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Compared to other respiratory viruses, the proportion of hospitalizations due to SARS-CoV-2 among children is relatively low. While severe illness is not common among children and young individuals, a particular type of severe condition called multisystem inflammatory syndrome in children (MIS-C) has been reported. The aim of this prospective cohort study, which followed a group of individuals under the age of 19, was to examine the characteristics of patients who had contracted SARS-CoV-2, including their coexisting medical conditions, clinical symptoms, laboratory findings, and outcomes. The study also aimed to investigate the features of children who met the WHO case definition of MIS-C, as well as those who required intensive care. A total of 270 patients were included between March 2020 and December 2021. The eligible criteria were individuals between 0-18 with a confirmed SARS-CoV-2 infection at the Infectious Disease Hospital "Prof. Ivan Kirov"in Sofia, Bulgaria. Nearly 76% of the patients were <= 12 years old. In our study, at least one comorbidity was reported in 28.1% of the cases, with obesity being the most common one (8.9%). Less than 5% of children were transferred to an intensive care unit. We observed a statistically significant difference in the age groups, with children between 5 and 12 years old having a higher likelihood of requiring intensive care compared to other age groups. The median values of PaO2 and SatO2 were higher among patients admitted to the standard ward, while the values of granulocytes and C-reactive protein were higher among those transferred to the intensive care unit. Additionally, we identified 26 children who met the WHO case definition for MIS-C. Our study data supports the evidence of milder COVID-19 in children and young individuals as compared to adults. Older age groups were associated with higher incidence of both MIS-C and ICU admissions.Copyright © 2023 P. Velikov et al., published by Sciendo.
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Background: Studies suggest perinatal infection with SARSCoV- 2 can induce adverse birth outcomes, but studies published to date have substantial limitations. Most have identified cases based upon their presentation for clinical care, and very few have examined pandemic-related stress which may also impact adverse birth outcomes. Objective(s): To evaluate the relationships between SARSCoV- 2 infection in pregnancy and pandemic-related stress with birth outcomes. Study Design: We conducted an observational study of 211 mother-newborn dyads in three urban cohorts participating in the Environmental Influences on Child Health Outcomes (ECHO) Program. Serology for SARS-CoV-2 was assessed in a convenience sample of prenatal maternal, cord serum or dried blood spots from births occurring between January 2020-September 2021. Specimens were assessed for IgG, IgM, and IgA antibodies to nucleocapsid, S1 spike, S2 spike, and receptor-binding domain. A Pandemic-related Traumatic Stress (PTS) scale was based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Acute Stress Disorder criteria. Result(s): 36% were positive for at least one antibody type, chiefly IgG. Self-report of infection was not significantly correlated with combined serology. There were no differences in gestational age (GA), birth weight, preterm birth (PTB), or low birth weight (LBW) among seropositive mothers. However, IgM seropositive mothers had children with lower BW (434g, 95% CI: 116- 752), BW Z score-for-GA (0.73 SD, 95% CI 0.10-1.36) and were more likely to deliver preterm (OR 8.75, 95% CI 1.22-62.4). Associations with LBW sustained in sensitivity analyses limited to pre-vaccine samples, and PTS symptoms were not associated with birth outcomes. The addition of PTS did not substantially change associations with BW, although associations with PTB attenuated to near-significance. Conclusion(s): We identified decreased birth weight and increased prematurity in mothers IgM seropositive to SARS-CoV-2, independent of PTS. Though there are limits to interpretation, the data support efforts to prevent SARS-CoV-2 infections in pregnancy.
