scholarly journals Waning of the Humoral Response to SARS-CoV-2 in Pregnancy is Variant-Dependent

2021 ◽  
Author(s):  
Romina Plitman Mayo ◽  
Tal Raz ◽  
Bar Ben David ◽  
Gila Meir ◽  
Haim Barr ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Humoral Response ◽  
Third Wave ◽  
Eligibility Criteria ◽  
Multicenter Cohort Study ◽  
Disease Etiology ◽  
The Third ◽  
Increased Risk ◽  
Alpha Variant ◽  
Wave Induced

Importance The SARS CoV2 alpha variant posed increased risk for COVID19 complications in pregnant women. However, its impact on the maternal humoral response and placental IgG transport remains unclear. Objective To characterize the maternal humoral waning and neonate immunity acquired during the third COVID19 wave in Israel, dominated by the Alpha variant, as compared to earlier Wildtype infections and humoral response to vaccination across gestation. Design Maternal and fetal blood serum were collected at delivery since April 2020 from parturients. Sera IgG and IgM titers were measured using the Milliplex MAP SARS CoV2 Antigen Panel supplemented with additional HA coupled microspheres. Setting A nationwide multicenter cohort study on SARS CoV2 infections and vaccination during pregnancy. Participants Expectant women presenting for delivery were recruited at 8 medical centers across Israel and assigned to 3 primary groups. 157 SARS CoV2 positive and 125 fully vaccinated during pregnancy, and 212 unvaccinated noninfected controls matched to the infected group by BMI, maternal age, comorbidities and gestational age. Eligibility criteria included pregnant women without active COVID19 disease, age over 18 years and willingness to provide informed consent. Main Outcomes and Measures Pregnant womens humoral response is dependent on the SARS CoV2 strain. Results The humoral response to infection as detected at birth, showed a gradual and significant decline as the interval between infection or vaccination and delivery increased. Significantly faster decay of antibody titers was found for infections occurring during the third wave compared to earlier infection or vaccination. Cord blood IgG antigens levels correlated with maternal IgG. However, cord IgG HA variance significantly differed in SARS CoV2 infections as compared to the other groups. No sexual dimorphism in IgG transfer was observed. Lastly, high fetal IgM response to SARS CoV2 was detected in 17 neonates, all showing elevated IgM to N suggesting exposure to SARS CoV2 antigens. Conclusions and Relevance Infections occurring during the third wave induced a faster decline in humoral response when compared to Wildtype infections or mRNA BNT162b2 vaccination during pregnancy, consistent with a shift in disease etiology and severity induced by the Alpha variant. Vaccination policies in previously infected pregnant women should consider the timing of exposure along pregnancy as well as the risk of infection to specific variants of concern.

scholarly journals Machine learning from fetal flow waveforms to predict adverse perinatal outcomes: a study protocol

2018 ◽  
Vol 2 ◽  
pp. 8
Author(s):  
Zahra Hoodbhoy ◽  
Babar Hasan ◽  
Fyezah Jehan ◽  
Bart Bijnens ◽  
Devyani Chowdhury
Keyword(s):  
Machine Learning ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Fetal Ultrasound ◽  
Eligibility Criteria ◽  
Early Neonatal Mortality ◽  
Increased Risk ◽  
Machine Learning Approach ◽  
Adverse Perinatal Outcomes ◽  
Flow Waveforms

Background: In Pakistan, stillbirth rates and early neonatal mortality rates are amongst the highest in the world. The aim of this study is to provide proof of concept for using a computational model of fetal haemodynamics, combined with machine learning. This model will be based on Doppler patterns of the fetal cardiovascular, cerebral and placental flows with the goal to identify those fetuses at increased risk of adverse perinatal outcomes such as stillbirth, perinatal mortality and other neonatal morbidities. Methods: This will be prospective one group cohort study which will be conducted in Ibrahim Hyderi, a peri-urban settlement in south east of Karachi. The eligibility criteria include pregnant women between 22-34 weeks who reside in the study area. Once enrolled, in addition to the performing fetal ultrasound to obtain Dopplers, data on socio-demographic, maternal anthropometry, haemoglobin and cardiotocography will be obtained on the pregnant women. Discussion: The machine learning approach for predicting adverse perinatal outcomes obtained from the current study will be validated in a larger population at the next stage. The data will allow for early interventions to improve perinatal outcomes.

scholarly journals Impact of SARS-CoV-2 variant on the severity of maternal infection and perinatal outcomes: Data from the UK Obstetric Surveillance System national cohort.

