Risk factors for illness severity among pregnant women with confirmed SARS-CoV-2 infection - Surveillance for Emerging Threats to Mothers and Babies Network, 20 state, local, and territorial health departments, March 29, 2020 -January 8, 2021

Background: Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk for severe illness compared with nonpregnant women. Data to assess risk factors for illness severity among pregnant women with COVID-19 are limited. This study aimed to determine risk factors associated with COVID-19 illness severity among pregnant women with SARS-CoV-2 infection. Methods: Pregnant women with SARS-CoV-2 infection confirmed by molecular testing were reported during March 29, 2020-January 8, 2021 through the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). Criteria for illness severity (asymptomatic, mild, moderate-to-severe, or critical) were adapted from National Institutes of Health and World Health Organization criteria. Crude and adjusted risk ratios for moderate-to-severe or critical COVID-19 illness were calculated for selected demographic and clinical characteristics. Results: Among 5,963 pregnant women with SARS-CoV-2 infection, moderate-to-severe or critical COVID-19 illness was associated with age 30-39 years, Black/Non-Hispanic race/ethnicity, healthcare occupation, pre-pregnancy obesity, chronic lung disease, chronic hypertension, cardiovascular disease, pregestational diabetes mellitus or gestational diabetes. Risk of moderate-to-severe or critical illness increased with the number of underlying medical or pregnancy-related conditions. Conclusions: Pregnant women with moderate-to-severe or critical COVID-19 illness were more likely to be older and have underlying medical conditions compared to pregnant women with asymptomatic infection or mild COVID-19 illness. This information might help pregnant women understand their risk for moderate-to-severe or critical COVID-19 illness and inform targeted public health messaging.

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POSSIBLE HEALTH CONSEQUENCES FOR NEWBORNS FROM MOTHERS WHO SUFFERED COVID-19 DURING PREGNANCY

Acta medica Eurasica ◽

10.47026/2413-4864-2021-3-35-47 ◽

2021 ◽

pp. 35-47

Author(s):

Tamara G. Denisova ◽

Adelina I. Sergeeva ◽

Alexandra S. Grigorieva ◽

Enje E. Rechapova ◽

Ivan I. Sergeev ◽

...

Keyword(s):

Pregnant Women ◽

Negative Impact ◽

Close Contact ◽

Relevant Literature ◽

Clinical Manifestations ◽

Future Generation ◽

World Health ◽

Practical Significance ◽

Increased Risk ◽

Coronavirus Infection

According to the WHO statement dated March 11, 2020, the coronavirus infection SARS-CoV-2 has reached the scale of a pandemic and is currently a world health problem. A special group of the population that requires increased attention is pregnant women due to the fact that pneumonia occupies the third place in the structure of indirect causes of maternal mortality. Pregnant women whose immune system has changed appeared to be at an increased risk of infection. Pregnancy is a risk factor for the development of a more severe course of acute respiratory viral diseases and influenza. To date, the issue of intrauterine transmission of coronavirus disease remains completely unexplored, which causes fear among pregnant women for the future generation. Addition of a new coronavirus infection SARS-CoV-2 has a negative impact on pregnancy, childbirth and the postpartum period, the health of newborns, especially in patients with a burdened obstetric history. Pregnancy itself and childbirth do not affect the course of COVID-19, but the infection addition can complicate the course of gestation, causing respiratory distress syndrome, premature birth and spontaneous miscarriages, congenital pneumonia and antenatal death of newborns born from covid-positive mothers. The literature published from December 1, 2019 to July 30, 2021 was searched in several databases, including PubMed, Web of Science, Google Scholar and the WHO COVID-19 database, of which 52 articles were selected for detailed consideration. The relevant literature was searched to understand the issues of infection transmission to newborns from infected mothers and the clinical manifestations of the disease in the former. As a result, it was found that newborns can become infected with SARS-Cov-2 in close contact with infected patients or asymptomatic virus carriers. However, based on the data of modern literature, it is impossible to unequivocally answer the questions posed, more facts are needed to solve the problem. The practical significance of the work is that the results of the study should be used for further studying the consequences of COVID-19 for the health of newborn children.