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Gallstone disease with advanced symptoms is one of the common abdominal emergencies during pregnancy and it is considered to be one of the most frequently reported non-obstetric surgical conditions in pregnant women. This study aimed to evaluate the outcomes of surgical cholecystectomy in pregnant women with symptoms of advanced gallstones. This is a retrospective analysis of 2814 pregnant women who attended various wards in government and private hospitals in the governorates of Diyala and Kirkuk in Iraq for more than 2 years, between February 2020 and June 2022. The hospital database was used to confirm the diagnosis of advanced gallstone symptoms in these pregnant women. The incidence of symptomatic gallstones in pregnant women, diagnosis and method of therapeutic management, cholecystectomy according to the pregnancy periods, and perinatal complications of patients according to therapeutic methods were determined. The results confirmed that out of 2814 pregnancies, only 126 (4%) had symptoms of gallstones. It was found that the majority of cases 67 (53%) were within the first trimester of pregnancy and the least 29 (23%) was observed in the second trimester. Acute cholecystitis was the generality 84 (67%) diagnosed in pregnant women with symptomatic gallbladder disease and only 9 (7%) of the patients had undergone prenatal cholecystectomy versus 117 (93%) who were managed conservatively. A total of 20 (16%) cases with undesirable complications were recorded, where 12 cases with low birth weight were noted, where 4 of them underwent surgery and 8 were treated conservatively. It was concluded that a large proportion of women suffer from symptoms of gallstones during pregnancy. Most cases can be managed conservatively, and intervention should be performed as often as needed.Copyright © 2023, Codon Publications. All rights reserved.
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Problem: Several large studies have demonstrated that COVID-19 pregnant individuals are at a significant risk for severe disease and adverse pregnancy outcomes. The mechanisms underlying these phenomena remain to be elucidated and are the focus of our project. Although fetal and placental infection is rare, placental abnormalities and adverse pregnancy outcomes associated with placental dysfunction in COVID-19 cases have been widely reported. In particular, placental thrombosis and lesions consistent with maternal vascular malperfusion (MVM) of the placenta are common in individuals with COVID-19. Since thrombotic complications have been associated with COVID-19, it is not surprising that pregnant individuals with COVID- 19 are at risk for placental thrombosis. Method of Study: Placentas were evaluated histologically. Extracellular vesicles were isolated by serial centrifugation. Result(s): Adverse pregnancy outcomes associated with these placental lesions, including hypertensive disorders of pregnancy (gestational hypertension and preeclampsia), small for gestational age (SGA, birthweight < 10th percentile for gestational age), and preterm birth (PTB, < 37 weeks) are significantly increased among pregnant individuals with COVID-19. Placental infection with SARSCoV- 2 is uncommon, but multiple inflammatory and metabolic factors are likely to affect the placenta, including circulating extracellular vesicles (EVs) derived from various organs that have been associated with COVID-19 pathology and disease severity.We have analyzed over 500 placentas from COVID-19 pregnancies and found marked changes in placental morphology, characterized by abnormal maternal and fetal vessels, intervillous thrombi, and fibrin deposition, even in the face of mild or asymptomatic disease. We detected increased levels of small EVs in maternal serum from COVID-19 cases compared to controls and increased levels of mitochondrial DNA in EVs from COVID-19 cases. In in vitro experiments, we found increased oxidative stress in uterine endothelial cells and primary trophoblasts. Syncytialization of trophoblast cells following exposure to EVs from pregnant COVID-19 patients was markedly reduced. RNAseq of trophoblast cells exposed to EVs from pregnant COVID-19 patients revealed disruption of multiple pathways related to mitochondria function, oxidative stress, coagulation defects, and inflammation. Timing of infection during pregnancy (first, second, and third trimester) altered EV size distribution, cargo content, and functional consequences of trophoblast EV exposure. Conclusion(s): Our studies show that COVID-19 infection during pregnancy has profound effects on placenta morphology and function. It remains to be determined what the long-term consequences are on the offspring.
