scholarly journals Measles and Pregnancy: Immunity and Immunization—What Can Be Learned from Observing Complications during an Epidemic Year

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Rosalia Ragusa ◽  
Armando Platania ◽  
Mario Cuccia ◽  
Gaetano Zappalà ◽  
Gabriele Giorgianni ◽  
...  
Keyword(s):  
Health Care ◽  
At Risk ◽  
Immune Response ◽  
Pregnant Women ◽  
Health Care Workers ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Measles Outbreak ◽  
Care Workers ◽  
Adverse Pregnancy

Measles is a highly contagious airborne disease. Unvaccinated pregnant women are not only at risk of infection but also at risk of severe pregnancy complications. As measles causes a dysregulation of the entire immune system, we describe immunological variations and how immune response mechanisms can lead to adverse pregnancy outcomes. We evaluated data during the measles outbreak reported in the province of Catania, Italy, from May 2017 to June 2018. We controlled hospital discharge records for patients admitted to hospital obstetric wards searching the measles diagnostic code. We have indicated the case as “confirmed” when the IgM was found to be positive with the ELISA method. We registered 843 cases of measles and 51% were females (430 cases). 24 patients between the ages of 17 and 40 had measles while they were pregnant. Adverse pregnancy outcomes included 2 spontaneous abortions, 1 therapeutic abortion, 1 foetal death, and 6 preterm deliveries. Respiratory complications were more prevalent in pregnant women (21%) than in nonpregnant women with measles (9%). 14 health care workers (1.7%) were infected with measles, and none of these had been previously vaccinated. Immune response mechanisms were associated with adverse pregnancy outcomes in women with measles. To reduce the rate of measles complications, gynaecologists should investigate vaccination history and antibody test results in all women of childbearing age. During a measles outbreak, gynaecologists and midwives should be active proponents of vaccination administration and counteract any vaccine hesitancy not only in patients but also among health care workers.

scholarly journals Is Indoor Air Pollution From Different Fuel Types Associated With the Anemia Status of Pregnant Women in Ethiopia?

2021 ◽  
Vol 12 ◽  
pp. 215013272110343
Author(s):  
Sewitemariam Desalegn Andarge ◽  
Abriham Sheferaw Areba ◽  
Robel Hussen Kabthymer ◽  
Miheret Tesfu Legesse ◽  
Girum Gebremeskel Kanno
Keyword(s):  
Air Pollution ◽  
Logistic Regression ◽  
Pregnant Women ◽  
Indoor Air ◽  
Pregnancy Outcomes ◽  
Indoor Air Pollution ◽  
Adverse Pregnancy Outcomes ◽  
Outcome Variable ◽  
Multivariable Logistic Regression Analysis ◽  
Adverse Pregnancy

Background Indoor air pollution from different fuel types has been linked with different adverse pregnancy outcomes. The study aimed to assess the link between indoor air pollution from different fuel types and anemia during pregnancy in Ethiopia. Method We have used the secondary data from the 2016 Ethiopian Demographic and Health Survey data. The anemia status of the pregnant women was the dichotomous outcome variable and the type of fuel used in the house was classified as high, medium, and low polluting fuels. Logistic regression was employed to determine the association between the exposure and outcome variables. Adjusted Odds Ratio was calculated at 95% Confidence Interval. Result The proportion of anemia in the low, medium, and high polluting fuel type users was 13.6%, 46%, 40.9% respectively. In the multivariable logistic regression analysis, the use of either kerosene or charcoal fuel types (AOR 4.6; 95% CI: 1.41-18.35) and being in the third trimester (AOR 1.72; 95% CI: 1.12-2.64) were significant factors associated with the anemia status of the pregnant women in Ethiopia. Conclusion According to our findings, the application of either kerosene or charcoal was associated with the anemia status during pregnancy in Ethiopia. An urgent intervention is needed to reduce the indoor air pollution that is associated with adverse pregnancy outcomes such as anemia.

scholarly journals 460. Point-of-Care, In-Home SARS-CoV-2 IgG Antibody Testing to Assess Seroprevalence in At-Risk Health Care Workers

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S297-S297
Author(s):  
Eric G Meissner ◽  
Christine Litwin ◽  
Tricia Crocker ◽  
Elizabeth Mack ◽  
Lauren Card
Keyword(s):  
Health Care ◽  
At Risk ◽  
Health Care Workers ◽  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
Significant Risk ◽  
Documented Infection ◽  
Inconclusive Result ◽  
Care Workers