2021 ◽  
Author(s):  
Nicola Vousden ◽  
Rema Ramakrishnan ◽  
Kathryn Bunch ◽  
Edward Morris ◽  
Nigel Simpson ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Severe Infection ◽  
Maternal Infection ◽  
Increased Risk ◽  
National Guidance ◽  
National Cohort ◽  
Alpha Variant ◽  
The Uk ◽  
The Impact

Background In the UK, the Alpha variant of SARS-CoV-2 became dominant in late 2020, rapidly succeeded by the Delta variant in May 2021. The aim of this study was to compare the impact of these variants on severity of maternal infection and perinatal outcomes within the time-periods in which they predominated. Methods This national, prospective cohort study collated data on hospitalised pregnant women with symptoms of confirmed SARS-CoV-2 infection and compared the severity of infection and perinatal outcomes across the Wildtype (01/03/20-30/11/20), Alpha (01/12/20-15/05/21) and Delta dominant periods (16/05/21-11/07/21), using multivariable logistic regression. Findings Of 3371 pregnant women, the proportion that experienced moderate to severe infection significantly increased between Wildtype and Alpha periods (24.4% vs. 35.8%; aOR1.75 95%CI 1.48-2.06), and between Alpha and Delta periods (35.8% vs. 45.0%; aOR1.53, 95%CI 1.07-2.17). Compared to the Wildtype period, symptomatic women admitted in the Alpha period were more likely to require respiratory support (27.2% vs. 20.3%, aOR1.39, 95%CI 1.13-1.78), have pneumonia (27.5% vs. 19.1%, aOR1.65, 95%CI 1.38-1.98) and be admitted to intensive care (11.3% vs. 7.7%, aOR1.61, 95%CI 1.24-2.10). Women admitted during the Delta period had further increased risk of pneumonia (36.8% vs. 27.5%, aOR1.64 95%CI 1.14-2.35). No fully vaccinated pregnant women were admitted between 01/02/2021 when vaccination data collection commenced and 11/07/2021. The proportion of women receiving pharmacological therapies for SARS-CoV-2 management was low, even in those critically ill. Interpretation SARS-CoV-2 infection during Alpha and Delta dominant periods was associated with more severe infection and worse pregnancy outcomes compared to the Wildtype infection, which itself increased risk compared to women without SARS-CoV-2 infection.1 Clinicians need to be aware and implement COVID-specific therapies in keeping with national guidance. Urgent action to tackle vaccine misinformation and policy change to prioritise uptake in pregnancy is essential. Funding National Institute for Health Research HS&DR Programme (11/46/12).

Topical issues of midwifery services under coronavirus pandemic in the area with low population density

2021 ◽  
Vol 19 (1) ◽  
pp. 110-114
Author(s):  
M. B Ovchinnikova ◽  
◽  
A. G. Arutyunyants ◽  
Keyword(s):  
Preterm Birth ◽  
Population Density ◽  
Pregnant Women ◽  
Critical Condition ◽  
Perinatal Outcomes ◽  
Gestation Period ◽  
Published Data ◽  
Third Wave ◽  
Pregnancy And Childbirth ◽  
The Third

The purpose was to describe the algorithms of midwifery services in the area with low population density under the coronavirus pandemic and to evaluate SARS-Cov-2 as a threatening factor for pregnancy and childbirth. Material and methods. 205 pregnant women aged from 16 to 42 y. o., with virusologically conformed presence of SARS-Cov-2, in the gestation period from 5 to 40 weeks were explored. Of them, 126 pregnant patients were hospitalized and monitored up to the recovery from COVID-19 or delivery. The features of pregnancy and childbirth, perinatal outcomes were studied. The obtained data were compared with the published data to identify the true and false threats of COVID-19 to a mother and a baby in case of the «third wave» of the pandemic. Results. Observation showed that pregnant women tend to have a lighter course of SARS-Cov-2 compared to the population and the frequency of critical condition is no more that 0.8%. The frequency of preterm birth is 1.5 % of all births of COVID-19 infected pregnant women, and the frequency of miscarriage is 0.58 % of all COVID-19 infected pregnant women. This does not confirm the published data of high proportion of preterm birth and misbirth (18-19%). Conclusion. Our investigation does not confirm that COVID-19 adds the complexity of the course of pregnancy and makes its outcomes worse.

