limited. This case report explains how COVID-19 neonatal sepsis was treated with immunomodulatory agents. Case presentation In this case, we present a premature male newborn who was ill. He was born to a mother with a negative nasopharyngeal swab test for SARS-CoV-2. On the fifth day of life, the baby developed respiratory distress, and a nasopharyngeal swab test for SARS-CoV-2 tested positive. The baby was Intubated, and intratracheal surfactant was administered. The infant was treated with intravenous immunoglobulin (IVIg) and corticosteroids for 14 days. Patient's demographics Age: under 1 month, Sex: Male, Ethnicity: Iranian. Conclusion The basics of treatment for neonatal COVID-19 is supportive care. Some studies have treated infants with various drugs such as Hydroxychloroquine, Favipiravir, and Remedsivir; however, in our case, a 5-day-old baby boy was treated with corticosteroids and IVIg. We achieved good outcomes after 2 weeks of treatment with dexamethasone 0.3 mg/kg per day and IVIg 2 g/kg/day (for 3 days). It appears that these treatments, along with adjuvant ventilation and the administration of endotracheal surfactant, can improve a patient's general condition.
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Affiliation(s)
- Mahbod Kaveh
- Bahrami Children Hospital, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed Mohsen Sadatinejad
- Bahrami Children Hospital, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
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Ahmed AK, Sijercic VC, Sayad R, Ruthig GR, Abdelwahab SF, El-Mokhtar MA, Sayed IM. Risks and Preventions for Pregnant Women and Their Preterm Infants in a World with COVID-19: A Narrative Review. Vaccines (Basel) 2023; 11:640. [PMID: 36992224 PMCID: PMC10056995 DOI: 10.3390/vaccines11030640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/05/2023] [Accepted: 03/11/2023] [Indexed: 03/17/2023] Open
Abstract
(1) Background and Aim: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is linked to increasing cases of coronavirus disease 2019 (COVID-19) around the world. COVID-19 infections have an important impact on pregnancy, preterm birth (PTB) and delivery. Although several complications have been reported in infected pregnant women, the effect of infection on PTB is controversial. The purpose of this study was to summarize the existing literature on the effects and complications of COVID-19 on the health of pregnant women and preterm babies and its impact on the incidence of PTB. We also discuss the effect of current COVID-19 vaccines during pregnancy. (2) Methods: We carried out a systematic search of MEDLINE, Embase, and PubMed for studies on preterm births associated with COVID-19. (3) Results and Conclusions: We discovered contradictory results regarding the prevalence of PTB during the pandemic compared to earlier years. While most studies indicated an increase in PTBs with COVID-19, some indicated a decline in the preterm delivery rate during this time. During pregnancy, COVID-19 infection can increase the incidence of cesarean section, stillbirth, ICU admission, preeclampsia/eclampsia, and mortality rates. In the treatment of pregnant women with severe COVID-19, methylprednisolone was favored over prednisolone, and a brief course of dexamethasone is advised for pregnant women with anticipated PTB to accelerate the development of the fetal lung. Generally, vaccination for COVID-19 in pregnant and lactating women stimulates anti-SARS-CoV2 immune responses, and it does not result in any noteworthy negative reactions or outcomes for the mother or baby.