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This dissertation research study aimed to determine the predictors of early literacy skills in kindergarteners with dyslexia familial risk. The home literacy environment, preschool attendance, and parental self-efficacy are known predictors of early literacy skills, specifically letter naming knowledge, in typically developing children. Letter naming knowledge is an early literacy skill that is important to future reading achievement and outcomes. Letter naming knowledge is also a powerful pre-literacy predictor of dyslexia. Dyslexia commonly manifest as difficulties in acquiring basic reading skills and is highly heritable. The population for this study was primary caregivers of kindergarteners with a first degree relative with a diagnosis of dyslexia. Participants completed the Home Literacy Checklist, Tool to Measure Parenting Self-Efficacy via an online survey with questions regarding preschool attendance, letter naming knowledge skills, and the presence of a diagnosis of dyslexia among first degree relatives. SPSS Statistics (Version 28) was used to run descriptive statistics. The sample was comprised of 12 primary caregivers. This sample size was not appropriate for the chosen analysis of multiple regression. Using exploratory data analysis, the data was organized and summarized. Due to an inadequate sample size caused by a low response rate, no conclusions could be drawn from this data. The research questions were not answered and there were no findings. COVID-19 restrictions impacted research sites and the level of participation, with participants being less available, school closures, and mandatory quarantines, creating a difficult atmosphere for completion of this research study. As a result, the lack of data during the COVID-19 pandemic and subsequent lockdowns led to several revisions of the research plan. The revisions involved eliminating the need for standardized test scores, using primary caregiver report to determine the level of difficulty of letter naming knowledge of the kindergarten student, and using social media to recruit participants. Recommendations for further research were comprised of ways to increase the pool of participants by expanding inclusion criteria, eliminating the use of standardized test scores, considering the length of the survey, and the use of social media along with an incentive. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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In recent years, research in Child-Computer Interaction has shifted the focus from design with children, giving them a voice in the design process, to design by children to bring child participants different benefits, such as engagement and learning. However, design workshops, encompassing different stages, are challenging in terms of engagement and learning, e.g., they require prolonged commitment and concentration. They are potentially more challenging when held at a distance, as in recent years due to the COVID-19 pandemic. This paper explores at-a-distance smart-thing design by children, how it can engage different children and support their learning in programming. The paper reports a series of design workshops with 20 children, aged from 8 to 16 years old, all held at a distance. They were all organised with the DigiSNaP design framework and toolkit. The first workshop enabled children to explore what smart things are, to start ideating their own smart things and to scaffold their programming. The other workshops enabled children to evolve their own smart-thing ideas and programs. Data were gathered in relation to children's engagement and learning from different sources. Results are promising for future editions of smart-thing design at a distance or in a hybrid modality. They are discussed along with guidelines for smart-thing design by children at a distance. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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This article reviews the evolution of a newborn through the first year of life and the potential impacts of COVID-19 on the infant, parent, and the parent-infant relationship. Babies grow in the context of relationships, and the quality of those relationships affects the physiological and psychological organization of the baby. Precisely because each baby is a being with unique biology, temperament, and ways of experiencing, feeling, and learning, much is to be discovered and understood about them. The baby's wordless communications require their parents to intuit, infer, hypothesize, and experiment as parents come to know the needs of their baby. As we walk alongside parents who struggle to come to know their infant-even as the infant is coming to know them-we are required to have conceptual knowledge of how a newborn becomes a fully awakened infant. Under typical conditions, the birth of a firstborn baby presents a caregiving challenge and developmental opportunity for the emerging parent. Environmental context can serve to support or interfere in the success of the adjustment. This paper will explore some theoretical underpinnings that contribute to infant and parent well-being and the possible impact of being born during the COVID-19 pandemic. Also considered will be the undue burden of families bearing the weight of economic inequities, oppression, and structurally supported racism. This article will explore the influence of parental perception, the development of attachment relationships, and how that is influenced by and influences infant communication. Finally, it will suggest ways that psychotherapists seeing individuals who are parents can hold the infant in mind as they work to understand and respond to their adult clients navigating the impacts of this pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Background: Since 1990, the maternal mortality significantly decreased at global scale as well as the North Africa and Middle East. However, estimates for mortality and morbidity by cause and age at national scale in this region are not available. Method(s): This study is part of the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. Here we report maternal mortality and morbidity by age and cause across 21 countries in the region from 1990 to 2019. Result(s): Between 1990 and 2019, maternal mortality ratio (MMR) dropped from 148.8 (129.6-171.2) to 94.3 (73.4-121.1) per 100 000 live births in North Africa and Middle East. In 1990, MMR ranged from 6.0 (5.3-6.8) in Kuwait to 502.9 (375.2-655.3) per 100 000 live births in Afghanistan. Respective figures for 2019 were 5.1 (4.0-6.4) in Kuwait to 269.9 (195.8-368.6) in Afghanistan. Percentages of deaths under 25 years was 26.0% in 1990 and 23.8% in 2019. Maternal hemorrhage, indirect maternal deaths, and other maternal disorders rank 1st to 3rd in the entire region. Ultimately, there was an evident decrease in MMR along with increase in socio-demographic index from 1990 to 2019 in all countries in the region and an evident convergence across nations. Conclusion(s): MMR has significantly declined in the region since 1990 and only five countries (Afghanistan, Sudan, Yemen, Morocco, and Algeria) out of 21 nations didn't achieve the Sustainable Development Goal (SDG) target of 70 deaths per 100 000 live births in 2019. Despite the convergence in trends, there are still disparities across countries.Copyright © 2022 Academy of Medical Sciences of I.R. Iran. All rights reserved.
