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1.
Clinical and Experimental Obstetrics and Gynecology ; 49(4), 2022.
Article in English | EMBASE | ID: covidwho-1822730

ABSTRACT

Objective: Antiviral therapy during pregnancy has always presented difficulties in clinical practice. This review covers the safety and efficacy of the direct use of antivirals during pregnancy. Mechanism: We conducted literature research to summarize the available evidence on the use of direct-acting antivirals during pregnancy for infections due to influenza, hepatitis B and C, human immunodeficiency, herpes simplex virus, cytomegalovirus, varicella-zoster virus, Ebola, and Zika viruses, and human coronavirus. Findings in brief: To support further the rational use of antivirals during pregnancy, the discussion includes the influence of pregnancy on pharmacokinetics, safety, and transplacental permeability, and the protection of mothers and children from vertical transmission. Conclusion: Data on the use of antiviral drugs during pregnancy are currently insufficient. Promoting research on the ethics of drug experimentation, and pharmacokinetics, drug metabolism, and pharmacological effects of pregnancy, is essential to improve the care of pregnant women and even save lives during current and future outbreaks.

2.
Annals of Medicine and Surgery ; : 103711, 2022.
Article in English | ScienceDirect | ID: covidwho-1821118

ABSTRACT

Background The impact of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic on expectant mother and their babies extends to many aspects of life. Necrotizing enterocolitis (NEC) has been recognized as a life-threatening gastrointestinal inflammatory process in neonates that has high rates of morbidity and mortality. Objective To investigate factors associated with NEC in hospitalized neonates whose mothers were SARS-CoV-2-positive and their relationship to mortality. Method This observational study was conducted from May 2020 to March 2021. All neonates who were hospitalized, after confirming that the mother was SARS-CoV-2-positive, were included in this study. The confirmation of positive SARS-CoV-2 was determined according to the reverse transcription-polymerase chain reaction (PCR) assay. The neonatal SARS-CoV-2 test was performed on the first day of birth. NEC was established based on a suggestive clinical presentation and abnormal abdominal radiographs. Results Of the 125 neonates enrolled in this study, there were 5 neonates who developed NEC and only one survived. Significant associated factors with NEC included lower birth weight (p < 0.001), lower gestational age (p < 0.001), positive SARS-CoV-2 PCR results (OR = 15.333;95% CI = 2.074–113.381, p = 0.007), asphyxia (OR = 13.143;95% CI = 1.411–122.443, p = 0.024), and mortality (OR = 156.000;95% CI = 13.157–1849.623;p < 0.001). Mortality was significantly associated with lower gestational age (p = 0.025), cesarean section delivery (p = 0.025), and asphyxia (p = 0.025). Conclusion Significant associated factors with NEC in neonates born to SARS-CoV-2-positive mothers included positive SARS-CoV-2 PCR results, asphyxia, lower gestational age, and lower birth weight. In addition to caesarean section delivery, these factors were related to mortality in neonates in such conditions.

3.
European Journal of Molecular and Clinical Medicine ; 9(3):2673-2681, 2022.
Article in English | EMBASE | ID: covidwho-1820578

ABSTRACT

Background- For successful management of Covid-19 pregnancy, adequate information and understanding of its clinical presentation and impact of the disease on pregnant mothers and their newborns is required. Aim- To describe the clinical manifestations of COVID -19 infection in pregnant women during peripartum period and to study the clinical outcomes of neonates born to these mothers. Methods- This prospective study was conducted at a COVID-19 Hospital of North India, from May 2021 to July 2021.All Covid-19 positive pregnant women who presented at the time of labor (symptomatic or asymptomatic) were included in the study. Follow up of these women and their newborns was done till discharge and neonates were further followed up till 28 days of life. Results-Total 70 patients were included in the study (24.2% symptomatic and 75.7% asymptomatic). Eighteen (25.7%) were NVD and 52(74.2%) were LSCS. LSCS was done more in symptomatic subjects (p<0.05). Frequency of AFD is higher in symptomatic subjects(p value< 0.05).Co morbidities noted were PIH, GDM, hypothyroidism and anemia in 15(21.4%), 2(2.8%), 11(15.7%) and 22(31.4%) respectively. All study women were successfully discharged. There were 69 live births(53(76.8%) term and 16(23.1%) preterms)and 1 IUD. Two (2.8%) babies were tested positive for COVID19. Both remained asymptomatic and discharged. Total 11 neonates required NICU admission due to non covid reasons. Number of deaths among neonates were 2 (2.8%). During followup visits 5(9.09%) neonates required readmission in NICU. Inadequate weight gain was seen in 3(5.4%) babies. None developed COVID related symptoms. Conclusion- COVID 19 infection during pregnancy is not associated with severe clinical presentation, high mortality and morbidity. There may be an association between symptomatic COVID19 pregnant women and AFD. There is high incidence of prematurity and LBW in neonates born to COVID positive mothers.

