Immunological assessment of SARS-CoV-2 infection in pregnancy from diagnosis to delivery: A multicentre prospective study

Background Background Population-based data on SARS-CoV-2 infection in pregnancy and assessment of passive immunity to the neonate, is lacking. We profiled the maternal and fetal response using a combination of viral RNA from naso-pharyngeal swabs and serological assessment of antibodies against SARS-CoV-2. Methods This multicentre prospective observational study was conducted between March 24th and August 31st 2020. Two independent cohorts were established, a symptomatic SARS-CoV-2 cohort and a cohort of asymptomatic pregnant women attending two of the largest maternity hospitals in Europe. Symptomatic women were invited to provide a serum sample to assess antibody responses. Asymptomatic pregnant women provided a nasopharyngeal swab and serum sample. RT-PCR for viral RNA was performed using the Cobas SARS-CoV-2 6800 platform (Roche). Umbilical cord bloods were obtained at delivery. Maternal and fetal serological response was measured using both the Elecsys® Anti-SARS-CoV-2 immunoassay (Roche), Abbott SARS-CoV-2 IgG Assay and the IgM Architect assay. Informed written consent was obtained from all participants. Results Ten of twenty three symptomatic women had SARS-CoV-2 RNA detected on nasopharyngeal swabs. Five (5/23, 21.7%) demonstrated serological evidence of anti-SARS-CoV-2 IgG antibodies and seven (30.4%, 7/23) were positive for IgM antibodies. In the asymptomatic cohort, the prevalence of SARS-CoV-2 infection in RNA was 0.16% (1/608). IgG SARS-CoV-2 antibodies were detected in 1·67% (10/598, 95% CI 0·8%-3·1%) and IgM in 3·51% (21/598, 95% CI 2·3–5·5%). Nine women had repeat testing post the baseline test. Four (4/9, 44%) remained IgM positive and one remained IgG positive. 3 IgG anti-SARS-CoV-2 antibodies were detectable in cord bloods from babies born to five seropositive women who delivered during the study. The mean gestation at serological test was 34 weeks. The mean time between maternal serologic positivity and detection in umbilical cord samples was 28 days. Conclusion Using two independent serological assays, we present a comprehensive illustration of the antibody response to SARS-CoV-2 in pregnancy, and show a low prevalence of asymptomatic SARS-CoV2. Transplacental migration of anti-SARS-CoV-2 antibodies was identified in cord blood of women who demonstrated antenatal anti-SARS-CoV-2 antibodies, raising the possibility of passive immunity.

Download Full-text

Factors influencing stress, anxiety, and depression among Iranian pregnant women: the role of sexual distress and genital self-image

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03575-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Afsaneh Keramat ◽

Mina Malary ◽

Mahmood Moosazadeh ◽

Nastaran Bagherian ◽

Mohammad-Reza Rajabi-Shakib

Keyword(s):

Pregnant Women ◽

Multivariate Linear Regression Analysis ◽

Depression And Anxiety ◽

Sexual Distress ◽

Self Image ◽

Factors Influencing ◽

Severity Of Depression ◽

The Mean ◽

Distress Scale ◽

In Pregnancy

Abstract Background Pregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress. In this study, we investigated the factors influencing depression, anxiety, and stress in pregnancy and identify their associations with Sexual Distress (SD) and Genital Self-Image (GSI). Methods This was a descriptive, correlational, cross-sectional study performed using the two-stage cluster sampling method between September 2019 and January 2020. Overall, 295 pregnant women completed a demographics and obstetric information checklist, Depression Anxiety and Stress Scale-21 (DASS-21), Female Genital Self-Image Scale (FGSI), and Female Sexual Distress Scale-Revised (FSDS-R). Results Analysis of Variance (ANOVA) showed significant differences in the mean scores of SD between the groups with varying degrees of depression, anxiety, and stress (P < 0.001) and in the mean score of GSI between the groups with varying degrees of depression (P = 0.01) and anxiety (P < 0.001). In multivariate linear regression analysis, higher (worse) depression, anxiety, and stress scores were found in women with more advanced age and higher SD scores; however, these scores were lower (better) in those with increased gestational age. Lower depression and anxiety scores were associated with moderate satisfaction with income, moderate satisfaction with BI in pregnancy, and lower stress and depression scores were linked to planned pregnancy. Higher (better) GSI score was a predictor of lower depression score, complication in a previous pregnancy was a predictor of higher stress score, and finally, fear of fetal abortion and being a housewife were predictors of a higher anxiety score. Conclusion Various factors contribute to the development of antenatal depression, anxiety, and stress. A positive correlation was found between SD and the severity of depression, anxiety, and stress, while a negative correlation was noted between GSI and the severity of depression and anxiety. Therefore, raising awareness regarding SD and GSI through screening and counseling sessions can have beneficial effects for mothers and their fetuses.