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The LEARN-COVID pilot study collected data on infants and their parents during the COVID-19 pandemic. Assessments took place between April and July 2021. Parents (N = 357) from Switzerland (predominantly), Germany, and Austria answered a baseline questionnaire on their behaviour related to the pandemic, social support, infant nutrition, and infant regulation. Subsequently, parents (n = 222) answered a 10- day evening diary on infant nutrition, infant regulation, parental mood, and parental soothing behaviour. Data and documentation are stored on Zenodo, https://doi. org/10.5281/zenodo.6946048. These data may be valuable to researchers interested in infant development and parenting during the pandemic as well as to researchers interested in daily variability in infant behaviour, parenting, and nutrition. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Grandparents who were separated from their infant grandchildren during COVID-19 sought other ways to connect, including video chat. Video chat supports learning, and its features (e.g., contingent responsiveness) may allow for cultural exchange. However, technological problems may disrupt these exchanges. In a seminaturalistic, longitudinal study, 47 families submitted up to three video chats and surveys. Families were predominantly White/Caucasian, highly educated, and lived between 1 and 2,700 miles apart. Multilevel models were used to predict the proportion of the sessions devoted to exchanging culture (e.g., holidays, parenting advice) and managing tech problems. Culture exchange did not change as a function of infant age, video chat experience, or when encountering tech problems. Although only marginally statistically significant, culture exchange increased as distance increased. Tech problems changed as a function of tech talk. Qualitative analysis revealed that cultural transmission occurred via a culture of care and sharing of information across video chat, that families adapted their behaviors to the new technology, and that technology disruptions rarely interfered with the flow of information. These findings demonstrate the ability to share culture when physically separated and in the presence of tech disruptions. Further, this study supports previous work on the emerging culture of video chat. Families adapted to being separated, and grandparents and infants successfully communicated through a new modality. Because video chat supports family relationships, equitable access to high-speed internet should be a priority to enable more families to use it. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement This study demonstrates that video chat allowed for familial culture exchanges to be maintained through a separation during COVID-19. Examining what and how cultural exchanges took place suggests that supports for using video chat, including access to high-speed internet, are necessary for families separated by other circumstances. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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This chapter describe a Storytelling and Narrative Medicine pilot study which focused on communication in therapeutic settings. The research was carried out by a group of Italian Health Care professionals (HCP) from Calambrone Institute for Rehabilitation (IRC), at the IRCCS Stella Maris Foundation, along with a group of parents of patients with disabilities. However, because of the Covid-19 outbreak in Italy, many of the participants found themselves in lockdown in their own homes with their children. To evaluate the efficacy of storytelling as a tool for emotional and communication support, the authors submitted to both the HCP and parents two original online surveys to get information on their current emotional state. The assessed areas were personal stress, the relationship with children and family members, and the relationship with colleagues and professionals. The chapter focuses on emotional and psychological consequences that lack of social and therapeutic interactions might have produced. This short but effective educational intervention gives skills and knowledge to structure one's feelings and thoughts in a narrative form, equipping the participants with the resources to perceive themselves and their life experiences as the elements of the story. