Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 10 de 10
Filter
1.
Biological Psychiatry ; 91(9):S11, 2022.
Article in English | EMBASE | ID: covidwho-1777988

ABSTRACT

Background: Given the emerging importance of the role of the gut microbiota-brain-axis in mediating prenatal stress-induced neurodevelopmental outcomes, a prospective cohort study was conducted. The COVID-19 Pandemic occurred halfway through study recruitment (n=35). The study aims to a) evaluate perceived stress across gestation, b) determine whether maternal microbiome composition changes with stress, and c) discern the influence of the COVID-19 pandemic on maternal stress, psychometric scores, and alterations in the microbiome. Methods: This longitudinal study design includes five time points across pregnancy and the post-partum period, at which biological samples were collected and psychometrics administered. Samples include maternal rectal and vaginal swabs. Psychometrics include measures of perceived stress, anxiety, depression, sleep, diet, and childhood adversity. Study participants identify as 62.9% White and 31.4% Black or African American. Finally, PacBio full-length 16S rRNA sequencing using SMRT Cell technology is used to identify the maternal rectal and vaginal microbial communities. Results: Participants delivering during the pandemic reporting greater perceived stress (p≤0.05). Of note, there were no significant differences in anxiety or depressive symptoms across gestation in the pre-pandemic participants as compared to participants during the pandemic. During the second trimester, increased depression associated with increased rectal alpha diversity, and increased perceived stress was associated with increased levels of Prevotella, Sneathia, and Gardnerella in the rectal samples. In contrast, participants with increased depressive symptoms during the third trimester had reduced vaginal alpha diversity measures at delivery. Conclusions: Findings suggests maternal perceived stress and depressive symptoms are associated with alterations in maternal microbiota Keywords: Gut Microbiome, Prenatal Maternal Stress, Gut-Brain Axis

2.
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.

3.
Open Access Macedonian Journal of Medical Sciences ; 9(E):1512-1516, 2021.
Article in English | EMBASE | ID: covidwho-1667396

ABSTRACT

BACKGROUND: Reducing and preventing stunting is currently a priority for health programs in Indonesia. As providers of midwifery care, midwives have a strategic position to play a role in accelerating stunting reduction. The provision of continuity of midwifery care is expected to be able to prevent stunting in infants. AIM: This study aims to determine the effectiveness of providing continuity of midwifery care for the incidence of stunting. METHODS: The study design was a cohort from the third trimester of gestation until the baby reached 6 months of age, with the population were all third-trimester pregnant women in the working area of Mapane Health Center. The number of samples was 32 as case and 32 as control. The research variables were the characteristics of the respondents, early initiation of breastfeeding, chronic energy deficiency, hypertension, place of birth, and the incidence of stunting. The hypothesis test was used as Chi-square. Data analysis used the WHO Anthro and STATA applications. RESULTS: The proportion of children who were stunted at the age of 6 months was 15.6%, where the proportion of children who experienced stunting at 6 months of age in the control group was 28.1%, while in the intervention group it was only 3.1%. Providing effective midwifery care to prevent stunting in children showed that maternal age (p = 0.017) and exclusive breastfeeding (p = 0.009) were associated with the incidence of stunting. CONCLUSION: Exclusive breastfeeding can prevent the occurrence of stunting in children.

