COVID-19 during the Third Semester of Pregnancy: Maternal Characteristic, Possibility of Intrauterine Transmission and Neonatal Outcome in Aceh, Indonesia

BACKGROUND: Pregnant women are vulnerable against COVID-19 infection due to physiological and immunological changes. COVID-19 in pregnancy affects fetal well-being with a potential for vertical infection. AIM: This study aims to determine the incidence of vertical infection and anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in infants born to mothers with positive COVID-19 infection. MATERIALS AND METHODS: Amniotic fluid, swabs of the newborn's nasopharynx and oropharynx, and swabs of the placenta were examined using reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2. Serological examination was performed by Electro-Chemiluminescence Immunoassay on infant's blood. RESULT(S): Four of 33 pregnant women gave birth to infants positive SARS-CoV-2 infection. RT-PCR examination of all amniotic fluid and placental swabs was negative for SARS-CoV-2. Four of 33 infants (12.1%) showed negative polymerase chain reaction (PCR) results but positive SARS-CoV-2 antibodies, another 4 newborns (12.1%) showed positive PCR results, but no SARS-CoV-2 antibodies detected. The remaining 25 babies (75.8%) showed both negative PCR and serologic results. CONCLUSION(S): No evidence of vertical transmission found in this study.Copyright © 2023 Cut Meurah Yeni, Zinatul Hayati, Sarjani M. Ali, Hasanuddin Hasanuddin, Rusnaidi Rusnaidi, Cut Rika Maharani.

Findings from the ECHO Cohorts Regarding the Effects of the COVID-19 Pandemic

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.

THE RELATIONSHIP BETWEEN THE FUNCTIONALITY OF CHILDREN WITH DISABILITIES AND ITS EFFECTS ON PARENTS DURING THE COVID-19 PANDEMIC PROCESS.

Purpose: The aim of this study was to investigate the relationship between the functionality of disabled children and its effects on parents during the Covid-19 pandemic. Method(s): A total of 168 people, including 84 disabled children and 84 mothers, were included in the study. The Pediatric Disability Assessment Inventory (PEDI) and Gross Motor Function Classification System (GMFCS) were used for children with disabilities. The Zarit Burden Scale (ZBS), Fatigue Severity Scale (FSS) and The Nordic Musculoskeletal Questionnaire (NMQ) were applied to the mothers to question musculoskeletal disorders. Result(s): There was no correlation between care burden score and PEDI, total score, self-care and mobility scores (p>0.05). A moderately negative (r=-0.306;p<0.01) significant linear relationship was found between care burden score and social function score. There was no significant linear relationship between the fatigue severity score and PEDI total score, self-care, mobility and social function scores (p>0.05). No correlation was found between care burden score and fatigue severity score (p>0.05). For the last 12 months, only the pain in the lumbar region of the parents prevented them from doing their usual work. It was determined that the most aching body parts of the parents who complained of musculoskeletal pain during the last 12 months were in the waist, neck, shoulder, back, and knee regions. Conclusion(s): As a result, no relationship was found between the functionality of disabled children and their parents' influences during the Covid-19 pandemic.Copyright © 2022 Turkish Physiotherapy Association. All rights reserved.

COVID-19 Infection and Vaccination in Pregnancy: What Do We Know Now?

SARS-CoV-2 infection during pregnancy has significant implications for both mothers and their offspring. Pregnant individuals are more likely to progress to severe or critical COVID-19 than nonpregnant reproductiveaged women. Similarly, COVID-19 is associated with a number of pregnancy complications including preterm birth, hypertensive disorders of pregnancy, and cesarean delivery. These adverse outcomes and the morbidity for pregnant people with COVID-19 are closely linked to the severity of COVID-19, and the variant of SARS-CoV-2. Recent data demonstrate that the worst maternal and fetal outcomes were present during the time period of the Delta variant of SARS-CoV-2. Specifically, there was an increase in stillbirth observed in association mostly with the Delta variant due to placental damage, and a greater risk of intensive care unit admission when compared to time periods when other non-Delta strains were predominant. Like other populations, pregnant individuals with other comorbidities such as obesity and chronic hypertension are at increased risk of more severe disease. Early in the pandemic, pregnant patients were much less likely than the general population to be vaccinated, due to a lack of data for vaccine efficacy and safety in pregnancy. As reassuring data have emerged, the vaccination rate of the pregnant population has increased, resulting in decreased disease severity and improved maternal outcomes. Vaccination also has beneficial implications for early neonatal health. The long-term implications of SARSCoV- 2 infection during pregnancy for both mothers and their children remain largely unknown and are a subject of ongoing investigation.

