scholarly journals Pertussis Infections Among Pregnant Women in the United States, 2012–2017

2020 ◽  
Author(s):  
Tami H Skoff ◽  
Amanda E Faulkner ◽  
Jennifer L Liang ◽  
Meghan Barnes ◽  
Kathy Kudish ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Respiratory Infections ◽  
Population Data ◽  
Complete Information ◽  
The United States ◽  
Similar Proportion ◽  
Childbearing Age ◽  
Increased Risk ◽  
Pregnancy Status ◽  
Pertussis Epidemiology

Abstract Background Little is known about pertussis among pregnant women, a population at increased risk for severe morbidity from respiratory infections such as influenza. We used the Centers for Disease Control and Prevention’s Enhanced Pertussis Surveillance (EPS) system to describe pertussis epidemiology among pregnant and nonpregnant women of childbearing age. Methods Pertussis cases in women aged 18–44 years with cough onset between 1 January 2012 and 31 December 2017 were identified in 7 EPS states. Surveillance data were collected through patient and provider interviews and immunization registries. Bridged-race, intercensal population data and live birth estimates were used as denominators. Results We identified 1582 pertussis cases among women aged 18–44 years; 5.1% (76/1499) of patients with a known pregnancy status were pregnant at cough onset. Of the pregnant patients with complete information, 81.7% (49/60) reported onset during the second or third trimester. The median ages of pregnant and nonpregnant patients were 29.0 and 33.0 years, respectively. Most pregnant and nonpregnant patients were White (78.3% vs. 86.4%, respectively; P = .09) and non-Hispanic (72.6% vs. 77.3%, respectively; P = .35). The average annual incidence of pertussis was 7.7/100000 among pregnancy women and 7/3/100000 among nonpregnant women. Compared to nonpregnant patients, more pregnant patients reported whoop (41.9% vs. 31.3%, respectively), posttussive vomiting (58.1% vs. 47.9%, respectively), and apnea (37.3% vs. 29.0%, respectively); however, these differences were not statistically significant (P values > .05 for all). A similar proportion of pregnant and nonpregnant patients reported ever having received Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine; 31.6% vs. 32.7%, respectively; P = .84). Conclusions Our analysis suggests that incidence of pertussis and clinical characteristics of disease are similar among pregnant and nonpregnant women. Continued monitoring is important to further define pertussis epidemiology in pregnant women.

Coverage and Timing of Influenza Vaccination Among Privately Insured Pregnant Women in the United States, 2010-2018

2021 ◽  
pp. 003335492110267
Author(s):  
Kai Hong ◽  
Megan C. Lindley ◽  
Fangjun Zhou
Keyword(s):  
Influenza Vaccination ◽  
Pregnant Women ◽  
Vaccination Coverage ◽  
Influenza Season ◽  
The United States ◽  
Metropolitan Statistical Area ◽  
Provider Education ◽  
Vaccination Uptake ◽  
Increased Risk ◽  
Privately Insured

Objective Pregnant women are at increased risk of serious complications from influenza and are recommended to receive an influenza vaccination during pregnancy. The objective of this study was to assess trends, timing patterns, and associated factors of influenza vaccination among pregnant women. Methods We used 2010-2018 MarketScan data on 1 286 749 pregnant women aged 15-49 who were privately insured to examine trends and timing patterns of influenza vaccination coverage. We examined descriptive statistics and identified factors associated with vaccination uptake by using multivariate log-binomial and Cox proportional hazard models. Results In-plan influenza vaccination coverage before delivery increased from 22.0% during the 2010-2011 influenza season to 33.2% during the 2017-2018 influenza season. About two-thirds of vaccinated women received the vaccine in September or October during each influenza season. For women who delivered in September through May, influenza vaccination coverage increased rapidly at the beginning of influenza season and flattened after October. For women who delivered in June through August, influenza vaccination coverage increased gradually until February and flattened thereafter. Most vaccinated women who delivered before January received the vaccine in the third trimester. Increased likelihood of being vaccinated was associated with age 31-40, living in a metropolitan statistical area, living outside the South, enrollment in a consumer-driven or high-deductible health plan, being spouses or dependents of policy holders, and delivery in November through January. Conclusions Despite increases during the past several years, vaccination uptake is still suboptimal, particularly after October. Health care provider education on timing of vaccination and recommendations throughout influenza seasons are needed to improve influenza vaccination coverage among pregnant women.