4.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617065

ABSTRACT

Background: The COVID-19 pandemic has changed the paradigm when it comes to infection control. However, there are still many doubts about pregnancy and the perinatal period in this context, even though many studies suggest the benignity of infection in this phase. The present study took place in a Level II Hospital with differentiated perinatal care and describes the newborns whose mothers were infected with COVID-19 during pregnancy. We aim to understand the mother-newborn pattern of transmission and clinical, analytical and serologic follow-up. Methods: Prospective observational study from 1/4/2020 to 31/5/2021, using the clinical files of every SARS-COV-2 PCR-positive mother and their newborns. Among others, we evaluated the state of infection of the newborn at 12 and 48h and after 14 days with SARS-Cov-2 PCR tests. In the first three months, serologic and clinical evaluation were performed. Results: Of the 1684 live births, 60 (3,6%) mothers were infected with SARS-COV-2 during pregnancy, 43% of which were diagnosed in the screening performed during/before labour. The median value of gestational age was 39 weeks, and the average weight was 3171g. 81,7% of the newborns remained with their mother in the hospital ward, and 85% were breastfed. 7 newborns (11,7%) needed NICU, one of which was born at 32 weeks because the mother needed ICU support due to COVID-19. Of the 26 newborns whose mothers were positive in labour, 15 were tested for SARS-Cov-2 PCR in the first 12 h, and 21 within 48h: all of them were negative.16 were tested after 14 days. Only one of them (6,2%) tested positive but remained asymptomatic. Serologic anti-spike and anti-nucleocapsid analyses were performed in 32 babies: 10 of them (31.3%) showed positive antibodies. In these cases, 80% of the mothers were positive in the 3rd trimester and 20% in the 2nd trimester. The clinical follow-up showed a positive outcome in all of them. Conclusions: This study supports others that show the benignity of perinatal SARS-COV-2 infection. There were no more significant rates of prematurity or NICU need. None of the newborns tested positive in SARS-Cov-2 PCR tests in the first 48h, supporting the rarity of the vertical infection, and only one has been affected by horizontal transmission.

5.
Pakistan Journal of Medical and Health Sciences ; 15(11):3279-3284, 2021.
Article in English | EMBASE | ID: covidwho-1614676

ABSTRACT

Background: Disturbance of haematological parameters is prevalent in pregnancy globally leading to a range of feto-maternal complications. Covid-19 infection has potential to enhance the severity of and complications impending due to anaemia in pregnancy. Objective: To determine the effects of Covid-19 infection on haematological parameters during antenatal care among pregnant women in rural Sindh. Study Design: Cross sectional study. Setting: Shaikh Zaid Institute, Chandka Medical College, Larkana. Duration: From March 1, 2021, and May 31, 2021. Materials and Method: A sample of 110 pregnant women, of 18-50 years of age, presenting in first through third trimester with single alive pregnancy, were included in the study after taking a valid written consent. The Research Evaluation Committee of SMBBMU- Larkana granted approval. Women having any haemoglobinopathy were excluded. Covid-19 test conducted through rt-PCR method. A standard questionnaire was used to collect data of two groups. Analysis was performed through SPSS Version-23. Descriptive and inferential statistics were calculated. Results: Mean ± SD age was 30.3 ± 6.99 (Range: 19 to 45) years. Both groups were identical in age. Mean ± SD gestational age was 28.12 ± 4.66 weeks (Range: 20-38). Covid-19 positive women had lower mean Hb (9.7 ± 2.11) than the covid-19 negative (10.54 ± 2.51;P = 0.158). Other haematological parameters like MCV, serum ferritin, TIBC, TLC & platelets were statistically different between groups. Women of eldest group i-e;in 41-50 years, from urban areas, second trimester (gest. age 13-24 weeks), and nulliparous had been affected more from covid-19 (P = 0.271, 0.748, 0.290 & 0.053). Frequency and severity of anaemia was more among Covid-19 positive women. Conclusion: Covid‐19 demands maternal healthcare to be extra vigilant to the haematological parameters of pregnant women during antenatal care till delivery.

