Placental pathology associated with maternal age and maternal obesity in singleton pregnancy.

OBJECTIVE: Maternal age, maternal obesity and neonatal sex dimorphism are known to affect pregnancy and neonatal outcome. However, the effects of these factors on specific placental pathology are less well-documented. STUDY DESIGN: Clinical information, placental pathology and neonatal data from singleton delivery were collected at our hospital in March 2020 to October 2021 and correlation studies were performed. RESULTS: A total 3,119 singleton placentas were examined between March 2020 and October 2021 in conjunction with clinical information and neonatal birth data. Advanced maternal age (>35) was significantly associated with a variety of pregnancy complications and placental pathology including preeclampsia/pregnancy induced hypertension (Pre/PIH), gestational diabetes mellitus (GDM2), intrauterine growth restriction (IUGR), and increased maternal body mass index (BMI) at delivery. Maternal obesity (BMI >30 at the time of delivery) was significantly associated with a variety of clinical features and placental pathology including PRE/PIH, GDM2 and decidual vasculopathy (mural arterial hypertrophy). No specific placental pathology was associated with neonatal sex except for more maternal inflammatory response (MIR, chronic deciduitis) in neonates of male sex. CONCLUSION: Maternal age and maternal obesity were associated with not only clinical complications of pregnancy and neonatal birth weight but also specific placental pathology. Understanding the effects of maternal and environmental factors will help improve pregnancy outcome.

Maternal, neonatal and placental characteristics of SARS-CoV-2 positive mothers.

BACKGROUND: COVID19 is caused by a newly identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) that affects pregnant women equally to the general population. How SARS-CoV2 affects the mothers, the neonates and the placental pathology remain controversial. OBJECTIVE: To explore the effects of maternal SARS-CoV2 infection on the neonates and placental pathology in comparison to those from the normal pregnancies. STUDY DESIGN: Maternal, neonatal and placental pathology data were collected from medical records between March and August 2020 from New York Presbyterian- Brooklyn Methodist Hospital. The data from a total 142 neonates and 101 placentas from SARS-CoV2 positive mothers were compared with those from SARS-CoV2 negative mothers. RESULTS: There were 142 SARS-CoV2 positive mothers within the study group, and 43 (36%) of them showed various degrees of COVID19 related clinical symptoms including fever (13.8%), cough (5.7%), loss of taste/smell (anosmia)(5.6%), shortness of breath (2.4%), muscle ache (2.4%), headache (1.6%) and pneumonia (0.8%). A total 142 neonates were born to the SARS-CoV-2 positive mothers, and only 1 neonate tested positive for SARS-CoV2 in the first 24 h. Two additional neonates were initially tested negative in first 24 h, and later tested positive on day 7 and the 1 month visit, and all these neonates were asymptomatic and had no sequelae. There was no increase of pre-term labor and delivery or NICU admissions from SARS-CoV2 positive mothers. Examination of 101 placentas from SARS-CoV2 positive mothers and 121 placentas from SARS-CoV2 negative mothers revealed no increase of placental pathologic features. There were more vaginal deliveries and more meconium stain of fetal membranes from the SARS-CoV2 positive mothers. Previous reports of more maternal vascular malperfusion and fetal vascular malperfusion were not demonstrated in our current data. CONCLUSION: Although SARS-CoV2 is a significant risk to the pregnant women (mothers) and general population, there is no increased risk for neonates. Vertical transmission is rare, and perinatal transmission can also occur. There is no increased frequency of placental abnormalities in both maternal and fetal circulation.

Systematic thematic review of e-health research in the Gulf Cooperation Council (Arabian Gulf): Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates.

Introduction The Gulf Cooperation Council (GCC or 'Arabian Gulf'), comprising Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates, is a political organization sharing a common history and culture. All GCC nations have made substantial investments in telecommunications and electronic health infrastructure since 2000. Methods We conducted a literature search in English and Arabic on peer-reviewed e-health research up to December 2014 originating in the GCC. The objective was to retrieve all research on e-health in the GCC and to categorize and analyse it qualitatively to reveal the current state of e-health research and development in the region. Inclusion criteria included peer-reviewed articles, books, book chapters, conference papers and graduate theses written on e-health in the GCC. Blogs, health websites and non-peer-reviewed literature were excluded. Results Three hundred and six articles were retrieved, categorized and analysed qualitatively to reveal the state of e-health research in the GCC. Both country-specific and GCC-wide major themes were identified using NVivo 10.0 qualitative software and summarized. The most common type of study was an overview (35.0%), with common study designs of case studies (26.8%) and descriptive articles (46.4%). Significant themes were: prospective national benefits from e-health, implementation and satisfaction with electronic health records, online technologies in medical education, innovative systems (case studies), and information security and personal health information. Discussion This is the first comprehensive analytical literature review of e-health in the GCC. Important research gaps were identified: few cost-benefit analyses, controlled interventional studies, or research targeting gender and religious issues were retrieved.