Abstract Background Health care workers are at significant risk for infection with the novel coronavirus SARS-CoV-2. Methods We utilized a point-of-care, lateral flow SARS-CoV-2 IgG immunoassay (RayBiotech) to conduct a seroprevalence study in a cohort of at-risk health care workers (n=339) and normal-risk controls (n=100) employed at an academic medical center. To minimize exposure risk while conducting the study, consents were performed electronically, tests were mailed and then self-administered at home using finger stick blood, and subjects uploaded a picture of the test result while answering an electronic questionnaire. We also validated the assay using de-identified serum samples from patients with PCR-proven SARS-CoV-2 infection. Results Between April 14th and May 6th 2020, 439 subjects were enrolled. Subjects were 68% female, 93% white, and most were physicians (38%) and nurses (27%). In addition, 37% had at least 1 respiratory symptom in the prior month, 34% had cared for a patient with known SARS-CoV-2 infection, 57% and 23% were worried about exposure at work or in the community, respectively, and 5 reported prior documented SARS-CoV-2 infection. On initial testing, 3 subjects had a positive IgG test, 336 had a negative test, and 87 had an inconclusive result. Of those with an inconclusive result who conducted a repeat test (85%), 96% had a negative result. All 3 positive IgG tests were in subjects reporting prior documented infection. Laboratory validation showed that of those with PCR-proven infection more than 13 days prior, 23/30 were IgG positive (76% sensitivity), whereas 1/26 with a negative prior PCR test were seropositive (95% specificity). Repeat longitudinal serologic testing every 30 days for up to 4 times is currently in progress. Conclusion We conducted a contact-free study in the setting of a pandemic to assess SARS-CoV-2 seroprevalence in an at-risk group of health care workers. The only subjects found to be IgG positive were those with prior documented infection, even though a substantial proportion of subjects reported significant potential occupational or community exposure and symptoms that were potentially compatible with SARS-COV-2 infection. Disclosures All Authors: No reported disclosures

Pregnancy outcomes in women with inflammatory bowel disease following exposure to thiopurines and antitumor necrosis factor drugs

2014 ◽  
Vol 34 (5) ◽  
pp. 445-459 ◽  
Author(s):  
S Mozaffari ◽  
AH Abdolghaffari ◽  
S Nikfar ◽  
M Abdollahi
Keyword(s):  
Inflammatory Bowel Disease ◽  
Pregnant Women ◽  
Bowel Disease ◽  
Pregnancy Outcomes ◽  
Congenital Abnormalities ◽  
Meta Analysis ◽  
Adverse Pregnancy Outcomes ◽  
Inflammatory Bowel ◽  
Adverse Pregnancy ◽  
Necrosis Factor

Several studies have indicated the harmful effect of flare-up periods in pregnant women with inflammatory bowel disease (IBD) on their newborns. Therefore, an effective and safe medical treatment during pregnancy is of great concern in IBD patients. The aim of this study was to perform a meta-analysis on the outcomes of thiopurines use and a systematic review of antitumor necrosis factor (anti-TNF) drugs used during pregnancy in women with IBD. The results of cohorts evaluating the safety of anti-TNF drugs during pregnancy up to July 2013 were collected and analyzed. In the meta-analysis, a total of 312 pregnant women with IBD who used thiopurines were compared with 1149 controls (women with IBD who were not treated with any medication and women who were exposed to drugs other than thiopurines) to evaluate the drug effect on different pregnancy outcomes, including prematurity, low birth weight, congenital abnormalities, spontaneous abortion, and neonatal adverse outcomes. Results of statistical analysis demonstrated that congenital abnormalities were increased significantly in thiopurine-exposed group in comparison with control group who did not receive any medicine for IBD treatment. The summary odds ratio was 2.95 with 95% confidence interval = 1.03–8.43 ( p = 0.04). We observed no significant differences in occurrence of other adverse pregnancy outcomes between compared groups. The results of cohorts evaluated the safety of anti-TNF drugs during pregnancy demonstrated no increase in occurrence of adverse pregnancy outcomes in comparison with controls except for the significant decrease in gestational age of newborns of drug-exposed mothers in one trial. In conclusion, a benefit–risk ratio should be considered in prescribing or continuing medicinal therapy during pregnancy of IBD patients.

scholarly journals Climate change is a major stressor causing poor pregnancy outcomes and child development