4.
International Journal of Environmental Research and Public Health ; 19(9), 2022.
Article in English | EMBASE | ID: covidwho-1818136

ABSTRACT

The aim of the study was to investigate the challenges of involuntary separation experienced by women during pregnancy and childbirth in the time of the COVID-19 pandemic. The study was conducted by the means of a self-administered questionnaire. One thousand and eleven women (1011) from Poland took part in the study, with an average age of approximately 30 years. The study was approved by the Research Ethics Committee of Warmia and Mazury University in Olsztyn, Poland. The results show that the majority of the surveyed women experienced involuntary separation from their partners during pregnancy and childbirth: 66.27% had no choice but to give birth alone and 84.37% had not been able to attend medical appointments with their partners. Solitary encounters with healthcare were associated with the feeling of fear (36.4%), anger (41%), a sense of injustice (52.2%), acute sadness (36.6%) and a sense of loss (42.6%), with all the reported levels higher in younger women. Over 74% of respondents were afraid of childbirth without a partner present. Almost 70% felt depressed because of a lonely delivery experience. Nearly a quarter of the mothers surveyed declared that if they could go back in time, they would not have made the decision to become pregnant during the pandemic. Based on our study, we found that adjustments to prenatal and neonatal care arrangements under COVID-19-related regimens are needed. Our pro-posal is to implement at least three fundamental actions: (1) risk calculations for pandemic-related cautionary measures should take into account the benefits of the accompanied medical appointments and births, which should be restored and maintained if plausible;(2) medical personnel should be pre-trained to recognise and respond to the needs of patients as a part of crisis prepared-ness. If the situation does not allow the patient to stay with her family during important moments of maternity care, other forms of contact, including new technologies, should be used;(3) psychological consultation should be available to all patients and their partners. These solutions should be included in the care plan for pregnant women, taking into account a risk-benefit assessment.

5.
Women's Studies International Forum ; : 102598, 2022.
Article in English | ScienceDirect | ID: covidwho-1815263

ABSTRACT

COVID-19 has disrupted women's lives by increasing their childcare and household labor responsibilities. This has detrimentally affected immigrant women with limited resources, who invest in their children's education for upward mobility. Based on a content analysis of 478 posts on the MissyUSA website, this study explores the ways in which Korean immigrant mothers in the U.S. navigate the management of middle and high school children's online education during lockdown. Before the pandemic, mothers' tasks were largely limited to scheduling and coordinating private-paid after-school programs that occurred outside the home. However, the pandemic transformed mothers into active coordinators of public middle and high school classes and of private online tutoring, and de facto schoolteachers at home. This breakdown of boundaries between the home and tasks normally relegated to the outside world has burdened mothers with augmented roles managing the ordinary functioning of their children's education during the pandemic.

