scholarly journals Obstetrical outcomes and maternal morbidities associated with COVID-19 in pregnant women in France: A national retrospective cohort study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (11) ◽  
pp. e1003857
Author(s):  
Sylvie Epelboin ◽  
Julie Labrosse ◽  
Jacques De Mouzon ◽  
Patricia Fauque ◽  
Marie-José Gervoise-Boyer ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Gestational Hypertension ◽  
Multiple Pregnancy ◽  
Fetal Distress ◽  
Spontaneous Preterm Birth ◽  
Multivariable Logistic Regression Model ◽  
Assisted Reproductive Technique ◽  
Obstetrical Outcomes ◽  
Venous Thromboembolic Events

Background To the best of our knowledge, no study has exhaustively evaluated the association between maternal morbidities and Coronavirus Disease 2019 (COVID-19) during the first wave of the pandemic in pregnant women. We investigated, in natural conceptions and assisted reproductive technique (ART) pregnancies, whether maternal morbidities were more frequent in pregnant women with COVID-19 diagnosis compared to pregnant women without COVID-19 diagnosis during the first wave of the COVID-19 pandemic. Methods and findings We conducted a retrospective analysis of prospectively collected data in a national cohort of all hospitalizations for births ≥22 weeks of gestation in France from January to June 2020 using the French national hospitalization database (PMSI). Pregnant women with COVID-19 were identified if they had been recorded in the database using the ICD-10 (International Classification of Disease) code for presence of a hospitalization for COVID-19. A total of 244,645 births were included, of which 874 (0.36%) in the COVID-19 group. Maternal morbidities and adverse obstetrical outcomes among those with or without COVID-19 were analyzed with a multivariable logistic regression model adjusted on patient characteristics. Among pregnant women, older age (31.1 (±5.9) years old versus 30.5 (±5.4) years old, respectively, p < 0.001), obesity (0.7% versus 0.3%, respectively, p < 0.001), multiple pregnancy (0.7% versus 0.4%, respectively, p < 0.001), and history of hypertension (0.9% versus 0.3%, respectively, p < 0.001) were more frequent with COVID-19 diagnosis. Active smoking (0.2% versus 0.4%, respectively, p < 0.001) and primiparity (0.3% versus 0.4%, respectively, p < 0.03) were less frequent with COVID-19 diagnosis. Frequency of ART conception was not different between those with and without COVID-19 diagnosis (p = 0.28). When compared to the non-COVID-19 group, women in the COVID-19 group had a higher frequency of admission to ICU (5.9% versus 0.1%, p < 0.001), mortality (0.2% versus 0.005%, p < 0.001), preeclampsia/eclampsia (4.8% versus 2.2%, p < 0.001), gestational hypertension (2.3% versus 1.3%, p < 0.03), postpartum hemorrhage (10.0% versus 5.7%, p < 0.001), preterm birth at <37 weeks of gestation (16.7% versus 7.1%, p < 0.001), <32 weeks of gestation (2.2% versus 0.8%, p < 0.001), <28 weeks of gestation (2.4% versus 0.8%, p < 0.001), induced preterm birth (5.4% versus 1.4%, p < 0.001), spontaneous preterm birth (11.3% versus 5.7%, p < 0.001), fetal distress (33.0% versus 26.0%, p < 0.001), and cesarean section (33.0% versus 20.2%, p < 0.001). Rates of pregnancy terminations ≥22 weeks of gestation, stillbirths, gestational diabetes, placenta praevia, and placenta abruption were not significantly different between the COVID-19 and non-COVID-19 groups. The number of venous thromboembolic events was too low to perform statistical analysis. A limitation of this study relies in the possibility that asymptomatic infected women were not systematically detected. Conclusions We observed an increased frequency of pregnant women with maternal morbidities and diagnosis of COVID-19 compared to pregnant women without COVID-19. It appears essential to be aware of this, notably in populations at known risk of developing a more severe form of infection or obstetrical morbidities and in order for obstetrical units to better inform pregnant women and provide the best care. Although causality cannot be determined from these associations, these results may be in line with recent recommendations in favor of vaccination for pregnant women.