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Genetic Association of ERAP1 and ERAP2 With Eclampsia and Preeclampsia in Northeastern Brazilian Women

10.21203/rs.3.rs-235628/v1 ◽

2021 ◽

Author(s):

LEONARDO CAPISTRANO FERREIRA ◽

CARLOS EDUARDO MAIA GOMES ◽

PRIYA DUGGAL ◽

INGRID DE PAULA HOLANDA ◽

AMANDA SAMARA DE LIMA ◽

...

Keyword(s):

Pregnant Women ◽

Genetic Variants ◽

Antigen Processing ◽

P Value ◽

Chronic Hypertension ◽

Ang Ii ◽

Small Peptides ◽

Increased Risk ◽

Genotype C ◽

Risk Of Preeclampsia

Abstract The clinical spectrum of hypertensive disorders of pregnancy (HDP) is determined by the interplay between environmental and genetic factors, most of which remains unknown. ERAP1, ERAP2 and LNPEP genes code for multifunctional aminopeptidases involved with antigen processing and degradation of small peptides such as angiotensin II (Ang II), vasopressin and oxytocin. We aimed to test for associations between genetic variants in aminopeptidases and HDP. A total of 1282 pregnant women (normotensive controls, n=693; preeclampsia, n=342; chronic hypertension with superimposed preeclampsia, n=61; eclampsia, n=74; and HELLP syndrome, n=112) were genotyped for variants in LNPEP (rs27300, rs38034, rs2303138), ERAP1 (rs27044, rs30187) and ERAP2 (rs2549796 rs2927609 rs11135484). We also evaluated the effect of ERAP1 rs30187 on plasma Ang II levels in an additional cohort of 65 pregnant women. The genotype C/C, in ERAP1 rs30187 variant (c.1583T>C, p.Lys528Arg), was associated with increased risk of eclampsia (OR=1.85, p=0.019) whereas ERAP2 haplotype rs2549796(C)-rs2927609(C)-rs11135484(G) was associated with preeclampsia (OR=1.96, corrected p-value=0.01). Ang II plasma levels did not differ across rs30187 genotypic groups (p=0.895). In conclusion, ERAP1 gene is associated with eclampsia whereas ERAP2 is associated with preeclampsia, although the mechanism by which genetic variants in ERAPs influence the risk of preeclampsia and eclampsia remain to be elucidated.

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P–384 First trimester pregnancy outcomes after confirmed SARS-CoV–2 infection in the community; a nationwide prospective longitudinal study of 10,000 pregnant women from the COVID–19 pandemic

