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1.
Matern Child Health J ; 24(9): 1093-1098, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-706005

ABSTRACT

The coronavirus 2019 (COVID-19) pandemic and related policies have led to an unequal distribution of morbidity and mortality in the U.S. For Black women and birthing people, endemic vulnerabilities and disparities may exacerbate deleterious COVID-19 impacts. Historical and ongoing macro-level policies and forces over time have induced disproportionately higher rates of maternal morbidity and mortality among Black women and birthing people, and contemporary macroeconomic and healthcare policies and factors continue to hold particular consequence. These factors induce detrimental psychological, health, and behavioral responses that contribute to maternal health disparities. The COVID-19 pandemic is likely to disproportionately impact Black women and birthing people, as policy responses have failed to account for the their unique socioeconomic and healthcare contexts. The resulting consequences may form a 'vicious cycle', with upstream impacts that exacerbate upstream macro-level policies and forces that can further perpetuate the clustering of maternal morbidity and mortality in this population. Understanding the impacts of COVID-19 among Black women and birthing people requires theoretical frameworks that can sufficiently conceptualize their multi-level, interacting, and dynamic nature. Thus, we advocate for the proliferation of syndemic perspectives to guide maternal disparities research and prevention during the COVID-19 pandemic. These perspectives can enable a holistic and nuanced understanding of the intersection of endemic and COVID-19-specific vulnerabilities and disparities experienced by Black women and birthing people. Syndemic-informed research can then lead to impactful multi-level prevention strategies that simultaneously tackle both endemic and COVID-19-specific factors and outcomes that lead to the clustering of vulnerabilities and disparities over time.


Subject(s)
African Continental Ancestry Group/statistics & numerical data , Coronavirus Infections/prevention & control , Coronavirus , Health Services Accessibility/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , African Americans/statistics & numerical data , Betacoronavirus , Comorbidity , Coronavirus Infections/epidemiology , Female , Health Status Disparities , Healthcare Disparities/ethnology , Humans , Maternal Health , Maternal Mortality , Morbidity , Pneumonia, Viral/epidemiology , Population Surveillance , Research , Socioeconomic Factors , Syndemic , United States/epidemiology
2.
Nutrients ; 12(8)2020 Jul 28.
Article in English | MEDLINE | ID: covidwho-680581

ABSTRACT

Reproductive health is a significant public health issue during pandemics; however, the impacts of the novel 2019 coronavirus disease (COVID-19) on noninfected pregnant women are still unknown. This study intends (1) to examine whether emotional eating (EE) occurred during the pandemic triggered by disease concerns and (2) to explore the associations among EE, dietary changes, and gestational weight gain (GWG). Based on an online survey, 640 new mothers who experienced the lockdown in their third trimester were recruited from seven provinces in China. EE was evaluated with the Chinese version of the Dutch Eating Behavior Questionnaire, EE domain. A self-designed e-questionnaire was used to collect the data of participants on the sociodemographic characteristics, concerns about the COVID-19 pandemic, maternity information, physical activities, and dietary changes during lockdown. The results show that the average EE score was 26.5 ± 8.3, and women living in a severely affected area, who are very worried about the pandemic and who had less physical activity had a higher tendency of EE. Although there is a dietary pattern changed during pandemic, the average GWG in the studied group was in the normal range. However, a higher EE score was associated with a significant excess of GWG in women not from Wuhan (EE score 33-65 vs. 13-22: adjusted Odd Ratio (OR), 95% Confidence Interval (CI) = 1.90, 1.08-3.32). The sensitivity analysis that additionally adjusted for the pregestational body mass index and gestational metabolic disease was consistent with this result. The mediation model was also examined and showed that, after adjusting for living area and exercise, EE was associated with significantly increased consumption of cereals (EE score 33-65 vs. 13-22: adjusted OR, 95% CI = 2.22, 1.29-3.82) and oil (EE score 33-65 vs. 13-22: adjusted OR, 95% CI = 3.03, 1.06-8.69) but decreased consumption of fish and seafood (EE score 33-65 vs. 13-22: adjusted OR, 95% CI = 1.88, 1.14-3.11; 23-32 vs. 13-22: adjusted OR, 95% CI = 1.79, 1.20-2.66). In conclusion, this study indicated that EE occurred in a proportional number of pregnant women during the COVID-19 pandemic and is associated with excess GWG mediated by increased intake of certain foods. The findings suggest the need for psychosocial and nutritional education and interventions during pregnancy checkups. Further studies are needed to determine modifiable psychosocial predictors and potential nutritional concerns in pregnant women during disease outbreaks.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Diet , Feeding Behavior/psychology , Gestational Weight Gain , Pandemics , Pneumonia, Viral/epidemiology , Adult , China/epidemiology , Emotions , Female , Humans , Maternal Health/statistics & numerical data , Maternal Nutritional Physiological Phenomena/physiology , Pregnancy , Pregnancy Trimester, Third , Retrospective Studies , Surveys and Questionnaires
4.
Matern Child Health J ; 24(9): 1093-1098, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-659750