Download Full-text

Interactions between Vitamin D Status, Calcium Intake and Parathyroid Hormone Concentrations in Healthy White-Skinned Pregnant Women at Northern Latitude

Nutrients ◽

10.3390/nu10070916 ◽

2018 ◽

Vol 10 (7) ◽

pp. 916 ◽

Cited By ~ 3

Author(s):

Andrea Hemmingway ◽

Karen O’Callaghan ◽

Áine Hennessy ◽

George Hull ◽

Kevin Cashman ◽

...

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Pregnant Women ◽

Calcium Intake ◽

Geometric Mean ◽

Vitamin D Status ◽

Metabolic System ◽

Cross Sectional ◽

The Mean ◽

In Pregnancy

Adverse effects of low vitamin D status and calcium intakes in pregnancy may be mediated through functional effects on the calcium metabolic system. Little explored in pregnancy, we aimed to examine the relative importance of serum 25-hydroxyvitamin D (25(OH)D) and calcium intake on parathyroid hormone (PTH) concentrations in healthy white-skinned pregnant women. This cross-sectional analysis included 142 participants (14 ± 2 weeks’ gestation) at baseline of a vitamin D intervention trial at 51.9 °N. Serum 25(OH)D, PTH, and albumin-corrected calcium were quantified biochemically. Total vitamin D and calcium intakes (diet and supplements) were estimated using a validated food frequency questionnaire. The mean ± SD vitamin D intake was 10.7 ± 5.2 μg/day. With a mean ± SD serum 25(OH)D of 54.9 ± 22.6 nmol/L, 44% of women were <50 nmol/L and 13% <30 nmol/L. Calcium intakes (mean ± SD) were 1182 ± 488 mg/day and 23% of participants consumed <800 mg/day. The mean ± SD serum albumin-adjusted calcium was 2.2 ± 0.1 mmol/L and geometric mean (95% CI) PTH was 9.2 (8.4, 10.2) pg/mL. PTH was inversely correlated with serum 25(OH)D (r = −0.311, p < 0.001), but not with calcium intake or serum calcium (r = −0.087 and 0.057, respectively, both p > 0.05). Analysis of variance showed that while serum 25(OH)D (dichotomised at 50 nmol/L) had a significant effect on PTH (p = 0.025), calcium intake (<800, 800–1000, ≥1000 mg/day) had no effect (p = 0.822). There was no 25(OH)D-calcium intake interaction effect on PTH (p = 0.941). In this group of white-skinned women with largely sufficient calcium intakes, serum 25(OH)D was important for maintaining normal PTH concentration.

Download Full-text

Differences in pregnancy and perinatal outcomes among symptomatic versus asymptomatic COVID-19-infected pregnant women: a systematic review and meta-analysis

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04250-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Durray Shahwar A. Khan ◽

La-Raib Hamid ◽

Anna Ali ◽

Rehana A. Salam ◽

Nadeem Zuberi ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Pregnant Women ◽

