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1.
J Pediatr ; 242: 137-144.e4, 2022 03.
Article in English | MEDLINE | ID: covidwho-1751121

ABSTRACT

OBJECTIVE: We hypothesized that a cumulative heart rate characteristics (HRC) index in real-time throughout the neonatal intensive care unit (NICU) hospitalization, alone or combined with birth demographics and clinical characteristics, can predict a composite outcome of death or neurodevelopmental impairment (NDI). STUDY DESIGN: We performed a retrospective analysis using data from extremely low birth weight infants who were monitored for HRC during neonatal intensive care. Surviving infants were assessed for NDI at 18-22 months of age. Multivariable predictive modeling of subsequent death or NDI using logistic regression, cross-validation with repeats, and step-wise feature elimination was performed each postnatal day through day 60. RESULTS: Among the 598 study participants, infants with the composite outcome of death or moderate-to-severe NDI had higher mean HRC scores during their stay in the NICU (3.1 ± 1.8 vs 1.3 ± 0.8; P < .001). Predictive models for subsequent death or NDI were consistently higher when the cumulative mean HRC score was included as a predictor variable. A parsimonious model including birth weight, sex, ventilatory status, and cumulative mean HRC score had a cross-validated receiver-operator characteristic curve as high as 0.84 on days 4, 5, 6, and 8 and as low as 0.78 on days 50-52 and 56-58 to predict subsequent death or NDI. CONCLUSIONS: In extremely low birth weight infants, higher mean HRC scores throughout their stay in the NICU were associated with a higher risk of the composite outcome of death or NDI. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00307333.


Subject(s)
Infant, Extremely Low Birth Weight , Intensive Care Units, Neonatal , Birth Weight , Heart Rate/physiology , Humans , Infant , Infant, Newborn , Retrospective Studies
2.
PLoS One ; 17(3): e0265147, 2022.
Article in English | MEDLINE | ID: covidwho-1745312

ABSTRACT

PURPOSE: To investigate changes in the number of preterm infants, low birth weight infants, and infants with fetal growth restriction (FGR) or retinopathy of prematurity (ROP) during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: In this retrospective cross-sectional study, we reviewed the medical records of infants born and admitted to the neonatal intensive care unit and growth care unit of Shiga University of Medical Science Hospital before the COVID-19 pandemic (April 1, 2019 to September 30, 2019) and during the pandemic (April 1, 2020 to September 30, 2020). Medical records of infants' mothers were also collected. Preterm infants, low birth weight infants, infants with FGR, infant and maternal factors associated with FGR, and infants requiring treatment for ROP were compared between the two periods. RESULTS: There were fewer infants born at < 28 weeks of gestation, infants with birth weight < 1,500 g, and infants with FGR during the pandemic period than the pre-pandemic period (pre-pandemic: n = 4 vs. during pandemic: n = 0, P = 0.048; pre-pandemic: n = 15 vs. during pandemic: n = 6, P = 0.02; and pre-pandemic: n = 31 vs. during pandemic: n = 12, P = 0.0002, respectively). There were no significant differences in any infant or maternal factors associated with FGR. The number of infants requiring treatment for ROP decreased during the pandemic, although this difference was not statistically significant (pre-pandemic: n = 3 vs. during pandemic: n = 0, P = 0.08). CONCLUSIONS: Our findings showed a reduction in the number of infants with FGR during the COVID-19 pandemic. The number of infants born at < 28 weeks of gestation and infants with birth weight < 1,500 g also decreased during the pandemic period. There was a trend toward fewer infants requiring treatment for ROP during the COVID-19 pandemic.


Subject(s)
COVID-19/epidemiology , Fetal Growth Retardation/epidemiology , Infant, Premature , Retinopathy of Prematurity/epidemiology , Birth Weight , Cross-Sectional Studies , Female , Gestational Age , Humans , Infant, Low Birth Weight , Infant, Newborn , Intensive Care Units, Neonatal , Japan/epidemiology , Male , Retrospective Studies
3.
Taiwan J Obstet Gynecol ; 60(6): 1043-1046, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1525965