6.
Psychoneuroendocrinology ; 131, 2021.
Article in English | EMBASE | ID: covidwho-1610894

ABSTRACT

Background: The research aimed to examine the biological and psychological aspects of stress in pregnant women during a coronavirus pandemic. Specifically, we focused on hair cortisol levels that reflect the second and third trimester of pregnancy, perceived stress, pregnancy anxiety and fear of coronavirus. Methods: Research group consisted of 40 pregnant women (21 primiparous and 19 multiparous women). A battery of questionnaires consisting of PSS-10, PRAQ-R2, FCV-19S. Results: The results showed that pregnant women had significantly higher levels of hair cortisol in the 3rd trimester compared to the 2nd trimester (z=-2,850, p=0,004, d=-0,45). In pregnancy anxiety, multiparous women had significantly higher scores compared to primiparous women (t(28,81)=- 2,90, p=0,007, d=0,48 especially in the subscale concerns about changes in appearance. There was no relationship between fear of coronavirus and pregnancy anxiety (r=0,301, p=0,059). Conclusion: In the 3rd trimester demonstrated significantly higher levels of hair cortisol in pregnant women compared to with the 2nd trimester, and these findings are consistent with other studies.

7.
American Journal of Obstetrics and Gynecology ; 226(1):S774-S775, 2022.
Article in English | EMBASE | ID: covidwho-1588398

ABSTRACT

Objective: Prior studies have shown maternal viral infections are associated with fetal growth restriction (FGR);however, the relationship between FGR and Sars-CoV-2 (SCOV2) infection during pregnancy remains unclear. In this study, we investigate the association between FGR & parental SCOV2 infection at a county hospital in Atlanta, Georgia. Study Design: A prospective cohort study was created by matching patients who had positive SCOV2 (PSCOV2) and negative SCOV2 (NSCOV2) PCR tests between 1/2020-4/2021 utilizing an institutional database. Cohorts were drawn from patients who received a 3rd trimester ultrasound (3TUS) & were matched by gestational age & month SCVO2 testing was performed. FGR was present when estimated fetal weight (EFW) was ≤10% or abdominal circumference (AC) ≤10% at time of either late 2nd or 3rd trimester ultrasound. Sample size calculations were performed to investigate a 15% difference in FGR rate requiring 74 subjects per group. Univariate analyses, chi-square tests and logistic regression were performed. Regression models were adjusted for comorbidities including preeclampsia, gestational diabetes, chronic hypertension, gestational hypertension, and maternal race. Results: 157 subjects were in the analyses (n=78 PSCOV2 and n=79 NSCVO2). 83.4% (n =131) self-identified as African American. FGR rates were 15.3% and 16.4% among PSCOV2 and NSCOV2 respectively. After adjusting for confounders, no difference in FGR was observed between the groups (adjusted OR: 1.12, 95% CI 0.46-2.73). Absolute EFW at time of FGR diagnosis was lower in PSCOV2 vs NSCOV2 (1,250 grams vs.1,337 grams, p= 0.015), a relationship that remained after adjusting for confounders (p=0.015). Conclusion: Our data suggest that despite a high background FGR rate (15.2%), there was no significant association between FGR and SCOV2. Also, EFW was lower in PSCOV2 cohort vs NSCOV2 cohort. Therefore, unlike other viral illnesses, while SCOV2 may not clinically drive FGR, further studies are necessary to investigate the effects of maternal SCVO2 on fetal growth & examine whether growth exams improve outcomes in this setting.