Low Birthweight ◽

Meta Analysis ◽

Perinatal Outcomes ◽

Respiratory Disorder ◽

Significant Difference ◽

The Mean ◽

In Pregnancy

Abstract Background There is dearth of information on COVID-19’s impact on pregnant women. However, literature reported trends of COVID-19 differ, depending on the presence of clinical features upon presentation. Objective This systematic review aimed to assess differences in risk factors, management, complications, and pregnancy and perinatal outcomes in symptomatic vs. asymptomatic pregnant women with confirmed SARS-CoV-2 infection. Methods A search was run on electronic databases to identify studies reporting COVID-19 in pregnancy. Meta-analysis was performed and odds ratios and mean difference with 95% confidence intervals were calculated using Review Manager 5.4. Review Prospero registration number CRD42020204662. Results We included ten articles reporting data from 3158 pregnancies; with 1900 symptomatic and 1258 asymptomatic pregnant women. There was no significant difference in the mean age, gestational age, and body mass index between the two groups. The meta-analysis suggested that pregnant women who were obese (OR:1.37;95%CI:1.15 to 1.62), hypertensive (OR:2.07;95%CI:1.38 to 3.10) or had a respiratory disorder (OR:1.64;95%CI:1.25 to 2.16), were more likely to be symptomatic when infected with SARS-CoV-2. Pregnant women with Black (OR:1.48;95%CI:1.19 to 1.85) or Asian (OR:1.64;95%CI:1.23 to 2.18) ethnicity were more likely to be symptomatic while those with White ethnicity (OR:0.63;95%CI:0.52 to 0.76) were more likely to be asymptomatic. Cesarean-section delivery (OR:1.40;95%CI:1.17 to 1.67) was more likely amongst symptomatic pregnant women. The mean birthweight(g) (MD:240.51;95%CI:188.42 to 293.51), was significantly lower, while the odds of low birthweight (OR:1.85;95%CI:1.06 to 3.24) and preterm birth (< 37 weeks) (OR:2.10;95%CI:1.04 to 4.23) was higher amongst symptomatic pregnant women. Symptomatic pregnant women had a greater requirement for maternal ICU admission (OR:13.25;95%CI:5.60 to 31.34) and mechanical ventilation (OR:15.56;95%CI:2.96 to 81.70) while their neonates had a higher likelihood for Neonatal Intensive Care Unit admission (OR:1.96;95%CI:1.59 to 2.43). The management strategies in the included studies were poorly discussed, hence could not be analyzed. Conclusion The evidence suggests that the presence of risk factors (co-morbidities and ethnicity) increased the likelihood of pregnant women being symptomatic. Higher odds of complications were also observed amongst symptomatic pregnant women. However, more adequately conducted studies with adjusted analysis and parallel comparison groups are required to reach conclusive findings.

Download Full-text

CLINICAL CHARACTERISTICS AND FETO-MATERNAL OUTCOMES IN PREGNANT WOMEN WITH COVID -19 INFECTIONS

10.36106/ijsr/6704051 ◽

2021 ◽

pp. 30-32

Author(s):

Gulshan Bano ◽

Anubha Prashad ◽

Rakhee Soni ◽

Mohammed Mishal

Keyword(s):

Pregnant Women ◽

Cesarean Delivery ◽

Clinical Features ◽

Clinical Characteristics ◽

Maternal Outcomes ◽

Hypertensive Disorder ◽

Co Morbidity ◽

Hypertensive Disorder Of Pregnancy ◽

The Mean ◽

In Pregnancy

Background and objectives:-COVID-19 is ongoing pandemic, caused by novel Corona Virus. There is very scarce information is available about clinical features and feto-maternal outcomes of COVID-19 in pregnancy. Therefore, this study was aimed to determine clinical characteristics and feto-maternal outcomes of pregnant women with COVID-19. Methods- In this retrospective study, we included all pregnant women admitted with COVID-19 over three months. Clinical features, laboratory ndings and feto-maternal outcomes were assessed.Results:-The mean age of the patients was 24 years. Hypertensive disorder of pregnancy was most common associated co-morbidity. Majority of patients (81%) were asymptomatic. Lymphocytopenia was seen in 58% of the patients and 47% had elevated levels of CRP. All patients who presented in rst trimester had spontaneous abortion. There is relatively higher rate of preterm birth (21%) and cesarean delivery(43%). All the neonates were tested negative for COVID-19. Conclusion;- There is relatively higher rate of cesarean delivery. Overall feto-maternal outcome was good and there was no evidence of vertical transmission.