scholarly journals Circadian misalignment measured by social jetlag from early to late pregnancy and its association with nutritional status: a longitudinal study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Laura Cristina Tibiletti Balieiro ◽  
Cristiana Araújo Gontijo ◽  
Luisa Pereira Marot ◽  
Gabriela Pereira Teixeira ◽  
Walid Makin Fahmy ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Pregnant Women ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Absolute Difference ◽  
Third Trimester ◽  
Circadian Misalignment ◽  
The Third ◽  
Social Jetlag ◽  
Increased Risk

AbstractA mismatch between circadian and social clocks leads to a circadian misalignment, which has been widely measured by social jetlag (SJL). There are several studies measuring SJL, but it has not been studied in pregnant women. Therefore, this study aimed to identify the occurrence of SJL throughout pregnancy and to verify whether there is an effect of pre-pregnancy body mass index (BMI) on SJL throughout pregnancy. The baseline of the present study was conducted with 205 1st trimester pregnant women of whom 100 were followed in their 2nd and 3rd trimester. SJL was calculated based on the absolute difference between mid-sleep time on workdays versus work-free days. The pre-pregnancy BMI and current BMI (kg/m2) were calculated. Linear regression and Generalised Estimating Equation (GEE) adjusted for confounders were used to determine the association between SJL and the gestational trimesters (time), and anthropometric variables. Most of the pregnant women (54.5%) presented SJL > 1 h in the first gestational trimester. We also found an isolated effect of the gestation trimester on the SJL mean. In this sense, pregnant women had a decrease in SJL from the second to the third trimester (1.33 ± 0.08 versus 1.12 ± 0.07, respectively; p = 0.012). GEE analyzes showed that pregnant women of a normal weight showed a decrease in SJL from the second to the third trimester (1.29 ± 0.11 and 0.93 ± 0.08, respectively, p = 0.032), but this was not found in the other groups of nutritional status (underweight, overweight and obesity). In addition, a positive association between SJL and pre-gestational BMI in the third trimester (β = 0.200, p = 0.046) was found. SJL is quite prevalent during the gestational period and excessive BMI both before and during pregnancy is associated with an increased risk of having SJL > 1 h in the third and second trimesters, respectively. In addition, pregnant women of normal weight—but not underweight or overweight—had decreased SJL from the second to the third trimester.

scholarly journals Serum vitamin D3 levels in pregnant women with preeclampsia at third trimester of pregnancy

2021 ◽  
Vol 2 (03) ◽  
pp. 131-137
Author(s):  
Anas Sadek ◽  
Rayah Baban ◽  
May Al-Habib ◽  
Enas Khazaali
Keyword(s):  
Pregnant Women ◽  
Vitamin D3 ◽  
Case Control Study ◽  
Serum Vitamin ◽  
Third Trimester ◽  
The Third ◽  
Increased Risk ◽  
Significant Difference ◽  
Vitamin D3 Deficiency ◽  
Control Study

Background: Preeclampsia (PE) is a pregnancy-specific condition, characterized by high blood pressure and proteinuria after 20 weeks of gestation. One of the hypotheses concerning the etiology of PE is vitamin D3 deficiency during pregnancy. Vitamin D3 is especially important during pregnancy as low maternal vitamin D3 stores may contribute to problems like low birth weight as well as an increased risk of maternal comorbidities. Objectives: To evaluate serum vitamin D3 levels and how they can be affected by the severity of PE at the third trimester of pregnancy. Methods: This case-control study included a total of 71 pregnant women at the third trimester of pregnancy (41 with PE and 30 without PE as controls). Vitamin D3 serum level was measured by enzyme-linked immune-sorbent assay (ELISA). Results: The study’s findings showed no significant difference in serum vitamin D3 level (p>0.05) between controls (14.41±1.41ng/ml) and PE patients (14.32±1.00). As well, subgroup analysis revealed non-considerable changes between mild PE cases (15.92±1.73 ng/ml) and severe ones (13.07±1.09 ng/ml). Conclusions: PE and its severity may have no significant effect on serum vitamin D3 levels of pregnant women at the third trimester of pregnancy.