8.
European Heart Journal ; 42(SUPPL 1):1843, 2021.
Article in English | EMBASE | ID: covidwho-1554210

ABSTRACT

Background: Novel coronavirus (COVID-19) has been a world concern since December 2019. The knowledge about vertical transmission and fetal morbidity and mortality from maternal COVID-19 infection is limited.We detected an increase in the number of cases of term and near-term neonates with persistent pulmonary hypertension (PPHN) during the COVID-19 pandemic in 2020. Methods and results: We collected data on all newborns with PPHN born between 2018 and 2020. We excluded premature infants (<34+0 weeks) and infants with other significant pathology or genetic syndromes. Compared to 5 cases of PPHN of 22930 live births in 2018, and 6 cases of PPHN of 22270 live births in 2019 (2-year average 0.02%, 95% CI 0.013%- 0.043%), there were 16 PPHN cases from 22323 live births in 2020 (0.07%, 95% CI 0.044%-0.12%), a 3 fold increase (p<0.01). We report 5 cases of term and near-term neonates born to mothers who had highly suspected (2) and PCR proven (3) COVID-19 infection during the third trimester of pregnancy, who presented with PPHN during COVID-19 pandemic in 2020. All had otherwise unexplained pulmonary hypertension, right ventricular hypertrophy (RVH) and dilatation. Two patients needed endotracheal intubation, one was supported by nasal continuous positive airway pressure (CPAP) without intubation, two needed O2 support by nasal cannula only ant two newborns (one of them was intubated) needed Nitric oxide (NO) as pulmonary vasodilator therapy. No patient required Extracorporeal membrane oxygenation (ECMO) or died, and no prolonged residual cardiovascular or pulmonary morbidity was recorded during a median follow up of 4.8 months (range 4-6 months). Conclusions: The increase in the incidence of PPHN during the COVID- 19 pandemic, and the cases presented, suggest an intrauterine effect of maternal COVID-19 infection on the fetal pulmonary circulation. It is possible that the maternal infection affected the fetal pulmonary vascular resistance, or altered the normal decline in the resistance after birth. The right ventricular hypertrophy and dilatation with reduced function may be secondary to this hypothetical increased afterload or a direct effect of the infection. Further studies are warranted to elucidate the pathogenesis and clinical implications of this phenomenon.

9.
Diagn Pathol ; 16(1): 8, 2021 Jan 14.
Article in English | MEDLINE | ID: covidwho-1028621

ABSTRACT

AIMS: To explore the clinical characteristics and placental pathological changes of pregnant women with 2019 novel coronavirus (CoV) disease (COVID-19) in the third trimester, and to assess the possibility of vertical transmission. METHODS AND RESULTS: The placenta tissues were evaluated by using immunohistochemistry for inflammatory cells and Hofbauer cells, and using severe acute respiratory syndrome (SARS) CoV-2 RNA Fluorescence In-Situ Hybridization (FISH) and SARS-CoV-2 spike protein immunofluorescence (IF) double staining. All eight placentas from the third trimester pregnancy women were studied. All patients were cured, no clinical or serological evidence pointed to vertical transmission of SARS-CoV-2. Features of maternal vascular malperfusion (MVM) such as increased syncytial knots were present in all 8 cases (8/8), and increased focal perivillous fibrin depositions were presented in 7 cases (7/8). No significate chronic histiocytic intervillositis was noted in the placenta. The number of macrophages and inflammatory cells such as T cells, B cells and plasma cells in the placental villous was not significantly increased in all cases. Moreover, all of eight cases demonstrated negative results by FISH using a SARS-CoV-2 virus RNA probe and by IF using a monoclonal antibody against SARS-CoV-2 spike protein. CONCLUSIONS: We found no evidence of vertical transmission and adverse maternal-fetal outcomes in the placentas of third trimester COVID-19 pregnancy women, which provided further information for the clinical management of those women in the third trimester. However, further studies are still needed for patients with infections in different stage of gestation, especially in first and second trimester.


Subject(s)
COVID-19/virology , Placenta/virology , Pregnancy Complications, Infectious/virology , SARS-CoV-2/pathogenicity , Adult , Female , Humans , Pregnancy , Pregnancy Trimester, Third/immunology , Pregnant Women , Spike Glycoprotein, Coronavirus/metabolism
10.
Open Forum Infect Dis ; 7(9): ofaa345, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-729188

ABSTRACT

We report a case of COVID-19 in third-trimester pregnancy, who required support in an intensive care unit and received remdesivir. After discharge, she had an uncomplicated vaginal delivery at term. COVID-19 in pregnancy may be managed without emergent delivery; a multispecialty team is critical in caring for these patients.

SELECTION OF CITATIONS
SEARCH DETAIL