National Trends and Reported Risk Factors Among Pregnant Women With Syphilis in the United States, 2012–2016

Background Suboptimal cardiovascular health (CVH) and social determinants of health (SDOH) have a significant impact on maternal morbidity and mortality. We aimed to evaluate the association of SDOH with suboptimal CVH among pregnant women in the United States. Methods and Results We examined cross‐sectional data of pregnant women aged 18 to 49 years from the National Health Interview Survey (2013–2017). We ascertained optimal and suboptimal CVH based on the presence of 0 to 1 and ≥2 risk factors (hypertension, diabetes, hyperlipidemia, current smoking, obesity, and insufficient physical activity), respectively. We calculated an aggregate SDOH score representing 38 variables from 6 domains (economic stability; neighborhood, physical environment, and social cohesion; community and social context; food; education; and healthcare system) and divided into quartiles. We used Poisson regression model to evaluate the association of SDOH with suboptimal CVH and risk factors. Our study included 1433 pregnant women (28.8±5.5 years, 13% non‐Hispanic Black). Overall, 38.4% (95% CI, 33.9–43.0) had suboptimal CVH versus 51.7% (95% CI, 47.0–56.3) among those in the fourth SDOH quartile. Risk ratios of suboptimal CVH, smoking, obesity, and insufficient physical activity were 2.05 (95% CI, 1.46–2.88), 8.37 (95% CI, 3.00–23.43), 1.54 (95% CI, 1.17–2.03), and 1.19 (95% CI, 1.01–1.42), respectively among those in the fourth SDOH quartile compared with the first quartile. Conclusions Over 50% of pregnant women with the highest SDOH burden had suboptimal CVH, highlighting the public health urgency for interventions in socially disadvantaged pregnant women with renewed strategies toward improving modifiable risk factors, especially smoking and insufficient physical activity.

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Unknown Human Immunodeficiency Virus Status and Associated Risk Factors among Pregnant Women in the United States: Findings from the 2013 Behavior Risk Factors Surveillance System

Journal of AIDS & Clinical Research ◽

10.4172/2155-6113.1000516 ◽

2015 ◽

Vol 06 (10) ◽

Author(s):

Ali Dehghanifirouzabadi ◽

Mina Qobadi

Keyword(s):

United States ◽

Risk Factors ◽

Human Immunodeficiency Virus ◽

Pregnant Women ◽

Surveillance System ◽

The United States ◽

Human Immunodeficiency Virus Status ◽

Immunodeficiency Virus ◽

Associated Risk Factors

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OBSTETRIC TACTICS FOR COVID - 19(LITERATURE REVIEW)

Farmaciâ Kazahstana ◽

10.53511/pharmkaz.2021.49.30.002 ◽

2021 ◽

pp. 9-14

Author(s):

Ж.С. БЕГНИЯЗОВА ◽

Б.Н. БИЩЕКОВА ◽

Н.Ж. ДЖАРДЕМАЛИЕВА ◽

А.М. МУХАМЕДОВА ◽

Ф.А. АРИФОВА ◽

...

Keyword(s):

United States ◽

Risk Factors ◽

Infant Mortality ◽

Literature Review ◽

Pregnant Women ◽

The United States ◽

Ultrasound Scan ◽

Third Trimester ◽

Neonatal Complications ◽

Management Protocol

Статья посвящена одной из актуальных проблем современного акушерства на сегодняшний день - Covid-19.На сегодняшний день нет достаточного количества наблюдений за беременными женщинами, инфицированными Covid-19, однако некоторые наблюдения за инфицированными беременными в Китае, США, России позволяют сделать некоторые выводы. Таким образом, Covid-19 наиболее опасен во втором и третьем триместре с учетом нагрузок на разные системы организма. Ни в коем случае нельзя забывать и про факторы риска самой беременности. Чтобы не увеличивать процент материнской или младенческой смертности, не надо забывать о периоде, когда больная должна проходить скрининги. Все беременные независимо от коронавируса должны проходить обследования в четко установленные протоколом ведения беременности сроки. Своевременно сдавать анализы, проводить УЗИ, консультироваться у врача. Не пропускать сроков акушерского скрининга - это гарантия снижения акушерских и неонатальных осложнений. To date, there are not enough observations of pregnant women infected with COVID-19, however, some observations of infected pregnant women in China, the United States, Russia allow us to draw some conclusions. Thus, COVID-19 is most dangerous in the second and third trimester, taking into account the loads on different body systems. In no case should we forget about the risk factors of pregnancy itself. In order not to increase the percentage of maternal or infant mortality, one should not forget about the period when the patient should be screened. All pregnant women, regardless of the coronavirus, must undergo examinations within the periods clearly established by the pregnancy management protocol. Timely take tests, conduct an ultrasound scan, consult a doctor. Not missing the deadlines for obstetric screening is a guarantee of reducing obstetric and neonatal complications.