scholarly journals GAMBARAN KLINIS GINGIVA PADA IBU HAMIL DI PUSKESMAS BAHU KECAMATAN MALALAYANG

e-GIGI ◽  
2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Lucyana S. Angwirawan ◽  
Shane H. R. Ticoalu ◽  
Krista V. Siagian
Keyword(s):  
Oral Cavity ◽  
Pregnant Women ◽  
Clinical Picture ◽  
Research Result ◽  
General Purpose ◽  
Third Trimester ◽  
Cross Sectional ◽  
The Third ◽  
Increased Risk ◽  
Age Category

Abstract: Pregnancy is a very unique phase on every women marked with complex physiologic changes that can affect the healthiness of the oral cavity. The increased risk of mouth disease on pregnant women can be affected by the surge of estrogen and progesterone that marked by swelling and inflammation on the teeth. The General purpose of this research is to identify the clinical conception of the gingiva on pregnant women on Puskesmas Bahu in Malalayang residency. This research is tend to be observational descriptive with the cross-sectional approach. Population of this research is all the pregnant women that made a visit to Puskesmas Bahu in the period of January to February 2015 with 60 samples. The research on pregnant women can be divided with the scoring of gingiva clinical conception which is 0 for normal and 1 for abnormal on the color, size, contour, consistency and texture of the gingiva. The research result shows that the clinical picture of the gingiva on pregnant women are generally experience changes the texture of the gingiva (75%), followed by the gingiva consistency (73%), contour of the gingiva (58%), color of the gingiva (48%) and the size of the gingiva(43%). On the age category, the highest value of the percentage present on age 36 to 45 years old especially the changes on the texture of the gingiva (86%). On the category of age of the pregnancy, the highest value of the percentage present on the third trimester especially the changes of the the gingival consistency (86%).Keywords: clinical picture of gingiva, pregnant womenAbstrak: Kehamilan ialah masa yang sangat unik pada setiap wanita yang ditandai dengan perubahan fisiologis secara kompleks, sehingga dapat memengaruhi kesehatan rongga mulut. Peningkatan resiko terjadinya penyakit mulut pada wanita hamil dapat disebabkan oleh peningkatan hormon estrogen dan progesteron yang biasanya ditandai dengan pembengkakan dan peradangan pada gingiva. Tujuan dari penelitian ini ialah untuk mengetahui gambaran klinis gingiva pada ibu hamil di Puskesmas Bahu Kecamatan Malalayang. Penelitian ini bersifat deskriptif observasional dengan pendekatan cross sectional. Populasi dalam penelitian ini ialah seluruh ibu hamil yang dating berkunjung ke Puskesmas Bahu Kecamatan Malalayang pada bulan Januari – Februari tahun 2015 dengan jumlah sampel sebanyak 60 sampel. Penelitian pada ibu hamil dapat dibedakan dengan pembagian skor gambaran klinis gingiva yaitu normal sama dengan 0 dan tidak normal sama dengan 1 pada warna gingiva, besar gingiva, kontur gingiva, konsistensi gingiva dan tektur gingiva. Hasil dari penelitian ini menunjukkan bahwa gambaran klinis gingiva pada ibu hamil kebanyakkan mengalami perubahan pada tekstur gingiva (75%), diikuti berurut-turut konsistensi gingiva (73%), kontur gingiva (58%), warna gingiva (48%) dan besar gingiva (43%). Pada kategori umur presentase terbesar terdapat pada umur 36-45 tahun khususnya perubahan pada tekstur gingiva (86%). Pada kategori usia kehamilan presentase terbesar terdapat pada trimester ke – III khususnya perubahan pada konsistensi gingiva (86%).Kata kunci: gambaran klinis gingiva, ibu hamil

scholarly journals Adipsin of the Alternative Complement Pathway Is a Potential Predictor for Preeclampsia in Early Pregnancy

