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1.
N Z Med J ; 135(1562): 63-77, 2022 Sep 23.
Article in English | MEDLINE | ID: covidwho-2147674

ABSTRACT

AIMS: Diabetes in pregnancy (DiP) rates are increasing worldwide. Pasifika, Indian and Maori peoples have high rates of DiP any improvements in clinical care may be beneficial for these populations. During COVID-19 lockdowns, the DiP service in Counties Manukau Health (CMH) South Auckland switched from face-to-face appointments to teleclinics. This study aims to: determine satisfaction of pregnant people with teleclinics for DiP; compare clinical outcomes and attendance for those receiving care through teleclinics versus standard care; and compare rates of clinic attendance between face-to-face and teleclinic appointments. METHODS: A standardised questionnaire was completed by those who had attended a teleclinic. The primary outcome was a high score (4-5/5) for satisfaction and future use. A separate, retrospective study of clinical outcomes, and the number of appointments scheduled/attended were compared between all DiP patients who were scheduled an appointment during lockdown, and all of those who were scheduled appointments the year prior. RESULTS: Of the thirty-five participants who completed the survey (response rate 37%), 89% scored the clinic highly for satisfaction and future use. There were 179 patients scheduled to clinic during the period where teleclinics were the default model of care, and 187 patients scheduled to clinic the year prior. No differences in clinical outcomes were observed. Those receiving care during lockdown were offered more appointments, although attendance rates did not differ. CONCLUSION: Teleclinics for DiP are acceptable to the people we surveyed, but should be developed further so they better support the needs of those using them.


Subject(s)
COVID-19 , Diabetes Mellitus , Appointments and Schedules , Communicable Disease Control , Female , Humans , New Zealand/epidemiology , Personal Satisfaction , Pregnancy , Pregnancy Outcome , Retrospective Studies
2.
Sci Rep ; 12(1): 20314, 2022 Nov 24.
Article in English | MEDLINE | ID: covidwho-2133617

ABSTRACT

Information on effects of medication therapies during pregnancy is lacking as pregnant patients are often excluded from clinical trials. This retrospective study explores the potential of using electronic health record (EHR) data to inform safety profiles of repurposed COVID medication therapies on pregnancy outcomes using pre-COVID data. We conducted a medication-wide association study (MWAS) on prescription medication exposures during pregnancy and the risk of cesarean section, preterm birth, and stillbirth, using EHR data between 2010-2017 on deliveries at PennMedicine. Repurposed drugs studied for treatment of COVID-19 were extracted from ClinicalTrials.gov (n = 138). We adjusted for known comorbidities diagnosed within 2 years prior to birth. Using previously developed medication mapping and delivery-identification algorithms, we identified medication exposure in 2,830 of a total 63,334 deliveries; from 138 trials, we found 31 medications prescribed and included in our cohort. We found 21 (68%) of the 31 medications were not positively associated with increased risk of the outcomes examined. With caution, these medications warrant potential for inclusion of pregnant individuals in future studies, while drugs found to be associated with pregnancy outcomes require further investigation. MWAS facilitates hypothesis-driven evaluation of drug safety across all prescription medications, revealing potential drug candidates for further research.


Subject(s)
COVID-19 , Premature Birth , Prescription Drugs , Humans , Infant, Newborn , Pregnancy , Female , Pregnancy Outcome/epidemiology , Pandemics , COVID-19/drug therapy , COVID-19/epidemiology , Retrospective Studies , Cesarean Section , Premature Birth/drug therapy , Prescription Drugs/adverse effects , Prescriptions
3.
PLoS One ; 17(11): e0276766, 2022.
Article in English | MEDLINE | ID: covidwho-2119160