scholarly journals AYURVEDA FOR PREGNANT WOMEN DURING COVID-19 ERA – A REVIEW

2021 ◽  
pp. 221-223
Author(s):  
Dr. Supriya B ◽  
Dr. Savita S. Patil
Keyword(s):  
Pregnant Women ◽  
Specific Activity ◽  
Respiratory Infections ◽  
Virus Disease ◽  
The Body ◽  
Safe Motherhood ◽  
Mental Wellbeing ◽  
The Novel ◽  
Dietary Regimen ◽  
Increased Risk

The Novel corona virus disease (COVID-19) is highly communicable viral infection caused by SARS-CoV 2. WHO mentions that pregnant women or recently pregnant women seem to have an increased risk of developing severe COVID-19. Due to physiological changes in the body and immune system, pregnant women can be badly affected by respiratory infections. It is therefore important that they take precautions to protect themselves against COVID-19. Overall, 10% of pregnant women suffered from COVID-19. Ayurveda mentions Garbhini paricharya (antenatal care of the pregnant) which recommends ahara (dietary regimen) and vihara (specific activity for physical, emotional and mental wellbeing) that is required for the safe motherhood and healthy progeny. Here is an attempt to understand how Garbhini paricharya helps in preventing corona. KEY WORDS: Garbhini paricharya, COVID-19, Pregnancy

scholarly journals Safety of Vaccines Used for Routine Immunization in the United States: An Update

2021 ◽  
Author(s):  
Courtney Gidengil ◽  
Matthew Bidwell Goetz ◽  
Margaret Maglione ◽  
Sydne J. Newberry ◽  
Peggy Chen ◽  
...  
Keyword(s):  
United States ◽  
Systematic Review ◽  
Adverse Events ◽  
Pregnant Women ◽  
Large Body ◽  
Febrile Seizures ◽  
The United States ◽  
Insufficient Evidence ◽  
Increased Risk ◽  
New Evidence

Objective. To conduct a systematic review of the literature on the safety of vaccines recommended for routine immunization in the United States, updating the 2014 Agency for Healthcare Research and Quality (AHRQ) report on the topic. Data sources. We searched MEDLINE®, Embase®, CINAHL®, Cochrane CENTRAL, Web of Science, and Scopus through November 9, 2020, building on the prior 2014 report; reviewed existing reviews, trial registries, and supplemental material submitted to AHRQ; and consulted with experts. Review methods. This report addressed three Key Questions (KQs) on the safety of vaccines currently in use in the United States and included in the Centers for Disease Control and Prevention’s (CDC) recommended immunization schedules for adults (KQ1), children and adolescents (KQ2), and pregnant women (KQ3). The systematic review was supported by a Technical Expert Panel that identified key adverse events of particular concern. Two reviewers independently screened publications; data were extracted by an experienced subject matter expert. Studies of vaccines that used a comparator and reported the presence or absence of adverse events were eligible. We documented observed rates and assessed the relative risks for key adverse events. We assessed the strength of evidence (SoE) across the existing findings from the prior 2014 report and the new evidence from this update. The systematic review is registered in PROSPERO (CRD42020180089). Results. A large body of evidence is available to evaluate adverse events following vaccination. Of 56,608 reviewed citations, 189 studies met inclusion criteria for this update, adding to data in the prior 2014 report, for a total of 338 included studies reported in 518 publications. Regarding vaccines recommended for adults (KQ1), we found either no new evidence of increased risk for key adverse events with varied SoE or insufficient evidence in this update, including for newer vaccines such as recombinant influenza vaccine, adjuvanted inactivated influenza vaccine, and recombinant adjuvanted zoster vaccine. The prior 2014 report noted a signal for anaphylaxis for hepatitis B vaccines in adults with yeast allergy and for tetanus, diphtheria, and acellular pertussis vaccines. Regarding vaccines recommended for children and adolescents (KQ2), we found either no new evidence of increased risk for key adverse events with varied SoE or insufficient evidence, including for newer vaccines such as 9-valent human papillomavirus vaccine and meningococcal B vaccine. The prior 2014 report noted signals for rare adverse events—such as anaphylaxis, idiopathic thrombocytopenic purpura, and febrile seizures—with some childhood vaccines. Regarding vaccines recommended for pregnant women (KQ3), we found no evidence of increased risk for key adverse events with varied SoE among either pregnant women or their infants following administration of tetanus, diphtheria, and acellular pertussis vaccines during pregnancy. Conclusion. Across this large body of research, we found no new evidence of increased risk since the prior 2014 report for key adverse events following administration of vaccines that are routinely recommended. Signals from the prior report remain unchanged for rare adverse events, which include anaphylaxis in adults and children, and febrile seizures and idiopathic thrombocytopenic purpura in children. There is no evidence of increased risk of adverse events for vaccines currently recommended in pregnant women. There remains insufficient evidence to draw conclusions about some rare potential adverse events.