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Affiliation(s)
| | | | - Reem Sayad
- Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Gregory R. Ruthig
- Department of Biology, North Central College, Naperville, IL 60540, USA
| | - Sayed F. Abdelwahab
- Department of Pharmaceutics and Industrial Pharmacy, College of Pharmacy, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Mohamed A. El-Mokhtar
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
- Microbiology and Immunology Department, Faculty of Pharmacy, Sphinx University, Assiut 71515, Egypt
| | - Ibrahim M. Sayed
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
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Imran S, Gupta R, Sharma R, Mukhopadhyay S, Yadav S. Perinatal Transmission of SARS-CoV-2 Infection and Its Clinical Attributes: A Single-Center Study From Western Uttar Pradesh. Cureus 2023; 15:e35824. [PMID: 37033580 PMCID: PMC10075277 DOI: 10.7759/cureus.35824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2023] [Indexed: 03/08/2023] Open
Abstract
Background Globally, severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) has infected millions of people to date. The morbidity and mortality associated with SARS-CoV-2 are higher in diabetics than those with chronic kidney disease and in the elderly. In pregnant women, it causes an increased risk for preeclampsia/eclampsia, infections, intensive care unit (ICU) admission, maternal mortality, and preterm birth. In neonates, SARS‑CoV‑2 infection has been found to cause stillbirths, growth retardation, premature delivery, increased neonatal intensive care unit (NICU) admission, and need for oxygen support. The neonate can get infected by vertical or horizontal transmission. As most studies have focussed on transmission at the time of birth only, in this study, we explored both vertical and horizontal transmission along with the clinical attributes of those born to mothers with SARS‑CoV‑2 infection. Methodology A prospective observational study was conducted in the Department of Pediatrics of a tertiary care hospital over 12 months from October 2020 to October 2021. All reverse transcription-polymerase chain reaction (RT-PCR) SARS-CoV-2-positive pregnant females admitted to the facility during the study duration were included. The enrolled mothers were followed till delivery. The mothers and neonates were managed per standard guidelines. Delivery details and neonatal outcomes were recorded. Coronavirus disease 2019 sampling in newborn babies was done at birth (within 24 hours) using a nasopharyngeal swab sample for RTPCR along with cord blood for SARS-CoV-2 immunoglobulin M (IgM). Complete blood count, C-reactive protein, serum electrolytes, random blood sugar, and chest X-ray were obtained for all babies at birth and thereafter according to requirement. In those roomed in with their mother, RT-PCR was repeated at the time of discharge or if they became symptomatic. Results A total of 44 mother-neonate dyads were included in the study. Cord blood IgM for SARS‑CoV‑2 was negative for all neonates, while throat swab RT-PCR was positive for two (4.5%) neonates immediately after birth. Overall, 13.6% of the neonates were premature, 27.2% of the neonates had low birth weight (<2,500 g), and 6.8% had very low birth weight (<1,500 g). Among those admitted to the NICU, 18.2% had respiratory distress; 4.5% had fever, lethargy, and poor feeding; and hyperbilirubinemia requiring phototherapy was observed in 11.3% of the neonates. Moreover, 4.5% of the neonates had hypocalcemia on initial investigations. Mortality was seen in 2.2% (1/44) of the neonates. Rooming-in and breastfeeding were seen in 68.2% of the neonates. The horizontal transmission was seen in one (3.3%) roomed-in neonate. Conclusions Perinatal transmission of SARS‑CoV‑2 infection does occur but its rate is not significant. Furthermore, with proper infection prevention and control measures, the risk of perinatal transmission can be decreased. Breastfeeding and rooming-in do not increase infection transmission if the mother takes all precautions.
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Rao MG, Toner LE, Stone J, Iwelumo CA, Goldberger C, Roser BJ, Shah R, Rattner P, Paul KS, Stoffels G, Bianco A. Pregnancy during a Pandemic: A Cohort Study Comparing Adverse Outcomes during and before the COVID-19 Pandemic. Am J Perinatol 2023; 40:445-452. [PMID: 35709734 DOI: 10.1055/a-1877-5973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE This study was aimed to evaluate how the novel coronavirus disease 2019 (COVID-19) pandemic may have negatively impacted birth outcomes in patients who tested negative for the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus. STUDY DESIGN We conducted a retrospective cohort study using electronic health records of pregnant women admitted to a tertiary medical center in New York City, an epicenter of the pandemic. Women with a singleton gestation admitted for delivery from March 27 to May 31, 2019, and March 27 to May 31, 2020, were included. Women less than 18 years of age, those with a positive SARS-CoV-2 polymerize chain reaction (PCR) test on admission, fetal anomaly, or multiple gestation were