6.
Natural Volatiles & Essential Oils ; 8(5):797-804, 2021.
Article in English | GIM | ID: covidwho-1812641

ABSTRACT

The World Health Organization declared a public health emergency on January 30, 2020, as a result of the coronavirus illness 2019 (COVID-19), which was caused by the novel severe acute respiratory syndrome coronavirus 2. (SARS-CoV-2). Newborns may show COVID-19 indications, according to the findings of current investigations. Despite the fact that the disease expresses itself differently in different cultures, only a few studies have been conducted on COVID-19-infected mothers. The World Health Organization termed the new coronavirus illness 2019, caused by severe acute respiratory syndrome. coronavirus disease on January 7, 2020. (COVID-19) reported in ANC-MOTHER : as a percentage of the total number of cases in the general population Because the United Nations Children's Fund (UNICEF) estimates that 0.35 million kids are born each year, screening pregnant women and providing perinatal care to babies of COVID-19 positive moms is critical. Initially, there was little evidence of mother-to-infant transmission, and only a few deaths in ANC- MOTHER and her newborn were reported, but now that transplacental transmission has been demonstrated, transmission can be controlled with good care or all preventive measures. Patient history: Due to uterine contractions, a 35-year-old woman was referred to the AVBRH Hospital, Sawangi Meghe, Wardha. She was gravida4, para3, with a 39-week pregnancy and three previous caesarean sections. She had no underlying illnesses and had no previous exposure to COVID-19-infected people. On admission, she didn't have a fever or any other symptoms like cough, sore throat, or muscle weakness. Clinical Findings: The patient had undergone with various investigations like blood test, USG, physical examination and CT scan, Computers tomography, and newborn assessment Medical Management: Patient was treated with calcium supplement and iron supplement. Inj. Piptaz 4.45gm, it is antibacterial Drug, It's Prevent the growth or spread of bacteria. Inj. clindamycin 600 mg, it is a antibiotic drug, and it's action is slowing and stopping the growth of bacteria. Inj Levoflox 750 mg, it is a antibiotic drug, Inj neomol 100 ml, it is a painkiller;Tab Limcee 500 mg, it is vitamin supplement. Tab zincovit, it is nutrition suppliment and preventing vitamin and mineral deficiency;Inj dexa 6 mg, it is a steroid, it is treat a condition such as a inflammatory and autoimmune condition, Tab ecosprin 75 mg, it is (NSAID) non-steroid Anti inflammatory drug, it decrease the formation harmful blood clots. Inj ramdesivir, it is antiviral drug used to treat Covid infection. Nursing management: Administered fluid replacement i.e. DNS and RL, Fetal monitoring, monitored all vital signs hourly. Do physical examination, Give proper information regarding the disease condition, provide proper environment to the patient, provide proper care to the patient, give psychological support to the patient, educate patient regarding the disease condition, discuss about the health issues of the patient with doctor. Conclusion : In conclusion, the intensity of Covid -19 Antenatal mother's stage and degree of sickness.

7.
Open Access Macedonian Journal of Medical Sciences ; 10:290-296, 2022.
Article in English | EMBASE | ID: covidwho-1798862

ABSTRACT

BACKGROUND: Stunting is a chronic nutritional problem that occurs worldwide, including in Indonesia. The impact of the COVID-19 pandemic has increasingly caused stunting to increase in coastal areas in particular. AIM: This study aimed to obtain a stunting prevention model with a Health-Promoting Family model approach in coastal families. METHODS: This study was quantitative research. The population in this study was mothers of toddlers aged 6–48 months in the coastal areas of Pamekasan. The sample in this study was mothers of 135 toddlers in Tlanakan and Talang villages who were selected using a simple random sampling technique. The independent variables are the history of present illness, mother’s knowledge, care patterns, literacy, cultural aspects, and family support—while the dependent variable is family prevention behavior regarding the incidence of stunting. Data collection was carried out by interview method using a questionnaire. Statistical analysis was carried out using the Logistic Regression test (=0.05) RESULTS: The factors that affect stunting prevention are knowledge p = 0.008 (CI: 1.438–11.780), literacy p = 0.000 (CI: 2.136–17.003), cultural aspects p = 0.00 (CI: 0.039–0.366) and family support p = 0.000 (CI: 1.273–20.498). CONCLUSION: Knowledge, family support, literacy, and culture affect stunting prevention in families. It takes the collaboration of the community, the government participation in strengthening maternal and child health programs that support the achievement of stunting prevention in families. There are opportunities to research what appropriate forms of literacy in families support the success of stunting prevention in toddlers for further studies.