scholarly journals Antipsychotic Use in Pregnancy: Patient Mental Health Challenges, Teratogenicity, Pregnancy Complications, and Postnatal Risks

2022 ◽  
Vol 14 (1) ◽  
pp. 62-74
Author(s):  
Amber N. Edinoff ◽  
Niroshan Sathivadivel ◽  
Shawn E. McNeil ◽  
Austin I. Ly ◽  
Jaeyeon Kweon ◽  
...  
Keyword(s):  
Mental Health ◽  
Pregnant Women ◽  
Antipsychotic Drugs ◽  
Congenital Abnormalities ◽  
Childbearing Age ◽  
Risks And Benefits ◽  
Increased Risk ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Potential Risks

Pregnant women constitute a vulnerable population, with 25.3% of pregnant women classified as suffering from a psychiatric disorder. Since childbearing age typically aligns with the onset of mental health disorders, it is of utmost importance to consider the effects that antipsychotic drugs have on pregnant women and their developing fetus. However, the induction of pharmacological treatment during pregnancy may pose significant risks to the developing fetus. Antipsychotics are typically introduced when the nonpharmacologic approaches fail to produce desired effects or when the risks outweigh the benefits from continuing without treatment or the risks from exposing the fetus to medication. Early studies of pregnant women with schizophrenia showed an increase in perinatal malformations and deaths among their newborns. Similar to schizophrenia, women with bipolar disorder have an increased risk of relapse in antepartum and postpartum periods. It is known that antipsychotic medications can readily cross the placenta, and exposure to antipsychotic medication during pregnancy is associated with potential teratogenicity. Potential risks associated with antipsychotic use in pregnant women include congenital abnormalities, preterm birth, and metabolic disturbance, which could potentially lead to abnormal fetal growth. The complex decision-making process for treating psychosis in pregnant women must evaluate the risks and benefits of antipsychotic drugs.

scholarly journals Epidemiology and Clinical Outcomes of Hospitalizations for Acute Respiratory or Febrile Illness and Laboratory-Confirmed Influenza Among Pregnant Women During Six Influenza Seasons, 2010–2016

2019 ◽  
Vol 221 (10) ◽  
pp. 1703-1712 ◽  
Author(s):  
Fatimah S Dawood ◽  
Shikha Garg ◽  
Rebecca V Fink ◽  
Margaret L Russell ◽  
Annette K Regan ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Low Socioeconomic Status ◽  
Seasonal Influenza ◽  
Febrile Illness ◽  
The United States ◽  
Influenza Viruses ◽  
Rt Pcr ◽  
Electronic Health Record Data ◽  
Sepsis Diagnosis ◽  
Increased Risk

Abstract Background Pregnant women are at increased risk of seasonal influenza hospitalizations, but data about the epidemiology of severe influenza among pregnant women remain largely limited to pandemics. Methods To describe the epidemiology of hospitalizations for acute respiratory infection or febrile illness (ARFI) and influenza-associated ARFI among pregnant women, administrative and electronic health record data were analyzed from retrospective cohorts of pregnant women hospitalized with ARFI who had testing for influenza viruses by reverse-transcription polymerase chain reaction (RT-PCR) in Australia, Canada, Israel, and the United States during 2010–2016. Results Of 18 048 ARFI-coded hospitalizations, 1064 (6%) included RT-PCR testing for influenza viruses, 614 (58%) of which were influenza positive. Of 614 influenza-positive ARFI hospitalizations, 35% were in women with low socioeconomic status, 20% with underlying conditions, and 67% in their third trimesters. The median length of influenza-positive hospitalizations was 2 days (interquartile range, 1–4), 18% (95% confidence interval [CI], 15%–21%) resulted in delivery, 10% (95% CI, 8%–12%) included a pneumonia diagnosis, 5% (95% CI, 3%–6%) required intensive care, 2% (95% CI, 1%–3%) included a sepsis diagnosis, and <1% (95% CI, 0%–1%) resulted in respiratory failure. Conclusions Our findings characterize seasonal influenza hospitalizations among pregnant women and can inform assessments of the public health and economic impact of seasonal influenza on pregnant women.

scholarly journals COVID-19 Severity among Women of Reproductive Age with Symptomatic Laboratory-Confirmed SARS-CoV-2 by Pregnancy Status – United States, Jan 1, 2020 – Sep 30, 2021