excluded. Adverse pregnancy outcomes were compared between groups. Univariable and multivariable logistic regression analyses were used to assess outcomes. The primary outcome was preterm birth. RESULTS Women who delivered during the 2020 study interval had a significantly higher rate of hypertensive disorders of pregnancy (gestational hypertension [GHTN] or preeclampsia; odds ratio [OR] = 1.40, 95% confidence interval [CI]: 1.05-1.85; p = 0.02), postpartum hemorrhage (PPH; OR = 1.77, 95% CI: 1.14-2.73; p = 0.01), and preterm birth (OR = 1.49, 95% CI: 1.10-2.02; p = 0.01). Gestational age at delivery was significantly lower in the 2020 cohort compared with the 2019 cohort (39.3 versus 39.4 weeks, p = 0.03). After adjusting for confounding variables, multivariate analysis confirmed a persistent increase in hypertensive disorders of pregnancy (OR = 1.56, 95% CI: 1.10-2.20, p = 0.01), PPH (OR = 1.74, 95% CI: 1.06-2.86, p = 0.03), and preterm birth (OR = 1.72, 95% CI: 1.20-2.47, p = 0.003) in patients who delivered in 2020 compared with the same period in 2019. Specifically, medically indicated preterm births increased during the pandemic (OR = 3.17, 95% CI: 1.77-5.67, p < 0.0001). CONCLUSION Those who delivered during the COVID-19 pandemic study interval were more likely to experience hypertensive disorders of pregnancy, medically indicated preterm birth, and PPH even in the absence of SARS-CoV2 infection. KEY POINTS · Stressful life events can lead to adverse pregnancy outcomes.. · Even patients negative for COVID-19 experienced GHTN, preeclampsia, PPH and preterm birth during the pandemic.. · Pandemic-related stress may adversely affect perinatal outcomes..
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Affiliation(s)
- Manasa G Rao
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lorraine E Toner
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joanne Stone
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Chioma A Iwelumo
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Cody Goldberger
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Brittany J Roser
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ruhee Shah
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Paige Rattner
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Keisha S Paul
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Guillaume Stoffels
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Angela Bianco
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
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Cheema R, Partridge E, Kair LR, Kuhn-Riordon KM, Silva AI, Bettinelli ME, Chantry CJ, Underwood MA, Lakshminrusimha S, Blumberg D. Protecting Breastfeeding during the COVID-19 Pandemic. Am J Perinatol 2023; 40:260-266. [PMID: 32693415 PMCID: PMC7872205 DOI: 10.1055/s-0040-1714277] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic has impacted all patient populations including pregnant mothers. There is an incomplete understanding of SARS-CoV-2 pathogenesis and transmission potential at this time and the resultant anxiety has led to variable breastfeeding recommendations for suspected or confirmed mothers with novel coronavirus disease 2019 (COVID-19). Due to the potential concern for transmission of infection from maternal respiratory secretions to the newborn, temporary separation of the maternal-baby dyad, allowing for expressed breast milk to be fed to the infant, was initially recommended but later revised to include breastfeeding by the American Academy of Pediatrics in contrast to international societies, which recommend direct breastfeeding. This separation can have negative health and emotional implications for both mother and baby. Only two publications have reported SARS-CoV-2 in human breast milk but the role of breast milk as a vehicle of transmission of COVID-19 to the newborns still remains unclear and may indeed be providing protective antibodies against SARS-CoV-2 infection even in infected neonates. Other modes of transmission of infection to neonates from infected mothers or any care providers cannot be overemphasized. Symptomatic mothers on hydroxychloroquine can safely breastfeed and no adverse effects were reported in a baby treated with remdesivir in another drug trial. The excretion of sarilumab in human breast milk is unknown at this time. Hence, given the overall safety of breast milk and both short-term and long-term nutritional, immunological, and developmental advantages of breast milk to newborn, breast milk should not be withheld from baby. The setting of maternal care, severity of maternal infection and availability of resources can impact the decision of breastfeeding, the role of shared decision making on breastfeeding between mother and physician needs to be emphasized. We strongly recommend direct breastfeeding with appropriate hygiene precautions unless the maternal or neonatal health condition warrants separation of this dyad. KEY POINTS: · Breastmilk does not appear to play a significant role in transmission of SARS-CoV-2.. · Mother-baby separation has negative health and emotional consequences.. · Mothers with suspected or confirmed COVID-19 can directly breastfeed with appropriate precautions..
