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1.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.03.19.24304557

ABSTRACT

Pandemic-related health service adaptations raised concerns about provision of quality, respectful maternity care globally. Despite this, little research has focused on the experiences of those using intrapartum care during this time. This study aimed to elevate the voices and document the experiences of birthing people in Nampula Province, Mozambique during the COVID-19 pandemic. We conducted a longitudinal qualitative study from March-August 2021 and present an analysis of the 17 follow-up in-depth interviews conducted with participants who had a vaginal live birth. Interviews explored participants experience of labor and delivery care. They were conducted in Makua and Portuguese, audio-recorded, transcribed and translated. We applied thematic content analysis. Overall, participants did not express major concerns about COVID-19 or related service adaptations when describing their experiences of intrapartum care. Some noted its negative effects on elements of respectful care such as restricting birth companions. Overcrowding became more concerning due to the threat of infection. While unclear if affected by the pandemic, all participants who gave birth at a health facility reported experiencing at least one form of mistreatment, some recounting threats of cesarean delivery. Most explained that they and their newborns received care without their consent, especially regarding enemas and episiotomies. At the same time, respondents described a range of intrapartum experiences that included both respectful and disrespectful care. Most recalled positive verbal communication with their providers and many described receiving continuous attentive care. Participants explained that their satisfaction with childbirth services was tied to their birth outcome and their experience of respectful care. The findings indicate that steadfast commitments to quality care are critical to ensure families benefit from high-quality, respectful care at all times. The ramifications of the COVID-19 pandemic were limited but nonetheless signal a need for tighter connections between maternal health and emergency preparedness stakeholders.


Subject(s)
COVID-19
2.
arxiv; 2024.
Preprint in English | PREPRINT-ARXIV | ID: ppzbmed-2402.06066v1

ABSTRACT

Faced with novel coronavirus outbreak, the most hard-hit countries adopted a lockdown strategy to contrast the spread of virus. Many studies have already documented that the COVID-19 control actions have resulted in improved air quality locally and around the world. Following these lines of research, we focus on air quality changes in the urban territory of Chieti-Pescara (Central Italy), identified as an area of criticality in terms of air pollution. Concentrations of NO2, PM10, PM2.5 and benzene are used to evaluate air pollution changes in this Region. Data were measured by several monitoring stations over two specific periods: from 1st February to 10 th March 2020 (before lockdown period) and from 11st March 2020 to 18 th April 2020 (during lockdown period). The impact of lockdown on air quality is assessed through functional data analysis. Our work makes an important contribution to the analysis of variance for functional data (FANOVA). Specifically, a novel approach based on multivariate functional principal component analysis is introduced to tackle the multivariate FANOVA problem for independent measures, which is reduced to test multivariate homogeneity on the vectors of the most explicative principal components scores. Results of the present study suggest that the level of each pollutant changed during the confinement. Additionally, the differences in the mean functions of all pollutants according to the location and type of monitoring stations (background vs traffic), are ascribable to the PM10 and benzene concentrations for pre-lockdown and during-lockdown tenure, respectively. FANOVA has proven to be beneficial to monitoring the evolution of air quality in both periods of time. This can help environmental protection agencies in drawing a more holistic picture of air quality status in the area of interest.


Subject(s)
Sleep Apnea, Central , COVID-19
3.
authorea preprints; 2024.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.170669213.35323604.v1

ABSTRACT

Background: There is an urgent need to review the status of COVID-19 vaccine immunization in pregnant women globally so that the adverse outcomes may be prevented. Objective: To evaluate the probable outcome of COVID-19 vaccination in pregnant women. Search strategy: An electronic search was conducted over the period of 3 months (June 15-August 15, 2021). Selection criteria: The original studies evaluating safety concerns in pregnant women for COVID-19 vaccination were included. Data collection and analysis: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 guidelines were used for the collection of the data and reporting of the findings. The inclusion and exclusion criteria for the studies were determined based on ‘PICO principle’ (Population, Intervention, Comparator, and Outcome, Study design. Risk of bias assessment was done using National Institute of Health (NIH) tool for systematic reviews. Main results: COVID-19 vaccination in pregnant women was not associated with increased adverse effects or complications to the mother as well as developing fetus or newborn compared to non-vaccinated pregnant women. Vaccinated pregnant women showed a robust immune response against COVID-19 infection. Conclusions: COVID-19 vaccination during pregnancy causes no significant health risks for the mother or developing fetus or newborn.