Postnatal SARSCOV2 Infection in Neonates, Characteristics and Outcomes: An Observational Study

Background: Many aspects of the severe acute respiratory syndrome coronavirus 2 (SARSCoV2) pandemic in 2019 have been unclear, especially in newborns, and reports of neonatal diseases are usually associated with perinatal infection. Objective(s): The purpose of this study was to evaluate clinical and para-clinical manifestations in newborns that contracted the infection after birth. Method(s): This observational research was conducted from October 2020 to March 2022 to examine postnatal SARSCoV2 infection in infants admitted to the NICU or neonatal ward at the Children's Medical Center in Tehran, Iran. Inclusion in the study was open to neonates who had positive RT-PCR results postnatally. Result(s): In total, 55 newborns were confirmed to have postnatal SARSCOV2. Fever was the most frequently observed symptom, with 35 (61%). Necrotizing enterocolitis was seen in 18% of neonates, and 30% of them were preterm. Neutropenia was seen in 34% of cases, with five cases having severe neutropenia. All neonates had a normal platelet count. Twenty percent of patients showed C-reactive protein higher than 6 mg/L. Two newborns had co-existing bacterial urinary tract infections. Our neonates didn't require antiviral, anticoagulant, or corticosteroid medications, and they recovered while receiving only supportive care. Everyone in the group of newborns was discharged without complications, and there were no deaths. Conclusion(s): The high rate of fever, high C-reactive protein, and neutropenia in SARSCoV2 neonates suggests that more observational research is needed to compare these symptoms to bacterial sepsis to avoid the overuse of antibiotics in these patients.Copyright © 2023, Author(s).

What are the mental health issues of postpartum mothers during a pandemic? A scoping review

Background. Postpartum mothers' mental health has a significant role in mothers' well-being and child's growth and develop-ment. This issue is worsened during a pandemic when social restrictions are regulated, resulting in perceived stress, baby blues, postpartum depression, and other mental health issues. Objective. This study intends to investigate postpartum moth-ers' mental health during the COVID-19 pandemic. Methods. This study's methodology is a scoping review using the prism-ScR checklist, the Joanna Briggs Institute critical appraisal tool, and a population, exposure, outcome framework. It uses 4 databases: Pubmed, Willey, Proquest, and ScienceDirect;its inclusion criteria is original English articles that can be accessed in full text between 2020 and 2022. Results. Out of 190 publications, we found 7 that are pertinent to the research goals. Qualitative research, cross-sectional studies, and longitudinal studies make up the research. The mapping result includes 4 themes: the types of mental health problems experi-enced by postpartum moms during the Pandemic, risk and predic-tive factors, postpartum mothers' experiences, and the effects of mothers' mental health problems. Conclusion. After giving birth, most mothers experience stress, anxiety, and depression. Postpartum mental health concerns are influenced by isolation, social exclusion, and crises. The cre-ation of a customized plan for early assistance for a woman's mental health requirements, as well as the establishment of an accessi-ble mental health provider, including medical personnel and medical facilities, is advised for pregnant and postpartum women. only.Copyright © the Author(s), 2023.

COVID-19 and homeschooling: factors of burden in women

The pandemic has increased the burden of household work for everyone, but women have been especially hard hit because of their traditional role as caregivers. As schools and childcare services closed, women were forced to assume responsibil-ity for the education and care of children and other family members. In addition, increased economic uncertainty has led to women being primarily responsible for finding work and providing income for their families. © GKA Ediciones, authors. Creative Commons Reconocimiento-NoComercial-SinObraDerivada.