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Affiliation(s)
- Ritu Cheema
- Division of Pediatric Infectious Disease, Department of Pediatrics, University of California, Davis, School of Medicine
| | - Elizabeth Partridge
- Division of Pediatric Infectious Disease, Department of Pediatrics, University of California, Davis, School of Medicine
| | - Laura R. Kair
- Division of Pediatric Hospital Medicine, Department of Pediatrics, University of California, Davis, School of Medicine
| | - Kara M Kuhn-Riordon
- Division of Neonatology, Department of Pediatrics, University of California, Davis, School of Medicine
| | - Angelique I Silva
- Perinatal Nurse Educator, Women’s Pavilion and Newborn Nursery, UC Davis Medical Center
| | | | - Caroline J Chantry
- Division of General Pediatrics, Department of Pediatrics, University of California, Davis, School of Medicine
| | - Mark A. Underwood
- Division of Neonatology, Department of Pediatrics, University of California, Davis, School of Medicine
| | - Satyan Lakshminrusimha
- Division of Neonatology, Department of Pediatrics, University of California, Davis, School of Medicine
| | - Dean Blumberg
- Division of Pediatric Infectious Disease, Department of Pediatrics, University of California, Davis, School of Medicine
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Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2: Current Evidence and Perspectives. MATERNAL-FETAL MEDICINE 2023. [DOI: 10.1097/fm9.0000000000000179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Malange VNE, Hedermann G, Lausten-Thomsen U, Hoffmann S, Voldstedlund M, Aabakke AJM, Eltvedt AK, Jensen JS, Breindahl M, Krebs L, Christiansen M, Hedley PL. The perinatal health challenges of emerging and re-emerging infectious diseases: A narrative review. Front Public Health 2023; 10:1039779. [PMID: 36684933 PMCID: PMC9850110 DOI: 10.3389/fpubh.2022.1039779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/30/2022] [Indexed: 01/07/2023] Open
Abstract
The world has seen numerous infectious disease outbreaks in the past decade. In many cases these outbreaks have had considerable perinatal health consequences including increased risk of preterm delivery (e.g., influenza, measles, and COVID-19), and the delivery of low birth weight or small for gestational age babies (e.g., influenza, COVID-19). Furthermore, severe perinatal outcomes including perinatal and infant death are a known consequence of multiple infectious diseases (e.g., Ebola virus disease, Zika virus disease, pertussis, and measles). In addition to vaccination during pregnancy (where possible), pregnant women, are provided some level of protection from the adverse effects of infection through community-level application of evidence-based transmission-control methods. This review demonstrates that it takes almost 2 years for the perinatal impacts of an infectious disease outbreak to be reported. However, many infectious disease outbreaks between 2010 and 2020 have no associated pregnancy data reported in the scientific literature, or pregnancy data is reported in the form of case-studies only. This lack of systematic data collection and reporting has a negative impact on our understanding of these diseases and the implications they may have for pregnant women and their unborn infants. Monitoring perinatal health is an essential aspect of national and global healthcare strategies as perinatal life has a critical impact on early life mortality as well as possible effects on later life health. The unpredictable nature of emerging infections and the potential for adverse perinatal outcomes necessitate that we thoroughly assess pregnancy and perinatal health implications of disease outbreaks and their public health interventions in tandem with outbreak response efforts. Disease surveillance programs should incorporate perinatal health monitoring and health systems around the world should endeavor to continuously collect perinatal health data in order to quickly update pregnancy care protocols as needed.