scholarly journals PREVALENCE, ASSOCIATED FACTORS AND ROLE OF VITAMIN D AND GLUTATHIONE REDUCTASE OF PRE-ECLAMPSIA IN PREGNANT WOMEN

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Simerpreet Kukreja
Keyword(s):  
Fatty Acids ◽  
Vitamin D ◽  
Pregnant Women ◽  
Glutathione Reductase ◽  
Gestational Hypertension ◽  
Multiple Pregnancy ◽  
Vitamin D Supplementation ◽  
Research Centre ◽  
Biochemical Basis

Introduction: In maternal and neonatal cases, preeclampsia is a multi-organ, heterogeneous pregnancy condition associated with significant morbidity and mortality. Since preeclampsia is a progressive disease, in some cases, delivery is necessary to stop the progression to the benefit of the mother and foetus. However, the need for early delivery has adverse effects on significant neonatal outcomes that are not limited to the most premature babies. The results include oxidative stress in the disease and invoke the biochemical basis for antioxidant clinical trials to prevent and treat hypertension caused by pregnancy. In the management of preeclampsia, supplementation of antioxidants along with polyunsaturated fatty acids, particularly omega-3 fatty acids, may be useful. This describes vitamin Ds potential role in the pathogenesis of preeclampsia. However, the role of vitamin D supplementation and dosing is controversial in preventing preeclampsia. Method: The study was carried out from March 2019 to April 2020 at Shalinitai Meghe Hospital and Research Centre using institutional-based cross-sectional study design among women whose age was greater than or equal to eighteen. Data were collected using a standardised and pretested questionnaire from 150 participants by face-to - face interview technique. Using Chemiluminiscent Immunoassay (CLIA), vitamin D estimation was performed. The behaviour of Glutathione Reductase was calculated according to the Goldberg et al 1983 procedure. To classify the factors associated with the development of preeclampsia, logistic regression analysis was used. Result: With a mean age of 30.28, a total of 150 participants were enrolled in the study. Evaluation of vitamin D and glutathione levels The prevalence of preeclampsia among current pregnant women attending ANC at Shalinitai Meghe Hospital was 16 with a 95 % CI. The current preeclampsia was significantly correlated with predictive variables such as the age of the respondents, current multiple pregnancy, and history of diabetes mellitus. Conclusion: The findings of this study showed that preeclampsia was present in a large proportion of women. For both urban and rural residents, health seeking actions towards pregnant women should be promoted, offering an opportunity to detect preeclampsia as early as possible and preventing the coming complication of preeclampsia. The role of antioxidants is controversial in the prevention of preeclampsia. Vitamin D deficiency is associated with preeclampsia in a major way. To document the role of vitamin D supplementation in the prevention of preeclampsia, further studies are required.  Keywords: Gestational hypertension, Pre-eclampsia, Vitamin D, GSH

scholarly journals Spontaneous preterm birth prevention in multiple pregnancy

2018 ◽  
Vol 20 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Sarah R Murray ◽  
Sarah J Stock ◽  
Shona Cowan ◽  
Elizabeth Sarah Cooper ◽  
Jane E Norman
Keyword(s):  
Preterm Birth ◽  
Multiple Pregnancy ◽  
Spontaneous Preterm Birth

scholarly journals Maternal Iodine Status and Associations with Birth Outcomes in Three Major Cities in the United Kingdom

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 441 ◽  
Author(s):  
Charles Snart ◽  
Claire Keeble ◽  
Elizabeth Taylor ◽  
Janet Cade ◽  
Paul Stewart ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Inductively Coupled Plasma ◽  
Urinary Iodine ◽  
World Health ◽  
Spontaneous Preterm Birth ◽  
Foetal Development ◽  
Iodine Status