2021 ◽  
Author(s):  
Penelope Strid ◽  
Lauren B. Zapata ◽  
Van T. Tong ◽  
Laura D. Zambrano ◽  
Kate R. Woodworth ◽  
...  
Keyword(s):  
United States ◽  
Severe Disease ◽  
The United States ◽  
Reproductive Age ◽  
Invasive Ventilation ◽  
Women Of Reproductive Age ◽  
Adjusted Risk ◽  
Increased Risk ◽  
Pregnancy Status ◽  
Risk Ratios

Abstract Importance: Pregnant people are at increased risk for severe COVID-19 compared with nonpregnant people. Limited information is available on the severity of COVID-19 attributable to the Delta variant, the predominant variant in the United States as of late June 2021, among pregnant persons.Objective: To assess risk for severe COVID-19 by pregnancy status and time period relative to Delta variant predominance. Design: Using a cross-sectional design, we describe characteristics of symptomatic women of reproductive age (WRA) with COVID-19 and calculate adjusted risk ratios for severe disease comparing pregnant with nonpregnant WRA during the pre-Delta period (January 1, 2020 – June 26, 2021) and the Delta period (June 27, 2021 – September 30, 2021). Additionally, we calculate adjusted risk ratios for severe disease comparing the Delta period with the pre-Delta period for pregnant and nonpregnant WRA.Setting: Reports of COVID-19 in the United States occurring from January 1, 2020 ─ September 30, 2021, submitted to the CDC.Participants: Pregnant and nonpregnant women aged 15-44 years.Exposure(s): Laboratory-confirmed, symptomatic SARS-CoV-2 infection.Main Outcome(s): Severe disease: (intensive care unit [ICU] admission, receipt of invasive ventilation or extracorporeal membrane oxygenation [ECMO], and death).Results: Among 1,856,428 cases of symptomatic COVID-19 in WRA, the risk for severe disease was increased among pregnant compared with nonpregnant WRA during the pre-Delta and Delta periods. Compared with the pre-Delta period, the risk of ICU admission during the Delta period was 66% higher (adjusted risk ratio [aRR] 1.66, 95% CI: 1.34-2.06) for pregnant WRA and 23% higher (aRR 1.23, 95% CI: 1.12-1.35) for nonpregnant WRA. The risk of invasive ventilation or ECMO was higher for pregnant and nonpregnant WRA in the Delta period. During the Delta period, the risk of death was 3.40 (95% CI: 2.36-4.91) times the risk in the pre-Delta period among pregnant WRA and 1.96 (95% CI: 1.75-2.18) among nonpregnant WRA. Conclusions and Relevance: The overall risk for severe COVID-19 among WRA remains low; however, symptomatic pregnant WRA remain at increased risk for severe outcomes compared with symptomatic nonpregnant WRA during Delta variant predominance. Compared with the pre-Delta period, pregnant and nonpregnant WRA are at increased risk for severe COVID-19 in the Delta period.

scholarly journals Effects of COVID-19 infection during pregnancy

2021 ◽  
Vol 9 (39) ◽  
pp. 28-34
Author(s):  
Sabiha Armin ◽  
Kenneth Nugent
Keyword(s):  
Pregnant Women ◽  
Vertical Transmission ◽  
Respiratory Infections ◽  
Healthcare Providers ◽  
Neonatal Infection ◽  
Fetal Tissue ◽  
Extensive Literature ◽  
Perinatal Complications ◽  
Increased Risk ◽  
Poor Outcomes

Women develop important changes in their cardiovascular and respiratory systems during pregnancy. They also have important changes in their immune system which are necessary to tolerate foreign fetal tissue. These expected alterations can increase the likelihood of poor outcomes with certain respiratory infections, especially viral infection. There is extensive literature describing COVID-19 in pregnant women, and there is evidence that this virus can infect the placenta, raising implications for maternal-fetal transmission. Women who contract COVID-19 during pregnancy are at increased risk of preterm labor and other perinatal complications when compared to non-pregnant women. Trials on the safety and efficacy of the COVID-19 vaccines during pregnancy are in progress; several reproductive societies have recommended that women who are planning to get pregnant or are pregnant should get vaccination since there are few reports of adverse events in pregnant women who have received vaccines. Healthcare providers will need to address concerns of infertility, the possibility of vertical transmission, and neonatal infection with women regarding timely vaccination against this disease and other necessary precautions. Keywords: coronavirus, COVID-19, pregnancy, placental pathology, vertical transmission

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