ABSTRACT

OBJECTIVES: Aim of this study is to evaluate the prognosis of pregnant women having SARS-CoV-2 infection and investigate whether there was a difference in perinatal outcomes between pregnant women who had SARS-CoV-2 infection and those who did not. MATERIALS AND METHODS: This prospective observational study was conducted with 116 singleton pregnancies. Cases enrolling in the study were divided into two groups. While those in the first group had a history of SARS-CoV-2 infection (n = 46) the second group consisted of healthy pregnant women (n = 70). RESULTS: Emergency Cesarean section was performed on three SARS-CoV-2 infected pregnancies (30, 33 and 34 gestational weeks). Intensive care unit admission was required for all three cases after delivery and two of them died. Among the pregnancies that had an infection in the third trimester, 71.4% (n = 20) of them had delivery in 14 days after diagnosis and 17.4% (n = 8) of their newborns were followed up at newborn intensive care unit. Overall, only one newborn had a positive swab test result for SARS-CoV-2. There was no statistically significant difference between groups regarding their delivery week (37.02 ± 5.85 vs 38.5 ± 2.33). Similarly, there was no significant difference between groups, concerning mean age, parity, and birth weight (P = 0.707, P = 0.092, P = 0.334; P < 0.05). Furthermore, the difference between SARS-CoV-2 infected pregnancies that were followed up as inpatient or outpatient with respect to the delivery week and birth weight was not significant (p > 0.05). Also, APGAR 5 scores of hospitalized women (9.3 ± 1.1) were found to be lower than the outpatient group (9.8 ± 0.8) (P = 0.043; p < 0.05). CONCLUSION: No significant difference was detected between groups in terms of the delivery week, birth weight, and APGAR scores. The inpatient group was found to have lower APGAR 5 scores.


Subject(s)
COVID-19/diagnosis , Cesarean Section/statistics & numerical data , Delivery, Obstetric , Infectious Disease Transmission, Vertical , Pregnancy Complications, Infectious/mortality , Pregnant Women/psychology , Abortion, Spontaneous/epidemiology , Birth Weight , COVID-19/mortality , COVID-19/therapy , COVID-19/virology , Female , Humans , Infant, Newborn , Pandemics , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/therapy , Pregnancy Complications, Infectious/virology , Pregnancy Outcome , Premature Birth/epidemiology , SARS-CoV-2
4.
Pediatr Infect Dis J ; 40(12): e475-e481, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1462545

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) infection during pregnancy has been associated with adverse perinatal outcomes. We aim to evaluate the neonatal outcomes including the incidence of preterm birth, admission to the neonatal unit and incidence of congenital anomalies in this cohort. We will also describe these outcomes in the context of the B.1.1.7. variant outbreak, the dominant variant in Ireland since January 2021, which has had a greater impact on pregnant patients. METHODS: This was a retrospective study of liveborn infants, delivered between 1st March 2020 and 1st March 2021, to women with a severe acute respiratory syndrome coronavirus 2 diagnosis during pregnancy, in a tertiary maternity hospital (8,500 deliveries/year). Clinical data were collected, and analyses were performed to evaluate the impact of maternal symptom status, time from diagnosis to delivery and the B.1.1.7. variant on neonatal outcome. RESULTS: In total 133 infants (1.6%) were born to women with severe acute respiratory syndrome coronavirus 2 identified during pregnancy. The median birth weight was 3.45 kg and gestational age at birth was 39.3 weeks. 14 infants (10.5%) were preterm. 22 infants (16.5%) required admission to the neonatal unit and 7 (5.3%) were small for gestational age. There was no difference in growth, preterm birth or neonatal unit admission based on maternal symptom status or infection after the outbreak of B.1.1.7. as the dominant strain. CONCLUSIONS: Following a COVID-19 infection in pregnancy, there was no increase in the incidence of preterm birth or neonatal intensive care unit admission compared with 5-year hospital data. Maternal symptom status did not influence neonatal outcomes. Further studies to evaluate the impact of COVID-19 in early pregnancy, the variants of concern, particularly the emerging Delta variant and COVID-19 placentitis are required.


Subject(s)
Birth Weight , COVID-19/complications , Gestational Age , Pregnancy Complications, Infectious/virology , Premature Birth , Adult , COVID-19/genetics , Female , Humans , Infant, Newborn , Placenta Diseases/virology , Pregnancy , Retrospective Studies , SARS-CoV-2
5.
Sci Rep ; 11(1): 13535, 2021 06 29.
Article in English | MEDLINE | ID: covidwho-1287821

ABSTRACT

As the novel coronavirus (COVID-19) has spread globally, a significant portion of pregnant and delivering women were infected with COVID-19. While emerging studies examined birth outcomes in COVID-19 positive women, knowledge of the psychological experience of childbirth and maternal wellness remains lacking. This matched-control survey-based study included a sample of women recruited during the first wave of the pandemic in the US who gave birth in the previous six months. Women reporting confirmed/suspected COVID-19 (n = 68) during pregnancy or childbirth were matched on background factors with women reporting COVID-19 negativity (n = 2,276). We found nearly 50% of COVID positive women endorsed acute traumatic stress symptoms at a clinical level in response to childbirth. This group was more than twice as likely to endorse acute stress and to have no visitors during maternity hospitalization than COVID negative women; they were also less likely to room-in with newborns. The COVID positive group reported higher levels of pain in delivery, lower newborn weights, and more infant admission to neonatal intensive care units. Our findings suggest COVID-19 affected populations are at increased risk for traumatic childbirth and associated risk for psychiatric morbidity. Attention to delivering women's wellbeing is warranted during the pandemic.