Benefits of Breastfeeding on Child and Postpartum Psychological Health of the Mother

Ab s t r ac t Aim: The aim of this study was to summarize different types of benefits that have been observed in the baby's development and the mother's psychological health during the postpartum period. Background(s): Breastfeeding is a natural process that plays a vital role in the physical as well as mental health of the mother and child. Breast milk is rich in contents such as proteins, fats, and vitamins, which are responsible for building the immune system of the baby. Lactation helps in decreasing the prevalence of infant mortality rate. It enhances the development of the physical health of the children. Breastfeeding protects the mother from many systemic conditions like endometrial cancer, ovarian cancer, breast cancer, etc. It has been observed that with an increase in healthy breastfeeding practices, there is a decline in the cases of maternal mental health issues reported mainly in the postpartum period. Review result: The authors have explained various types of advantages of breastfeeding on the child's and mother's health, their mechanism of action, effects on the baby, and mother-child relationship. Conclusion(s): The mother's mental health plays a crucial role in a healthy infant, and breastfeeding is key to it. The role of breastfeeding is therefore considered a boon for the mother because if there is a decrease in health issues in the child, the mother's mental condition improves automatically. Therefore, breastfeeding should be promoted at the national level. Clinical significance: Breastfeeding not only helps in reducing maternal stress and postpartum depression but also improves the physical health of the child and mother during the postpartum period. The clinicians should teach mothers about the importance and also the correct positions of breastfeeding. "Breastfeeding week" is celebrated every year from August 1 to August 7, as implemented by the Indian government.Copyright © The Author(s). 2023 Open Access.

The Impact of Prenatal Maternal Mental Health during the COVID-19 Pandemic on Birth Outcomes: A Study within CONCEPTION Cohort

Background: External natural events, such as hurricanes, floods, and the COVID-19 pandemic can contribute to increased populational stress, especially for pregnant persons. Exposure to crises can produce short- and longterm health effects on pregnant persons and their offspring. There has been much interest in the association between maternal depression, anxiety, and stress during pregnancy and perinatal outcomes such as preterm birth (PTB) and low birth weight (LBW), before and since the COVID-19 pandemic, however results are controversial. Objective(s): Assess the association between prenatal mental health during the COVID-19 pandemic and preterm birth (delivery <37 weeks gestation) and low birthweight (<2,500 grams). Method(s): Pregnant individuals, >18 years, were recruited in Canada and provided data through a web-based questionnaire. We analyzed data on persons recruited between 06/2020-08/2021 who completed questionnaires while pregnant and two months post-partum. Data on maternal sociodemographics, comorbidities, medication use, mental health (Edinburgh Postnatal Depression Scale, General Anxiety Disorder-7, stress), pandemic hardship (CONCEPTION - Assessment of Stress from COVID-19), and on gestational age at delivery and birth weight, were selfreported. Crude and adjusted relative risks (aRR) with 95% confidence interval (95%CI) were calculated to quantify the association between PTB/LBW and maternal mental health. Result(s): A total of 1,265 and 1,233 participants were included in the analyses of PTB and LBW, respectively. No associations between PTB and prenatal mental health (depression [aRR 1.01, 95%CI 0.91-1.11], anxiety [aRR 1.04, 95%CI 0.93-1.17], stress [aRR 0.88, 95%CI 0.71-1.10], nor hardship [aRR 1.00, 95%CI 0.96-1.04]) after adjusting for potential confounders. The risk of PTB was increased with nonwhite ethnicity/race (aRR 3.85, 95%CI 1.35-11.00), consistently with the literature. Similar findings were observed for LBW (depression [aRR 1.03, 95%CI 0.96- 1.13], anxiety [aRR 1.05, 95%CI 0.95-1.17], COVID stress [aRR 0.92, 95%CI 0.77-1.09], or overall hardship [aRR 0.97, 95%CI 0.94-1.01]). Conclusion(s): No association was found between prenatal mental health nor hardship during the COVID-19 pandemic and the risk of PTB or LBW. However, it is imperative to continue the follow-up of mothers and their offspring to detect long-term health problems early.