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1222
Author(s):  
David M. Olson ◽  
Gerlinde A.S. Metz
Keyword(s):  
Climate Change ◽  
Mental Health ◽  
At Risk ◽  
Pregnancy Outcomes ◽  
Allostatic Load ◽  
Developmental Trajectories ◽  
Adverse Pregnancy Outcomes ◽  
Ecological Resilience ◽  
Adverse Pregnancy ◽  
Climate Crisis

The climate crisis is the existential threat of our times and for generations to come. This is no longer a threat but a reality affecting us, our children, and the generations that follow. Pregnant mothers, their fetuses, and their children are among those at greatest risk in every population and every jurisdiction. A timely consideration is the health of racialized groups who are particularly vulnerable owing to the confluence of several risk factors that are compounded by climate change. Included among these are Indigenous communities that are the most directly threatened by climate change. This review discusses the main health challenges faced by mothers, fathers, and their children during the climate crisis, focusing on mental health as a causal factor. Exploration of this topic includes the role of prenatal maternal and paternal stresses, allostatic load, and the effect of degradation of the environment and ecosystems on individuals. These will be examined in relation to adverse pregnancy outcomes and altered developmental trajectories of children. The climate crisis is a health threat multiplier that amplifies the health inequities of the most at-risk populations and individuals. It accelerates the increase in allostatic load of those at risk. The path of tragedy begins with an accumulating allostatic load that overwhelms both individual and socio-ecological resilience. This can lead to worse mental health including depression and anxiety and, in the case of pregnant women and their children, more adverse pregnancy outcomes and impaired developmental trajectories for their newborn children. We argue that there is an urgent need to develop new (or re-discover or re-purpose existing) tools that will predict communities and individuals who are experiencing the highest levels of climate-related hazards and intervene to reduce stress and increase resilience in pre-conceptual women and men, pregnant and post-partum women, and their young children.

COVID-19 in healthcare workers (literature review and own data)

2021 ◽  
Vol 61 (1) ◽  
pp. 18-26
Author(s):  
Lyubov A. Shpagina ◽  
Lyudmila P. Kuzmina ◽  
Olga S. Kotova ◽  
Ilya S. Shpagin ◽  
Natalya V. Kamneva ◽  
...  
Keyword(s):  
Health Care ◽  
At Risk ◽  
Health Care Workers ◽  
Work Experience ◽  
Medical Personnel ◽  
Scientific Data ◽  
Main Group ◽  
Panic Attacks ◽  
Care Workers ◽  
Occupational Infection

Introduction. Health care workers are at risk of infection with the SARS-CoV-2 virus. However, many aspects of the professionally conditioned COVID-19 are still poorly understood. The aim of study is to conduct a brief review and analysis of scientific data on the prevalence, features of clinical and laboratory COVID-19 syndromes in medical professionals. To evaluate the structure of post-COVID syndrome in health care workers who are observed in a large multidisciplinary medical organization that has a center for occupational pathology. To present the current state of the problem of examination of the connection of COVID-19 with the profession and admission to work in conditions of high risk of SARS-CoV-2 infection. Materials and methods. At the first stage, a brief review of the literature on the problem of COVID-19 in health care workers was performed, at the second - a single-center observational prospective study of COVID-19 convalescents. The main group consisted of health care workers (n=203), the comparison group - people who do not have occupational health risks (n=156). The groups were comparable in demographic characteristics. The work experience of the medical staff was 15 (5; 21) years. Of the participants in the main group, 20.2% worked in hospitals, and 79.8% in outpatient institutions. Three of the participants (1.5%) were employees of specialized COVID hospitals. Doctors were 25.6%, secondary medical personnel - 51.7%, junior medical and technical personnel - 22.7%. A severe form of COVID-19 was suffered by 25 (12.3%) people, after the artificial ventilation of the lungs (AVL) - two participants. The observation time is 60 days. Statistical analysis included standard methods of descriptive statistics, determination of relationships by the method of logistic regression. The significance level is p<0.05. Results. Most of the known data on COVID-19 in health care workers is obtained in cross-sectional studies. The possibility of occupational infection has been sufficiently proven. The risk probably depends on the work performed and is higher in conditions of direct contact of medical personnel with adults, potentially infected patients, but not in a specialized hospital. It is possible that the course of COVID-19 in health care workers differs from the general population of patients there is evidence of a greater frequency of weakness and myalgia. Studies of the features of post-COVID syndrome in health care workers in available sources could not be identified. According to the results of their own research, health care workers who had experienced COVID-19 had a higher frequency of central thermoregulation disorders, arrhythmias, heart failure, panic attacks and depression. Conclusions. Health care workers are at risk of COVID-19. Professionally conditioned post-COVID syndrome is characterized by the frequency of violations of the central mechanisms of thermoregulation and arrhythmias. COVID-19 in health care workers meets the definition of occupational disease.