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Objective: The COVID-19 pandemic is the deadliest pandemic in American history. This study aims to assess the differences in youth reported traumatic stress among those with and without chronic illness, and how those reports are impacted by parental level of concern regarding the COVID-19 pandemic. Methods: Using convenience sampling, parents and their children completed a series of questionnaires focused on demographic information including questions about medical conditions, parental level of concern about COVID-19, and youth-report of posttraumatic stress symptoms. Results: Results of the anonymous survey (n = 164) found that parental reported level of concern of COVID-19 significantly predicted youth report of posttraumatic stress symptoms (F(4, 159) = 2.607, p = .038). There was no significant difference in youth-report of posttraumatic stress symptoms between youth with and without chronic medical conditions (F(1, 162) = .438, p = .509). Conclusions: Children often look to their parents for guidance during stressful life events, as confirmed by our findings. Parental emotional and behavioral responses may influence how youth make sense of highly stressful events and should be considered when determining intervention strategies in the COVID-19 era. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement This study found that youth with and without chronic health conditions did not differ in their report of posttraumatic stress 6 months after the onset of the COVID-19 pandemic. However, youth report of traumatic stress symptoms was predicted by their parents' level of concern regarding the impact of COVID-19 on their families, suggesting the need for targeted parent-based intervention. Clinical interventions to prevent chronic posttraumatic stress responses in youth regardless of medical comorbidity are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Aim: Standard diagnosis of gestational diabetes (GDM) is based on the Oral Glucose Tolerance test (OGTT). During the Covid-19 outbreak, due to Covid restrictions, criteria were modified i.e Fasting Blood Glucose >=5.3 and/ or HbA1c >= 39 for diagnosis of GDM. After the lifting of the Covid restrictions, the standard criteria were reimplemented and on analyzing the data, it was highlighted that some of the patients could have tested negative for GDM based on Covid Criteria. Method(s): We analyzed the data of 43 patients based on standard criteria (OGTT and HbA1c) after Covid restrictions, with the following results. Result(s): 11/43(28%) patients who were diagnosed on the basis of standard criteria could have been missed based on Covid criteria. Out of 11 deliveries, 2 babies with weight above 4 kg. There were no admissions to NICU. One patient had postpartum hemorrhage with 670 mL of blood loss. Conclusion(s): This was a retrospective study in which we analyzed the data of 45 pregnant females diagnosed with GDM based on testing using the Covid criteria and compared this to 43 pregnant females who were diagnosed with GDM on the basis of OGTT based on GOLD standard NICE criteria. In addition, we also examined maternal and obstetric outcomes in both groups such as the mode of delivery, the baby's birth weight, the incidence of shoulder dystocia, mean blood loss (MBL), and NICU admission. We understand that Covid GDM diagnosis was a necessity of time. In this study, we want to learn what could have been missed with that diagnostic criteria. For future pandemics, we need to revise our diagnostic criteria to avoid the risk of underdiagnosing GDM and associated complications.
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Background: SARS-Cov-2 infection during pregnancy causes adverse effects on the maternal and foetal outcome. In order to minimize the adverse outcomes of COVID-19 infection, Government of India recommends COVID-19 vaccination during antenatal period with Covaxin and Covishield. Despite the recommendation of vaccination by the Government of India, there are few clinical trials and still there exists a gap in the knowledge and awareness of outcome of pregnant women after COVID-19 vaccination during pregnancy. Material(s) and Method(s): This is a prospective observational study conducted in 50 antenatal women who were already vaccinated at a tertiary care hospital in Southern India from August 2021 to October 2021. All antenatal women who were already vaccinated and attending the OPD were considered for further follow-up. Result(s): This study was conducted among 50 antenatal women who received COVID-19 vaccination during pregnancy. Among these antenatal women, 27 (54%) were multigravida, 23(46%) were primigravida, 32(64 %) completed 2 doses of covid vaccination, and 18(36%) took a single dose in antenatal period. Among the vaccinated 27(54%) pregnant women had no symptoms after vaccination. Though 23(46%) women had symptoms after vaccination, symptoms are mild and resolved within 48 hours. All vaccinated antenatal women were observed till delivery, among them 46 (92%) had term deliveries, 4(8%) had preterm deliveries and 8[16%] new-born babies required NICU admission. Conclusion(s): COVID-19 vaccination was not associated with adverse immediate pregnancy outcomes or new born complications. Hence COVID-19 vaccination is strongly recommended in antenatal period.Copyright © 2023 Dr. Yashwant Research Labs Pvt. Ltd.. All rights reserved.