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Affiliation(s)
| | - Gitte Hedermann
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ulrik Lausten-Thomsen
- Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Steen Hoffmann
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | | | - Anna J. M. Aabakke
- Department of Obstetrics and Gynecology, Copenhagen University Hospital - North Zealand, Hillerød, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital - Holbæk, Holbæk, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anna K. Eltvedt
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- Global Health Unit, Department of Paediatric and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jørgen S. Jensen
- Department of Bacteria, Parasites & Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Morten Breindahl
- Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lone Krebs
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark
| | - Michael Christiansen
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- Department of Biomedical Science, University of Copenhagen, Copenhagen, Denmark
| | - Paula L. Hedley
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- Brazen Bio, Los Angeles, CA, United States
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Marteleto LJ, Dondero M, Koepp A. Scars from a Previous Epidemic: Social Proximity to Zika and Fertility Intentions during the COVID-19 Pandemic. SOCIUS : SOCIOLOGICAL RESEARCH FOR A DYNAMIC WORLD 2023; 9:23780231231184767. [PMID: 37520157 PMCID: PMC10372507 DOI: 10.1177/23780231231184767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
We examine whether women's social proximity to Zika during the Zika epidemic predicts intentions to avoid a pregnancy because of the COVID-19 pandemic either directly or indirectly via subjective assessments of the pandemic. We apply path models on unique microdata from Brazil, the country most affected by Zika and an epicenter of COVID-19, to understand whether a novel infectious disease outbreak left lasting imprints shaping fertility intentions during a subsequent novel infectious disease outbreak. Findings show that Zika social proximity is associated with fertility intentions through an indirect path related to subjective assessment of the COVID-19 pandemic. These findings emerged regardless of whether a woman herself had or suspected she had Zika and speak to the transformative consequences of novel infectious disease outbreaks that go beyond mortality and health.
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Abstract
Early-onset sepsis can cause significant morbidity and mortality in newborn infants. Risk factors for sepsis include birth to mothers with inadequately treated maternal group B Streptococcus colonization, intra-amniotic infection, maternal temperature greater than 100.4°F (>38°C), rupture of membranes greater than 18 hours, and preterm labor. The organisms that most commonly cause early-onset sepsis include group B Streptococcus, Escherichia coli, and viridans streptococci. Infants often present within the first 24 hours after birth with clinical signs of sepsis, with respiratory distress as the most common presenting symptom. However, infants can also have respiratory distress from noninfectious etiologies. Therefore, when physicians are faced with asymptomatic infants with risk factors or infants with respiratory distress without risk factors, there is a delicate balance between empirically treating with antibiotics and observing these infants without treating.
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Affiliation(s)
- Courtney Briggs-Steinberg
- Division of Neonatology, Department of Pediatrics, Staten Island University Hospital, Northwell Health, Staten Island, NY.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Philip Roth
- Division of Neonatology, Department of Pediatrics, Staten Island University Hospital, Northwell Health, Staten Island, NY.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
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Li M, Hao J, Jiang T, Deng W, Lu H, Wang S, Wan G, Xie Y, Yi W. Maternal and neonatal safety of COVID-19 vaccination during the peri-pregnancy period: A prospective study. J Med Virol 2023; 95:e28378. [PMID: 36478410 PMCID: PMC9878102 DOI: 10.1002/jmv.28378] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/25/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND To investigate the safety of inactivated COVID-19 vaccine in Chinese pregnant women and their fetuses when inoculated during the peri-pregnancy period. METHODS Eligible pregnant women were prospectively collected and divided into a vaccine group (n = 93) and control group (n = 160) according to whether they had been vaccinated against COVID-19 within 3 months before their last menstruation period (LMP) and after pregnancy. Demographic data of couples, complications during pregnancy and delivery of pregnant women, and data of newborns at birth were collected. RESULTS Sixty-six women were vaccinated with a median time of 35.5 (range = 0-91) days before LMP, and 27 women were vaccinated with a median time of 17 (range = 1-72) days after LMP. The incidence of premature rupture of membrane (PROM) in the vaccine group was significantly higher than that in the control group (16.13% vs. 6.88%, p = 0.019). Multivariate logistic regression analysis revealed that maternal peri-pregnancy COVID-19 vaccination was not an independent risk factor for PROM (odds ratio: 2.407, 95% confidence interval: 0.932-6.216, p = 0.069). There was no difference in the incidence of other complications during pregnancy and delivery between the two groups. A total of 253 neonates were delivered, including two cases with congenital abnormalities in each group. The incidence of congenital abnormalities between the two groups was similar (2.15% vs. 1.25%, p = 0.626). There was no difference in neonatal length, weight, head circumference, and Apgar score between the two groups (p > 0.05), but the incidence of neonatal jaundice in the vaccine group was significantly higher than that in the control group (20.43% vs. 7.5%, p = 0.002). Multivariate logistic regression analysis revealed that maternal peri-pregnancy vaccination, postpartum blood loss, cesarean section, 1-min Apgar score, and paternal smoking were independent risk factors for neonatal jaundice. CONCLUSIONS It is safe for pregnant women and their fetuses to be inoculated the inactivated COVID-19 vaccine during the peri-pregnancy period, but attention should be paid to neonatal jaundice.