Subject(s)
COVID-19
4.
authorea preprints; 2024.
Preprint in English | PREPRINT-AUTHOREA PREPRINTS | ID: ppzbmed-10.22541.au.170669452.27361474.v1

ABSTRACT

Abstract Background: Lung ultrasound (LUS) has become an important tool in diagnosing and following an adult patient with COVID-19; however, the literature for the pediatric age group is limited. Herein, we reviewed the up-to-date literatures on ultrasound use for COVID-19 pediatric patients for better management of COVID-19 in children. Methods and Objectives: The search terms “COVID-19,” “SARS-CoV2,” “coronavirus,” “2019-nCoV,” “lung ultrasound,” “sonography,” “adolescents” “children,” “childhood” and “newborn” were searched on the online databases PubMed, Embase and Medline. Articles meeting the inclusion criteria were included in the analysis and review. Results: We identified only fifteen studies to date using LUS to diagnose SARS-CoV-2 infection in children. These studies involved a total of 334 newborns, children and adolescents. Regarding the use of chest X-ray (CXR) and LUS in pediatric patients with COVID-19, we identified six studies with a total of 162 participants, with the following results: 33patients(14.11%) with lung abnormalities on lung US had a normal CXR; however, no patients with normal lung US had abnormalities on the CXR. In addition, regarding the use of computed tomography (CT) and LUS in pediatric patients with COVID-19 infection, we identified five studies with a total of 50 participants and 3 patients(6%) with lung abnormalities on chest LUS had a normal CT. Conclusion: Our findings suggest that LUS is a useful tool in the diagnosis of children and reduction in chest CT assessments may be possible when LUS is used in early diagnosis and follow-up monitoring of COVID-19 pneumonia in the children.


Subject(s)
Lung Diseases , Pneumonia , COVID-19
5.
medrxiv; 2024.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2024.01.18.24301357

ABSTRACT

BackgroundThe outbreak of COVID 19 in 2019 lead to destabilization of all sectors globally including access to health care. The strain on the health care system as a result of the disease outbreak led to a shift in operations in the health care system. Maternal and neonatal care was affected as women and their families could not freely access health care owing to the restrictions to curb the spread of COVID 19. This led to a risk of a reversal in the gains made in maternal and neonatal health, prompting the need to strengthen community midwifery. AimThe aim of this study was to strengthen community reproductive, maternal and newborn health in the context of COVID-19 pandemic in Kenya. Materials and methodsThis is part of an interventional study that sought to strengthen community maternal and neonatal health services. A baseline survey was conducted to assess the uptake of reproductive, maternal and neonatal care services in one sub-county in Kilifi and Kitui, where five wards in each sub-county were selected. An interviewer administered questionnaire was used to collect data. The sample size for the two Counties was 414. ResultsThere was a total of 378 respondents mostly comprising a rural population 75.7% (n=286). Outpatient and COVID 19 services (tests and vaccine) were most sought 37.5% (n= 137) and 29.9% (n=109) respectively. Antenatal care services were sought by 26% (n=95) of the respondents, postnatal care 9% (n=33) and skilled birth attendance 8.8% (n=32). ConclusionThe most utilized health facility services were outpatient and COVID 19 services. Antenatal care was also sought, however skilled birth attendance and postnatal care services were least sought.


Subject(s)
COVID-19
6.
ClinicalTrials.gov; 05/01/2024; TrialID: NCT06238648
Clinical Trial Register | ICTRP | ID: ictrp-NCT06238648

ABSTRACT

Condition:

Diffuse Large B-Cell Lymphoma, Not Otherwise Specified;Primary Mediastinal Large B-Cell Lymphoma;Transformed Indolent B-Cell Non-Hodgkin Lymphoma to Diffuse Large B-Cell Lymphoma

Intervention:

Procedure: Biopsy;Procedure: Biospecimen Collection;Procedure: Computed Tomography;Biological: Epcoritamab;Procedure: Magnetic Resonance Imaging;Other: Patient Observation;Procedure: Positron Emission Tomography

Primary outcome:

Objective status of complete response (CR)

Criteria:


Inclusion Criteria:

- Men and women >= 18 years of age

- Documented histological confirmation of diffuse large b-cell lymphoma not otherwise
specified [DLBCL NOS], primary mediastinal large b-cell lymphoma (LBCL), or
transformations of indolent B-cell lymphomas, according to the 5th edition of World
Health Organization (WHO) classification of lymphoid neoplasms, with CD20 positivity
as determined by assessment of tumor cells =< 6 months prior to registration pre-
CAR-T biopsy specimen by immunohistochemistry or flow cytometry

- Patients treated with the commercially available CD19-directed CAR-T products
axicabtagene ciloleucel (axi-cel), tisagenlecleucel (tisa-cel), or lisocabtagene
maraleucel (liso-cel), and who have a partial response at day 30 +/- 7 days PET- CT
assessment based on Lugano criteria (Deauville score of 4 or 5)

- Documented measurable disease

- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, or 2. (Form is
available on the Academic and Community Cancer Research United [ACCRU] web site under
Study Resources -> Forms)