Health-related quality of life, mental health and caregiver burden in children with autosomal recessive polycystic kidney disease (ARPKD)

Objective: To examine whether established patient-reported outcome measures are suitable for capturing the impact of ARPKD in children and their families. Method(s): We assessed 44 children with ARPKD (40 families) with respect to patients' health-related quality of life ((hr- QOL) using PedsQLTM ESRD module) and mental health (strength and difficulties questionnaire (SDQ)) as well as family and caregiver burden (Impact on family score (IFS) und Ulm inventory of parental caregiver QOL (ULQIE)) and compared them to published data and 36 healthy control children matched for age and time. Result(s): Patients were aged 9.5 +/- 5.9 years (vs. controls 8.8 +/- 5.0, p = ns) and 21 (48%) were female (vs. 19 controls (53%), p = ns). Mean eGFR was 81 ml/min*1.73m2 (range 4 - 165);7 received dialysis and 11 had functioning kidney transplants (KTX, 2 combined with liver transplants). Eight patients had developmental delay secondary to medical complications, while chronic illness was an exclusion criterion for healthy controls. 61 caregivers of affected children had same gender-distribution (61% vs. 60% mothers) and age (both 42 +/- 7 years) and number of dependent children (1.8 +/- 0.9 vs. 2.0 +/- 0.8) as 57 caregivers of healthy children. The mean proxy reported PedsQL Total score was 77.5 +/- 10.6 (range 59 - 96). It correlated significantly to eGFR (r = 0.5, p < 0.01, (also within the subpopulations pre- and post-KTX)). Parents reported greater mental health problems in affected than in control children with a higher SDQ total score mainly due to higher scores in the hyperactivity and peerinteraction subscales. ULQIE revealed that parents of affected children had significantly lower levels of physical functioning, self-fulfillment and general QOL, but despite higher emotional burden scores they indicated similar satisfaction with family life. Impact on family scores were in a similar range to those of children with moderate to severe disabilities. Conclusion(s): The good spread of PedsQLTM ESRD-scores and their correlation to renal function indicates that it captures significant aspects of ARPKD, however, it may need further adjustment to include liver complications. All four chosen instruments revealed significant impact of ARPKD on hrQOL and mental health of affected children as well as family life and parental wellbeing in comparison to healthy controls. More problems with peer-interactions may also be due to more stringent shielding of chronically ill children from social contacts during the COVID pandemic compared to healthy children.

Congenital miliaria crystallina in a neonate of a COVID- 19 positive mother

Introduction: Miliaria crystallina occurring during neonatal period is one of the differential diagnosis for vesiculopustular lesions in that age group. Congenital miliaria crystallina is a rare condition developing due to various causes. Case Report: An otherwise well, term female neonate born by caesarean section presented with generalised clear fluid filled vesicles over the trunk, upper limbs, face and scalp at birth. Mother was COVID-19 positive with fever and cough for 1 week. Otherwise she had an unremarkable antenatal, sexual history and examination. The vesicles were located on normal looking skin and ruptured easily on rubbing. Palms, soles and mucosae were normal. Tzanck smear from the vesicles showed a few deformed keratinocytes only. Venereal Disease Research Laboratory test in dilution for both mother and child was non-reactive. Baby's RT-PCR came negative. She fared well on follow up, the vesicles started to desquamate on the second day and completely disappeared on the third day. Mother's COVID-19 symptoms also subsided after child birth. A final diagnosis of congenital miliaria crystallina was made based on the characteristics of the vesicles. Discussion(s): Miliaria crystallina is triggered by environmental temperature and humidity. Congenital cases are associated with maternal febrile illnesses. However, there are reports of it occurring in newborns of mothers without fever in whom other factors are involved. This is the first report of congenital miliaria crystallina occurring in a neonate born to a COVID-19 positive mother. Conclusion(s): This case report highlights the importance of recognizing this benign self-limiting condition so as to avoid unnecessary investigations to find an alternative cause.