Subject(s)
COVID-19/psychology , Parturition/psychology , Pregnant Women/psychology , Stress Disorders, Post-Traumatic/diagnosis , Adult , Anxiety/diagnosis , Birth Weight , COVID-19/diagnosis , COVID-19/virology , Female , Hospitals , Humans , Infant, Newborn , Intensive Care Units, Neonatal , Pain/pathology , Patient Admission/statistics & numerical data , Pregnancy , SARS-CoV-2/isolation & purification , Stress, Psychological , Surveys and Questionnaires
6.
Infect Dis Obstet Gynecol ; 2021: 9952701, 2021.
Article in English | MEDLINE | ID: covidwho-1277021

ABSTRACT

During the coronavirus disease 2019 (COVID-19) pandemic, the number of pregnant women and neonates suffering from COVID-19 increased. However, there is a lack of evidence on clinical characteristics and neonatal outcomes in pregnant women with COVID-19. We evaluated short-term outcomes (4 weeks postdischarge) and symptoms in neonates born to mothers infected with COVID-19. In this retrospective cohort study, we included all neonates born to pregnant women with COVID-19 admitted to Ayatollah Rohani Hospital, Babol, Iran, from February 10 to May 20, 2020. Clinical features, treatments, and neonatal outcomes were measured. Eight neonates were included in the current study. The mean gestational age and birth weight of newborns were 37 ± 3.19 weeks (30₊6-40) and 3077.50 ± 697.64 gr (1720-3900), respectively. Apgar score of the first and fifth minutes in all neonates was ≥8 and ≥9 out of 10, respectively. The most clinical presentations in symptomatic neonates were respiratory distress, tachypnea, vomiting, and feeding intolerance. This manifestation and high levels of serum C-reactive protein (CRP) in three infants are common in neonatal sepsis. The blood culture in all of them was negative. They have been successfully treated with our standard treatment. Our pregnant women showed a pattern of clinical characteristics and laboratory results similar to those described for nonpregnant COVID-19 infection. This study found no evidence of intrauterine or peripartum transmission of COVID-19 from mother to her child. Furthermore, the long-term outcomes of neonates need more study.


Subject(s)
COVID-19/epidemiology , Infectious Disease Transmission, Vertical , Pregnancy Complications, Infectious/epidemiology , Respiratory Distress Syndrome, Newborn/epidemiology , SARS-CoV-2/isolation & purification , Apgar Score , Birth Weight , COVID-19/complications , COVID-19/diagnosis , COVID-19/transmission , COVID-19 Nucleic Acid Testing/statistics & numerical data , Female , Follow-Up Studies , Gestational Age , Humans , Infant, Low Birth Weight , Infant, Newborn , Infant, Premature , Iran/epidemiology , Lung/diagnostic imaging , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/virology , RNA, Viral/isolation & purification , Respiratory Distress Syndrome, Newborn/diagnosis , Respiratory Distress Syndrome, Newborn/virology , Retrospective Studies , SARS-CoV-2/genetics
7.
BMC Pregnancy Childbirth ; 21(1): 378, 2021 May 17.
Article in English | MEDLINE | ID: covidwho-1232423