- Absolute neutrophil count (ANC) >= 1,000/mm^3, granulocyte colony stimulating factor
(G-CSF) allowed (obtained =< 14 days prior to registration)

- Platelet count >= 50,000/mm^3 (obtained =< 14 days prior to registration)

- Hemoglobin >= 7.0 g/dL if asymptomatic or hemoglobin > 8 if symptomatic; transfusion
support allowed, if necessary (obtained =< 14 days prior to registration)

- NOTE: symptoms include shortness of breath, fatigue, lightheadedness

- Total bilirubin =< 1.5 x upper limit of normal (ULN) unless bilirubin rise is due to
Gilbert's syndrome or of non-hepatic origin or lymphoma involvement of the liver and
total bilirubin is =< 5 x ULN (obtained =< 14 days prior to registration)

- Alanine aminotransferase (ALT) and aspartate transaminase (AST) =< 3 x ULN (=< 5 x ULN
for patients with liver involvement) (obtained =< 14 days prior to registration)

- Calculated creatinine clearance must be >= 45 mL/min using the Crockcroft- Gault
formula (obtained =< 14 days prior to registration)

- NOTE: If your site laboratory reports use different units of measurement than
what is required by the protocol eligibility requirements, please use the "Lab
Test Unit Conversion Worksheet" available on the ACCRU website under "General
Forms."

- Negative serum pregnancy test done =< 7 days prior to registration for a woman of
childbearing potential (WOCBP) only

- NOTE: A WOCBP is a sexually mature female who:

- Has not undergone a hysterectomy or bilateral oophorectomy; or

- Has not been naturally postmenopausal for at least 12 consecutive months
(i.e., has had menses at any time in the preceding 12 consecutive months)

- Provide informed written consent =< 28 days prior to registration

- Willing to return to enrolling institution for follow-up (during the active monitoring
phase of the study, i.e., active treatment and clinical follow-up)

- Willing to provide mandatory tissue specimens and blood specimens for correlative
research purposes

Exclusion Criteria:

- Patients post CAR-T who have bulky disease defined as a disease focus >= 7.5cm in
diameter at day 30 +/- 7 days PET-CT assessment

- Patients post CAR-T who have progressive disease, stable disease or complete response
at day 30 +/- 7 days PET-CT assessment based on Lugano criteria

- Any of the following because this study involves an investigational agent whose
genotoxic, mutagenic, and teratogenic effect on the developing fetus and newborn are
unknown

- Pregnant persons

- Nursing persons

- Persons of childbearing potential who are unwilling to employ adequate
contraception (men and women)

- Any of the following prior therapies:

- CD20xCD3 bispecific antibody at any point prior to registration

- CD20-targeted monoclonal antibody (e.g., rituximab, obinutuzumab or biosimilars)
=< 4 weeks prior to registration

- Ongoing cytokine release syndrome (CRS) or neurotoxicity post CAR-T

- Prior grade 4 CRS or neurotoxicity after most recently administered CAR-T

- Primary central nervous system (CNS) lymphoma or CNS involvement by lymphoma at
screening and based on clinical symptoms, MRI, or lumbar puncture

- Co-morbid systemic illness or other severe concurrent disease which, in the judgement
of the investigator, would make the patient inappropriate for entry into the study or
interfere significantly with the proper assessment of safety and toxicity of the
prescribed regimens

- Uncontrolled intercurrent illness including, but not limited to:

- Ongoing or active infection requiring systemic treatment (excluding prophylactic
treatment) =< 14 days prior to registration, including COVID- 19 infection.

- NOTE: If evidence of chronic hepatitis B virus (HBV) infection, HBV viral
load must be undetectable and on suppressive therapy.

- NOTE: If history of treated hepatitis C virus (HCV) infection, HCV viral
load must be undetectable.

- NOTE: Patients known to be human immunodeficiency virus (HIV) positive, but
stable on anti-retroviral therapy with an undetectable HIV viral load
pre-CART, are eligible for this trial.

- NOTE: Simple urinary tract infection (UTI) and uncomplicated bacterial
pharyngitis are permitted if responding to active treatment

- NOTE: Past COVID-19 infection may be a risk factor, but if resolved symptoms
and the subject is vaccinated, they may be enrolled

- Symptomatic congestive heart failure (New York Heart Association [NYHA] class 3
or 4)

- Unstable angina pectoris

- Unstable cardiac arrhythmia present =< 14 days prior to registration

- Psychiatric illness/social situations that would limit compliance with study
requirement

- History or presence of CNS disorder such as seizure disorder (not including
resolved childhood febrile seizures), cerebrovascular ischemia/hemorrhage (not
including transient ischemic attacks), cerebellar disease, or any autoimmune
disease with CNS involvement

- Receiving any other investigational agent which would be considered treatment for the
primary neoplasm =< 14

7.
ClinicalTrials.gov; 18/09/2023; TrialID: NCT06052371
Clinical Trial Register | ICTRP | ID: ictrp-NCT06052371

ABSTRACT

Condition:

Diabetes Mellitus

Intervention:

Device: VerioVue (Enhancements) blood glucose monitoring system

Primary outcome:

Performance evaluation: blood glucose monitoring system accuracy: BGMS vs reference instrument

Criteria:


Inclusion Criteria:

- Age - Newborn babies, 28 days old or less with a corrected gestational age of at least
34 weeks and a weight of at least 1700g or more at the time of participation.