ABSTRACT

BACKGROUND: Pregnancies complicated by Coronavirus Disease 2019 (COVID-19) are at an increased risk of severe morbidity due to physiologic changes in immunologic, cardiovascular, and respiratory function. There is little is known about how severity of COVID-19 changes protein and metabolite expression in pregnancy. OBJECTIVE: This study aims to investigate the pathophysiology behind various clinical trajectories in pregnant patients diagnosed with COVID-19 using multi-omics profiling. STUDY DESIGN: This is a prospective cohort study of 30 pregnant patients at a single tertiary care center. Participants were categorized by severity of COVID-19 disease (control, asymptomatic, mild/moderate, or severe). Maternal serum samples underwent LC-MS-based multiomics analysis for profiling of proteins, lipids, electrolytes, and metabolites. Linear regression models were used to assess how disease severity related to analyte levels. Reactome pathway enrichment analysis was conducted on differential analytes. RESULTS: Of 30 participants, 25 had confirmed diagnosis of COVID-19 (6 asymptomatic (one post-infection), 13 mild/moderate (all post-infection), 6 severe), and 5 participants were controls. Severe COVID-19 was associated with distinct profiles demonstrating significant proteomic and lipidomic signatures which were enriched for annotations related to complement and antibody activity. (FDR < 0.05). Downregulated analytes were not significantly enriched but consisted of annotation terms related to lipoprotein activity (FDR > 0.2). Post-infection mild/moderate COVID-19 did not have significantly altered serum protein, metabolite, or lipid metabolite levels compared to controls. CONCLUSIONS: Pregnancies with severe COVID-19 demonstrate greater inflammation and complement activation and dysregulation of serum lipids. This altered multiomic expression provides insight into the pathophysiology of severe COVID-19 in pregnancy and may serve as potential indicators for adverse pregnancy outcomes.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Pregnancy , Female , Humans , SARS-CoV-2 , Prospective Studies , Proteomics , Pregnancy Outcome , Complement Activation , Lipids
4.
Int J Environ Res Public Health ; 19(22)2022 Nov 19.
Article in English | MEDLINE | ID: covidwho-2116213

ABSTRACT

Pregnant women and their neonates belong to the group of individuals with elevated risk for COVID-19 infection. Data on the course of the disease and how it affects the pregnancy and neonatal wellbeing remain conflicting. The aim of the study was to evaluate the effect of SARS CoV-2 infection on the mode of delivery, neonatal condition and selected maternal and fetal laboratory parameters. This was a single-center retrospective case-control study. This dataset was generated using electronic medical records collected by medical personnel. Two groups of patients, hospitalized between April, 2020 and February, 2021, were included in the study: study group (304)-pregnant women with SARS-CoV-2 and control group (N = 329)-healthy pregnant women or parturients. Mothers with a severe course of COVID-19 had higher activated partial thromboplastin-APTT (p = 0.02), C-Reactive Protein-CRP (p = 0.00) and procalcitonin (p = 0.032) levels as compared to pregnant women with mild or moderate course of the disease. Neonates born to SARS-CoV-2-infected mothers presented with worse condition at 1 and 5 minutes of life (p = 0.000 and 0.00, respectively) and lower Arterial Blood Gas-ABG pH scores (p = 0.016). Elective cesarean section is the most common mode of delivery for SARS-CoV2-infected mothers. Emergency cesarean sections are performed at earlier gestational age as compared to vaginal delivery and elective cesarean section. Lower Apgar scores were observed in neonates born to SARS-CoV-2-infected mothers who required oxygen therapy and whose procalcitonin levels were elevated. There is a relationship between more severe course of COVID-19 and APTT, as well as CRP and procalcitonin levels.


Subject(s)
COVID-19 , Cesarean Section , Infant, Newborn , Humans , Pregnancy , Female , SARS-CoV-2 , Retrospective Studies , Pregnancy Outcome/epidemiology , COVID-19/epidemiology , Procalcitonin , Case-Control Studies , RNA, Viral
5.
PLoS One ; 17(10): e0276923, 2022.
Article in English | MEDLINE | ID: covidwho-2098766