Peripartum Covid 19 admissions in an intensive care unit - Case series

Introduction: Peripartum women are at increased risk for severe illness with coronavirus disease (Covid-19) infection. Recent medical literature has drawn attention to the possible influence of COVID-19 on the course of pregnancies and its long-term effects.1-5 Objective: This case series aimed to observe the clinical course of peripartum women with confirmed Covid-19 admitted to a critical care unit in the North-west of England. Method(s): Since the start of the pandemic, all pregnant women with Covid-19 infection admitted to the critical care unit were monitored and followed up. Demographic profile, medical co-morbidities, treatment received, respiratory support and vaccination status were noted. Result(s): From March 2020 until February 2022, 8 women in our practice were shifted to the critical care unit post-partum in view of worsening work of breathing & increasing oxygen requirement after initial management in the delivery suite. All admissions were during the 3rd wave of the pandemic in the UK, between June to October 2021. 5 patients underwent Caesarean section under spinal anesthesia & 3 were shifted post normal vaginal delivery. Mean age in the study population was 33.25 years (SD +/- 3.99) and mean length of stay in the ICU was 6.62 days (SD +/- 3.99). Only one woman required intubation & mechanical ventilation for 10 days and the rest were managed on High Flow Nasal Cannula (HFNC) or Continuous Positive Airway Pressure (CPAP) hood and self-proning manoeuvres. 50% of the patients received Tocilizumab. All women were discharged home and there were no maternal deaths. Pre- admission none of the women were vaccinated, but on follow up 5 out of the 8 had completed their vaccination. All women were emotionally distraught due to being isolated from their family and new born. When reviewed at 12 weeks, one patient experienced post traumatic stress disorder (PTSD) and one had features of long Covid syndrome. On follow up, all new born babies were doing well. Conclusion(s): From the limited amount of data available, psychological stress was common to all patients. Being isolated from their new-born and family was the most difficult emotional aspect for the mothers in addition to finding it difficult to breathe and uncertainty about the future. Most mothers and new-born babies were discharged from the hospital without any serious complications. However, further observation and long term follow up is imperative. Use of guidelines in peripartum patients will aid in appropriate escalation of care. Key words: COVID-19, Pregnancy, Peri-partum, Long Covid syndrome.

Postpartum screening results in Ontario, Canada before and after the COVID-19 pandemic: An interrupted time-series analysis

Aims: This study examined the impact of the COVID-19 pandemic on mothers or childbearing parents using ongoing, systematic screening of a representative Ontario sample. Method(s): An interrupted time series analysis was conducted on data captured in the Healthy Babies Healthy Children (HBHC) screening tool to determine effects of the pandemic on relationships, support, mental health, and related clinical outcomes at the time of postpartum discharge from hospital. The ability to parent or care for the baby/child and other psychosocial and behavioural outcomes were assessed. Result(s): The co-primary outcomes of inability to parent or care for the baby/child were infrequently observed in both the pre -pandemic (March 9, 2019-March 15, 2020) and initial pandemic periods (March 16, 2020-March 23, 2021) ((parent 209/63,006 (0.33%) to 177/56,117 (0.32%), care 537/62,955 (0.85%) to 324/56,086 (0.58%)). Changes following pandemic onset were not observed for either outcome although a significant (beta = 1.013, 95% CI 1.002-1.025, p = 0.02) increase in slope was observed for inability to parent (with questionable clinical significance). For secondary outcomes, worsening was only seen for complications during labour/delivery. Significant improvements were observed in the likelihood of being unable to identify a support person to assist with care, need of newcomer support, and concerns about money over time. Conclusion(s): Despite more complications during labour/delivery, there were no substantive changes in concerns about ability to parent or care for children. Adverse impacts of the pandemic may have been mitigated by accommodations for remote work and social safety net policies.Copyright © 2023

Difficulties in the schooling of children and adolescents during the COVID-19 pandemic in Argentina in households supported by women

This article analyzes the way in which children and adolescents went through schooling, particularly in single-mother households, during the COVID-19 pandemic. The scarce official information published is reconstructed and compiled, specific cross-check are made through the official microdata base and different documents produced by international organizations, particularly UNICEF, are selected. A quantitative and qualitative (that is, mixed) analysis is combined here, based on the work with the aforementioned sources. It is expected to provide inputs for decision-making while at the same time providing material that contributes to the field of work on school inequality that was generated during the pandemic. The general question guiding this work is to what extent the COVID-19 pandemic will deepen pre-existing marks in the educational system and what is the schooling gap by gender that the pandemic will leave behind.