8.
Pakistan Journal of Medical and Health Sciences ; 16(2):186-190, 2022.
Article in English | EMBASE | ID: covidwho-1798526

ABSTRACT

Aim: To ascertain the frequency of acceptance and rejection of covid-19 vaccination and the reasons behind their choices among pregnant and breast feeding women visiting outpatient department of a tertiary care setup. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Unit -1 for a period of one month. All women attending outpatient department during the study, fulfilling the inclusion criteria and willing to participate in the study were included after informed consent. A questionnaire designed to acquire general information about the study participant was filled by the researcher. Data was entered and analyzed using SPSS vr 21.0. Results: Out of 500 enrolled women, 249(49.8%) women were pregnant and 251(51.2%) were breast feeding. 171(34.2%) were vaccinated and 329(65.8%) were unvaccinated. There is a significant association between the concept regarding unavailability of significant data regarding safety during pregnancy and breast feeding or vaccine being harmful during pregnancy and breastfeeding for mother & baby and acceptance of vaccine (p-value < 0.001) Conclusion: Safety concerns regarding the vaccine for pregnant and breast-feeding mothers still hold them from getting vaccinated. Obstetricians and Gynaecologists of the country need to play a vital role in building up the confidence of this population over vaccination and should strongly recommend pregnant and breast feeding women following up in clinics to get vaccinated.

9.
Trends in Biomaterials and Artificial Organs ; 36(Special Issue 1):90-93, 2022.
Article in English | Scopus | ID: covidwho-1790664

ABSTRACT

Coronavirus disease 2019 is a communicable disease caused by severe acute metabolic process respiratory syndrome coronavirus. Symptoms begin one to 14 days after exposure to the virus (81%) develop mild to moderate symptoms, while 14% develop severely and 5% suffer critical symptoms. The present study aimed to formulate psychological interventions to enhance mental state and psychological resilience throughout the COVID-19 pandemic. To correlate the level of Psychological impact of COVID 19 among antenatal mothers and to find out association between the Psychological impact of COVID 19 among antenatal mothers with their selected demographic variables. This study was conducted with 60 antenatal mothers in a quantitative approach, non-experimental descriptive design by purposive sampling technique. Demographic variables data were collected by using a multiple-choice questionnaire followed by assessing the psychological impact of COVID 19 among antenatal mothers were assessed using completely three different standardized tools. The results showed that 42(70%) had a high level of anxiety of COVID-19 among antenatal mothers, and 18(30%) had no anxiety. 46(76.6%) had had moderate stress, 10(16.7%) had high perceived stress, and 4(6.7%) had low stress. 35(58.3%) had probable depression, 14(23.3%) had a fairly high possibility of depression, 10(16.7%) had depression possible, and only 1(1.7%) had depression not likely among antenatal mothers. Psychological impact of COVID-19 has moderate to severe levels of stress, anxiety, and depression among antenatal mothers in the second and third trimesters. So it is vital to formulate Psychological interventions to enhance mental state, and maternal mental health should be prioritized during the pandemic. © (2022) Society for Biomaterials & Artificial Organs #20059222.

10.
Pakistan Paediatric Journal ; 46(1):67-74, 2022.
Article in English | EMBASE | ID: covidwho-1790130

ABSTRACT

Objective: The current study intends to look at how COVID-19 pandemic affected parenting practices during COVID-19 in Pakistan and if the children were exposed to more abuse and neglect at home. Study Design: A quantitative design survey. Place and Duration of the Study: Data was collected from parents visiting outpatient departments (OPDs) in four hospitals of Lahore, Peshawar, and Karachi in three months from July to September 2020. Material and Methods: A quantitative design survey was used, and data (N=923) were collected using a self-administered COVID-19 Parenting Response Scale (α = 0.74). Results: The primary responsibility of taking care of children rested with mothers in most of the cases. Ratio of severe disciplinary practices like shouting, yelling, cursing, and slapping children was increased significantly during the lock down as the anger and frustration in the parents also mounted. This effect was more pronounced in families from lower socioeconomic groups as well as for those who suffered income loss during COVID-19. Conclusion: Financial and emotional stress caused by COVID-19 exacerbated the already difficult parenting practices. Ultimately children suffered more violence at the hands of parents. In Pakistani society there is little awareness on building one‟s capacity on good parenting and little availability of such trainings. There is a need to understand implications for good parenting and create awareness of positive parenting methods.