ABSTRACT

BACKGROUND: Physiological changes during pregnancy put pregnant women at higher risk for COVID-19 complications. The objective of this study was to evaluate clinical and laboratory characteristics and outcomes of 24 COVID-19 pregnant patients and their newborns referred to the Al-Zahra tertiary maternity hospital in Tabriz, Iran. METHODS: Clinical records of 24 COVID-19 confirmed pregnant patients were retrospectively reviewed from10 March 2020 to 15 April 2020. Vertical transition was assessed through neonatal pharyngeal swab samples. The study has been approved by the Tabriz University Medical Ethics Committee (IR.TBZMED.REC.1399.497). RESULTS: There were 24 hospitalized cases with clinical symptoms and confirmed diagnosis of COVID-19. The mean age of cases was 26.5 years; most were nulliparous (54.2%), in their third trimester (62.5%) and were in the type A blood group. Clinical symptoms in order of prevalence were cough, fever, dyspnea, myalgia, anosmia, and diarrhea. Oxygen saturation (SpO2) in 70.8% cases was in the normal range (greater than 93%). The risk of premature labor or abortion in cases showed no increase. 12 cases were in ongoing normal status; on follow up, 11 cases had delivered their babies at term and one had ended in IUFD because of pregnancy-induced hypertension. All delivered babies were healthy. Caesarean section in all cases was performed under obstetric indications or maternal demand, and no relation was found between COVID-19 and Caesarean delivery. Neonatal outcomes according to gestational age in 8 cases out of 11 (72.72%) were desirable; neonatal morbidity and mortality resulted from pregnancy complications. Blood pH in 6 neonates was assessed due to immaturity and NICU admission, all of which were in normal ranges except one case related to HELLP syndrome. There was no evidence of vertical transmission. CONCLUSIONS: Findings suggest that clinical symptoms in pregnancy were similar to non-pregnant women, no rise in risk of premature labor or abortion was seen, and vertical transmission was not observed in none of cases. Lymphopenia was the leading laboratory change. Given asymptomatic cases despite severe forms of infection in pregnancies, we propose screening in all suspected cases. All placentas and newborns should be tested in the field for vertical transmission.


Subject(s)
COVID-19/epidemiology , Hospitalization , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome , Adolescent , Adult , Apgar Score , Birth Weight , Cesarean Section/statistics & numerical data , Delivery, Obstetric , Female , Humans , Infant, Newborn , Iran/epidemiology , Leukocyte Count , Oxygen/blood , Pre-Eclampsia , Pregnancy , Retrospective Studies , Young Adult
8.
Int J Gynaecol Obstet ; 150(1): 53-57, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-1196386

ABSTRACT

OBJECTIVE: To study vaginal delivery outcomes and neonatal prognosis and summarize the management of vaginal delivery during the COVID-19 pandemic. METHODS: A retrospective analysis of medical records and comparison of vaginal delivery outcomes between 10 pregnant women with clinical diagnosis of COVID-19 and 53 pregnant women without COVID-19 admitted to Zhongnan Hospital of Wuhan University between January 20 and March 2, 2020. Results of laboratory tests, imaging tests, and SARS-CoV-2 nucleic acid tests were also analyzed in neonates delivered by pregnant women with clinical diagnosis of COVID-19. RESULTS: There were no significant differences in gestational age, postpartum hemorrhage, and perineal resection rates between the two groups. There were no significant differences in birth weight of neonates and neonatal asphyxia rates between the two groups. Neonates delivered by pregnant women with clinical diagnosis of COVID-19 tested negative for SARS-CoV-2 infection. CONCLUSIONS: Under the premise of full evaluation of vaginal delivery conditions and strict protection measures, pregnant women with ordinary type COVID-19 can try vaginal delivery without exacerbation of COVID-19 and without increasing the risk of SARS-CoV-2 infection in neonates.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Delivery, Obstetric/methods , Pneumonia, Viral/complications , Pregnancy Complications, Infectious/virology , Pregnancy Outcome/epidemiology , Adult , Birth Weight , COVID-19 , China/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Female , Hospitalization , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical/statistics & numerical data , Pandemics , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Postpartum Hemorrhage/epidemiology , Postpartum Hemorrhage/virology , Pregnancy , Retrospective Studies , SARS-CoV-2 , Vagina/virology
9.
Eur J Obstet Gynecol Reprod Biol ; 259: 7-11, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1068900

ABSTRACT

BACKGROUND: The pandemic of the severe acute respiratory distress syndrome-associated Coronavirus-2 (SARS-CoV-2) has affected millions around the world. In pregnancy the dangers to the mother and fetus are still being explored. SARS-CoV2 can potentially compromise maternal and neonatal outcomes and this may be dependent on the pregnancy stage during which the infection occurs. OBJECTIVE: The present study was done to find the histopathological alterations in the placenta of SARS-CoV-2 positive pregnancies with either no symptoms or mild coronavirus disease (COVID)-19 related symptoms and its association with neonatal outcomes. STUDY DESIGN: This was a prospective analytical study. Twenty seven asymptomatic or mildly symptomatic SARS-CoV-2 positive pregnant women with a singleton pregnancy delivered between 1st July 2020 and 15th September 2020, were included as cases. An equal number of SARS-CoV-2 negative singleton pregnancies matched for maternal and gestational age during the same period were included as controls. After delivery the histopathological examination of the placenta of these women was done and the findings recorded on a predesigned proforma based on the Amsterdam consensus criteria for evidence of maternal and fetal vascular malperfusion changes. RESULTS: The baseline characteristics were comparable between the cases and controls. The following features of maternal vascular malperfusion (MVM) were significantly higher in the placentae of COVID-19 positive pregnancies: retroplacental hematomas (RPH), accelerated villous maturation (AVM), distal villous hyperplasia (DVH), atherosis, fibrinoid necrosis, mural hypertrophy of membrane arterioles (MHMA), vessel ectasia and persistence of intramural endovascular trophoblast (PIEVT). Fetal vascular malperfusion (FVM) significantly associated with the positive pregnancies were chorioangiosis, thrombosis of the fetal chorionic plate (TFCP), intramural fibrin deposition (IMFD) and vascular ectasia. Additionally, perivillous fibrin deposition was also significantly higher in the placentae of cases. The percentage of spontaneously delivered women was comparable in the two groups. The sex and weight of the newborn and the number of live births were comparable between the two groups. CONCLUSIONS: Asymptomatic or mildly symptomatic SARS-CoV-2 positive pregnant women, with otherwise uncomplicated pregnancies, show evidence of placental injury at a microscopic level. Similar findings have been demonstrated in other studies too. This placental injury apparently does not lead to poor pregnancy outcomes. The extent of this injury in symptomatic cases of COVID-19 pregnancies and its consequences on the outcomes need to be analysed.