- Informed Consent - Study participants parents must read the Parental Participant
Information Sheet and sign the Parental Informed Consent Form

- Study participants parent agrees to provide information related to demographics,
prescription medication, dietary supplements, and results from other physician ordered
testing e.g., Bilirubin (total, conjugated, and unconjugated) where available.

- Study participants parent agrees to allow study staff access to medical records where
necessary.

- Study participants parents agree to all aspects of the study process, including where
applicable arterial blood draw from an existing arterial line or a heel prick
performed by an HCP for medical purposes.

Exclusion Criteria:

- Age- Newborn more than 28 days old.

- Study participants with a gestational age of less than 34 weeks at the time of
participation.

- Study participants with a gestational weight of less than 1700g

- Current positive test result for Covid-19.


8.
medrxiv; 2023.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2023.07.26.23293218

ABSTRACT

BackgroundNeonatal mortality is a global problem especially in resource-poor settings such as sub-Saharan African Countries. Trends and factors associated with neonatal mortality vary in different settings. This cross-sectional study investigated trends and factors that are associated with increased neonatal mortality among hospitalised neonates with a view of identifying pointers that can be modified to help improve neonatal survival. MethodsMedical records for all neonates admitted to the NICU in 2018 and 2019 were reviewed for the study. The Mortality rates were calculated using WHO standard and Microsoft excel 2010 used to construct monthly trends analysis using monthly totals. Univariate and multivariate logistic regression analysis to determine the factors associated with neonatal deaths at the tertiary facility using Stata version 14.2. Model fit was evaluated using Hosmer and Lemeshow test (chi2=13.90, P =0.0845), implies the models estimates fit the data at an acceptable level. ResultsA total of 7,581 admissions were seen and 2340 files were extracted for analysis, of which 940 (40.2%) died. The overall Neonatal mortality percentage during the study period was 31.8%. Relatively similar trends were observed during the study period with differences in case fatality rates. Factors associated with an increased odds of dying were not attending antenatal care (AOR=2.09, 95% CI [1.46 - 2.99] p <0.0001), parity (AOR=1.09, 95% CI [1.02 - 1.16] p=0.0013) and age of the neonate in days (AOR=0.92, 95% CI [0.91- 0.94] p <0.0001). ConclusionNeonatal mortality is high among hospitalized neonates at the Women and New-born Hospital in Zambia. Associated Factors included no antenatal attendance, increased parity, and early age of the neonate. This has detrimental effects; hence emphasis is on early Antenatal Care for easy monitoring of mother and neonates for fast actions in case of complications

9.
preprints.org; 2023.
Preprint in English | PREPRINT-PREPRINTS.ORG | ID: ppzbmed-10.20944.preprints202307.1683.v1

ABSTRACT

The COVID-19 pandemic has raised questions about indirect impact in pregnant women on the development of their future children. Investigating the characteristics of lipid metabolism in the "mother-placenta-fetus" system can give information about the pathophysiology of COVID-19 infection during pregnancy. 234 women were included in study. Maternal plasma, cord blood, amniotic fluid lipidome were analyzed using HPLC-MS/MS. Differences in lipid profile were searched by Manna-Whitney and Kruskall-Wallis test, diagnostic model based on logistic regres-sion were bilt by AIC. Elevation levels of lysophospholipids, triglycerides, sphingomyelins, and oxidized lipids was registered in patients’ after COVID-19 maternal and cord plasma. An increase in maternal plasma sphingomyelins and oxidized lipids was observed in cases of infection during the second trimester. In amniotic fluid, compared to the control group, nine lipids are reduced, six lipids are elevated. Levels of phosphoglycerides, lysophosphoglycerides, and phosphatidylinosi-tols decreased during infection in the second and third trimesters of pregnancy. Newborn’s health diagnostic model based on maternal plasma were developed for each group and exhibit good di-agnostic value (AUC> 0.85). Maternal and cord plasma’s lipidome changes during delivery, asso-ciated with Covid-19 infection during pregnancy, are synergistic. The most significant disturbances occur with infections in the second trimester of pregnancy.