ABSTRACT

The coronavirus 2019 (COVID-19) pandemic and related policies have led to an unequal distribution of morbidity and mortality in the U.S. For Black women and birthing people, endemic vulnerabilities and disparities may exacerbate deleterious COVID-19 impacts. Historical and ongoing macro-level policies and forces over time have induced disproportionately higher rates of maternal morbidity and mortality among Black women and birthing people, and contemporary macroeconomic and healthcare policies and factors continue to hold particular consequence. These factors induce detrimental psychological, health, and behavioral responses that contribute to maternal health disparities. The COVID-19 pandemic is likely to disproportionately impact Black women and birthing people, as policy responses have failed to account for the their unique socioeconomic and healthcare contexts. The resulting consequences may form a 'vicious cycle', with upstream impacts that exacerbate upstream macro-level policies and forces that can further perpetuate the clustering of maternal morbidity and mortality in this population. Understanding the impacts of COVID-19 among Black women and birthing people requires theoretical frameworks that can sufficiently conceptualize their multi-level, interacting, and dynamic nature. Thus, we advocate for the proliferation of syndemic perspectives to guide maternal disparities research and prevention during the COVID-19 pandemic. These perspectives can enable a holistic and nuanced understanding of the intersection of endemic and COVID-19-specific vulnerabilities and disparities experienced by Black women and birthing people. Syndemic-informed research can then lead to impactful multi-level prevention strategies that simultaneously tackle both endemic and COVID-19-specific factors and outcomes that lead to the clustering of vulnerabilities and disparities over time.


Subject(s)
African Continental Ancestry Group/statistics & numerical data , Coronavirus Infections/prevention & control , Coronavirus , Health Services Accessibility/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , African Americans/statistics & numerical data , Betacoronavirus , Comorbidity , Coronavirus Infections/epidemiology , Female , Health Status Disparities , Healthcare Disparities/ethnology , Humans , Maternal Health , Maternal Mortality , Morbidity , Pneumonia, Viral/epidemiology , Population Surveillance , Research , Socioeconomic Factors , Syndemic , United States/epidemiology
5.
Am J Clin Nutr ; 112(2): 251-256, 2020 08 01.
Article in English | MEDLINE | ID: covidwho-608368

ABSTRACT

Coronavirus disease 2019 (COVID-19) continues to ravage health and economic metrics globally, including progress in maternal and child nutrition. Although there has been focus on rising rates of childhood wasting in the short term, maternal and child undernutrition rates are also likely to increase as a consequence of COVID-19 and its impacts on poverty, coverage of essential interventions, and access to appropriate nutritious foods. Key sectors at particular risk of collapse or reduced efficiency in the wake of COVID-19 include food systems, incomes, and social protection, health care services for women and children, and services and access to clean water and sanitation. This review highlights key areas of concern for maternal and child nutrition during and in the aftermath of COVID-19 while providing strategic guidance for countries in their efforts to reduce maternal and child undernutrition. Rooted in learnings from the exemplars in Global Health's Stunting Reduction Exemplars project, we provide a set of recommendations that span investments in sectors that have sustained direct and indirect impact on nutrition. These include interventions to strengthen the food-supply chain and reducing food insecurity to assist those at immediate risk of food shortages. Other strategies could include targeted social safety net programs, payment deferrals, or tax breaks as well as suitable cash-support programs for the most vulnerable. Targeting the most marginalized households in rural populations and urban slums could be achieved through deploying community health workers and supporting women and community members. Community-led sanitation programs could be key to ensuring healthy household environments and reducing undernutrition. Additionally, several COVID-19 response measures such as contact tracing and self-isolation could also be exploited for nutrition protection. Global health and improvements in undernutrition will require governments, donors, and development partners to restrategize and reprioritize investments for the COVID-19 era, and will necessitate data-driven decision making, political will and commitment, and international unity.