Human Reproduction ◽

10.1093/humrep/deab130.383 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

N Balachandren ◽

M Davies ◽

J Hall ◽

D Mavrelos ◽

E Yasmin

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

First Trimester ◽

Severe Illness ◽

Healthy Controls ◽

Household Contacts ◽

Increased Risk ◽

Early Miscarriage ◽

Study Participants ◽

Prospective Longitudinal

Abstract Study question Are pregnant women in the community with confirmed diagnosis of SARS-CoV–2 infection, at increased risk of an early miscarriage? Summary answer Women diagnosed with COVID–19 in their first trimester were not at increased risk of an early miscarriage. What is known already: In the earliest stages of the pandemic, the Human Fertilisation and Embryology Authority and the European Society of Human Reproduction and Embryology, independently advised against starting assisted reproductive treatments. At the time of this recommendation, among other reasons, there were concerns about the complications of SARS-CoV–2 during pregnancy and the potential for vertical transmission. We now having growing evidence that pregnant women are at an increased risk of severe illness along with higher rates of preterm births in those with severe acute respiratory syndrome. However, data on the impact of community infections of SARS-CoV–2 in early pregnancy has been sparse. Study design, size, duration This is an online survey study undertaken in the UK between May and November 2020. Pregnant women at any stage in their pregnancy were invited to participate in the study. Study participants were asked to complete online surveys at the end of each trimester. 10, 430 women were recruited to take part in the study. Participants/materials, setting, methods: We analysed pregnancy outcomes from women who were under 13 weeks gestation at the time of registration. We compared miscarriage rates among women with a confirmed diagnosis of SARS-CoV–2 infection to healthy controls. Those in the control group had not been diagnosed with or had symptoms of SARS-CoV–2 infection nor did they have any household contacts that were diagnosed with or had symptoms of SARS-CoV–2 infection. Main results and the role of chance 10, 430 pregnant women were recruited to participate in the study. 2934 were under 13 weeks gestation at the time of registration. The median age was 32.6 [IQR 29.8–35.6]. The median gestational age at registration was 8 weeks [IQR [6–10]. 246 women reported a miscarriage before 13 weeks of gestation. The overall miscarriage rate before 13 weeks of gestation was 8.4% (95% CI 7.3%–9.4%). 68 women reported a confirmed diagnosis of SARS-CoV–2 infection in their first trimester. The overall rate of confirmed SARS-CoV–2 infections in the first trimester was 2.3% (95% CI 1.8–2.9%). 3/68 (4.4%) were asymptomatic. Among those reporting symptoms, the commonest symptoms were fatigue (82%), headache (69%) and loss of smell/taste (69%). Only 38% of those with a confirmed diagnosis reported a fever. None of the 68 women with confirmed diagnosis of SARS-CoV–2 infection were hospitalised. The rate of miscarriage before 13 weeks of gestation in women who were diagnosed with SARS-CoV–2 infections was not significantly higher compared to healthy controls (11.8% versus 9.3%, p = 0.35). A further 35 women had household contacts with confirmed SARS-CoV–2 infection although they themselves had not been diagnosed. No miscarriages were reported in this group. Limitations, reasons for caution None of the 68 patients diagnosed with SARS-CoV–2 were hospitalised. We do not know whether the rate of miscarriage among hospitalised women with SARS-CoV–2 infection is the same as those with community infections. Wider implications of the findings: The overall rate of miscarriage during the pandemic was not higher than rates occurring outside of the pandemic. The rate of miscarriage among women diagnosed with SARS-CoV–2 infection was not significantly higher compared to healthy controls. This data can be used to counsel women planning a pregnancy during this pandemic Trial registration number Not applicable

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Assessment of Prevalence of Hypertension in pregnant women with its Complications: A Cross Sectional Study

Research Journal of Pharmacy and Technology ◽

10.52711/0974-360x.2021.00659 ◽

2021 ◽

pp. 3805-3808

Author(s):

Hemalatha S. ◽

S. M. Shaheedha ◽

Ramakrishna Borra

Keyword(s):

Pregnant Women ◽

Cross Sectional Study ◽

World Health ◽

Chronic Hypertension ◽

Pregnancy Induced Hypertension ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Gynecology And Obstetrics ◽

Induced Hypertension ◽

History Of

Introduction: World Health Organization has reported that pregnancy induced hypertension is one of the main causes for mortality and morbidity in maternal and fetal deaths. About 60% of deaths accounted of eclampsia. Aims and Objectives: To diagnose for hypertension in pregnant women. To evaluate the knowledge of pregnancy induced hypertension among the pregnant women. To investigate the complications reported in Pregnancy induced hypertension (PIH) women, during and after labor. Study area and period: The present study was conducted in Chittoor government hospital, Chittoor, during the period of Jan 2016 and Dec 2017. The information and materials required for the study have been collected from the gynecology and obstetrics departments of the respective hospital. Results: During the study period of Jan 2016 and Dec 2017, about 2234 number of pregnant women have visited the obstetrics and gynecology department. All the 2234 pregnant women were tested for blood pressure. Among which 198 women were found to have hypertension, which may be of early onset PIH or chronic hypertension (HTN). Different variables of the study population like period of gestation [<20 weeks, ≥20 weeks], previous cesarean section if present, previous preterm delivery if present, hypertension in previous pregnancy, history of paternal hypertension, history of abortions if have been, history of any still births, family history of PIH have been noted and reported in table 2. More than 8% of women were found to been falling in <20 weeks of gestational age (GA). Conclusion: The study included 2234 pregnant women, in which 198 women were diagnosed with hypertension. Thus, prior investigation and identification hypertension in pregnant women helps in better management of PIH and to overcome the complications that are reported due to PIH during and after labor. Better knowledge and treatment is required for managing hypertension in maternal women in gynecology and obstetrics department for maternal and fetal care.