Subject(s)
COVID-19/pathology , Placenta Diseases/pathology , Placenta/pathology , Pregnancy Complications, Infectious/pathology , Adult , Birth Weight , COVID-19/complications , COVID-19/physiopathology , Carrier State , Case-Control Studies , Female , Humans , Infant, Newborn , Male , Placenta/blood supply , Placenta Diseases/etiology , Placenta Diseases/physiopathology , Pregnancy , Pregnancy Complications, Infectious/physiopathology , Pregnancy Outcome , Prospective Studies , SARS-CoV-2 , Severity of Illness Index , Young Adult
10.
Am J Hum Biol ; 32(5): e23385, 2020 09.
Article in English | MEDLINE | ID: covidwho-995839

ABSTRACT

OBJECTIVES: To analyze the relationship of birth weight, birth order, breastfeeding duration, and age of introduction of solid foods with height, fat mass, and fat-free mass in a sample of Maya children when aged 6 to 8 years old. METHODS: We collected data on anthropometry, body composition, children's birth weight, birth order, early feeding practices, and household socioeconomic characteristics in a sample of 260 Maya children aged 6 to 8 years living in Merida and Motul, two cities in Yucatan, Mexico. Multiple regression models were performed to identify variables associated with height-for-age (HAZ), fat mass index (FMI), and fat-free mass index (FFMI). The predictors included in the models were birth weight (kg), birth order, duration of breastfeeding (months), age at introduction of solid foods (months), maternal age (years), and height (cm). Models were adjusted for the influence of children's age and sex, maternal educational level, and household overcrowding. RESULTS: HAZ was positively associated with child birthweight and maternal height and age, but inversely associated with birth order and age of introduction of solid foods. FMI was positively associated with birth weight, maternal age, and height, and negatively associated with birth order. FFMI was positively associated with maternal age and birth weight. CONCLUSIONS: These results are evidence of the importance of the first 1000 days of life for the growth and body composition of Maya children and contributed to understand the development of nutritional dual burden in this population.


Subject(s)
Birth Order , Birth Weight , Child Development , Eating , Feeding Behavior , Age Factors , Child , Female , Humans , Male , Mexico
11.
BMJ Open ; 10(11): e039933, 2020 11 03.
Article in English | MEDLINE | ID: covidwho-910339

ABSTRACT

INTRODUCTION: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has been growing at an accelerating rate, and has become a public health emergency. Pregnant women and their fetuses are susceptible to viral infection, and outcomes in this population need to be investigated. METHODS AND ANALYSIS: PubMed, Web of Science, Embase, CINAHAL, Latin American and Caribbean Health Sciences Literature, clinicaltrials.gov, SCOPUS, Google Scholar and Cochrane Central Controlled Trials Registry will be searched for observational studies (cohort and control cases) published from December 2019 to present. This systematic review and meta-analysis will include studies of pregnant women at any gestational stage diagnosed with COVID-19. The primary outcomes will be maternal and foetal morbidity and mortality. Three independent reviewers will select the studies and extract data from the original publications. The risk of bias will be assessed using the Newcastle-Ottawa Scale for observational studies. To evaluate the strength of evidence from the included data, we will use Grading of Recommendation Assessment, Development, and Evaluation method. Data synthesis will be performed using Review Manager software V.5.2.3. To assess heterogeneity, we will compute the I2 statistics. Additionally, a quantitative synthesis will be performed if the included studies are sufficiently homogenous. ETHICS AND DISSEMINATION: This study will be a review of the published data, and thus it is not necessary to obtain ethical approval. The findings of this systematic review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: PROSPERO 2020: CRD42020181519.