Subject(s)
Child Health , Coronavirus Infections , Infant Health , Infant, Newborn , Malnutrition , Maternal Health , Nutritional Status , Pandemics , Pneumonia, Viral , Child , Child Nutrition Disorders/prevention & control , Child, Preschool , Coronavirus , Coronavirus Infections/complications , Family Characteristics , Food Supply , Global Health , Growth Disorders/prevention & control , Humans , Infant , Malnutrition/complications , Malnutrition/prevention & control , Pneumonia, Viral/complications , Poverty
6.
Matern Child Nutr ; 16(3): e13036, 2020 07.
Article in English | MEDLINE | ID: covidwho-599152

ABSTRACT

Globally, the COVID-19 pandemic has already led to major increases in unemployment and is expected to lead to unprecedented increases in poverty and food and nutrition insecurity, as well as poor health outcomes. Families where young children, youth, pregnant and lactating women live need to be protected against the ongoing protracted pandemic and the aftershocks that are very likely to follow for years to come. The future wellbeing of the vast majority of the world now depends on reconfiguring the current ineffective food, nutrition, health, and social protection systems to ensure food and nutrition security for all. Because food, nutrition, health, and socio-economic outcomes are intimately inter-linked, it is essential that we find out how to effectively address the need to reconfigure and to provide better intersecoral coordination among global and local food, health care, and social protection systems taking equity and sutainability principles into account. Implementation science research informed by complex adaptive sytems frameworks will be needed to fill in the major knowledge gaps. Not doing so will not only put the development of individuals at further risk, but also negatively impact on the development potential of entire nations and ultimately our planet.


Subject(s)
Child Health , Coronavirus Infections , Food Supply , Maternal Health , Pandemics , Pneumonia, Viral , Betacoronavirus , Child , Child Nutritional Physiological Phenomena , Female , Global Health , Humans , Hunger , Maternal Nutritional Physiological Phenomena , Poverty , Pregnancy , Risk
7.
Matern Child Nutr ; 16(3): e13036, 2020 07.
Article in English | MEDLINE | ID: covidwho-378014

ABSTRACT

Globally, the COVID-19 pandemic has already led to major increases in unemployment and is expected to lead to unprecedented increases in poverty and food and nutrition insecurity, as well as poor health outcomes. Families where young children, youth, pregnant and lactating women live need to be protected against the ongoing protracted pandemic and the aftershocks that are very likely to follow for years to come. The future wellbeing of the vast majority of the world now depends on reconfiguring the current ineffective food, nutrition, health, and social protection systems to ensure food and nutrition security for all. Because food, nutrition, health, and socio-economic outcomes are intimately inter-linked, it is essential that we find out how to effectively address the need to reconfigure and to provide better intersecoral coordination among global and local food, health care, and social protection systems taking equity and sutainability principles into account. Implementation science research informed by complex adaptive sytems frameworks will be needed to fill in the major knowledge gaps. Not doing so will not only put the development of individuals at further risk, but also negatively impact on the development potential of entire nations and ultimately our planet.


Subject(s)
Child Health , Coronavirus Infections , Food Supply , Maternal Health , Pandemics , Pneumonia, Viral , Betacoronavirus , Child , Child Nutritional Physiological Phenomena , Female , Global Health , Humans , Hunger , Maternal Nutritional Physiological Phenomena , Poverty , Pregnancy , Risk
9.
Int J Gynaecol Obstet ; 150(2): 151-158, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-246230

ABSTRACT

An integrated approach to population health, disease surveillance, and preventive care will dominate the health agenda in the post COVID-19 world. Because of their huge burden and the vulnerability imposed during a health crisis, prevention and care of non-communicable diseases (NCDs) will need to be prioritized even further. Maternal and child health are inextricably linked with NCDs and their risk factors. The intergenerational impact of poor maternal nutrition and health conditions during pregnancy, particularly NCD-related pregnancy complications, can be considered as a multiplier of the ongoing pandemic of NCDs. The economic cost of poor maternal health and NCD-related pregnancy complications is likely very high, but is not adequately researched or documented in the context of long-term population health. Interventions to address NCDs in pregnancy have beneficial effects on short-term pregnancy outcomes; but even more importantly, identifying "at-risk" mothers and offspring opens up the opportunity for targeted early preventive action. Preventive actions to address obesity, hypertension, type 2 diabetes, and cardiovascular diseases have a common lifestyle approach-identifying any one of these problems in pregnancy provides an opportunity to address them all. Cost-benefit analyses that only focus on the short-term and on one condition do not capture the full value of downstream, long-term benefits for population health. This requires urgent attention from FIGO.