Protecting Mothers and Babies Through Research: A Time for Change

Pregnant patients deserve access to curated information that informs them on the safe use of medicines to treat or prevent disease. Limited or absent drug information can lead to unsafe use of medicines or even refusal or reluctance to prescribe or receive treatment. Decisions not to treat or inadequately treat comorbid conditions during pregnancy can pose significant health risks to mothers impacted by these decisions and their babies. Experiences gained during the SARS-CoV-2 pandemic that found a higher risk of hospitalization and death in pregnant populations have accentuated the need for targeted efficacy and safety data to optimally treat or prevent disease during pregnancy. In the United States, Congress has previously recognized that the lack of information within drug labels to convey certainty in prescribing medications during pregnancy is an urgent public health issue. Similarly, regulatory agencies such as the Food and Drug Administration acknowledge the role that data evaluating drug disposition, pharmacology, and disease biology play in reducing regulatory uncertainty and informing decisionmaking for the good of public health. Historically, in the absence of labeled drug information, networks such as MotherToBaby, have become the trusted expert source providing evidence-based information on the benefit or risk of medications and other exposures during pregnancy. To facilitate the more timely generation of data to inform the use of medicines in pregnancy, multistakeholder initiatives such as the Task Force on Research in Pregnant Women and Lactating Women (PRGLAC) have been established to identify gaps and provide findings to Congress for action. These initiatives have identified a set of opportunities to address the many challenges contributing to the disproportionate exclusion of pregnant populations in clinical trials. As a complimentary mechanism, broader reforms could be considered to foster a research culture that is purposeful and inclusive of pregnant patients. Together, these approaches can reduce uncertainty in prescribing in pregnancy and better address the needs of mothers and their babies.

COVID-19 Infection and Medicines in Pregnancy in Canada

Background: Although over 100 million pregnant women worldwide are at risk of infection with SARS-CoV-2, little data exists on the impact of COVID-19 and related treatments on maternal/neonatal health. Objective(s): (1) To quantify the prevalence of medication use in pregnancy to treat COVID-19, and (2) To quantify and compare the risk of adverse pregnancy/neonatal outcomes in those with and without COVID-19. Method(s): In the Canadian Mother-Child population-based cohort (CAMCCO), two sub-cohorts were identified using prospective data collection of medical services, prescription drugs, hospitalization archives data, and COVID-19 surveillance testing program (02/28/2020- 2021). The first cohort included all pregnant women during the study period regardless of pregnancy status (delivery, induced/planned or spontaneous abortion);this cohort was further stratified on COVID-19 status. The second cohort included all nonpregnant women (aged 15-45) with a positive COVID-19 test. COVID-19 in pregnant or nonpregnant women was assessed using COVID-19 test results or ICD-10CM code U07.1 from hospital data. COVID-19 severity was categorized based on hospital admission. Women were considered exposed to COVID-19 medications if they filled at least one prescription for a medicine included in the WHO list in the 30 days pre- or 30 days post-COVID-19 positive test/diagnosis. Considering potential confounders, association between COVID-19 during pregnancy, treated vs not, and perinatal outcomes were quantified using log-binomial regression models. Result(s): 150,345 pregnant women (3,464 (2.3%) had COVID-19), and 112,073 nonpregnant women with COVID-19 diagnoses were included. Pregnant women with COVID-19 were more likely to have severe infections compared to nonpregnant women with COVID-19 (11.4% vs 1.6%, p<0.001). The most frequent medications used in pregnancy to treat COVID-19 were antibacterials (13.96%), psychoanaleptics (7.35%), and medicines for obstructive airway disease (3.20%). In pregnancy COVID-19 was associated with spontaneous abortions (adjRR 1.76, 95%CI 1.37, 2.25), gestational diabetes (adjRR 1.52, 95%CI 1.18, 1.97), prematurity (adjRR 1.30, 95%CI 1.01, 1.67), NICU admissions (adjRR 1.32, 95%CI 1.10, 1.59);COVID-19 severity was increasing these risks but exposures to COVID-19 medications reduced all risks. Conclusion(s): COVID-19 severity was higher in pregnancy. Antibacterials, psychoanaleptics, and medicines for obstructive airway disease were the most used overall. COVID-19 was associated with adverse outcomes for mothers and newborns.