Subject(s)
Lipid Metabolism Disorders , COVID-19
11.
ClinicalTrials.gov; 09/07/2023; TrialID: NCT05948020
Clinical Trial Register | ICTRP | ID: ictrp-NCT05948020

ABSTRACT

Condition:

Phenylketonuria

Intervention:

Biological: CBT102-A capsule;Other: Placebo capsule

Primary outcome:

Changes from Baseline in Blood Phe Concentration

Criteria:


Inclusion Criteria:

- Blood phe = 600µmol/L at newborn screening;

- Blood phe = 600µmol/L at least 3 times in the last 1 year before screening, and the
blood Phe = 600µmol/L in the last 1 time;

- Screening laboratory evaluations (e.g., chemistry panel, complete blood count,
urinalysis, creatinine clearance, CRP) within normal limits or judged to be not
clinically significant by the investigator;

- Stable diet for at least 60 days prior to screening;

- Able to produce at least 2 bowel movements per week on average without using any form
of laxatives;

- Adolescents and children's guardians can voluntarily complete the whole process of
informed consent, including stool, urine and blood collection, adherence to diet
control, hospital monitoring, follow-up and oral trial drug compliance, and sign
informed consent.

Exclusion Criteria:

- The standard percentile values of height and weight of Chinese children aged 0 to 18
years were evaluated with weight less than P3 or weight greater than P97;

- History of active or chronic passage of 3 or more loose stools per day;

- Have any medical conditions or medications that may affect the absorption of
medications or nutrients;

- History of or current immunodeficiency disorder including autoimmune disorders;

- Subjects with obvious influenza-like symptoms caused by COVID-19 or other viral
infections during screening;

- Hepatitis B surface antigen and/or hepatitis C antibodies and/or treponema pallidum
antibodies positive;

- Subjects who are dependent on drugs and alcohol;

- Received gene therapy related to PKU;

- Intolerant or allergic to Escherichia coli Nissle 1917 (EcN);

- Active gastrointestinal bleeding or a proven history of gastrointestinal bleeding
within 60 days prior to screening;

- Antibiotics within 28 days before the planned first dose of investigational product
(IP), or anticipated during the study period;

- Take probiotic supplements within 28 days before the planned first dose of IP, or
anticipated during the study period;

- A history of fever, confirmed bacteremia, or other active infection within 30 days
prior to the planned first dose of IP;

- Drugs that use of the digestive system has been used within 30 days prior to the
planned first dose of IP;

- Drugs that may affect gastrointestinal function has been used within 30 days prior to
the planned first dose of IP;

- Major survery performed within 90 days before the anticipated first dose of IP or
planned surgery or hospitalization during the study period;

- Take sapropterin (KUVAN®) within 1 week before the planned first dose of IP;

- Use pegylated recombinant phenylalanine ammonia lyase (PALYNZIQ™) within 30 days
before the planned first dose of IP;

- History of severe immune adverse reactions to PALYZIQ;

- Participated in an interventional clinical trial and used the investigational drug
within 60 days or 5 half-lives before the planned first dose of IP;

- Subjects who may not be able to complete the study for other reasons.


12.
J Gynecol Obstet Hum Reprod ; 51(10): 102509, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-20241820

ABSTRACT

OBJECTIVE: To report results of the 2021 French National Perinatal Survey (ENP) in metropolitan France and assess trends in the main indicators of perinatal health, medical practices, and risk factors in France since 1995. POPULATION AND METHOD: All the samples included all women giving birth at a gestational age of at least 22 weeks of gestation and/or to an infant weighing at least 500 grams in all maternity units in metropolitan France during one week in 1995 (N=13 048), 2003 (N=14 324), 2010 (N=14 546), 2016 (N=12 553), and 2021 (N=12 088). The data came from postpartum interviews of the women at the hospital and their medical records. Comparisons between surveys showed trends over time. RESULTS: Between 1995 and 2021, maternal characteristics changed. Maternal age and the frequency of women with obesity rose: in 2021, 24.6% of women were 35 years or older (21.1% in 2016, 19.2% in 2010, 15.9% in 2003 and 12.4% in 1995) and 14.4% were obese (11.8% in 2016, 9.9% in 2010 and 7.4% in 2003). Some antenatal prevention behaviors that improved in 2021 were not smoking during the third trimester, acid folic administration before pregnancy, and vaccination against influenza. The percentage of women with an early prenatal appointment ("4th month appointment"), implemented to facilitate screening of maternal vulnerability during pregnancy, has continued to rise. The percentage of women receiving prenatal care by midwives has risen markedly (39.0% in 2021 versus 11.7% in 2016). Serum screening for Down syndrome continues to increase (91.8% of women in 2021). The rate of induction of labor has risen significantly (20.2% in 1995 and 25.8% in 2021). The mode of delivery has not varied significantly since 2003; in 2021, the cesarean rate was 21.4% and the instrumental vaginal delivery rate 12.4%. Episiotomy was increasingly rare, among both primiparous and multiparous women (16.5% and 2.9% in 2021, respectively). The prevalence of coronavirus (SARS-CoV2) infection during pregnancy was 5.7%. Preterm live births increased regularly, slightly but significantly over the 1995-2016 period and then remained stable between 2016 and 2021 (7.0%). In 2021, 56.3% of women exclusively breastfed during their hospital stay, a modest increase in comparison with 2016 (54.6%). CONCLUSION: Routine national perinatal surveys highlight positive trends over time in some preventive practices, decreases in some medical interventions consistent with national guidelines, and the increasing role of midwives in prenatal care. Nonetheless, some indicators remain less than optimal and require more detailed analyses.