Study on the Relationship Between Hepatitis B Virus Infection in Pregnant Women and Adverse Pregnancy Outcomes

2021 ◽  
Author(s):  
Zhi-Hao Huang ◽  
Ting-Ting Peng ◽  
Sheng-Guang Yan ◽  
Dong-Dong Yu ◽  
Jun-Chao Qiu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Hbv Dna ◽  
Adverse Pregnancy Outcomes ◽  
Hbv Infection ◽  
Hbsag Carrier ◽  
B Virus ◽  
Adverse Pregnancy ◽  
Dna 2 ◽  
The Relationship

Abstract Objective: Aim to the relationship between adverse pregnant outcomes with chronic hepatitis B virus (HBV) infection in pregnant women. Simultaneously, assess the incidence of adverse pregnancy outcomes (APO) among different serum HBV status in pregnant women. Method: From 2017 to 2019, we studied HBsAg (+) pregnant women and HBsAg (-) who gave birth at our hospital in Guangzhou City, China. We compared of the incidence of pregnant women with HBsAg(+) or HBsAg(-). Further, among HBsAg(+) pregnant women, We compared of the incidence of pregnant women with HBeAg(+) group or HBeAg(-) group, high HBV DNA loads (HBV DNA≥2×10^5IU/mL) group or low HBV DNA loads (HBV DNA＜2×10^5IU/mL) group, respectively. Finally, multivariate logistic regression analysis was used to evaluate the independent association between HBV infection and the risk of developing APO.Result: First, Our research Indicates that the rates of gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP), premature rupture of membrane (PROM), Fetal distress (FD), Oligohydramnios, Premature delivery (PD), Low birth weight (LBW), Meconium contamination (MC), Neonatal hyperbilirubinemia(NH) in HBsAg(+) group were higher than those in HBsAg(-) group (P<0.05). Second, among 711 HBsAg(+) pregnant women, the rates of GDM and ICP in high loads of HBV DNA were higher than those in low loads of HBV DNA group (P<0.05). Similarly, The rates of ICP in HBeAg(+) group were higher than those in HBeAg(-) group. Further, through multivariable logistical regression model analysis, we observed maternal HBsAg carrier (OR, 6.758; 95% CI, 2.358-19.369) had an independent risk for ICP. Similarly, HBsAg carrier(OR, 1.101; 95% CI, 1.066-1.137) ,advanced age (OR, 1.407; 95% CI,1.016-1.137) and abortion(OR,1.446; 95% CI, 1.062-1.969) had independent risk for GDM. Conclusions: Chronic HBV infection can increase the rate of host adverse pregnancy outcomes (APO). The maternal viral load and HBeAg status were significantly associated with the incidence of GDM and ICP. Maternal HBsAg carrier had an independent risk for GDM and ICP.

Prenatal oral health literacy status: a survey on patient’s perception and awareness among health care professionals

2017 ◽  
Vol 9 (2) ◽  
pp. 16-22
Author(s):  
Sandya Devi S Patil ◽  
Madhu K ◽  
Rachna Thakur ◽  
Santhosh T Paul ◽  
Mihir Nayak
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Health Care Professionals ◽  
Oral Care ◽  
Oral Health Care ◽  
Attitude And Practice ◽  
Group A ◽  
Adverse Pregnancy

Pregnancy is characterized by complex physiological changes which may adversely affect the oral health and pregnancy outcomes. This study reports a survey on assessing the knowledge, attitude and practice behaviours of gynaecologists and oral health care professionals towards prenatal oral care and barriers limiting the utilization of prenatal oral care health care to pregnant women. The study population comprised of 3 groups: A- Gynaecologists, B- oral health care professionals and C – Pregnant women, 100 in each group. The prevalidated questionnaire included questions about their knowledge, attitude, beliefs and practices regarding oral health care for pregnant women. The data obtained was subjected to statistical analysis using ANOVA test and Pearson’s correlation test. The response rate was 100%. Regarding the association of periodontal disease and adverse pregnancy outcomes, Group A (75%) have high degree of knowledge than B (61%) and C (36%) but the attitude and practice behaviors were significantly high in Group B as compared to Group A and Group C Two-thirds of respondents in both Group A and B (75%) were interested in receiving continuing dental education (CDE) regarding the care of pregnant women.The self-assessed maternal barriers evaluated in this study were lack of knowledge, lack of perceived need.

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