Determination of COVID-19 Mortality and Morbidity in Women Who Had Cesarean Sections and Terminated Pregnancies

Background: COVID-19 infection is a contemporary global concern with serious ramifications. This disease is caused by a virus belonging to the Coronaviridae family named SARS-CoV-2. Immunologic and physiologic changes during pregnancy make pregnant women more susceptible to viral infection, especially COVID-19. Objective(s): The present study aimed to identify the clinical manifestations, radiologic findings, indications for cesarean delivery, underlying conditions, and the critical outcome of mothers and newborns regarding COVID-19 women who had cesarean sections and terminated pregnancies. Method(s): This cross-sectional study was conducted on the mortality and morbidity rates of 98 women with terminated pregnancies infected with COVID-19 at the time of their cesarean delivery. The demographic, clinical, and pregnancy data were collected from Razi Teaching Hospital between March 2020 and March 2021 and analyzed using SPSS version 24. Result(s): The mean age was 31.31 +/- 7.16, and the mean gestational age was 36.45 +/- 3.334 weeks. The most prevalent cause of cesarean section was fetal distress (28%), followed by preeclampsia and meconium aspiration. The most common symptoms were sore throat, cough, fever, nausea, diarrhea, and weakness;moreover, hypothyroidism and diabetes mellitus were the most predominant underlying diseases. The mean duration for hospitalization was 5.21 +/- 4.584 days, the maternal death rate was 5.1%, and the neonatal death rate was 2%. Conclusion(s): The majority of women infected with COVID-19 had cesarean sections and terminated pregnancies in the third trimester. This highlights the need for better care and education for mothers in this period. The body mass index (BMI) level and obesity are strongly associated with COVID-19 severity. Furthermore, healthcare workers should pay more attention to underlying diseases during pregnancy.Copyright © 2023, Author(s).

Parental Involvement in Digital Learning: Mother's Experiences of Elementary School Students

After the implementation of the school closure policy, parents are acclimating to studying with their children due to the effects of COVID-19 pandemic. Therefore, this study thoroughly discusses the involvement of parents in a child's digital education, especially the experience of the mothers with elementary school students. The survey approach and qualitative methods are used to obtain 277 respondents from the population of parents in Berau, Indonesia. Structural Equation Modeling (SEM) and Partial Least Square (PLS) are the data analysis technique used with the help of SmartPLS software version 3. The results shows that the direction of the relationship between the use of gadgets and maternal involvement is positive, hence the hypothesis decision is accepted. The digital learning of children includes letter and number recognition, reading, learning to count, coloring, drawing, playing educational games, and studying. Some of the mothers' involvement includes explaining websites accessible by children to communicate politely on social media. These results are valuable insights for parents in providing involvement in digital learning for elementary school students. It is important for parents to have a higher level of understanding and familiarity with the application or technology that their children utilize. © 2023,nternational Journal of Interactive Mobile Technologies. All Rights Reserved.

Nursing and Maternity in the Pandemic: A Qualitative Study from Turkey.

OBJECTIVES: This study was conducted to examine the experiences and perceived challenges of nurses who are also mothers having a child during the coronavirus disease (COVID-19) pandemic. METHODS: A descriptive phenomenological design. The study was conducted with 18 nurse mothers working at COVID-19 clinics in Turkey. RESULTS: Nurse mothers missed their children and are worried about infecting their children. Based on content analysis, the themes of the study were determined as follows: (1) Nursing Care Process, (2) Disruption of Family Processes, (3) Nurse Mother's Perspective: Being a Child in a Pandemic, and (4) Coping with Challenges-"Searching for a solution." CONCLUSIONS: Necessary conditions should be provided for nurses with children or family members in need of care and protocols should be made with relevant institutions.

What is already known on the subject? Nurses working in COVID-19 units wear protective equipment and work for a long time under difficult conditions. In addition, nurses who have children are separated from their children because of the fear of transmitting COVID-19.What does this study add? Therefore, nurses caring for COVID-19 patients should alternately be replaced by nurses working in other services. They should be given the opportunity to rest and spend time with their loved ones if they are not carriers of COVID-19.

Symptoms of Anxiety in Mothers During the COVID-19 Lockdown: A Structural Equation Model Approach.

The COVID-19 global pandemic has forced millions of people to stay confined at home, increasing symptoms of anxiety and stress levels. Women who are also mothers, for their part, not only face the demands of motherhood but must combine working life with family life locked down in their homes. Main objective was to develop an explanatory model of the psychological consequences of COVID-19 and parental and perceived stress in mothers. A total of 261 mothers were evaluated coinciding with the lockdown imposed by the Spanish Government. The model displayed adequate indices and it was found that symptoms of anxiety in mothers increased the levels of perceived stress. The model allows to understand the close relationships between the psychological consequences of lockdown and stress in mothers. Understanding these relationships will help to prepare and direct psychological interventions in this population in the case of a possible new surge.