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Negative latent tuberculosis at time of incarceration: identifying a very high-risk group for infection

Epidemiology and Infection ◽

10.1017/s0950268817001558 ◽

2017 ◽

Vol 145 (12) ◽

pp. 2491-2499 ◽

Cited By ~ 8

Author(s):

L. ARROYAVE ◽

Y. KEYNAN ◽

L. LÓPEZ ◽

D. MARIN ◽

M. P. ARBELÁEZ ◽

...

Keyword(s):

Risk Factors ◽

High Risk ◽

Latent Tuberculosis ◽

Risk Groups ◽

High Risk Group ◽

World Health ◽

Formerly Incarcerated ◽

Adjusted Risk ◽

Number Needed To Screen ◽

Health Organization

SUMMARYThe main aim was to measure the incidence of latent tuberculosis infection (LTBI) and identify risk factors associated with infection. In addition, we determined the number needed to screen (NNS) to identify LTBI and active tuberculosis. We followed 129 prisoners for 2 years following a negative two-step tuberculin skin test (TST). The cumulative incidence of TST conversion over 2 years was 29·5% (38/129), among the new TST converters, nine developed active TB. Among persons with no evidence of LTBI, the NNS to identify a LTBI case was 3·4 and an active TB case was 14·3. The adjusted risk factors for LTBI conversion were incarceration in prison number 1, being formerly incarcerated, and overweight. In conclusion, prisoners have higher risk of LTBI acquisition compared with high-risk groups, such as HIV-infected individuals and children for whom LTBI testing should be performed according to World Health Organization guidance. The high conversion rate is associated with high incidence of active TB disease, and therefore we recommend mandatory LTBI screening at the time of prison entry. Individuals with a negative TST at the time of entry to prison are at high risk of acquiring infection, and should therefore be followed in order to detect convertors and offer LTBI treatment. This approach has a very low NNS for each identified case, and it can be utilized to decrease development of active TB disease and transmission.

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COVID-19 OUTCOMES IN PREGNANCY: A REVIEW OF 275 SCREENED STUDIES

10.1101/2021.08.28.21262778 ◽

2021 ◽

Author(s):

Rupalakshmi Vijayan ◽

Hanna Moon ◽

Jasmine Joseph ◽

Madiha Zaidi ◽

Chhaya Kamwal ◽

...

Keyword(s):

Literature Review ◽

Pregnant Women ◽

Direct Evidence ◽

Case Series ◽

Adverse Outcomes ◽

Morbidity And Mortality ◽

World Health ◽

Increased Risk ◽

Immunological Changes ◽

In Pregnancy

In December 2019, a novel strain of severe acute respiratory syndrome (SARS-CoV-2), was declared as a cause of respiratory illness, called coronavirus 2019 (COVID-19), characterized by fever and cough. In diagnostic imaging, the afflicted population showed pathognomonic findings of pneumonia. What started out as an epidemic in China, rapidly spread across geographical locations with a significant daily increase in the number of affected cases. According to the World Health Organization (WHO) reports, the range of worldwide mortality is 3 to 4%. Maternal adaptations and immunological changes predispose pregnant women to a prolonged and severe form of pneumonia, which results in higher rates of maternal, fetal, and neonatal morbidity and mortality. There is limited data about the consequences of COVID-19 in pregnancy, thereby limiting the prevention, counseling, and management of these patients. The objective of this literature review is to explore pregnancy and perinatal outcomes of COVID-19, complications, morbidity, and mortality in this sub-population. We conducted a literature review pertaining to COVID-19 and pregnancy in databases such as: PubMed, Google Scholar, and Science Direct. The studies we chose to focus on were systematic reviews, meta-analysis, case series, and case reports. Twenty four articles were reviewed regarding COVID-19 and pregnancy, complications and their outcomes. Due to immunological changes during pregnancy as evidenced by the flaring of auto-immune diseases; pregnant women may be at an increased risk for infection. Women (19.7%) who had underlying comorbidities such as gestational DM, HTN, hypothyroidism, and autoimmune disease, COPD, or HBV infection were considered high risk. The most common maternal outcomes were premature rupture of membranes (PROM) and pre-eclampsia. Asthma was the most common comorbidity associated with maternal mortality. The most common neonatal complications were fetal distress leading to NICU admissions and preterm birth <37 weeks. The most common laboratory changes were elevated CRP and lymphocytopenia. Most patients underwent C-section due to their underlying comorbidities. Pregnant and lactating women did not shed viral particles through their vaginal mucus and milk, as evidenced by negative nucleic-acid tests of these secretions. Neonatal infections as demonstrated by positive RT-PCR were rare, but direct evidence supporting intrauterine transmission was not confirmed. Direct evidence indicating vertical transmission of COVID-19 is not available, but risk for transmission cannot be ruled out. Pregnant women should be closely monitored due to increased risk of adverse outcomes.