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Affiliation(s)
- Minghui Li
- Department of Hepatology Division 2Capital Medical UniversityBeijing Ditan HospitalBeijingChina,Department of Hepatology Division 2Peking University Ditan Teaching HospitalBeijingChina
| | - Jianzhen Hao
- Department of GynecologyMaternal and Children's Healthcare Hospital of Beijing Dongcheng DistrictBeijingChina
| | - Tingting Jiang
- Department of Hepatology Division 2Capital Medical UniversityBeijing Ditan HospitalBeijingChina
| | - Wen Deng
- Department of Hepatology Division 2Capital Medical UniversityBeijing Ditan HospitalBeijingChina
| | - Huihui Lu
- Department of Hepatology Division 2Capital Medical UniversityBeijing Ditan HospitalBeijingChina,Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Shiyu Wang
- Department of Hepatology Division 2Capital Medical UniversityBeijing Ditan HospitalBeijingChina
| | - Gang Wan
- Department of Biostatistics, Beijing Ditan HospitalCapital Medical UniversityBeijingChina
| | - Yao Xie
- Department of Hepatology Division 2Capital Medical UniversityBeijing Ditan HospitalBeijingChina,Department of Hepatology Division 2Peking University Ditan Teaching HospitalBeijingChina
| | - Wei Yi
- Department of Gynecology and Obstetrics, Beijing Ditan HospitalCapital Medical UniversityBeijingChina
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Harthi AM, Harthi AM, Hendy A. Effect of Training Program on Knowledge and Practice of Breast feeding Women During COVID-19. SAGE Open Nurs 2023; 9:23779608231167826. [PMID: 37020659 PMCID: PMC10068981 DOI: 10.1177/23779608231167826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/06/2023] [Accepted: 03/19/2023] [Indexed: 04/03/2023] Open
Abstract
Aim Evaluate the effect of the training program on knowledge and practice of breastfeeding women during coronavirus disease 2019 (COVID-19). Methods One-group pretest/post-test quasiexperimental research design was utilized to accomplish the aim of this study. The study was carried out at the primary health care units Ad Dar Al Baida 1, Ad Dar Al Baida 2, Al Aziziyah at Riyadh Province of Saudi Arabia. The study included a convenience sample of 100 breastfeeding women. Tool A structured interviewing questionnaire sheet was used for data collection that included three parts knowledge, reported practice, and demographic characteristics. Results More than one-quarter (30%) and (28%) of studied women had satisfactory knowledge-related causes, risk factor and signs, symptoms of COVID-19 at preintervention, while the majority 85% and 86% of them had satisfactory knowledge postintervention at p-value <.01**. In addition, less than one-fifth (17%) and (16%) of studied women had satisfactory knowledge about Breastfeeding guidelines during COVID-19 and care of breastfeeding women during COVID-19, compared with most of them (89%) and (92%) postintervention at p-value <.01**. Conclusion Based on our current study, it was concluded that the educational program effectively improves breastfeeding women's knowledge and practices. There was a highly statistically significant positive linear correlation between the breastfeeding women's knowledge and reported practices regarding COVID-19 infection before and after the implementation of the educational program at p < .0.
