Antepartum vaginal Candida colonization and the risk for obstetrical tears.

OBJECTIVE: Vaginal Candida colonization is very common during pregnancy. An association between Candida colonization and obstetrical tears has not yet been investigated. We investigated whether vaginal Candida colonization during pregnancy is associated with an increased risk for obstetrical tears. STUDY DESIGN: A prospective cohort study was undertaken between the years 2014-2016, comparing pregnancy and delivery characteristics of women with and without Candida colonization during pregnancy. Clinical characteristics of Candida positive women and those with normal vaginal flora were collected. To test the statistical significance of the categorical variables, the chi-square test or Fisher's exact test were used, where appropriate. For continuous variables, the Student's t-test was used. RESULTS: During the study period, 102 women with vaginal Candida during pregnancy (of whom 70% had Candida albicans species) and 102 controls with normal vaginal flora were included in the analysis. No significant differences were observed between Candida positive women and those with normal vaginal flora. Pregnancy and delivery outcomes were comparable and no increased risk of obstetrical tears was found in the Candida group. CONCLUSIONS: Vaginal colonization with Candida species during pregnancy was not found to be associated with an increased risk of obstetrical tears.

The Association between Delivery during the COVID-19 Pandemic and Immediate Postpartum Maternal Cognitive Function.

Survivors of the 2003 SARS epidemic were found to have higher rates of adverse mental conditions. This study aimed to assess cognitive function in women delivering during the COVID-19 pandemic, as compared to women who delivered before the COVID-19 pandemic. A cohort study was performed during the immediate postpartum period of women delivering singletons at term. Cognitive function was assessed using an objective neurocognitive test (Symbol Digit Modalities Test SDMT90, SDMT4) and a subjective self-estimation questionnaire (Attention Function Index AFI). The exposed group was recruited during the COVID-19 outbreak in Israel (May 2020), whereas the comparison group consisted of women delivering at the same medical center before the COVID-19 pandemic (2016-2017). Multivariable regression models were constructed to control potential confounders. There were 79 parturients recruited during the COVID-19 pandemic and compared with 123 women who delivered before the COVID-19 pandemic. Women delivering during the COVID-19 pandemic scored lower in the subjective AFI test compared to the unexposed group (70.0 ± 15.4 vs. 75.1 ± 14.7, p = 0.018). However, no significant difference was found in the objective SDMT tests scores. These results remained similar in the multivariable regression models when controlling for maternal age, ethnicity and time from admission to assessment, for AFI, SDMT90 and SDMT4 scores (p = 0.014; p = 0.734; p = 0.786; respectively). While no significant difference was found in objective tests, our findings propose that the exposure to the COVID-19 pandemic is independently associated with a significant decrease in subjective maternal cognitive function during the immediate postpartum period.

Risk for probable post-partum depression among women during the COVID-19 pandemic.

The aim of the current study was to assess the risk for post-partum depression among women delivering during the COVID-19 pandemic as compared to the risk among women delivering before the COVID-19 pandemic. A cohort study was performed among women delivering singletons at term which were recruited in the maternity wards of the Soroka University Medical Center. Recruitment was done during the COVID-19 strict isolation period (March 18 and April 29, 2020). Women delivering during the COVID-19 pandemic completed the Edinburgh Postnatal Depression Scale (EPDS), and the results were compared to women delivering at the same medical center before the COVID-19 pandemic. Multivariable logistic regression models were constructed to control for potential confounders. A total of 223 women who delivered during the COVID-19 strict isolation period were recruited. Women delivering during the COVID-19 pandemic had lower risk of having a high (> 10) or very high (≥ 13) EPDS score as compared with women delivering before the COVID-19 pandemic (16.7% vs 31.3%, p = 0.002, and 6.8% vs 15.2%, p = 0.014, for EPDS ≥ 10 and EPDS ≥ 13, respectively). These results remained similar in the multivariable logistic regression models, for both EPDS score ≥ 10 and EPDS score ≥ 13, while controlling for maternal age, ethnicity, marital status, and adverse pregnancy outcomes (adjusted OR 0.4, 95% CI 0.23-0.70, p = 0.001 and adjusted OR 0.3, 95% CI 0.15-0.74, p = 0.007 for EPDS score > 10 and > 13, respectively). In our population, delivering during the COVID-19 pandemic was independently associated with lower risk of post-partum depression.

Risk for Depressive Symptoms among Hospitalized Women in High-Risk Pregnancy Units during the COVID-19 Pandemic.

OBJECTIVE: Higher rates of mental disorders, specifically depression, were found among affected people in previous epidemiological studies taken after disasters. The aim of the current study was to assess risk for depression among pregnant women hospitalized during the "coronavirus disease 2019" (COVID-19) pandemic, as compared to women hospitalized before the COVID-19 pandemic. STUDY DESIGN: A cross-sectional study was performed among women hospitalized in the high-risk pregnancy units of the Soroka University Medical Center (SUMC). All participating women completed the Edinburgh Postnatal Depression Scale (EPDS), and the results were compared between women hospitalized during the COVID-19 strict isolation period (19 March 2020 and 26 May 2020) and women hospitalized before the COVID-19 pandemic. Multivariable logistic regression models were constructed to control for potential confounders. RESULTS: Women hospitalized during the COVID-19 strict isolation period (n = 84) had a comparable risk of having a high (>10) EPDS score as compared to women hospitalized before the COVID-19 pandemic (n = 279; 25.0% vs. 29.0%, p = 0.498). These results remained similar in the multivariable logistic regression model, while controlling for maternal age, ethnicity and known mood disorder (adjusted odds ratio (OR) 1.0, 95% CI 0.52-1.93, p = 0.985). CONCLUSION: Women hospitalized at the high-risk pregnancy unit during the COVID-19 strict isolation period were not at increased risk for depression, as compared to women hospitalized before the COVID-19 pandemic.