Subject(s)
Coronavirus Infections , Fetal Mortality , Maternal Mortality , Pandemics , Pneumonia, Viral , Pregnancy Complications, Infectious , Pregnancy Outcome , Betacoronavirus , Birth Weight , COVID-19 , Female , Fetal Diseases , Fetal Distress , Humans , Infant, Newborn , Infant, Newborn, Diseases , Meta-Analysis as Topic , Pregnancy , SARS-CoV-2 , Stillbirth , Systematic Reviews as Topic
12.
J Perinat Med ; 49(3): 263-268, 2021 Mar 26.
Article in English | MEDLINE | ID: covidwho-902091

ABSTRACT

OBJECTIVES: Data regarding the pathogenesis and clinical manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to emerge, however, there's limited data in regard to maternal and neonatal outcomes. Therefore, we conducted a retrospective analysis of all pregnant women who tested positive for SARS-CoV-2 within Nuvance Health system. METHODS: Data were abstracted from the medical records of each patient and descriptive analysis was performed. Variables included demographics, COVID testing results, symptoms, management, labor course, neonatal information, and complications. RESULTS: Total of 40 patients were identified. Average age was 29.6 years old, 35% were Hispanic, and approximately one in three patients had comorbidities. Of the patients who had repeated testing, the average number of days between first positive test and negative test was 36.8 days (± 19.9 days). Three out of four women reported symptoms. Of the 40 pregnant women who were positive for SARS-CoV-2, 25 of them delivered. About 84% of the women delivered after 37 weeks. Twelve percent of the women delivered under 33 and 6/7 weeks. Most patients had vaginal deliveries (68%) and the remaining had cesarean deliveries. Neonatal outcomes included: mean 1 and 5 min Apgar scores of 8 and 8.8, respectively and the mean birth weight was 3212 g. Twenty neonates were tested for SARS-CoV-2 and were all found to be negative. CONCLUSIONS: Overall, with routine prenatal care and preventive measures, pregnant patients and neonates in our study had good outcomes. At this time, there appears to be no evidence of vertical transmission.


Subject(s)
COVID-19 Testing , COVID-19 , Infectious Disease Transmission, Vertical , Perinatal Care/methods , Pregnancy Complications, Infectious , Adolescent , Adult , Apgar Score , Birth Weight , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , COVID-19/transmission , Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Infectious Disease Transmission, Vertical/statistics & numerical data , Male , New York/epidemiology , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/therapy , Pregnancy Outcome , Retrospective Studies , Treatment Outcome , Young Adult
13.
Sci Rep ; 10(1): 18126, 2020 10 22.
Article in English | MEDLINE | ID: covidwho-889217

ABSTRACT

This systematic review and meta-analysis aimed to evaluate the impact of COVID-19 on pregnant women. We searched for qualified studies in PubMed, Embase, and Web of Science. The clinical characteristics of pregnant women with COVID-19 and their infants were reported as means and proportions with 95% confidence interval. Eleven studies involving with 9032 pregnant women with COVID-19 and 338 infants were included in the meta-analysis. Pregnant women with COVID-19 have relatively mild symptoms. However, abnormal proportions of laboratory parameters were similar or even increased, compared to general population. Around 30% of pregnant women with COVID-19 experienced preterm delivery, whereas the mean birth weight was 2855.9 g. Fetal death and detection of SARS-CoV-2 were observed in about 2%, whereas neonatal death was found to be 0.4%. In conclusion, the current review will serve as an ideal basis for future considerations in the treatment and management of COVID-19 in pregnant women.


Subject(s)
Coronavirus Infections/pathology , Perinatal Death/etiology , Pneumonia, Viral/pathology , Premature Birth/etiology , Betacoronavirus/isolation & purification , Birth Weight , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/virology , Female , Fetal Death/etiology , Humans , Infant, Newborn , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/virology , Pregnancy , SARS-CoV-2
14.
PLoS One ; 15(8): e0237420, 2020.
Article in English | MEDLINE | ID: covidwho-713718