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Background. Every life aspect and group of the community have changed during the COVID-19 pandemic, including the group of pregnant, childbirth, and postpartum woman. COVID-19 Pandemic occurred in 2020-2021. Maternal mortality in East Java Province was the highest in Indonesia during the pandemic. Objective. This study analyzed the effect of spatial determinants that consist of antenatal, childbirth, and post-partum care on maternal mortality in East Java Province during the Pandemic. Methods. This study used a crossectional method with the unit of analysis in this study was all pregnant, childbirth and postpartum women in 38 districts of East Java Province from 2020 until 2021. Data were analyzed with spatial regression by using Geographically Weighted Regression Software. Results. Maternal mortality in East Java had a spreading pat-tern and negative value of the diff criterion, so we concluded that there was a spatial influence. The variables of antenatal care, accessibility of healthcare service, third postpartum visit, and complication service had significant effects on maternal mortality in all regions (P<0,05). There were four groups of districts that showed a similarity of significant factors. This result showed that each region's diversity of the accessibility of health services affects maternal mortality during the COVID-19 era. Antenatal services, access to health facilities and complication services affected maternal mortality in regions with high maternal mortality rate. Conclusion. Every region has its spatial determinants of maternal mortality. The top government should give authority to local government to have programs to reduce maternal mortality according to the condition in their region. r.Copyright © the Author(s), 2023.
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Student performance on kindergarten screening measures and level of kindergarten-entry skills have been shown to be predictive of subsequent academic achievement, thus making kindergarten screening measures a useful tool that guides the monitoring of student progress over time. Though a commonly used tool to assist in kindergarten placement considerations by educators nationwide, the literature is lacking in studies that demonstrate the predictive ability of the Developmental Indicators for the Assessment of Learning - Fourth Edition (DIAL-4) on later academic achievement. Related, behavioral and emotional functioning has been demonstrated to significantly impact student achievement. While the literature supports the predictive ability of kindergarten screening measures on academic performance, research is limited on how behavioral functioning moderates this predictive relationship. The present study aimed to examine the predictive ability of the DIAL-4 on later academic achievement and identify whether behavioral and emotional functioning impacts upon, and to what degree, the relationship between academic achievement and the DIAL-4. Additionally, this study examined the impact of the pause of in-person learning, as caused by the COVID-19 pandemic on student achievement and behavioral and emotional functioning through within-samples comparisons of student functioning in 2019 and 2021 to identify change amongst individual students. The results support the predictive ability of the DIAL-4 on subsequent academic achievement with significant correlations between DIAL-4 scores obtained before kindergarten with subsequent measures of academic achievement. The was no evidence found for a moderation effect of behavioral and emotional functioning on the prediction of academic achievement. Lastly, when controlling for scores on the DIAL-4, the data suggest a decrease in rate of student academic achievement and an increase in emotional and behavioral dysregulation following the onset of the COVID-19 pandemic demonstrated by statistically significant differences in BERI scores as well as significant decreases in rates of growth in reading ability within some cohorts. These findings provide educators with empirical evidence for the utility of the DIAL-4 in predicting academic achievement as well as insight into how the COVID-19 pandemic impacted students' functioning. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Objectives: Severe acute respiratory syndrome-coronavirus 2/COVID-19 infection is still a global concern, with pregnant women are considered as vulnerable population. Until now, the characteristics of pregnant women in Indonesia who are infected with COVID-19, as well as pregnancy and neonatal outcomes, are still unknown. This study aims to obtain national data, which are expected to be useful for the prevention and management of COVID-19 in pregnant women in Indonesia. Method(s): There were 1,427 patients recruited in this retrospective multicenter study. This study involved 11 hospitals in 10 provinces in Indonesia and was carried out using secondary patient data from April 2020 to July 2021. COVID-19 severity was differentiated into asymptomatic-to-mild symptoms and moderate-to-severe symptoms. The collected data include maternal characteristics, laboratory examinations, imaging, pregnancy outcomes, and neonatal outcomes. Result(s): Leukocyte, platelets, basophil, neutrophils segment, lymphocytes, monocytes, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP), urea, and creatinine were found to be significantly associated with severity differences (p < 0.05). Moderate-severe symptoms of COVID-19 also shown to have suggestive pneumonia findings on chest X-ray findings. Patients with asymptomatic-to-mild symptoms had significantly (p < 0.001) higher recovery rate, shorter hospital stay, less intensive care unit (ICU) admission, and had more vaginal delivery. Neonates from mother with mild symptoms also had significantly (p < 0.001) higher survival rate, higher birth weight, and higher APGAR score. Conclusion(s): Several laboratory and radiology components, as well as maternal and neonatal outcomes are related to the severity of COVID-19 in pregnant women in Indonesia.Copyright © The Author(s). 2023.