ABSTRACT

OBJECTIVE: Identifying the time of SARS-CoV-2 viral infection relative to specific gestational weeks is critical for delineating the role of viral infection timing in adverse pregnancy outcomes. However, this task is difficult when it comes to Electronic Health Records (EHR). In combating the COVID-19 pandemic for maternal health, we sought to develop and validate a clinical information extraction algorithm to detect the time of clinical events relative to gestational weeks. MATERIALS AND METHODS: We used EHR from the National COVID Cohort Collaborative (N3C), in which the EHR are normalized by the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). We performed EHR phenotyping, resulting in 270,897 pregnant women (June 1st, 2018 to May 31st, 2021). We developed a rule-based algorithm and performed a multi-level evaluation to test content validity and clinical validity, and extreme length of gestation (<150 or >300). RESULTS: The algorithm identified 296,194 pregnancies (16,659 COVID-19, 174,744 without COVID-19) in 270,897 pregnant women. For inferring gestational age, 95% cases (n = 40) have moderate-high accuracy (Cohen's Kappa = 0.62); 100% cases (n = 40) have moderate-high granularity of temporal information (Cohen's Kappa = 1). For inferring delivery dates, the accuracy is 100% (Cohen's Kappa = 1). The accuracy of gestational age detection for the extreme length of gestation is 93.3% (Cohen's Kappa = 1). Mothers with COVID-19 showed higher prevalence in obesity or overweight (35.1% vs. 29.5%), diabetes (17.8% vs. 17.0%), chronic obstructive pulmonary disease (0.2% vs. 0.1%), respiratory distress syndrome or acute respiratory failure (1.8% vs. 0.2%). DISCUSSION: We explored the characteristics of pregnant women by different gestational weeks of SARS-CoV-2 infection with our algorithm. TED-PC is the first to infer the exact gestational week linked with every clinical event from EHR and detect the timing of SARS-CoV-2 infection in pregnant women. CONCLUSION: The algorithm shows excellent clinical validity in inferring gestational age and delivery dates, which supports multiple EHR cohorts on N3C studying the impact of COVID-19 on pregnancy.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Premature Birth , Female , Pregnancy , Humans , COVID-19/epidemiology , Pandemics , Pregnant Women , Gestational Age , SARS-CoV-2 , Electronic Health Records , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome , Algorithms , Premature Birth/epidemiology
7.
Georgian Med News ; (328-329): 100-107, 2022.
Article in English | MEDLINE | ID: covidwho-2092168

ABSTRACT

Currently, in relation to the effect of this pandemic on pregnancy, there are more questions than certainties about the real impact of COVID-19 on pregnant women. Studies are updated and often contradict each other. There is no evidence to suggest that pregnant women with COVID-19 have higher morbidity than affected non-pregnant women. We aimed to know whether maternal morbidities were more frequent in pregnant woman with COVID-19 compared to non-infected pregnant women. A retrospective case control study was conducted during a period of 6 months. Medical records were reviewed. A 120 files of COVID-19 infected women from Mosul city, and 95 files of non-infected pregnant women were reviewed and analyzed. We found that Infection with COVID-19 had a significant effect on pregnancy outcome, infected women were more likely to have higher incidence rates of adverse perinatal outcomes in both mothers and the newborns. Also, higher odds of complications associated with severe disease form Findings of our study came in line with previous studies in other countries, however, more medical care and support should be provided to pregnant women infected with COVID-19, particularly severe cases. Further studies with larger sample size are still needed for good understanding of the effect of virus on pregnancy outcomes.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Infant, Newborn , Female , Pregnancy , Humans , Pregnancy Trimester, Third , Case-Control Studies , Retrospective Studies , Pregnancy Outcome
8.
J Korean Med Sci ; 37(41): e297, 2022 Oct 24.
Article in English | MEDLINE | ID: covidwho-2089755

ABSTRACT

BACKGROUND: This study aimed to describe the maternal, obstetrical, and neonatal outcomes in pregnant women with coronavirus disease 2019 (COVID-19) and identify the predictors associated with the severity of COVID-19. METHODS: This multicenter observational study included consecutive pregnant women admitted because of COVID-19 confirmed using reverse transcriptase-polymerase chain reaction (RT-PCR) test at 15 hospitals in the Republic of Korea between January 2020 and December 2021. RESULTS: A total of 257 women with COVID-19 and 62 newborns were included in this study. Most of the patients developed this disease during the third trimester. Nine patients (7.4%) developed pregnancy-related complications. All pregnant women received inpatient treatment, of whom 9 (3.5%) required intensive care, but none of them died. The gestational age at COVID-19 diagnosis (odds ratio [OR], 1.096, 95% confidence interval [CI], 1.04-1.15) and parity (OR, 1.703, 95% CI, 1.13-2.57) were identified as significant risk factors of severe diseases. Among women who delivered, 78.5% underwent cesarean section. Preterm birth (38.5%), premature rupture of membranes (7.7%), and miscarriage (4.6%) occurred, but there was no stillbirth or neonatal death. The RT-PCR test of newborns' amniotic fluid and umbilical cord blood samples was negative for severe acute respiratory syndrome coronavirus 2. CONCLUSION: At the time of COVID-19 diagnosis, gestational age and parity of pregnant women were the risk factors of disease severity. Vertical transmission of COVID-19 was not observed, and maternal severity did not significantly affect the neonatal prognosis.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Premature Birth , Infant, Newborn , Female , Humans , Pregnancy , COVID-19 Testing , Cesarean Section , Pregnant Women , Pregnancy Complications, Infectious/diagnosis , Pregnancy Outcome , Infectious Disease Transmission, Vertical , RNA-Directed DNA Polymerase
10.
Reprod Toxicol ; 114: 33-43, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2083105