Severe iodine deficiency in mothers is known to impair foetal development. Pregnant women in the UK may be iodine insufficient, but recent assessments of iodine status are limited. This study assessed maternal urinary iodine concentrations (UIC) and birth outcomes in three UK cities. Spot urines were collected from 541 women in London, Manchester and Leeds from 2004–2008 as part of the Screening for Pregnancy End points (SCOPE) study. UIC at 15 and 20 weeks’ gestation was estimated using inductively coupled plasma-mass spectrometry (ICP-MS). Associations were estimated between iodine status (UIC and iodine-to-creatinine ratio) and birth weight, birth weight centile (primary outcome), small for gestational age (SGA) and spontaneous preterm birth. Median UIC was highest in Manchester (139 μg/L, 95% confidence intervals (CI): 126, 158) and London (130 μg/L, 95% CI: 114, 177) and lowest in Leeds (116 μg/L, 95% CI: 99, 135), but the proportion with UIC <50 µg/L was <20% in all three cities. No evidence of an association was observed between UIC and birth weight centile (−0.2% per 50 μg/L increase in UIC, 95% CI: −1.3, 0.8), nor with odds of spontaneous preterm birth (odds ratio = 1.00, 95% CI: 0.84, 1.20). Given the finding of iodine concentrations being insufficient according to World Health Organization (WHO) guidelines amongst pregnant women across all three cities, further studies may be needed to explore implications for maternal thyroid function and longer-term child health outcomes.

scholarly journals Serum apolipoprotein A-II and alpha-2-antiplasmin levels in midtrimester can be used as predictors of preterm delivery

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095228
Author(s):  
Jianxia Huang ◽  
Yuhong Yang ◽  
Pei He
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Preterm Delivery ◽  
Coagulation Cascade ◽  
Protein Markers ◽  
Spontaneous Preterm Birth ◽  
Retrospective Case ◽  
Normal Delivery ◽  
Apolipoprotein A ◽  
Group D

Objective To identify serum protein markers in midtrimester that predict preterm delivery. Methods A retrospective case–control study randomly selected patients that experienced spontaneous preterm birth and healthy control patients that experienced a normal delivery at term. A proteomic analysis was undertaken using the data-independent acquisition method. Results A total of 30 singleton pregnant women were randomly selected from 12 800 pregnant women: 15 women had a spontaneous preterm birth (group Y) and 15 age- and body mass index-matched women gave birth at term (group D). All of the patients provided serum at 15–20 weeks of gestation. A total of 39 differentially expressed proteins were identified. Compared with group D, 24 proteins were upregulated and 15 were downregulated in the preterm group Y. Using Kyoto Encyclopedia of Genes and Genomes pathway enrichment, the 24 upregulated proteins were significantly enriched in the complement and coagulation cascade pathways. Search Tool for the Retrieval of Interacting Genes Furthermore (STRING) analysis showed that apolipoprotein A-II (apoA-II) and alpha-2-antiplasmin (α2-AP), two upregulated proteins, were key nodes in the STRING protein–protein network. Conclusions These findings suggest that apoA-II and α2-AP might be new markers for predicting preterm delivery in the midtrimester.

Investigation of factors associated with spontaneous preterm birth in pregnant women living with HIV

AIDS ◽  
2020 ◽  
Vol 34 (5) ◽  
pp. 719-727
Author(s):  
Arianne Y.K. Albert ◽  
Chelsea Elwood ◽  
Emily C. Wagner ◽  
Zahra Pakzad ◽  
Tessa Chaworth-Musters ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Spontaneous Preterm Birth ◽  
Factors Associated ◽  
Women Living With Hiv ◽  
Living With Hiv

scholarly journals Maternal and fetal outcomes in pregnant women with hyperemesis gravidarum

2019 ◽  
Vol 8 (3) ◽  
pp. 901
Author(s):  
Sangeeta Parihar ◽  
Swatantar Singh
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Apgar Score ◽  
Gestational Hypertension ◽  
Hyperemesis Gravidarum ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Nutritional Deficiencies ◽  
P Value ◽  
Maternal Weight