Subject(s)
COVID-19 , RNA, Viral , Pregnancy , Infant , Infant, Newborn , Female , Humans , SARS-CoV-2 , Parturition , Delivery, Obstetric
13.
Cien Saude Colet ; 27(11): 4195-4202, 2022 Nov.
Article in Spanish | MEDLINE | ID: covidwho-20239494

ABSTRACT

The COVID-19 pandemic induced changes in the dynamics of the life of women in the perinatal phase who, due to the health crisis, restructured social care and coexistence practices. The scope of this paper was to assess the experiences of high-risk perinatal pregnancy risk among COVID-19 positive women through social interaction. The work was conducted in a hospital of tertiary perinatal care. Qualitative methodology was used, whereby questionnaires and interviews were conducted via zoom with 14 COVID-19 positive women in the perinatal phase. Critical-interpretative discourse analysis was applied based on the concept of social interaction and complex thinking. Three types of social interaction were developed to assess the results: a) Initial social interaction: experiences when becoming aware of being COVID-19 positive; b) Acquired social interaction: experiences of care prior to COVID-19; c) Enduring social interaction: experience required in the face of COVID-19. The result of experience leads to new forms of social interaction after notification ranging from care to resilience. The conclusion drawn is that the experience of COVID-19 of women in the perinatal period remodeled their ways of coexistence and care within the institutional, family, and personal spheres.


La pandemia COVID-19 provocó cambios en la dinámica de la vida de las mujeres en etapa perinatal quienes, ante la crisis sanitaria reconfiguraron prácticas de cuidado y convivencia social. El objetivo fue conocer a través de la interacción social algunas experiencias de mujeres con embarazo de alto riesgo positivas a COVID-19. El trabajo se realizó en un hospital de tercer nivel de atención perinatal. Se empleó metodología cualitativa, se aplicaron cuestionarios y entrevistas a 14 mujeres positivas a COVID-19 en etapa perinatal vía zoom. Se realizó análisis crítico-interpretativo del discurso con base al concepto interacción social y el pensamiento complejo. Para los resultados se desarrollaron tres tipos de interacción social: a) Interacción social primaria: Experiencias ante la notificación de la positividad al COVID-19; b) Interacción social aprendida: Experiencias del cuidado ante el COVID-19; y c) Interacción social resiliente: Experiencias necesarias ante el COVID-19. El vínculo de las experiencias desemboca en nuevas formas de interacciones sociales que van desde la notificación pasando por el cuidado y la resiliencia. Concluimos que las experiencias por el COVID-19 vividas por mujeres en etapa perinatal reinventaron sus modos de convivencia y cuidado dentro de lo institucional, familiar y personal.


Subject(s)
COVID-19 , Pregnancy , Infant, Newborn , Child , Female , Humans , Pandemics , Parturition , Social Support , Perinatal Care
14.
Front Glob Womens Health ; 3: 929173, 2022.
Article in English | MEDLINE | ID: covidwho-20236891

ABSTRACT

Midwives are the front-line workers providing maternity care for women in many countries. The role of the midwife includes providing information about, and recommendations for, maternal vaccination in pregnancy and for the baby in the postnatal period. Vaccinations recommended in pregnancy include those to prevent influenza, pertussis, tetanus and now COVID-19. Vaccinations for the newborn baby include hepatitis B. Healthcare professionals play an important role in influencing decision-making around vaccination and midwives are key in supporting vaccination uptake. Midwives are strong influencer in women's decisions around vaccination for themselves and their babies. The COVID-19 vaccination programs have shone a light on vaccination in pregnancy especially as SARS-COV-2 infection has significant adverse effects in pregnancy. COVID-19 vaccination has been shown to be safe and effective in pregnancy. Despite this, there is vaccine hesitancy from pregnant women in many countries. Midwives play a unique role in the provision of care to women and families but they need specific support and information regarding vaccination in pregnancy. Targeted education, supportive mentoring and supervision and opportunities to lead innovative ways of ensuring vaccine access is logistically easy and possible are all needed. This Commentary outlines the key vaccinations recommended in pregnancy including COVID-19 vaccination and highlights some strategies to scale-up vaccination programs in pregnancy with a particular focus on the role of midwives.