11.
Clinical and Experimental Obstetrics and Gynecology ; 49(3), 2022.
Article in English | EMBASE | ID: covidwho-1780432

ABSTRACT

Background: The aim of this study was to show the frequency and epidemiological characteristics of pregnant women who tested positive for SARS-CoV-2 during childbirth as well as the course, mode and outcome of their newborn treatment and diet after discharge. The aim is also to show individual symptoms developed by newborn from pregnant women who test positive for SARS-CoV-2. Method: The study included all the infants born to the pregnant women who tested positive for SARS-CoV-2 on a PCR test 24 hours prior to delivery or, had already been confirmed positive for the infection and had developed symptoms of the virus or had started treatment for SARS-CoV-2 several days prior to delivery. Results: 43/3237 (1.32%) of the pregnant women tested positive for the SARS-CoV-2 virus or had been infected prior to admission and were positive during delivery. A total of 45 newborn infants were transferred to a special room for the care of newborn infants born to SARS-CoV-2-positive mothers at the Department of Neonatology. Specifically, 30/45 (66.7%) of the newborn infants developed symptoms within the first hours of birth which withdrew spontaneously within 24–48 hours after birth. The symptoms referred to are not specific forSARS-CoV-2 infection and are not particularly indicative of infection. Conclusions: The conclusion of this short 21-month study is that prenatal and postnatal duration and outcome in infants is not aggravated by pregnant women who tested positive for SARS-CoV-2. Despite the individual symptoms described above and the pathological states the children developed during hospitalization, all the newborn infants were discharged from hospital in full health, and they were all breastfeeding following discharge in conditions which respected all the epidemiological preventive measures.

12.
Embase; 2021.
Preprint in English | EMBASE | ID: ppcovidwho-331114

ABSTRACT

Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to escalate worldwide and has become a pressing global health concern. This article comprehensively reviews the current knowledge on the impact of COVID-19 over pregnant women and neonates, as well as current recommendations for their management. We also analyse previous evidences from viral respiratory diseases such as SARS, Middle East respiratory syndrome, and influenza that may help to guide clinical practice during the current pandemic. We collected 23 case reports, case series, and case-control studies (18 from China) comprising 174 pregnant women with COVID-19. The majority of mothers showed a clinical presentation of the disease similar to that of non-infected adults. Preliminary evidences point towards a potentially increased risk of pregnancy adverse outcomes in women with COVID-19, with preterm delivery the most frequently observed (16.7%) followed by fetal distress (9.77%). The most commonly reported adverse neonatal outcomes included respiratory symptoms (7.95%) and low birth weight (6.81%). A few studies reported other maternal comorbidities that can influence these outcomes. Mothers with other comorbidities may be at higher risk of infection. Mother-tochild transmission of SARS-CoV-2 appears unlikely, with no study observing intrauterine transmission, and a few cases of neonatal infection reported a few hours after birth. Although the WHO and other health authorities have published interim recommendations for care and management of pregnant women and infants during COVID-19 pandemic, many questions remain open. Pregnant women should be considered in prevention and control efforts, including the development of drugs and vaccines against SARS-CoV-2. Further research is needed to confirm the exact impact of COVID-19 infection during pregnancy. To fully quantify this impact, we urgently need to integrate the current knowledge about viral characteristics, epidemiology, disease immunopathology, and potential therapeutic strategies with data from the clinical practice.

13.
Diagnostics (Basel) ; 12(3)2022 Mar 02.
Article in English | MEDLINE | ID: covidwho-1760429

ABSTRACT

Hepatitis B (HBV) infection is a major public health concern. Perinatal transmission of HBV from mother to child represents the main mode of transmission. Despite the existence of effective immunoprophylaxis, the preventive strategy is inefficient in neonates born to mothers with HBV viral loads above 2 × 105 IU/mL. To prevent mother-to-child transmission, it is important to identify highly viremic pregnant women and initiate antiviral therapy to decrease their viral load. We developed a simple innovative molecular approach avoiding the use of automatic devices to screen highly viremic pregnant women. This method includes rapid DNA extraction coupled with an isothermal recombinase polymerase amplification (RPA) combined with direct visual detection on a lateral flow assay (LFA). We applied our RPA-LFA approach to HBV DNA-positive plasma samples with various loads and genotypes. We designed a triage test by adapting the analytical sensitivity to the recommended therapeutic decision threshold of 2 × 105 IU/mL. The sensitivity and specificity were 98.6% (95% CI: 92.7-99.9%) and 88.2% (95% CI: 73.4-95.3%), respectively. This assay performed excellently, with an area under the ROC curve value of 0.99 (95% CI: 0.99-1.00, p < 0.001). This simple method will open new perspectives in the development of point-of-care testing to prevent HBV perinatal transmission.