2021 ◽  
Vol 12 ◽  
Author(s):  
Min Liu ◽  
Xiaolei Luo ◽  
Qin Xu ◽  
Hongbiao Yu ◽  
Linbo Gao ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Early Pregnancy ◽  
Plasma Levels ◽  
Receiver Operating Curve ◽  
Plasma Samples ◽  
Third Trimester ◽  
Complement Proteins ◽  
The Third ◽  
Increased Risk ◽  
Pregnancy And Postpartum

ObjectiveThe concentrations of complement proteins (adipsin, C3a, and C5a) and soluble endoglin (sENG) in the plasma were measured in this study, and their value as early-pregnancy predictors and potential diagnostic marker of preeclampsia was assessed, respectively.Experimental DesignPlasma samples were obtained from healthy and preeclampsia pregnant women before delivery for a cross-sectional study. Plasma samples were collected from healthy and preeclampsia pregnant women throughout pregnancy and postpartum for a follow-up study. Enzyme-linked immunosorbent assays were used to detect plasma levels of several complement proteins (adipsin, C3a, and C5a) and sENG.ResultsThe plasma levels of adipsin, C5a, and sENG were significantly increased before delivery in pregnant women with preeclampsia. During pregnancy, the plasma adipsin, C5a, and sENG levels were increased from the third trimester in healthy pregnant women; plasma adipsin levels remained stable after delivery, while C3a levels increased in the second trimester and remained stable afterward. Furthermore, levels of adipsin, C5a, and sENG were higher in preeclampsia patients at different stages of pregnancy; the C3a level presents a similar change and no difference was found in the third trimester. In the first trimester, receiver-operating curve (ROC) curve analysis showed that adipsin (AUC, 0.83 ± 0.06, P=0.001) and sENG (AUC, 0.74 ± 0.09, P=0.021) presented high value as predictors of early pregnancy.ConclusionsAdipsin is likely a novel plasma biomarker to monitor the increased risk of preeclampsia in early pregnancy. Moreover, the increased plasma levels of adipsin, C5a, and sENG before delivery may be associated with preeclampsia.

ASSESSMENT OF THE PLATELET COUNT IN THE PREGNANT WOMEN IN IGIMS, PATNA, BIHAR

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Tanwi Singh ◽  
Anshuman Sinha
Keyword(s):  
Platelet Count ◽  
Pregnant Women ◽  
Screening Test ◽  
Low Cost ◽  
Medical Science ◽  
Cost Effective ◽  
Platelet Indices ◽  
Increased Risk ◽  
Low Platelet Count ◽  
Severity Of The Disease

The major risk associated with low platelet count in pregnancy is the increased risk of bleeding during the childbirth or post that. There is an increased blood supply to the uterus during pregnancy and the surgical procedure requires cutting of major blood vessels. Women with thrombocytopenia are at increased risk of losing excessive blood. The risk is more in case of caesarean delivery as compared to vaginal delivery. Hence based on above findings the present study was planned for Assessment of the Platelet Count in the Pregnant Women in IGIMS, Patna, Bihar. The present study was planned in Department of Pathology, Indira Gandhi Institute of Medical Science, Patna, Bihar, India. The present study was planned from duration of January 2019 to June 2019. In the present study 200 pregnant females samples received for the platelet estimation were enrolled in the present study. Clinically platelet indices can be a useful screening test for early identification of preeclampsia and eclampsia. Also platelet indices can assess the prognosis of this disease in pregnant women and can be used as an effective prognostic marker because it correlates with severity of the disease. Platelet count is a simple, low cost, and rapid routine screening test. Hence the data generated from the present study concludes that platelet count can be used as a simple and cost effective tool to monitor the progression of preeclampsia, thereby preventing complications to develop during the gestational period. Keywords: Platelet Count, Pregnant Women, IGIMS, Patna, Bihar, etc.

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