Download Full-text

Functional Status of Maternal Thyroid Gland in Eclampsia

TAJ Journal of Teachers Association ◽

10.3329/taj.v31i1.41567 ◽

2019 ◽

Vol 31 (1) ◽

pp. 9-14

Author(s):

M Hafizur Rahman ◽

Mahbub Ara Chowdhury ◽

Shahin Mahmuda

Keyword(s):

Pregnant Women ◽

Normal Pregnancy ◽

Hormonal Changes ◽

Free Triiodothyronine ◽

College Hospital ◽

Medical College ◽

The Mean ◽

Maternal Thyroid ◽

Complicated Pregnancy ◽

In Pregnancy

Marked changes in maternal thyroid activity occur in pregnancy. During pregnancy bodily hormonal changes and metabolic demands result in complex alteration in the bio-chemical parameters of thyroid activities. Besides these, thyroid enlargement, increased thyroid capability for iodine uptake and increase in basal metabolic rate are evidential though these findings are not usually associated with symptoms of hyperthyroidism in pregnancy. Serum concentration of thyroid hormone thyroxine and triiodothyronine in complicated pregnancy like eclamptic toxemia is another field of controversy. To evaluate the changes in thyroid function in normal pregnancy and eclamptic toxemia, a study was undertaken in Rajshahi Medical College Hospital. We collected serum specimens from non pregnant but married women, normal 3rd trimester pregnant women and patients with eclampsia at 3rd trimester of pregnancy and measured serum concentrations of total and free thyroxine (TT4 & FT4) and total and free triiodothyronine (TT3 & FT3 ) by using RIA. Among the study subjects, 10 women were married but non pregnant, 12 women were in their 3rd trimester of normal pregnancy and 32 patients of eclamptic toxemia with 3rd trimester of pregnancy. In normal pregnancy, FT4 and FT3 levels remained normal while TT4 and TT3 levels were elevated. In patients with toxemia of pregnancy, the mean serum TT3 concentration was significantly lower than that of normal pregnancy and the serum FT3 concentrations were below the normal pregnancy range. The mean serum TT4 and FT4 concentrations in patients with eclampsia were however, significantly higher than those in normal pregnant women. TAJ 2018; 31(1): 9-14

Download Full-text

Mindfulness and insomnia at pregnancy

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.706 ◽

2016 ◽

Vol 33 (S1) ◽

pp. s269-s269

Author(s):

M. Marques ◽

A.T. Pereira ◽

E. Bento ◽

S. Xavier ◽

J. Azevedo ◽

...

Keyword(s):

Anxiety Disorders ◽

Pregnant Women ◽

Mean Value ◽

Inner Experience ◽

The Mean ◽

Competing Interest ◽

Acting With Awareness ◽

The Impact ◽

Insomnia Symptoms ◽

In Pregnancy

IntroductionThe impact of mindfulness in improving insomnia symptoms is documented in different samples (e.g. anxiety disorders; insomnia samples) and mindfulness based programs for pregnancy refer the association between mindfulness development and the reduction of insomnia symptoms/improvement of sleep.ObjectiveTo explore differences in the Facets Mindfulness Questionnaire-10 (FMQ-10; Azevedo et at. 2015), between sleep groups, in Portuguese pregnant women.MethodsFour hundred and nineteen pregnant women (mean age: 32.51 ± 4.759; weeks of gestation: 17.32 ± 4.803) answered the Facets Mindfulness Questionnaire-10 and the Insomnia Assessment Scale (IAS, Marques et al., 2015). Three sleep groups were created considering all the IAS items: good sleepers (no insomnia symptoms; no associated daily impairment); insomnia symptoms groups (one/more insomnia symptoms; no associated daily impairment; exclusion of other conditions/disorders explaining the symptoms); insomniacs (one/more insomnia symptoms; one/more daily associated impairment; exclusion of other conditions/disorders explaining the symptoms).ResultsThere were significant differences in the total FMQ-10 score, the F1/Nonjudging of inner experience and the F2/acting with awareness, between sleep groups [respectively, F (2.402) = 6,933; P = 0.001; F (2.406) = 10.243; P = 0.001; F (2.406) = 37.431; P = 0.002]. Tukey tests indicated that the mean total FMQ-10 and F1/Nonjudging of inner experience scores of good sleepers and insomnia symptoms group were significantly higher than of the insomniacs. The mean value of F2/acting with awareness in the good sleepers was significantly higher than of the insomniacs.ConclusionsIt seems important to develop mindfulness to improve sleep in pregnancy or reduce the impact of insomnia symptoms (common at pregnancy).Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text