Background: Hyperemesis gravidarum (HG) is associated with maternal weight loss, nutritional deficiencies, fluid and electrolyte abnormalities, which may lead to adverse fetal and maternal outcomes. The purpose of this study was to evaluate the relationship of hyperemesis gravidarum to maternal and foetal outcomes.Methods: A hospital-based prospective observational study was carried out. All patients with singleton pregnancy diagnosed as / history of hyperemesis gravidarum the current pregnancy was included in the study. The pregnant women with multiple pregnancy, molar pregnancy, presence of pre-gestational diabetes, pre-gestational hypertension, and other causes of nausea such as appendicitis and pyelonephritis were excluded from the study.Results: 36 pregnant women with prevalence rate of 3.28% have been found to be suffering from HG. Almost half (17, 47.22%) of the pregnant women with HG had age less than 25 years. The significant association (p-value: 0.0099) has been found between parity and smoking with HG. HG was significantly associated with low birth weight (p-value: 0.0133); small for gestational age (SGA) (p-value: 0.0316); APGAR score < 7 after 1 minute (p-value: 0.0060); and APGAR score <7 after 5 minutes (p-value: 0.0006). There is no association found between mode of delivery, gestational diabetes, and pregnancy-induced hypertension with HG.Conclusions: HG can adversely affect fetal as well as maternal, though not significant, pregnancy outcomes.

Delivery prediction in pregnant women with spontaneous preterm birth using fetal adrenal gland biometry

2016 ◽  
Vol 29 (23) ◽  
pp. 3756-3761 ◽  
Author(s):  
Aline Pinto Lemos ◽  
Francisco Edson de Lucena Feitosa ◽  
Edward Araujo Júnior ◽  
Helvécio Neves Feitosa ◽  
João Gabriel Damasceno Pereira ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Adrenal Gland ◽  
Pregnant Women ◽  
Spontaneous Preterm Birth

scholarly journals Specific Characteristics of Bioelectric Activity of the Brain in Women with Placental Dysfunction Considering the Type of Psychological Component of Gestation Dominant

2018 ◽  
Vol 24 (2) ◽  
Author(s):  
Nataliya Henyk ◽  
Nataliya Yakumchuk
Keyword(s):  
Pregnant Women ◽  
Comparison Group ◽  
Clinical Symptoms ◽  
Gestational Hypertension ◽  
Fetal Distress ◽  
Main Group ◽  
Software Complex ◽  
Placental Dysfunction ◽  
Psychological Component ◽  
Attitude Test

 The study of the influence of the autonomic nervous system on the course of pregnancy, childbirth and fetal state remains relevant. Changes in the parameters of electroencephalography may be detected long before the onset of clinical symptoms in the complicated course of pregnancy.  The objective of the research was to evaluate electroencephalography in women with placental dysfunction and gestational complications taking into account the type of psychological component of gestation dominant.  Materials and methods. Electroencephalography was performed in 60 pregnant women at the age of 19 to 45 years with gestational hypertension and fetal distress during pregnancy. The main group included 40 patients, who were stratified according to the type of psychological component of gestation dominant: 10 patients with euphoric type, 20 pregnant women with anxious and depressive type, 10 patients with hypogestognostic type. The comparison group comprised 20 patients with optimal type of psychological component of gestation dominant and normal course of the first half of pregnancy. The assessment of psychological component of gestation dominant was carried out according to the method proposed by Dobriakov I.V. - "Pregnant woman attitude test". Registrations, spectral and coherent analysis of electroencephalography were performed using BrainTest-24 hardware and software complex.  \textbf{Results and discussion. }Electroencephalography of the patients of the comparison group was in line with current concepts regarding the physiological norm. In the main group, there were the following changes in electroencephalography: non-sinusoidal forms of alpha-oscillations (77.5%), high index of fast rhythms, flashes of spike waves under load, disturbances of the frontal occipital gradient with the focus on the anterior sections of the hemispheres.  Conclusions. The use of electroencephalography in women with different types of psychological component of gestation dominant in case of progressive placental dysfunction and preeclampsia on its background allows identifying characteristic changes, modifying the program of therapeutic measures, differentiating obstetric tactics and terms of delivery.

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