15.
Open Access Macedonian Journal of Medical Sciences ; 11(B):293-298, 2023.
Article in English | EMBASE | ID: covidwho-20245045

ABSTRACT

BACKGROUND: Pregnant women are vulnerable against COVID-19 infection due to physiological and immunological changes. COVID-19 in pregnancy affects fetal well-being with a potential for vertical infection. AIM: This study aims to determine the incidence of vertical infection and anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in infants born to mothers with positive COVID-19 infection. MATERIALS AND METHODS: Amniotic fluid, swabs of the newborn's nasopharynx and oropharynx, and swabs of the placenta were examined using reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2. Serological examination was performed by Electro-Chemiluminescence Immunoassay on infant's blood. RESULT(S): Four of 33 pregnant women gave birth to infants positive SARS-CoV-2 infection. RT-PCR examination of all amniotic fluid and placental swabs was negative for SARS-CoV-2. Four of 33 infants (12.1%) showed negative polymerase chain reaction (PCR) results but positive SARS-CoV-2 antibodies, another 4 newborns (12.1%) showed positive PCR results, but no SARS-CoV-2 antibodies detected. The remaining 25 babies (75.8%) showed both negative PCR and serologic results. CONCLUSION(S): No evidence of vertical transmission found in this study.Copyright © 2023 Cut Meurah Yeni, Zinatul Hayati, Sarjani M. Ali, Hasanuddin Hasanuddin, Rusnaidi Rusnaidi, Cut Rika Maharani.

16.
Birth Defects Research ; 115(8):844, 2023.
Article in English | EMBASE | ID: covidwho-20243926

ABSTRACT

Background: Studies suggest perinatal infection with SARSCoV- 2 can induce adverse birth outcomes, but studies published to date have substantial limitations. Most have identified cases based upon their presentation for clinical care, and very few have examined pandemic-related stress which may also impact adverse birth outcomes. Objective(s): To evaluate the relationships between SARSCoV- 2 infection in pregnancy and pandemic-related stress with birth outcomes. Study Design: We conducted an observational study of 211 mother-newborn dyads in three urban cohorts participating in the Environmental Influences on Child Health Outcomes (ECHO) Program. Serology for SARS-CoV-2 was assessed in a convenience sample of prenatal maternal, cord serum or dried blood spots from births occurring between January 2020-September 2021. Specimens were assessed for IgG, IgM, and IgA antibodies to nucleocapsid, S1 spike, S2 spike, and receptor-binding domain. A Pandemic-related Traumatic Stress (PTS) scale was based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Acute Stress Disorder criteria. Result(s): 36% were positive for at least one antibody type, chiefly IgG. Self-report of infection was not significantly correlated with combined serology. There were no differences in gestational age (GA), birth weight, preterm birth (PTB), or low birth weight (LBW) among seropositive mothers. However, IgM seropositive mothers had children with lower BW (434g, 95% CI: 116- 752), BW Z score-for-GA (0.73 SD, 95% CI 0.10-1.36) and were more likely to deliver preterm (OR 8.75, 95% CI 1.22-62.4). Associations with LBW sustained in sensitivity analyses limited to pre-vaccine samples, and PTS symptoms were not associated with birth outcomes. The addition of PTS did not substantially change associations with BW, although associations with PTB attenuated to near-significance. Conclusion(s): We identified decreased birth weight and increased prematurity in mothers IgM seropositive to SARS-CoV-2, independent of PTS. Though there are limits to interpretation, the data support efforts to prevent SARS-CoV-2 infections in pregnancy.

17.
The Psychoanalytic Study of the Child ; 75(1):22-36, 2022.
Article in English | APA PsycInfo | ID: covidwho-20241937

ABSTRACT

This article reviews the evolution of a newborn through the first year of life and the potential impacts of COVID-19 on the infant, parent, and the parent-infant relationship. Babies grow in the context of relationships, and the quality of those relationships affects the physiological and psychological organization of the baby. Precisely because each baby is a being with unique biology, temperament, and ways of experiencing, feeling, and learning, much is to be discovered and understood about them. The baby's wordless communications require their parents to intuit, infer, hypothesize, and experiment as parents come to know the needs of their baby. As we walk alongside parents who struggle to come to know their infant-even as the infant is coming to know them-we are required to have conceptual knowledge of how a newborn becomes a fully awakened infant. Under typical conditions, the birth of a firstborn baby presents a caregiving challenge and developmental opportunity for the emerging parent. Environmental context can serve to support or interfere in the success of the adjustment. This paper will explore some theoretical underpinnings that contribute to infant and parent well-being and the possible impact of being born during the COVID-19 pandemic. Also considered will be the undue burden of families bearing the weight of economic inequities, oppression, and structurally supported racism. This article will explore the influence of parental perception, the development of attachment relationships, and how that is influenced by and influences infant communication. Finally, it will suggest ways that psychotherapists seeing individuals who are parents can hold the infant in mind as they work to understand and respond to their adult clients navigating the impacts of this pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