14.
American Journal of Obstetrics and Gynecology ; 226(1):S28-S29, 2022.
Article in English | EMBASE | ID: covidwho-1757066

ABSTRACT

Objective: SARS-CoV-2 infection triggers a significant maternal inflammatory response. There is a dearth of data regarding whether maternal SARS-CoV-2 infection or SARS-CoV-2 vaccination triggers an inflammatory response in the fetus. Fetal Inflammatory Response Syndrome (FIRS) has been described in other clinical conditions such as intraamniotic infection and has been defined as a cord blood Interleukin-6 (IL-6) level > 11 pg/ml. The objective of the study is to evaluate Il-6 levels in the cord blood of three delivering women: SARS-CoV-2 infection group, SARS-CoV-2 vaccinated group, and a control group. Study Design: A prospective case control study of a total of 61 pregnant women who presented for delivery at William Beaumont Hospital, Royal Oak, MI. All patients were tested for SARS-CoV-2 infection by polymerase chain reaction test (PCR). Three groups were evaluated: 22 pregnant women with positive SARS-CoV-2 PCR test (case group), 23 Pregnant women with negative SARS-CoV-2 PCR test (control group), and 16 pregnant women who had recent SAR-CoV-2 vaccination and a negative SARS-CoV-2 PCR test. At delivery, cord blood was collected for IL-6 levels. Results: IL-6 level (mean +/- SEM) was for the case group: 8.99 +/- 3.33 pg/ml, control group: 5.19 +/- 0.76 pg/ml, and vaccine group: 7.11 +/- 2.47 pg/ml. There was no statistical difference between the three groups with ANOVA p-value 0.51. Pairwise comparison also revealed no statistical difference with p-values for case versus control, case versus vaccine, and control versus vaccine being 0.52, 0.85, and 0.84 respectively. Conclusion: IL-6, the most sensitive measure of inflammation in obstetric practice, did not identify increased inflammation in PCR negative newborns of vaccinated or SARS-CoV-2 infected mothers. Evaluation using other markers of possible intrauterine inflammation is warranted.

15.
J Matern Fetal Neonatal Med ; 35(8): 1610-1618, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1747012

ABSTRACT

Corona virus disease 2019 started in December 2019 as an outbreak of unexplained pneumonias in Wuhan, a city in Hubei province of China. This illness emerged as an epidemic in China and later spread to almost all countries over the globe except Antarctica. This is caused by a beta Corona virus, which is genetically similar to SARS virus. The predominant mode of transmission is via droplet spread, when the infected person coughs, sneezes or talks the virus is released in the respiratory secretions. As there are only a few cases of COVID 19 in neonates, there is no convincing evidence to support the possibility of vertical transmission. Clinical presentation in neonates is nonspecific, commonly observed are temperature instability, respiratory distress, poor feeding, lethargy, vomiting and diarrhea. Laboratory examinations may be nonspecific. Definitive test for 2019-nCoV is the detection of viral nucleic acid by real-time fluorescence polymerase chain reaction (RT-PCR). Suspected and confirmed COVID positive mothers should be delivered in separate delivery rooms and operation theaters. Since there is no approved treatment or drug for this disease, prevention of infection and breaking the chain of transmission plays a crucial role.


Subject(s)
COVID-19 , SARS Virus , COVID-19/diagnosis , Disease Outbreaks , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , SARS-CoV-2
16.
Open Forum Infectious Diseases ; 8(SUPPL 1):S35, 2021.
Article in English | EMBASE | ID: covidwho-1746791