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Affiliation(s)
| | - Abeer M. Harthi
- King Fahad Medical City Hospital, Riyadh, Kingdom of Saudi Arabia
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Banjac L, Banjac B. Pulmonary air leak syndrome in а premature infant born to mother with COVID-19. SRP ARK CELOK LEK 2023; 151:694-697. [DOI: 10.2298/sarh220928103b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2025] Open
Abstract
Introduction. The clinical course of premature infants born to mothers with coronavirus disease 2019 (COVID-19) has not been well characterized. The aim of this paper was to report a complicated clinical course of pulmonary air leak syndrome (pneumomediastinum and pneumothorax) in a premature infant born to a mother with COVID-19. Case outline. The patient was a male infant born at 35 weeks of gestation. The mother had confirmed coronavirus pneumonia six days prior to delivery. At approximately 25 hours of age, chest X-ray showed pneumomediastinum, giving the classic ?spinnaker-sail? sign. After intubation, chest X-ray showed the typical ?angel-wing? sign, which indicates pneumomediastinum and bilateral pneumothorax (pulmonary air leak syndrome). Conclusion. Based on the presented case, we believe that the mother?s COVID-19 infection is an additional risk factor for the occurrence of pulmonary air leaks in the infant. To confirm this hypothesis as well as explain the exact pathophysiology of air leakage in COVID-19, larger, prospective, and well designed studies are needed.
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Affiliation(s)
- Lidija Banjac
- Department of Neonatology, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Boban Banjac
- University of Montenegro, Faculty of Medicine, Podgorica, Montenegro
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Hisey JC, Patterson BM, Tsai AJ, Khan AM. COVID-19 via intrauterine transmission in a critically ill preterm infant: A case report. J Neonatal Perinatal Med 2022; 15:837-844. [PMID: 36155532 DOI: 10.3233/npm-221094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A preterm infant was born emergently at 29 weeks gestation to a mother with active coronavirus disease 2019 (COVID-19). Clinical presentation and evaluation were consistent with in utero transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The neonate experienced progressive, refractory respiratory failure and catastrophic intracranial hemorrhage which ultimately led to limitation of care.
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Affiliation(s)
- J C Hisey
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, McGovern Medical School at UTHealth, Houston, TX, USA
| | - B M Patterson
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, McGovern Medical School at UTHealth, Houston, TX, USA
| | - A J Tsai
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, McGovern Medical School at UTHealth, Houston, TX, USA
| | - A M Khan
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, McGovern Medical School at UTHealth, Houston, TX, USA
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50
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Knowledge, Attitudes, and Practices towards COVID-19 among Pregnant Women in Northern Bangladesh: A Community-Based Cross-Sectional Study. Behav Sci (Basel) 2022; 13:bs13010002. [PMID: 36661574 PMCID: PMC9855099 DOI: 10.3390/bs13010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/16/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
Background: COVID-19, caused by SARS-CoV-2, remains a global public health concern despite the availability of effective antiviral treatment against multiple strains. Studies have shown that pregnant women are more susceptible to COVID-19 due to altered physiology and immunological features. Therefore, this study was designed to investigate pregnant women’s knowledge, attitudes, and practice (KAP) to prevent COVID-19 and determine the factors associated with KAP. Methods: A community-based cross-sectional study was conducted among 425 pregnant women in Northern Bangladesh. The samples were obtained using a simple random sampling technique from 5 April to 15 June 2020. The data were collected by face-to-face survey with a structured and pre-tested questionnaire and analyzed using SPSS version 25. Bivariable and multivariable logistic regression analyses were performed, and p-values < 0.05 at 95% CI were considered statistically significant. Results: Overall, the score of KAP among the respondents was 47.76%, 49.41%, and 56.24%, respectively. Participants’ area of residence, educational status of the husband, and antenatal care (ANC) visit were significantly associated with the level of knowledge, whereas age, educational status of the husband, number of living children, and knowledge were significant predictors of attitude. The knowledge of COVID-19 was the only predictor associated with the practice. Conclusion: Our study shows that almost half of the participants had poor knowledge, a negative attitude, and poor practices regarding COVID-19. Additional health education programs by healthcare professionals and different media, coordinated and combined efforts of government and individuals’ participation will be required to fight the spread of the infection.
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