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INTRODUCTION: During the early months of the COVID-19 pandemic, policies were implemented that sought to reduce in-person prenatal visits and ultrasounds. We sought to evaluate the effect of those policies on the rate of diagnosed fetal growth restriction and infant low birth weight. METHODS: We performed a cohort study of patients delivered at an academic center. Participants who received prenatal care during the time period of restricted visits were matched in a 1:1 ratio to patients receiving care during an equivalent time period when there were no such restrictions (group I: July 1, 2019, to December 31, 2019;and group II: March 23, 2020, to September 23, 2020). Medical records were reviewed for clinical and demographic characteristics. Neonatal morbidity was defined as any of the following: stillbirth, neonatal death, preterm birth, neonatal intensive care unit admission, low birth weight. Data were analyzed using chi-square and Mann-Whitney U test where appropriate. P <.05 was significant. RESULTS: Our cohort included 580 patients. Overall, the group had a 13% preterm birth rate, 8.2% were diagnosed with fetal growth restriction, and 26% had the composite neonatal morbidity. All patients in the cohort had at least one ultrasound. Compared to group I, group II had more individuals who had only one ultrasound during the pregnancy (3.1 versus 0%, P =.004), but overall the group had more total ultrasounds performed (1.5 [1–3] versus 1 [1–2], P =.02) and had more patients who required fetal surveillance for maternal and fetal conditions (56 versus 44, P =.014). Group II was more likely to have a neonatal demise (1.4 versus 0.3%, P <.01), but there was no difference in the rate of prenatal diagnosis of fetal growth restriction or low birth weight. CONCLUSION: Policies to reduce prenatal ultrasounds were not effective in reducing ultrasounds performed, and there was no difference in the diagnosis of fetal growth restriction despite an increase in comorbidity. [ FROM AUTHOR] Copyright of Obstetrics & Gynecology is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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This chapter reflects upon being pregnant, and giving birth, during the Covid-19 pandemic, via engagement with existential-phenomenological ideas and concepts. It focuses on uncertainty and anxiety, a changing sense of self, and warped temporality - are as much about the general experience of being-in-the-world, as they are about the specific conditions which prompted them: pregnancy and the Covid-19 outbreak. But the multiple layers of apprehension, caused by proliferating pandemic appendages (on top of the worries already associated with being pregnant after miscarriage), caused excessive levels of anxiety. As a pregnant person, rather than prompting entirely new fears and feelings, the coronavirus outbreak served to intensify the recognition of the mortality and the revitalising nature of procreation that is often felt when one discovers they are gestating a new life. Pregnancy, like any other bodily occurrence, is always a 'lived' experience, undergone and understood in a unique way by a specific human being (or animal). Despite the conversation about not bringing a baby into a virus-ridden world, in the first few hours after the positive pregnancy test, the pandemic was not at the forefront of the partner's or the mind. (PsycInfo Database Record (c) 2023 APA, all rights reserved)