Subject(s)
Betacoronavirus , Coronavirus Infections , Maternal Health , Noncommunicable Diseases/prevention & control , Pandemics , Pneumonia, Viral , Cardiovascular Diseases/epidemiology , Coronavirus Infections/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Female , Humans , Hypertension/epidemiology , Investments , Life Style , Obesity/epidemiology , Pneumonia, Viral/epidemiology , Pregnancy , Pregnancy Complications, Infectious , Risk Factors
10.
Lima; Perú. Ministerio de salud; 20200400. 13 p.
Monography in Spanish | LILACS (Americas) | ID: covidwho-221114

ABSTRACT

El documento contiene las disposiciones para realizar las actividades de atención de la salud materna relacionadas con las prestaciones que contribuyan a la prevención, reducción y manejo de los casos de gestantes y puérperas sospechosas o infectadas por el COVID-19, y para mantener la continuidad de la provisión de métodos anticonceptivos a la población que lo requiera.


Subject(s)
Communicable Disease Control , Guidelines as Topic , Family Planning (Public Health) , Maternal Health
11.
J Med Virol ; 92(7): 731-739, 2020 07.
Article in English | MEDLINE | ID: covidwho-97647

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a novel type of highly contagious pneumonia caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite the strong efforts taken to control the epidemic, hundreds of thousands of people were infected worldwide by 11 March, and the situation was characterized as a pandemic by the World Health Organization. Pregnant women are more susceptible to viral infection due to immune and anatomic alteration, though hospital visits may increase the chance of infection, the lack of medical care during pregnancy may do more harm. Hence, a well-managed system that allows pregnant women to access maternal health care with minimum exposure risk is desired during the outbreak. Here, we present the managing processes of three pregnant women who had fever during hospitalization in the gynecology or obstetrics department, and then, we further summarize and demonstrate our maternal health care management strategies including antenatal care planning, patient triage based on the risk level, admission control, and measures counteracting emergencies and newly discovered high-risk cases at in-patient department. In the meantime, we will explain the alterations we have done throughout different stages of the epidemic and also review relative articles in both Chinese and English to compare our strategies with those of other areas. Although tens of COVID-19 cases were confirmed in our hospital, no nosocomial infection has occurred and none of the pregnant women registered in our hospital was reported to be infected.


Subject(s)
Betacoronavirus/pathogenicity , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Disease Outbreaks , Fever/diagnosis , Health Services Accessibility/organization & administration , Pneumonia, Viral/diagnosis , Pregnancy, Ectopic/diagnosis , Adult , Betacoronavirus/genetics , Biomarkers/blood , China/epidemiology , Coronavirus Infections/blood , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Diagnosis, Differential , Female , Fever/blood , Fever/epidemiology , Fever/virology , Hospitalization/statistics & numerical data , Humans , Maternal Health , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Pregnancy , Pregnancy, Ectopic/blood , Pregnancy, Ectopic/epidemiology , Pregnancy, Ectopic/virology , Tomography, X-Ray Computed , Triage/organization & administration
12.
J Med Virol ; 92(7): 731-739, 2020 07.
Article in English | MEDLINE | ID: covidwho-17561

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a novel type of highly contagious pneumonia caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite the strong efforts taken to control the epidemic, hundreds of thousands of people were infected worldwide by 11 March, and the situation was characterized as a pandemic by the World Health Organization. Pregnant women are more susceptible to viral infection due to immune and anatomic alteration, though hospital visits may increase the chance of infection, the lack of medical care during pregnancy may do more harm. Hence, a well-managed system that allows pregnant women to access maternal health care with minimum exposure risk is desired during the outbreak. Here, we present the managing processes of three pregnant women who had fever during hospitalization in the gynecology or obstetrics department, and then, we further summarize and demonstrate our maternal health care management strategies including antenatal care planning, patient triage based on the risk level, admission control, and measures counteracting emergencies and newly discovered high-risk cases at in-patient department. In the meantime, we will explain the alterations we have done throughout different stages of the epidemic and also review relative articles in both Chinese and English to compare our strategies with those of other areas. Although tens of COVID-19 cases were confirmed in our hospital, no nosocomial infection has occurred and none of the pregnant women registered in our hospital was reported to be infected.


Subject(s)
Betacoronavirus/pathogenicity , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Disease Outbreaks , Fever/diagnosis , Health Services Accessibility/organization & administration , Pneumonia, Viral/diagnosis , Pregnancy, Ectopic/diagnosis , Adult , Betacoronavirus/genetics , Biomarkers/blood , China/epidemiology , Coronavirus Infections/blood , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Diagnosis, Differential , Female , Fever/blood , Fever/epidemiology , Fever/virology , Hospitalization/statistics & numerical data , Humans , Maternal Health , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Pregnancy , Pregnancy, Ectopic/blood , Pregnancy, Ectopic/epidemiology , Pregnancy, Ectopic/virology , Tomography, X-Ray Computed , Triage/organization & administration
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