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Hubungan Faktor Resiko Dengan Kejadian Eklampsia Pada Ibu Hamil di RSUD Ambarawa

JOURNAL EDUCATIONAL OF NURSING(JEN) ◽

10.37430/jen.v2i2.38 ◽

2019 ◽

Vol 2 (2) ◽

pp. 7-17

Author(s):

Nur Cahyani Ari Lestari ◽

Syahrida Wahyu Utami ◽

Reni Rahayu

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

Health Workers ◽

Sampling Technique ◽

Endothelial Activation ◽

P Value ◽

Chronic Hypertension ◽

Cross Sectional ◽

Specific Syndrome ◽

Twin Pregnancies

Eclampsia is a pregnancy-specific syndrome in the form of decreased organ perfusion due to vasospasm and endothelial activation, characterized by increased blood pressure, proteinuria, with or without edema accompanied by seizures. Eclampsia can harm the mother and fetus. The exact cause of eclampsia is unknown, but eclampsia can be triggered by several risk factors including the age of too young or too young, nulliparous, obesity in pregnancy, chronic hypertension, diabetes and multiple pregnancies. This study aims to determine the relationship between risk factors and the incidence of eclampsia in pregnant women in Ambarawa Hospital. The research method used was descriptive analytic research with a cross-sectional approach. Research variables included age, parity, obesity, chronic hypertension, diabetes, twin pregnancies as risk factors for eclampsia and eclampsia. The study population was all pregnant women in Ambarawa General Hospital in January-June of 896 people. The research sample was taken using the proportionate stratified random sampling technique that was in accordance with the inclusion and exclusion criteria as many as 90 people. The results showed that pregnant women aged between 20-35 years were 49 people (54.4%), the parity of pregnant women was nulliparous as many as 37 people (41.1%), pregnant women were not obese as many as 72 people (80%) and not experiencing chronic hypertension as many as 70 people (77.8%), almost all pregnant women did not suffer from diabetes as many as 86 people (95.6%) and did not experience twin pregnancies as many as 83 people (92.2%). Risk factors associated with pre-eclampsia events included parity (p value 0.033), obesity (p value 0.017), chronic hypertension (p value 0,000) and diabetes (p value 0.041. The most dominant risk factor after multivariate regression analysis logistics is chronic hypertension, it is recommended for health workers and the public to prevent the occurrence of pre-eclampsia, especially for mothers who have risk factors. Keywords: Risk Factors, Incidence of Eclampsia

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P626 SARS-CoV-2 seroprevalence in patients with Inflammatory Bowel Disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.746 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S564-S564

Author(s):

S García Mateo ◽

S J Martínez-Domínguez ◽

M C Aso Gonzalvo ◽

C J Gargallo-Puyuelo ◽

B Gallego Llera ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Potential Risk ◽