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Thrombosis and Mortality in Pregnant Patients with COVID-19

Blood ◽

10.1182/blood-2020-137779 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 8-9

Author(s):

Elizabeth Behrens ◽

Surbhi Warrior ◽

Joshua Thomas ◽

Xavier Pombar ◽

Sefer Gezer ◽

...

Keyword(s):

United States ◽

Risk Factors ◽

Mortality Rate ◽

Pregnant Women ◽

Postpartum Period ◽

The United States ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Significant Difference ◽

In Pregnancy

Background Coronavirus disease-2019 (COVID-19) has become a global pandemic causing respiratory compromise, coagulopathy and renal failure in severe cases. Studies demonstrate a high incidence of venous thromboembolism (VTE), up to 69% in patients with severe COVID-19 infection. Coagulopathy in COVID-19 patients is attributed to excessive inflammation and endotheliopathy. Pregnant patients have approximately a 4-fold increase of VTE incidence. This is in part due to an increase in clotting factors and fibrinogen and a decrease in fibrinolytic activity and protein S. Increased stasis and the presence of acquired and inherited thrombophilias can contribute to increased VTE incidence during pregnancy and postpartum period (PP). Risk factors for thrombosis in pregnancy include African American race, heart disease, diabetes, smoking, multiparity, age >35 years, and obesity. Pregnancy/PP state and COVID-19 infection independently increase the risk of VTE which raises concern for an even higher incidence of thromboembolic events in pregnant/PP patients with COVID-19. Data pertaining to hypercoagulability in COVID-19 infected pregnant patients is currently limited. We conducted this study to evaluate the incidence of thrombosis and mortality in pregnant/PP COVID-19 positive patients. Methods A retrospective analysis was performed on all COVID-19 positive hospitalized patients between March 2020-June 2020 at our institution. Pregnant and PP patients were extracted from this cohort and individually chart reviewed by clinicians. Data from the Centers for Disease Control and Prevention on COVID-19 positive pregnant women in the United States from January 22-July 7, 2020 was utilized for comparison analyses. Statistical analysis was performed with chi-square testing. The incidences of thrombosis and mortality were compared between hospitalized COVID-19 positive pregnant/PP patients and hospitalized adult COVID-19 positive women of childbearing age (18-51 years). A subgroup analysis was performed to evaluate risk factors for thrombosis such as demographics, trimester of pregnancy, and single/multiple gestation (Table 1). Anticoagulation and COVID-19 related therapies administered in this cohort were also studied. Results Forty-three pregnant/PP COVID-19 positive patients were identified out of 1265 hospitalized COVID-19 positive patients at our institution. Thrombosis (DVT, PE, or stroke) incidence in our cohort was 0%, which was not significantly different compared to 6.12% incidence of thrombosis in hospitalized COVID-19 positive women of childbearing age (P = .097). The mortality rate of COVID-19 positive pregnant/PP patients was 0%, which was not significantly different compared to the mortality rate of 3.06% in hospitalized COVID-19 women of childbearing age (P = .25). Further, VTE incidence of 0% in hospitalized COVID-19 positive pregnant/PP patients was not significantly different from the 0.1% incidence of VTE in the non COVID-19 pregnant population in the United States (P=.84). Lastly, the 0% mortality rate in COVID-19 positive pregnant/PP patients at our institution was no different than the 0.0169% mortality rate of pregnant women without COVID-19 infections in the United States (P = .93). Conclusion Our study demonstrates no significant difference in incidence of thrombosis and mortality rate between hospitalized COVID-19 positive pregnant/PP patients and hospitalized COVID-19 positive women of childbearing age. There was also no difference in VTE incidence between hospitalized COVID-19 positive pregnant/PP patients and non COVID-19 pregnant women in the United States. The lack of significant difference in both thrombosis incidence and mortality rate in patients who are both COVID-19 positive and pregnant/PP is reassuring and may imply that pregnancy might play a role in decreasing the inflammatory response of COVID-19. During certain phases of pregnancy a high number of macrophages, natural killer cells, and T regulator cells in the decidua have been identified, which could indicate an overall increased systemic immune response, potentially decreasing the dysregulation of the cytokine storm seen in critically ill COVID-19 patients. However, the systemic immunologic changes in pregnancy and the postpartum period remain largely unknown and prospective studies are needed to further investigate the effects of COVID-19 on pregnant patients. Disclosures No relevant conflicts of interest to declare.

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