ABSTRACT

The rapidly evolving COVID-19 pandemic has resulted in an upsurge of scientific productivity to help address the global health crisis. One area of active research is the impact of COVID-19 on pregnancy. Here, we provide an epidemiological overview about what is known about the effects of maternal SARS-CoV-2 infection and COVID-19 vaccination on maternal-fetal outcomes, and identify gaps in knowledge. Pregnant people are at increased risk for severe COVID-19, and maternal SARS-CoV-2 infection increases the risk of negative maternal-fetal outcomes. Despite this elevated risk, there have been high rates of vaccine hesitancy, heightened by the initial lack of safety and efficacy data for COVID-19 vaccination in pregnancy. In response, retrospective cohort studies were performed to examine the impact of COVID-19 vaccination during pregnancy. Here, we report the vaccine's efficacy during pregnancy and its impact on maternal-fetal outcomes, as well as an overview of initial studies on booster shots in pregnancy. We found that pregnant people are at risk for more severe COVID-19 outcomes, maternal SARS-CoV-2 infection is associated with worse birth outcomes, COVID-19 vaccine hesitancy remains prevalent in the pregnant population, and COVID-19 vaccination and boosters promote better maternal-fetal outcomes. The results should help reduce vaccine hesitancy by alleviating concerns about the safety and efficacy of administering the COVID-19 vaccine during pregnancy. Overall, this review provides an introduction to COVID-19 during pregnancy. It is expected to help consolidate current knowledge, accelerate research of COVID-19 during pregnancy and inform clinical, policy, and research decisions regarding COVID-19 vaccination in pregnant people.


Subject(s)
COVID-19 Vaccines , COVID-19 , Female , Humans , Pregnancy , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Pandemics , Retrospective Studies , SARS-CoV-2 , Vaccination , Vaccination Hesitancy , Pregnancy Outcome , Vaccine Efficacy , Immunization, Secondary , Risk
11.
Am J Trop Med Hyg ; 107(5): 1060-1065, 2022 Nov 14.
Article in English | MEDLINE | ID: covidwho-2080693

ABSTRACT

Previous coronavirus epidemics were associated with increased maternal morbidity, mortality, and adverse obstetric outcomes. Reports for SARS-CoV-2 indicate that the obstetric population is at increased risk for severe illness, although there are still limited data on mild COVID-19 infection during pregnancy. To determine the association between mild COVID-19 infection during pregnancy, and maternal and neonatal outcomes, we performed a prospective cohort study among pregnant women with COVID-19 and a control group. Postnatal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. We recruited 84 pregnant women with mild COVID-19 and 88 pregnant women without COVID-19. All participants were unvaccinated. The most common acute COVID-19 symptoms were headache (82.1%), loss of smell (81%), and asthenia (77.4%). The median duration of long COVID symptoms was 60 days (interquartile range, 130). Pregnant women with a COVID-19 diagnosis were at greater risk for obstetric ultrasound abnormalities-mainly, fetal growth restriction (relative risk [RR], 12.40; 95% CI, 1.66-92.5), premature birth (RR, 2.62; 95% CI, 1.07-6.43), and postpartum depression (RR, 2.28; 95% CI, 1.24-4.21). Our results alert clinicians to the consequences of COVID-19 during pregnancy, even in mild cases, given the increased risk of ultrasound abnormalities, premature birth, long COVID symptoms, and postpartum depression. National guidelines on preventive measures and treatments should be based on scientific evidence, including attention to the impact on health and family needs during and after the COVID-19 pandemic.