Bowel Disease ◽

Biologic Agents ◽

World Health ◽

Indeterminate Colitis ◽

Increased Risk ◽

Potential Risk Factors ◽

Inflammatory Bowel

Abstract Background Patients with Inflammatory Bowel Disease (IBD) suffer from a chronic illness and many of them need immunosuppressive therapy throughout the course of the disease. Consequently, COVID-19 pandemic has caused uncertainty about the possible increased risk of suffering SARS-CoV-2 infection that could confer IBD or its treatments. The aim of this study is to assess SARS-CoV-2 seroprevalence in patients with IBD as well as the existence of potential risk factors for its development. Methods This is a unicentric cross-sectional study developed in IBD unit of University Hospital “Lozano Blesa” of Zaragoza. Patients older than 18 years with established diagnosis of Crohn′s Disease (CD), Ulcerative Colitis (UC) or Indeterminate Colitis (IC) have been included. A blood sample has been drawn from each patient to detect IgG against SARS-CoV-2 (ELISA method) and each patient has completed a questionnaire to know symptoms related to infection and previous comorbidity. We have performed a descriptive analysis and a univariate analysis to study relationship between potential risk factors and seroconversion against SARS-CoV-2. Results 431 patients have been included, with a mean age of 50.2 ± 14.1 years and a 51.3% of women. Of them, 49.7% suffer from UC, 49.2% CD and 1.2% IC. Related to the treatment, 23.5% receive anti-TNF biologic agents, 13.1% other kind of biologic agents, 9.3% immunomodulators, 7.7% combined treatment (biologic agent and immunomodulator), 33.1% other treatment and 13.3% no treatment. According to World Health Organization (WHO) definitions, 85.6% had not suffered the infection, 7.7% were confirmed cases (only 3 admitted patients) and 6.7% were probable cases. The seroprevalence of SARS-CoV-2 obtained is 8.8%, being significantly higher among confirmed cases than among probable cases (71.0% in confirmed vs 6.9% in probable; RR 10.3; p<0.001). A higher risk of seroconversion has been detected among patients without biologic agents (11.8% in patients without biologic agents vs 5.3% in patients with biologic agents; RR 2.2; p=0.021). No differences have been observed in the seroprevalence of patients with other treatments for IBD or in terms of age, active smoking, level of inflammation markers, the presence of symptoms of infection or hospital admission. Conclusion The seroprevalence of SARS-CoV-2 of Aragon′s patients with IBD is similar to that described in national seroprevalence study of Ministry of Health for the region (8.8%). The treatment with biologic agents is associated with a lower risk of seroconversion

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Serological prevalence of toxoplasmosis in pregnant women in Luanda (Angola): Geospatial distribution and its association with socio-demographic and clinical-obstetric determinants

PLoS ONE ◽

10.1371/journal.pone.0241908 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0241908

Author(s):

Amélia Nkutxi Vueba ◽

Clarissa Perez Faria ◽

Ricardo Almendra ◽

Paula Santana ◽

Maria do Céu Sousa

Keyword(s):