ABSTRACT

Background. SARS-CoV-2 has exacerbated healthcare disparities. Maine's population of 1.3 million is comprised of only 6% Black, Indigenous, People of Color (BIPOC);however, statewide 18% of SARS-CoV-2 infections have occurred in this group. This study examines newborn care inequities for infants born to mothers with SARS-CoV-2. Methods. This study was conducted at Maine Medical Center in Portland, the largest hospital in Maine. Maternal SARS-CoV-2 infections from March 15, 2020 through April 1, 2021 were identified by PCR near time of delivery. Cases were matched to uninfected women by date of delivery. Chart review was conducted assessing demographic and clinical characteristics, comparing SARS-CoV-2 exposed and unexposed infants. The subset of SARS-CoV-2 exposed infants was further analyzed for trends in care by race. Protocol was exempt by MaineHealth IRB. Results. Twenty four women and their infants were identified with maternal positive SARS-CoV-2 PCR just prior to delivery. An additional 24 unexposed infants were enrolled. When compared to unexposed infants, SARS-CoV-2 exposed were more likely to be racial minorities (63% vs 21%, p = 0.003), to have foreign-born mothers (58% vs 0.4%, p< 0.05) or to receive health care in a language other than English (29% vs 0.4%, p =0.02). For infants born to SARS-CoV-2 infected mothers, only 29% had initial follow up visit in person with their primary care provider (13% of BIPOC infants vs 56% of non-BIPOC infants, p = 0.03). Time to in-person follow up for exposed infants varied by race, with median time of 21 days (range 2-53 days) for racial minorities and 7.5 days (range 2-30 days) for non minorities. All families were discharged with a thermometer and scale for home management. No infants required re-admission during the month after discharge. One exposed infant tested positive for SARS-CoV-2. Conclusion. The American Academy of Pediatrics recommends evaluation of newborns 3-5 days after discharge to identify maternal and child health factors affecting newborn well-being. The SARS-CoV-2 pandemic has made this challenging for patients, particularly for racial minorities. BIPOC pediatric patients were disproportionately affected by the pandemic in Maine, and were disproportionately affected by care discrepancies even when the infant was uninfected.

17.
Open Forum Infectious Diseases ; 8(SUPPL 1):S337, 2021.
Article in English | EMBASE | ID: covidwho-1746527

ABSTRACT

Background. The COVID-19 pandemic was associated with an array of social and economic events, influencing how the pandemic affected people of all genders. In particular, job losses surged during the COVID-19 pandemic, especially among women. We analyzed how the pandemic and rising job losses affected the mental health of unmarried women with and without children in order to identify possible health disparities, potential causal factors and opportunities for interventions. Methods. Data were collected from Wave 3 (January 6-February 15, 2021) of the US Census COVID-19 Household Pulse online survey designed to measure the impact of COVID-19. Microdata files were downloaded from the Census website and included N=13,940 never-married female respondents aged 25-54 years old. Data were analyzed using χ2 tests, with z-tests for more granular between-group comparisons. Results. When asked if they had felt anxiety in the past week, 31% of respondents without children in the household and 28% of those with children reported feeling anxiety nearly every day (p< .05). Among those who did not lose work during the pandemic, 24% of those without children felt anxiety nearly every day vs. 20% of those with children (p< .05). Among those who did experience pandemic-related job loss, 33% of those with children and 42% of those without children reported daily anxiety (p< .05). Conclusion. Overall, COVID-19 job loss was associated with higher levels of anxiety for never-married adult women. Notably, respondents without children expressed significantly higher levels of anxiety than respondents with children, and this difference was even greater when comparing those who had lost jobs during the pandemic. Reasons are being further researched but may be related to mothers' greater opportunities for social and community support, particularly when encountering difficult circumstances. These results have implications for the development of mental health programs serving women experiencing environmental stressors such as job loss, especially women without children who may not have the same mental health and community support.