Subject(s)
COVID-19 , Depression, Postpartum , Infant, Newborn, Diseases , Pregnancy Complications, Infectious , Pregnancy Complications , Premature Birth , Infant, Newborn , Female , Pregnancy , Humans , COVID-19/epidemiology , SARS-CoV-2 , Pandemics , Premature Birth/epidemiology , COVID-19 Testing , Depression, Postpartum/epidemiology , Prospective Studies , Pregnancy Outcome , Brazil/epidemiology , Cohort Studies , Infant, Newborn, Diseases/epidemiology , Pregnancy Complications, Infectious/epidemiology
12.
BMC Pregnancy Childbirth ; 22(1): 775, 2022 Oct 18.
Article in English | MEDLINE | ID: covidwho-2079400

ABSTRACT

BACKGROUND: Studies of preterm delivery after COVID-19 are often subject to selection bias and do not distinguish between early vs. late infection in pregnancy, nor between spontaneous vs. medically indicated preterm delivery. This study aimed to estimate the risk of preterm birth (overall, spontaneous, and indicated) after COVID-19 during pregnancy, while considering different levels of disease severity and timing. METHODS: Pregnant and recently pregnant people who were tested for or clinically diagnosed with COVID-19 during pregnancy enrolled in an international internet-based cohort study between June 2020 and July 2021. We used several analytic approaches to minimize confounding and immortal time bias, including multivariable regression, time-to-delivery models, and a case-time-control design. RESULTS: Among 14,264 eligible participants from 70 countries who did not report a pregnancy loss before 20 gestational weeks, 5893 had completed their pregnancies and reported delivery information; others were censored at time of their last follow-up. Participants with symptomatic COVID-19 before 20 weeks' gestation had no increased risk of preterm delivery compared to those testing negative, with adjusted risks of 10.0% (95% CI 7.8, 12.0) vs. 9.8% (9.1, 10.5). Mild COVID-19 later in pregnancy was not clearly associated with preterm delivery. In contrast, severe COVID-19 after 20 weeks' gestation led to an increase in preterm delivery compared to milder disease. For example, the risk ratio for preterm delivery comparing severe to mild/moderate COVID-19 at 35 weeks was 2.8 (2.0, 4.0); corresponding risk ratios for indicated and spontaneous preterm delivery were 3.7 (2.0, 7.0) and 2.3 (1.2, 3.9), respectively. CONCLUSIONS: Severe COVID-19 late in pregnancy sharply increased the risk of preterm delivery compared to no COVID-19. This elevated risk was primarily due to an increase in medically indicated preterm deliveries, included preterm cesarean sections, although an increase in spontaneous preterm delivery was also observed. In contrast, mild or moderate COVID-19 conferred minimal risk, as did severe disease early in pregnancy.


Subject(s)
COVID-19 , Premature Birth , Female , Pregnancy , Infant, Newborn , Humans , Premature Birth/epidemiology , COVID-19/epidemiology , Cohort Studies , Gestational Age , Registries , Pregnancy Outcome/epidemiology
13.
Nat Commun ; 13(1): 6124, 2022 Oct 17.
Article in English | MEDLINE | ID: covidwho-2077055

ABSTRACT

Data on the safety of COVID-19 vaccines in early pregnancy are limited. We conducted a national, population-based, matched cohort study assessing associations between COVID-19 vaccination and miscarriage prior to 20 weeks gestation and, separately, ectopic pregnancy. We identified women in Scotland vaccinated between 6 weeks preconception and 19 weeks 6 days gestation (for miscarriage; n = 18,780) or 2 weeks 6 days gestation (for ectopic; n = 10,570). Matched, unvaccinated women from the pre-pandemic and, separately, pandemic periods were used as controls. Here we show no association between vaccination and miscarriage (adjusted Odds Ratio [aOR], pre-pandemic controls = 1.02, 95% Confidence Interval [CI] = 0.96-1.09) or ectopic pregnancy (aOR = 1.13, 95% CI = 0.92-1.38). We undertook additional analyses examining confirmed SARS-CoV-2 infection as the exposure and similarly found no association with miscarriage or ectopic pregnancy. Our findings support current recommendations that vaccination remains the safest way for pregnant women to protect themselves and their babies from COVID-19.