Risk Factors ◽

Multivariate Analysis ◽

Hepatitis B ◽

Pregnant Women ◽

Dietary Habits ◽

Congenital Toxoplasmosis ◽

Maternity Hospital ◽

Serum Samples ◽

Increased Risk ◽

Potential Risk Factors

We report a study on toxoplasmosis in pregnant women in Luanda, Angola, determining the seroprevalence, geospatial distribution and its association with socio-economic features, dietary habits and hygiene and health conditions. Anti-Toxoplasma gondii IgG and IgM were quantified in serum samples of women attended at the Lucrecia Paim Maternity Hospital between May 2016 and August 2017. The IgG avidity test and qPCR assay were used for dating the primary infection. Data were collected by questionnaire after written consent, and spatial distribution was assessed through a Kernel Density Function. The potential risk factors associated with Toxoplasma infection were evaluated using bivariate and multivariate binomial logistic regression analysis. Anti-T. gondii antibodies were quantified in 878 pregnant women, and 346 (39.4%) samples were IgG positive, 2 (0.2%) positive for IgM and IgG, and 530 (60.4%) negative for both immunoglobulins. The longitudinal study showed that none of the seronegative women seroconverted during the survey. Regarding other infections, 226 (25.7%) were positive for hepatitis B, while 118 (13.4%) were HIV-positive. The seroprevalence of toxoplasmosis was similar in most municipalities: 43.8% in Cazenga (28 of 64); 42.5% in Viana (88 of 207); 42.3% in Cacuaco (22 of 52); and 41.1% in Luanda ((179 of 435). In contrast, the seroprevalence in municipality of Belas was lower (25.8%; 31 of 120) and bivariate and multivariate analysis has shown a lower risk for toxoplasmosis in this area (OR 0.479, CI: 0.305–0.737; OR 0.471, CI: 0.299–0.728). The multivariate analysis has shown a significant increased risk for toxoplasmosis in women in the last trimester of pregnancy (OR 1.457, CI: 1.011–2.102), suffering spontaneous abortion (OR 1.863, CI: 1.014–3.465) and having pets at home (OR 1.658, CI: 1.212–2.269). Also, women who tested positive for hepatitis B (OR 1.375, CI: 1.008–1.874) and HIV (OR 1.833, CI: 1.233–2.730) had a significant increased risk for T. gondii infection. In conclusion, our study showed that a large number of pregnant women are not immunized for toxoplasmosis and identified the risk factors for this infection in Luanda. It is crucial to establish the diagnosis of primary maternal infection as well as the diagnosis of congenital toxoplasmosis. Our results underlined the need for diagnostic and clinical follow-up of toxoplasmosis, HIV and hepatitis B during pregnancy.

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Risk Factors associated with Fetal and Pregnancy Complications in Palestine

10.21203/rs.3.rs-511095/v1 ◽

2021 ◽

Author(s):

Sana ’ Al-Aqqad ◽

Nihal Al-Natour ◽

Mariam Al-Tell

Keyword(s):

Risk Factors ◽

Health Care ◽

Primary Health Care ◽

Pregnant Women ◽

Gestational Age ◽

Pregnancy Complications ◽

Health Care Clinics ◽

Primary Health ◽

Increased Risk ◽

Fetal Complications

Abstract Background: Complications observed during pregnancy affect both mother and fetus, and are more commonly observed among pregnant women from developing countries. The study aims to identify the most common pregnancy and fetal complications during pregnancy, and associated risk factors with these complications. Methods: A longitudinal study was conducted from September 2017 to July 2018 among pregnant women attending and registering in primary health care clinics of the Palestinian Ministry of Health in Nablus city. Data were collected through interviews and by reviewing medical records. Women were followed up during their regular visits to the primary health care clinics. Any complication affecting either the fetus or the mother during the pregnancy period was recorded. Binary logistic regression was used to identify independent risk factors for pregnancy and fetal complications. Results: A total of 380 pregnant women were included in the study. The most common complications seen among women during pregnancy were preterm labor (PTL) (11.3%), followed by an equal number of gestational diabetes (GDM) and pregnancies induce hypertension (PIH), i.e. (7.9%). Large for gestational age (LGA) (11.6 %) and small for gestational age (SGA) (10.5%) were the most commonly observed fetal complications. Pregnant women living in camps (O.R 2.35, 95% [CI] 1.02- 5.45), nulliparity (O.R 14.9, 95% [CI] 1.09-202.5) and low parity women (O.R 16.8, 95% [CI] 1.47- 192.5) were at higher risk of having pregnancy complications. However, lower risk was noticed between women with gravida 4 (O.R 0.11, 95% [CI] 0.03-0.47) compared to women having more than 6 pregnancies. Age younger than 41 years was a protective factor against fetal complications, while parity (≤ 6 parities) especially 4 to 6 parities (OR 36.17; 95% CI 4.88-268) and active smoking mothers (OR 1.25; 95% CI 1.0-3.07) were identified as risk factors that are associated with an increased risk of fetal complications. Conclusions: Fetal and pregnancy-related complications are prevalent among Palestinian pregnant women. Increasing the awareness and improving the understanding of the identified risk factors related to these complications among the public, and specifically, females may help to reduce the prevalence of these conditions and the associated risk of these complications.

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