18.
Pediatric Dermatology ; 40(Supplement 2):20, 2023.
Article in English | EMBASE | ID: covidwho-20241213

ABSTRACT

Objectives: A 7-month-old boy presented with generalized urticaria since the first week of life, without any other clinical manifestation. Cow's milk allergy was ruled out. His development was normal for his age. Maternal history was significant for COVID-19 infection in the third trimester of pregnancy with mild symptoms. Family history was significant for dermatographism in a maternal uncle. Hives were migratory with no single lesion persisting more than 24 h. There were no recognizable triggers and only relieved for 1-2 days after each vaccination. Patient was treated with optimal doses of antihistamines without improvement. Method(s): Laboratory tests and further studies were performed Results: Laboratory tests were normal including complete blood testing, circulating autoantibodies and infectious studies. C-reactive protein level and erythrocyte sedimentation rate were elevated. Due to chronic urticaria of newborn onset unresponsive to antihistamines a monogenic autoinflammatory disease was suspected. A targeted gene panel covering causative genes revealed the unreported p.Gly307Ala variant in the NLRP3 gene with a variant allele frequency (VAF) of 3% compatible with gene mosaicism. NLRP3 variant was classified as "likely pathogenic" based on its location, where a different variant has been reported as causing a severe form of cryopyrin-associated periodic syndromes (CAPS), and bioinformatic analyses. As expected, the variant was absent in patient's parents supporting for its de novo nature. Vision and hearing exams were normal. Treatment with canakinumab will start soon. Discussion(s): CAPS are dominantly-inherited autoinflammatory diseases caused by gain-of-function NLRP3 variants. These variants are often germline, but in some reported cases the variants are postzygotic causing gene mosaicism as in the patient here described. We believe that the mild presentation in our patient, despite having a likely pathogenic variant, may be explained by the low VAF. The genetic diagnosis in our patient allowed early initiation of anti-IL-1 treatment, which probably will prevent the development of other CAPS manifestations.

19.
Geburtshilfe und Frauenheilkunde ; 83(5):517-546, 2022.
Article in English, German | EMBASE | ID: covidwho-20241160

ABSTRACT

Objective This S2k guideline of the German Society for Gynecology and Obstetrics (DGGG) and the German Society of Perinatal Medicine (DGPM) contains consensus-based recommendations for the care and treatment of pregnant women, parturient women, women who have recently given birth, and breastfeeding women with SARS-CoV-2 infection and their newborn infants. The aim of the guideline is to provide recommendations for action in the time of the COVID-19 pandemic for professionals caring for the above-listed groups of people. Methods The PICO format was used to develop specific questions. A systematic targeted search of the literature was carried out using PubMed, and previously formulated statements and recommendations issued by the DGGG and the DGPM were used to summarize the evidence. This guideline also drew on research data from the CRONOS registry. As the data basis was insufficient for a purely evidence-based guideline, the guideline was compiled using an S2k-level consensus-based process. After summarizing and presenting the available data, the guideline authors drafted recommendations in response to the formulated PICO questions, which were then discussed and voted on. Recommendations Recommendations on hygiene measures, prevention measures and care during pregnancy, delivery, the puerperium and while breastfeeding were prepared. They also included aspects relating to the monitoring of mother and child during and after infection with COVID-19, indications for thrombosis prophylaxis, caring for women with COVID-19 while they are giving birth, the presence of birth companions, postnatal care, and testing and monitoring the neonate during rooming-in or on the pediatric ward.Copyright © 2023. Thieme. All rights reserved.

20.
American Journal of Reproductive Immunology ; 89(Supplement 1):32, 2023.
Article in English | EMBASE | ID: covidwho-20239846

ABSTRACT

SARS-CoV-2 infection during pregnancy is associated with increased risk of adverse maternal and pregnancy outcomes. Maternal COVID- 19 is associated with immune activation and inflammatory response in the pregnant individual and an altered immune repertoire in the placenta. Mother-to-child transmission of infection is reported but uncommon. Still, the potential impact of maternal SARS-CoV-2 infection on the immunologic and inflammatory state of the infant is of interest, both for the acute health of the newborn and longer-term outcomes. In this talk, we will discuss the mixed data from cord blood and infant studies of cytokine profiles, transcriptomics, immunophenotyping, and functional studies. We will address the timing and severity of maternal infection as we explore the potential immunological consequences of in utero exposure to maternal SARS-CoV-2 infection.

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