Subject(s)
Abortion, Spontaneous , COVID-19 Vaccines , COVID-19 , Influenza, Human , Pregnancy, Ectopic , Female , Humans , Pregnancy , Abortion, Spontaneous/epidemiology , Cohort Studies , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Influenza, Human/prevention & control , Pregnancy Outcome , SARS-CoV-2 , Vaccination
14.
Nutrients ; 14(19)2022 Sep 28.
Article in English | MEDLINE | ID: covidwho-2066296

ABSTRACT

The link between being pregnant and overweight or obese and the infectivity and virulence of the SARS CoV-2 virus is likely to be caused by SARS-CoV-2 spike protein glycosylation, which may work as a glycan shield. Methylglyoxal (MGO), an important advanced glycation end-product (AGE), and glycated albumin (GA) are the results of poor subclinical glucose metabolism and are indices of oxidative stress. Forty-one consecutive cases of SARS-CoV-2-positive pregnant patients comprising 25% pre-pregnancy overweight women and 25% obese women were recruited. The aim of our study was to compare the blood levels of MGO and GA in pregnant women with asymptomatic and symptomatic SARS-CoV-2 infection with pregnant women without SARS-CoV-2 infection with low risk and uneventful pregnancies and to evaluate the relative perinatal outcomes. The MGO and GA values of the SARS-CoV-2 cases were statistically significantly higher than those of the negative control subjects. In addition, the SARS-CoV-2-positive pregnant patients who suffered of moderate to severe COVID-19 syndrome had higher values of GA than those infected and presenting with mild symptoms or those with asymptomatic infection. Premature delivery and infants of a small size for their gestational age were overrepresented in this cohort, even in mild-asymptomatic patients for whom delivery was not indicated by the COVID-19 syndrome. Moreover, ethnic minorities were overrepresented among the severe cases. The AGE-RAGE oxidative stress axis on the placenta and multiple organs caused by MGO and GA levels, associated with the biological mechanisms of the glycation of the SARS-CoV-2 spike protein, could help to explain the infectivity and virulence of this virus in pregnant patients affected by being overweight or obese or having gestational diabetes, and the increased risk of premature delivery and/or low newborn weight.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Premature Birth , COVID-19/pathology , Female , Glucose , Glycosylation , Humans , Infant, Newborn , Inflammation , Obesity , Overweight , Pregnancy , Pregnancy Complications, Infectious/pathology , Pregnancy Complications, Infectious/virology , Pregnancy Outcome , Pregnant Women , Pyruvaldehyde , SARS-CoV-2 , Spike Glycoprotein, Coronavirus
16.
J Pak Med Assoc ; 72(7): 1391-1395, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-2057185

ABSTRACT

OBJECTIVE: To determine clinical characteristics, obstetrics and perinatal outcome of coronavirus disease 2019 infection in pregnant women. METHODS: The cross-sectional study was conducted at the Department of Obstetrics and Gynaecology of the Ruth Pfau Civil Hospital, Karachi, and Dow University of Health Sciences, Karachi, from August 2020 to July 2021, and comprised pregnant women with suspicion of coronavirus disease 2019 infection, who underwent recommended testing, and were found to be positive. Oral swabs for the presence of infection were also taken from the neonate within 24 hours of delivery. Data was analysed using Stata 11. RESULTS: There were 41 women with a mean age of 27±5 years, a mean gestational age of 35±3 weeks, and mean parity 1.2±1.01. Of them, 3(7.3%) women died. Medical complications found along with coronavirus disease 2019 infection were pregnancy-induced hypertension 2(4.8%), eclampsia 4(11%) and diabetes mellitus 2(4.8%). Fever was the most common symptom seen in 12(30%) women, followed by cough 7(20%) and shortness of breath 6(14%). Majority 32(82%) of the women underwent caesarean section. The most common maternal complication was postpartum haemorrhage 6(20%). Also, 36(86%) women required intensive care unit stay for a mean 5±9 days. CONCLUSIONS: Fever, followed by cough and breathlessness, were the most common clinical features. Most common maternal and foetal complication was postpartum haemorrhage and low birth weight, respectively.


