Allostatic Load and Adverse Perinatal Outcomes

Pregnant women who are infected with SARS-CoV-2 are at an increased risk of adverse perinatal outcomes. With this study, we aimed to better understand the relationship between maternal infection and perinatal outcomes, especially preterm births, and the underlying medical and interventionist factors. This was a prospective observational study carried out in 78 centers (Spanish Obstetric Emergency Group) with a cohort of 1347 SARS-CoV-2 PCR-positive pregnant women registered consecutively between 26 February and 5 November 2020, and a concurrent sample of PCR-negative mothers. The patients’ information was collected from their medical records, and the association of SARS-CoV-2 and perinatal outcomes was evaluated by univariable and multivariate analyses. The data from 1347 SARS-CoV-2-positive pregnancies were compared with those from 1607 SARS-CoV-2-negative pregnancies. Differences were observed between both groups in premature rupture of membranes (15.5% vs. 11.1%, p < 0.001); venous thrombotic events (1.5% vs. 0.2%, p < 0.001); and severe pre-eclampsia incidence (40.6 vs. 15.6%, p = 0.001), which could have been overestimated in the infected cohort due to the shared analytical signs between this hypertensive disorder and COVID-19. In addition, more preterm deliveries were observed in infected patients (11.1% vs. 5.8%, p < 0.001) mainly due to an increase in iatrogenic preterm births. The prematurity in SARS-CoV-2-affected pregnancies results from a predisposition to end the pregnancy because of maternal disease (pneumonia and pre-eclampsia, with or without COVID-19 symptoms).

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Fetal movement counting is associated with the reduction of delayed maternal reaction after perceiving decreased fetal movements: a prospective study

Scientific Reports ◽

10.1038/s41598-021-90240-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Shigeki Koshida ◽

Shinsuke Tokoro ◽

Daisuke Katsura ◽

Shunichiro Tsuji ◽

Takashi Murakami ◽

...

Keyword(s):

Pregnant Women ◽

Maternal Behavior ◽

Multivariable Analysis ◽

Perinatal Outcomes ◽

Fetal Movement ◽

Post Intervention ◽

Fetal Movements ◽

Adverse Perinatal Outcomes ◽

The Impact ◽

Maternal Reaction

AbstractMaternal perception of decreased fetal movement is associated with adverse perinatal outcomes. Although there have been several studies on interventions related to the fetal movements count, most focused on adverse perinatal outcomes, and little is known about the impact of the fetal movement count on maternal behavior after the perception of decreased fetal movement. We investigated the impact of the daily fetal movement count on maternal behavior after the perception of decreased fetal movement and on the stillbirth rate in this prospective population-based study. Pregnant women in Shiga prefecture of Japan were asked to count the time of 10 fetal movements from 34 weeks of gestation. We analyzed 101 stillbirths after the intervention compared to 121 stillbirths before the intervention. In multivariable analysis, maternal delayed visit to a health care provider after the perception of decreased fetal movement significantly reduced after the intervention (aOR 0.31, 95% CI 0.11–0.83). Our regional stillbirth rates in the pre-intervention and post-intervention periods were 3.06 and 2.70 per 1000 births, respectively. Informing pregnant women about the fetal movement count was associated with a reduction in delayed maternal reaction after the perception of decreased fetal movement, which might reduce stillbirths.

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Sneathia: an emerging pathogen in female reproductive disease and adverse perinatal outcomes

Critical Reviews in Microbiology ◽

10.1080/1040841x.2021.1905606 ◽

2021 ◽

pp. 1-26

Author(s):

Kevin R. Theis ◽

Violetta Florova ◽

Roberto Romero ◽

Andrei B. Borisov ◽

Andrew D. Winters ◽

...

Keyword(s):

Perinatal Outcomes ◽

Emerging Pathogen ◽

Reproductive Disease ◽

Adverse Perinatal Outcomes

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Maternal nativity and risk of adverse perinatal outcomes among Black women residing in California, 2011–2017

Journal of Perinatology ◽

10.1038/s41372-021-01149-9 ◽

2021 ◽

Author(s):

Safyer McKenzie-Sampson ◽

Rebecca J. Baer ◽

Bridgette E. Blebu ◽

Deborah Karasek ◽

Scott P. Oltman ◽

...

Keyword(s):

Black Women ◽

Perinatal Outcomes ◽

Maternal Nativity ◽

Adverse Perinatal Outcomes

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1033: Obesity-induced epigenetic changes associated with adverse perinatal outcomes

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2019.11.1048 ◽

2020 ◽

Vol 222 (1) ◽

pp. S642

Author(s):

WeiBin Shen ◽

Jingxiang Ni ◽

Penghua Yang ◽

Ruofan Yao ◽

Christopher Harman ◽

...