ABSTRACT

OBJECTIVE: To prevent the rapid spread of COVID-19, the Chinese government implemented a strict lockdown in Wuhan starting on 23 January, 2020, which inevitably led to the changes in indications for the mode of delivery. In this retrospective study, we present the changes in the indications for cesarean delivery (CD) and the birth weights of newborns after the lockdown in Wuhan. METHODS: A total of 3,432 pregnant women in the third trimester of their pregnancies who gave birth in our hospital from 23 January 2019 to 24 March 2020 were selected as the observation group, while 7,159 pregnant women who gave birth from 1 January 2019 to 22 January 2020 were selected as the control group; control group was matched using propensity score matching (PSM). A comparative analysis of the two groups was performed with the chi-square test, t test and rank sum test. RESULTS: The difference in the overall rate of CD between the two groups was not statistically significant (p<0.05). Among the indications for CD, CD on maternal request (CDMR) and fetal distress were also significantly more common in the observation group (p<0.05) than the control group. Furthermore, we found that the weight of newborns was significantly heavier in the observation group than in the control group when considering full-term or close-to-full-term births (p<0.05). CONCLUSIONS: The results may provide useful information to management practices regarding pregnancy and childbirth after lockdown in other cities or countries, enabling better control of the rate of CD due to CDMR, reducing fetal distress, and controlling newborn weight. We recommend that pregnant women pay more attention to controlling the weight of newborns through diet and exercise.


Subject(s)
Betacoronavirus , Birth Weight , Cesarean Section , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Quarantine/methods , Adolescent , Adult , COVID-19 , China/epidemiology , Coronavirus Infections/virology , Female , Fetal Distress , Humans , Infant, Newborn , Middle Aged , Natural Childbirth , Pneumonia, Viral/virology , Pregnancy , Retrospective Studies , SARS-CoV-2 , Term Birth , Young Adult
15.
Cad. Saúde Pública (Online) ; 36(7): e00087320, 2020. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-664711

ABSTRACT

In less than four months, the total of confirmed cases of COVID-19 was 1,684,833 worldwide. Outcomes among the public of pregnant women with COVID-19 are still unclear. We performed a systematic review and meta-analysis to analyze whether COVID-19 in pregnant women is related to premature birth and birth weight, and to summarize the diagnostic results of neonates born to mothers with COVID-19 for investigating the possibility of vertical transmission. Searches were performed in PubMed, Scopus, LILACS, Web of Science, Google Scholar, Preprints, bioRxiv, and medRxiv. We used the odds ratio (OR) and mean difference (MD) as measure of analysis. Summary estimates were calculated using random effects models. 38 studies were included; data from 279 women were analyzed; 60 patients were diagnosed with COVID-19. The meta-analysis showed no significant association between COVID-19 and preterm delivery (OR = 2.25; 95%CI: 0.96, 5.31; p = 0.06; I² = 0%). No significant relationship was found between birth weight and COVID-19 (MD = -124.16; 95%CI: -260.54, 12.22; p = 0.07; I² = 0%). Among 432 newborns, 10 were reported with positive results for early SARS-CoV-2. Due to the characteristics of the studies, the level of evidence of this meta-analysis was considered very low. COVID-19 in pregnant women may not be associated with the occurrence of preterm deliveries or the birth weight of the newborn children, however the evidence to date is very uncertain. A few reports suggest vertical transmission of SARS-CoV-2 to newborn is possible, but evidence is still uncertain.


O número de casos confirmados de COVID-19 no mundo ultrapassou 1.684.833 em apenas quatro meses. Ainda não há evidências claras sobre os efeitos da COVID-19 em gestantes. Realizamos uma revisão sistemática e meta-análise em gestantes para esclarecer se a COVID-19 tem relação com a prematuridade e o peso ao nascer, além de resumir os resultados diagnósticos em recém-nascidos de mães com COVID-19 para investigar a possibilidade de transmissão vertical. Foram realizadas buscas em PubMed, Scopus, LILACS, Web of Science, Google Scholar, Preprints, bioRxiv e medRxiv. Como medidas de análise, utilizamos a razão de chances (OR) e a diferença média (DM). Foram calculadas estimativas sintéticas com o uso de modelos de efeitos randômicos. Trinta e oito estudos foram incluídos, com análise de dados de 279 mulheres, 60 das quais diagnosticadas com COVID-19. A meta-análise não mostrou associação significativa entre COVID-19 e parto prematuro (OR = 2,25; IC95%: 0,96, 5,31; p = 0,06; I² = 0%). Não houve relação significativa entre peso ao nascer e COVID-19 (DM = -124,16; IC95%: -260,54, 12,22; p = 0,07; I² = 0%). Entre 432 recém-nascidos, 10 testaram positivos para SARS-CoV-2. Devido às características dos estudos, o nível de evidências do estudo foi considerado muito baixo. A COVID-19 em gestantes pode não estar associada à ocorrência de prematuridade ou peso ao nascer, mas as evidências acumuladas até o momento não são conclusivas. Alguns relatos sugerem que a transmissão vertical do SARS-CoV-2 para o feto seja possível, mas as evidências ainda são incompletas.