Subject(s)
COVID-19 , Postpartum Hemorrhage , Adult , Cesarean Section , Cough , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Male , Pregnancy , Pregnancy Outcome , Pregnant Women , Young Adult
17.
Int J Clin Pract ; 2022: 2699532, 2022.
Article in English | MEDLINE | ID: covidwho-2053403

ABSTRACT

Objective: There are studies on the perinatal outcomes of COVID-19, but the audiometric effects of the maternal immune system against COVID-19 in the newborn are not clear. In this study, we aimed to investigate the relationship between the perinatal outcomes of COVID-19 positive pregnant women and the audiological outcomes of newborns. Materials and Methods: This retrospective, single-center cohort study was conducted with 65 polymerase chain reaction (PCR) positive pregnant women and newborns and 66 normal pregnant women and newborns who were admitted between January 2020-December 2021. Pregnancy data, perinatal outcomes, and newborn hearing test results of pregnant women and newborns were recorded and compared. Results: A total of 131 patients were enrolled in the study. The number of normal pregnant women was 66 (50.4%) and the number of pregnant women who had COVID-19 disease was 65 (49.6%). In general, gestational week, age, parity, biochemical parameters, duration of hospital stay, week of delivery, fetal weight, and apgar scores were compared between pregnant women with COVID-19 and normal. White blood cell (WBC), neutrophil, aspartate aminotransferase (AST), and C-reactive protein (CRP) parameters were found to be significantly higher, and lymphocyte and neutrophil/lymphocyte (N/L) ratios were significantly lower (p < 0.05). There was no statistically significant difference between the two groups (χ 2=0.001; p = 1,000). The normal delivery status, the normal delivery rate in patients with COVID-19 was found to be statistically significantly higher than the cesarean section delivery status (p = 0.012). In the statistical comparison between the COVID-19 and normal pregnant groups in the cesarean section group, the gestational week, delivery week, and apgar1 scores of the pregnant women with COVID-19 were found to be significantly higher. There was no statistically significant difference between the distributions of the rate of infants with hearing impairment in the comparison with hearing tests in pregnant women with COVID-19 (n=1) and normal pregnant women (n=1) (χ 2=0.001; p = 1,000). Conclusion: Although the negative effects of COVID-19 on pregnancy outcomes are rare, it was determined that there was no increased audiological risk factor, and the most important predictor of COVID-19 was lymphopenia.


Subject(s)
COVID-19 , Infant , Infant, Newborn , Pregnancy , Humans , Female , COVID-19/diagnosis , Cesarean Section , Pregnant Women , Retrospective Studies , Cohort Studies , C-Reactive Protein , Pregnancy Outcome , Aspartate Aminotransferases , Audiometry
18.
BMJ Open ; 12(10): e065588, 2022 10 03.
Article in English | MEDLINE | ID: covidwho-2053224

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has led to concerns about potential adverse pregnancy outcomes associated with infection, resulting in intensive research. Numerous studies have attempted to examine whether COVID-19 is associated with an increased risk of pregnancy loss. However, studies and reviews to date have drawn differing conclusions. The aim of this systematic review is to provide a summary of all quantitative research on the relationship between pregnancy loss and COVID-19 infection and, if appropriate, to synthesise the evidence into an overall effect estimate. METHODS AND ANALYSIS: Three publication databases (Embase, PubMed and Cochrane) and four preprint databases (medRxiv, Lancet Preprint, Gates Open Research and Wellcome Open Research) will be searched. Boolean logic will be used to combine terms associated with pregnancy loss and COVID-19. The population of interest are pregnant women. Retrieved results will be assessed in two phases: (1) abstract screening and (2) full text evaluation. All studies which compare pregnancy loss outcomes in women who had COVID-19 versus those who did not quantitatively will be included. Narrative and non-English studies will be excluded. Two reviewers will screen independently, with results compared and discrepancies resolved by the study team. Study quality and risk of bias will be assessed using a quality appraisal tool. Results will be summarised descriptively and where possible synthesised in a meta-analysis. ETHICS AND DISSEMINATION: This systematic review requires no ethical approval. This review will be published in a peer-reviewed journal and provide an important update in a rapidly evolving field of research. PROSPERO REGISTRATION NUMBER: CRD42022327437.