Keyword(s):

Perinatal Outcomes ◽

Epigenetic Changes ◽

Adverse Perinatal Outcomes

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The effect of maternal position on fetal middle cerebral artery Doppler indices and its association with adverse perinatal outcomes: a pilot study

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0399 ◽

2020 ◽

Vol 48 (4) ◽

pp. 317-321

Author(s):

Rodney McLaren ◽

Bharati Kalgi ◽

Chima Ndubizu ◽

Peter Homel ◽

Shoshana Haberman ◽

...

Keyword(s):

High Risk ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Repeated Measures ◽

Adverse Outcome ◽

Perinatal Outcomes ◽

Low Risk ◽

Doppler Velocity ◽

Chronic Hypertension ◽

Adverse Perinatal Outcomes

AbstractObjectiveThe aim of this study was to compare position-related changes in fetal middle cerebral artery (MCA) Doppler pulsatility indices (PI).MethodsA prospective study of 41 women with conditions associated with placental-pathology (chronic hypertension, pregestational diabetes, and abnormal analytes) and 34 women without those conditions was carried out. Fetal MCA Doppler velocity flow waveforms were obtained in maternal supine and left lateral decubitus positions. MCA PI Δ was calculated by subtracting the PI in the supine position from the PI in the left lateral position. Secondary outcomes included a composite of adverse perinatal outcomes (fetal growth restriction, oligohydramnios, and preeclampsia). χ2 and Student t-tests and repeated-measures analysis of variance were used.ResultsMCA PI Δ was significantly less for high-risk pregnant women ([P = 0.03]: high risk, left lateral PI, 1.90 ± 0.45 vs. supine PI, 1.88 ± 0.46 [Δ = 0.02]; low risk, left lateral PI, 1.90 ± 0.525 vs. supine PI, 1.68 ± 0.40 [Δ = 0.22]). MCA PI Δ was not significantly different between women who had a composite adverse outcome and women who did not have a composite adverse outcome (P = 0.843).ConclusionOur preliminary study highlights differences in position-related changes in fetal MCA PI between high-risk and low-risk pregnancies. These differences could reflect an attenuated ability of women with certain risk factors to respond to physiologic stress.

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Increased pulsatility index of uterine artery Doppler between 26 and 28 weeks of gestation and adverse perinatal outcomes

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2020.1865301 ◽

2021 ◽

pp. 1-8

Author(s):

Daniela Rocha Ramos ◽

Edward Araujo Júnior ◽

Caetano Galvão Petrini ◽

Fernando Felix Dulgheroff ◽

Taciana Mara Rodrigues da Cunha Caldas ◽

...

Keyword(s):

Pulsatility Index ◽

Uterine Artery ◽

Perinatal Outcomes ◽

Uterine Artery Doppler ◽

Adverse Perinatal Outcomes

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Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy cohort

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0403 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Esin Merve Erol Koç ◽

Rahime Bedir Fındık ◽

Hatice Akkaya ◽

Işılay Karadağ ◽

Eda Özden Tokalıoğlu ◽

...

Keyword(s):

Complete Blood Count ◽

Perinatal Outcomes ◽

Control Group ◽

Strong Positive Correlation ◽

Monocyte Count ◽

Distribution Width ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Significant Difference ◽

Adverse Perinatal Outcomes

AbstractObjectivesTo evaluate the relationship between Coronavirus Disease 2019 (COVID-19) in pregnancy and adverse perinatal outcomes. The secondary aim is to analyze the diagnostic value of hematologic parameters in COVID-19 complicated pregnancies.MethodsThe current study is conducted in a high volume tertiary obstetrics center burdened by COVID-19 pandemics, in Turkey. In this cohort study, perinatal outcomes and complete blood count indices performed at the time of admission of 39 pregnancies (Study group) complicated by COVID-19 were compared with 69 uncomplicated pregnancies (Control group).ResultsThere was no significant difference between the obstetric and neonatal outcomes of pregnancies with COVID-19 compared to data of healthy pregnancies, except the increased C-section rate (p=0.026). Monocyte count, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) were significantly increased (p<0.0001, p=0.009, p=0.043, p<0.0001, respectively) whereas the MPV and plateletcrit were significantly decreased (p=0.001, p=0.008) in pregnants with COVID-19. ROC analysis revealed that the optimal cut-off value for MLR was 0.354 which indicated 96.7% specificity and 59.5% sensitivity in diagnosis of pregnant women with COVID-19. A strong positive correlation was found between the MLR and the presence of cough symptom (r=41.4, p=<0.0001).ConclusionsThe study revealed that, pregnancies complicated by COVID-19 is not related with adverse perinatal outcomes. MLR may serve as a supportive diagnostic parameter together with the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in assessment of COVID-19 in pregnant cohort.

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