En menos de cuatro meses, el total de casos confirmados de COVID-19 fue 1.684.833 en todo el mundo. Los resultados entre el colectivo de mujeres embarazadas con COVID-19 son todavía poco claros. Realizamos una revisión sistemática y metaanálisis para analizar si el COVID-19 en mujeres embarazadas está relacionado con el parto prematuro y peso al nacer, así como para resumir los resultados diagnósticos de los neonatos nacidos de madres con COVID-19, con el fin de investigar la posibilidad de una transmisión vertical. Las búsquedas se realizaron en PubMed, Scopus, LILACS, Web of Science, Google Scholar, Preprints, bioRxiv y medRxiv. Usamos odds ratio (OR) y la diferencia media (MD por sus siglas en inglés) como medida de análisis. El resumen estima que se calcularon usando modelos de efectos aleatorios. Se incluyeron 38 estudios; se analizaron datos de 279 mujeres; 60 pacientes fueron diagnosticados con COVID-19. El metaanálisis mostró que no hubo una asociación significativa entre la COVID-19 y el parto pretérmino (OR = 2,25; 95%CI: 0,96, 5,31; p = 0,06; I² = 0%). No se encontró una relación significativa entre el peso al nacer y el COVID-19 (MD = -124,16; IC95%: -260,54, 12,22; p = 0,07; I² = 0%). Entre 432 recién nacidos, 10 fueron diagnosticados como positivos tempranamente en SARS-CoV-2. Debido a las características de los estudios, el nivel de evidencia de este metaanálisis fue considerado como muy bajo. La COVID-19 en mujeres embarazadas, tal vez no está asociada con la ocurrencia de partos prematuros, o peso al nacer en niños recién nacidos, no obstante, la evidencia hasta la fecha es muy dudosa. Algunos informes sugieren que la transmisión vertical del SARS-CoV-2 al recién nacido es posible, pero la evidencia todavía no está clara.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pneumonia, Viral/complications , Pneumonia, Viral/transmission , Pregnancy Complications, Infectious , Birth Weight , Coronavirus Infections/complications , Coronavirus Infections/transmission , Infectious Disease Transmission, Vertical , Delivery, Obstetric , Premature Birth , Pandemics , Brazil , Betacoronavirus , SARS-CoV-2 , COVID-19
16.
J Clin Virol ; 127: 104356, 2020 06.
Article in English | MEDLINE | ID: covidwho-45884

ABSTRACT

BACKGROUND: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is causing an outbreak of pneumonia in Wuhan, Hubei Province, China, and other international areas. OBJECTIVE: Here, we report the clinical characteristics of the newborns delivered by SARS-CoV-2 infected pregnant women. METHODS: We prospectively collected and analyzed the clinical features, laboratory data and outcomes of 7 newborns delivered by SARS-CoV-2 infected pregnant women in Zhongnan Hospital of Wuhan University during January 20 to January 29, 2020. RESULTS: 4 of the 7 newborns were late preterm with gestational age between 36 weeks and 37 weeks, and the other 3 were full-term infants. The average birth weight was 2096 ± 660 g. All newborns were born without asphyxia. 2 premature infants performed mild grunting after birth, but relieved rapidly with non-invasive continuous positive airway pressure (nCPAP) ventilation. 3 cases had chest X-ray, 1 was normal and 2 who were supported by nCPAP presented mild neonatal respiratory distress syndrome (NRDS). Samples of pharyngeal swab in 6 cases, amniotic fluid and umbilical cord blood in 4 cases were tested by qRT-PCR, and there was no positive result of SARS-CoV-2 nucleic acid in all cases. CONCLUSIONS: The current data show that the infection of SARS-CoV-2 in late pregnant women does not cause adverse outcomes in their newborns, however, it is necessary to separate newborns from mothers immediately to avoid the potential threats.


Subject(s)
Coronavirus Infections/diagnosis , Infectious Disease Transmission, Vertical , Pneumonia, Viral/diagnosis , Pregnancy Complications, Infectious/virology , Amniotic Fluid/virology , Betacoronavirus , Birth Weight , COVID-19 , China/epidemiology , Continuous Positive Airway Pressure , Coronavirus Infections/epidemiology , Female , Fetal Blood/virology , Gestational Age , Humans , Infant Health , Infant, Newborn , Infant, Premature , Male , Pandemics , Pneumonia, Viral/epidemiology , Pregnancy , Prospective Studies , Risk Assessment , SARS-CoV-2 , Thorax/diagnostic imaging , Thorax/virology , Tomography, X-Ray Computed
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