Subject(s)
Abortion, Spontaneous , COVID-19 , Abortion, Spontaneous/epidemiology , COVID-19/epidemiology , Female , Humans , Meta-Analysis as Topic , Pandemics , Pregnancy , Pregnancy Outcome/epidemiology , Research Design , Stillbirth/epidemiology , Systematic Reviews as Topic
19.
J Diabetes ; 14(10): 711-720, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2052157

ABSTRACT

AIMS: Our study aimed to investigate changes in the prevalence of gestational diabetes mellitus (GDM) in the COVID-19 pandemic and postpandemic era and the risk of adverse pregnancy outcomes in pregnant women diagnosed with GDM during the blockade period. METHODS: First, we investigated changes in the prevalence of GDM and the population undergoing oral glucose tolerance tests (OGTT) after the COVID-19 pandemic. We then collected clinical information from pregnant women diagnosed with GDM to explore the risk of adverse pregnancy outcomes in pregnant women with GDM during the COVID-19 pandemic. RESULTS: After the COVID-19 pandemic, the proportion of pregnant women in the total number of outpatient OGTT tests decreased yearly. The ratio was 81.30%, 79.71%, and 75.48% from 2019 to 2021, respectively, with the highest proportion of pregnant women in February 2020 (92.03%). The prevalence of GDM was higher in March 2020 compared to the same period in 2019. However, from 2019 to 2021, the prevalence decreased year by year with 21.46%, 19.81%, and 18.48%, respectively. The risk of adverse pregnancy outcomes for pregnant women diagnosed with GDM during the most severe period of the COVID-19 pandemic did not differ from before the COVID-19 pandemic. CONCLUSIONS: After the COVID-19 pandemic, the prevalence of GDM increased during the most severe period of the epidemic, but the overall prevalence of GDM decreased year by year. In addition, the pandemic did not change the risk of adverse pregnancy outcomes in pregnant women with GDM.


Subject(s)
COVID-19 , Diabetes, Gestational , COVID-19/epidemiology , China/epidemiology , Diabetes, Gestational/diagnosis , Diabetes, Gestational/epidemiology , Female , Humans , Pandemics , Pregnancy , Pregnancy Outcome/epidemiology , Retrospective Studies , Risk Factors
20.
Clin Infect Dis ; 75(Supplement_2): S308-S316, 2022 Oct 03.
Article in English | MEDLINE | ID: covidwho-2051338

ABSTRACT

BACKGROUND: The objective was to estimate risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy and assess adverse maternal and perinatal outcomes. METHODS: We used a population-based, retrospective cohort of all pregnancies with a live birth or fetal death in Florida from 1 March 2020 to 30 April 2021. Coronavirus disease 2019 (COVID-19) case reports were matched to vital registries. Outcomes assessed were risk of infection in pregnancy, preterm birth, maternal or neonatal admission to an intensive care unit (ICU), perinatal or fetal death, and maternal death. Modified Poisson and multinomial logistic regression models were used to derive relative risk estimates. RESULTS: Of 234 492 women with a live birth or fetal death during the study period, 12 976 (5.5%) were identified with COVID-19 during pregnancy. Risk factors for COVID-19 in pregnancy included Hispanic ethnicity (relative risk [RR] = 1.89), Black race (RR = 1.34), being unmarried (RR = 1.04), and being overweight or obese pre-pregnancy (RR = 1.08-1.32). COVID-19 during pregnancy was associated with preterm birth (RR = 1.31), Cesarean delivery (RR = 1.04), and neonatal (RR = 1.17) and maternal (RR = 3.10) ICU admission; no association was found with increased risk of perinatal (RR = 0.72) or fetal death (RR = 0.86). Women infected during any trimester showed increased risk of preterm birth. Fourteen maternal deaths were identified among COVID-19 cases; of those who died, 12 were obese. The death rate per 10 000 was 22.09 among obese and 1.22 among non-obese gravida with COVID-19 during pregnancy (RR = 18.99, P = .001). CONCLUSIONS: Obesity is a risk factor for SARS-CoV-2 infection in pregnancy and for more severe COVID-19 illness among pregnant women. SARS-CoV-2 infection is associated with preterm birth.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Premature Birth , COVID-19/epidemiology , Female , Fetal Death , Florida/epidemiology , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome/epidemiology , Premature Birth/epidemiology , Retrospective Studies , SARS-CoV-2
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