18.
Indian Journal of Medical Microbiology ; 39:S73, 2021.
Article in English | EMBASE | ID: covidwho-1734517

ABSTRACT

Background:SARS- CoV-2 has radically influenced the health care workers, especially Obstetricians who are at high-risk COVID-19 transmission due to the nature of their specialty as a result of exposure to infectious particles, hence they have to be judg emental in taking up pregnant females. As the Obstetrical population has to go through a unique challenge during this pandemic, the aim of the study was to know the incidence of SARS- CoV-2 positivity rate in pregnant women admitted to hospital for delivery. Furthermore, infected patients may be asymptomatic on admission and may easily transmit the disease during delivery. Methods:The study protocol was approved by the Institutional Review Board and Ethics Committee. It was conducted between Sep- tember and November 2020 at Deccan College of Medical Sciences, includes 75 pregnant women who were screened for SARS -CoV-2 positivity upon admission to the hospital for delivery. Detection of SARS-CoV-2 in Nasopharyngeal and oropharyngeal samples was performed by Real-Time Reverse Transcriptase PCR (RT-PCR) method, targeting Screening Envelope (E) gene and Confirmatory gene RNA dependent RNA polymerase gene (RdRp). Results:Out of 75 women;two (2) women had mild symptoms of fever and shortness of breath on admission respectively, on testing tested positive for SARS-CoV-2. Of the other 73 women admitted without symptoms screened for SARS-CoV-2, two (2) were found to be positive for SARS-CoV-2. Although this prevalence has limited generaliza- bility to geographical regions with lower rates of infection, it underscores the risk of Covid-19 among asymptomatic obstetrical patients. [Formula presented] Conclusions:Health care professionals have to be meticulous about taking precautionary potential steps regarding COVID-19 status of the patient to determine hospital isolation practices and control measures which also includes judicious use of Personal protective equipment. Access to such clinical data from the laboratory provides an important opportunity to pro- tect mothers, babies, and health care teams during these challenging times.

19.
Chin Med Sci J ; 2022 Feb 28.
Article in English | MEDLINE | ID: covidwho-1732612

ABSTRACT

Mother-to-child transmission (MTCT) of syphilis remains a leading cause of stillbirth and death among neonates in many developing countries. In 2007, WHO launched the global elimination of MTCT (EMTCT) of syphilis. Given the high burden of congenital syphilis, China subsequently released the specific national EMTCT policies and programs to reduce MTCT of syphilis. The congenital syphilis incidence rate per 100 000 live births in China has markedly decreased from 69.9 in 2013 to 11.9 in 2019. However, due to the global pandemic of COVID-19, the current measures for eliminating MTCT of syphilis are great challenged. In this article, we summarize the strategies and measures for the EMTCT of syphilis in China in the past 20 years, point out that we have made remarkable achievements due to the national health policy support and strong leadership of the government. In the context of COVID-19 pandemics, strengthening emergency response to the regional outbreaks of COVID-19 and adopting safe, rapid, early and high-quality clinical care to ensure that 100% of pregnant women receive prenatal syphilis testing services, ensuring the availability of Benzathine penicillin for the treatment, and strengthening the closed-loop management of pregnant women and newborns infected with syphilis are key measures to determine the effect of MTCT of syphilis. Lessons from China may be valuable for other countries that are planning to eliminate MTCT of syphilis.

20.
Front Psychol ; 12: 734492, 2021.
Article in English | MEDLINE | ID: covidwho-1731824

ABSTRACT

The COVID-19 pandemic has necessitated innovations in data collection protocols, including use of virtual or remote visits. Although developmental scientists used virtual visits prior to COVID-19, validation of virtual assessments of infant socioemotional and language development are lacking. We aimed to fill this gap by validating a virtual visit protocol that assesses mother and infant behavior during the Still Face Paradigm (SFP) and infant receptive and expressive communication using the Bayley-III Screening Test. Validation was accomplished through comparisons of data (i.e., proportions of missing data for a given task; observed infant and maternal behaviors) collected during in-person laboratory visits and virtual visits conducted via Zoom. Of the 119 mother-infant dyads who participated, 73 participated in lab visits only, 13 participated in virtual visits only, and 33 dyads participated in a combination of lab and virtual visits across four time points (3, 6, 9, and 12 months). Maternal perspectives of, and preferences for, virtual visits were also assessed. Proportions of missing data were higher during virtual visits, particularly for assessments of infant receptive communication. Nonetheless, comparisons of virtual and laboratory visits within a given time point (3, 6, or 9 months) indicated that mothers and infants showed similar proportions of facial expressions, vocalizations and directions of gaze during the SFP and infants showed similar and expected patterns of behavioral change across SFP episodes. Infants also demonstrated comparable expressive and receptive communicative abilities across virtual and laboratory assessments. Maternal reports of ease and preference for virtual visits varied by infant age, with mothers of 12-month-old infants reporting, on average, less ease of virtual visits and a preference for in-person visits. Results are discussed in terms of feasibility and validity of virtual visits for assessing infant socioemotional and language development, and broader advantages and disadvantages of virtual visits are also considered.

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