PROTEIN BINDING OF CORTISOL IN HEALTH AND IN PREGNANCY

Journal of Endocrinology ◽

10.1677/joe.0.0230025 ◽

1961 ◽

Vol 23 (1) ◽

pp. 25-35 ◽

Cited By ~ 25

Author(s):

MOLLIE BOOTH ◽

P. F. DIXON ◽

C. H. GRAY ◽

J. M. GREENAWAY ◽

N. J. HOLNESS

Keyword(s):

Pregnant Women ◽

Binding Sites ◽

Plasma Cortisol ◽

Equilibrium Constants ◽

Qualitative Difference ◽

Mean Values ◽

The Mean ◽

Normal Men ◽

Mean Concentration ◽

In Pregnancy

SUMMARY The binding of plasma cortisol to transcortin at 37° c was studied in normal men and in non-pregnant and pregnant women. The mean concentrations of transcortin were 8, 11·5 and 14 × 10−7 moles/l. and the percentages of the binding sites occupied by cortisol were 45, 24 and 40%, respectively. The mean values of the equilibrium constants were 2·9, 1·8 and 4·6 × 107 l./mole, suggesting that there might be a qualitative difference in transcortin from the three groups. The mean concentration of diffusible cortisol was 1·12 μg./100 ml. in men and 0·65 μg./100 ml. in non-pregnant and pregnant women. The significance of these findings is discussed.

Download Full-text

Prevalence of asymptomatic Plasmodium falciparuminfection, anaemia and use of ITNs among pregnant women yet to receive IPTp in parts of southern Ghana

Second Edition in 2020 of the HSI Journal Volume 1 Issue 2 Publication - Health Sciences Investigations Journal ◽

10.46829/hsijournal.2020.6.1.1.36-42 ◽

2020 ◽

pp. 36-42

Author(s):

Leslie L Afutu ◽

Johnson N Boampong ◽

Neils B Quashie

Keyword(s):

Pregnant Women ◽

Parasite Density ◽

Intermittent Preventive Treatment ◽

Malaria In Pregnancy ◽

Asymptomatic Malaria ◽

Nested Polymerase Chain Reaction ◽

Increased Risk ◽

The Mean ◽

To Receive ◽

In Pregnancy

Background: Asymptomatic malaria in pregnancy evades most fever-based surveillance systems yet causes significant morbidities such as anaemia in the pregnant woman and low birth weight in the neonate. Objective:This study determined the prevalence of asymptomatic malaria and its association with anaemia among pregnant women who are yet to receive their first dose of Sulphadoxine-Pyrimethamine (SP) as intermittent preventive treatment of malaria in pregnancy (IPTp). Information on the use of insecticide treated nets(ITNs)as vector control by the pregnant women was also sought. Methods: This is a cross-sectional hospital-based study conducted in the Western Region of Ghana. Pregnant women at gestational ages, 16-26 wkwere included. A structured questionnaire was used to collect vital information from the participants. Plasmodiumparasitaemia was determined by rapid diagnostic test (MRDT), microscopy and species-specific nested polymerase chain reaction (PCR). Anaemia was classified using the level of haemoglobin. Results: A total of 413 antenatal clinic attendants were recruited. Prevalence of asymptomatic Plasmodium falciparuminfection was 13.1% by MRDT, 10.1% by microscopy and 13.8% by PCR. The mean haemoglobin was 10.73g/dL. Prevalence of anaemia was 40.49% and the mean parasite density was 149.6 parasite/μL. Pregnant women with asymptomatic malaria were 4 times more at risk of being anaemic (adjusted odds ratio with 95% confidence interval: 4.42, 1.82 -10.70)than those who did not have malaria. There was statistically significant negative correlation between parasite density and anaemia (r=0.0028, p=0.02). Conclusion: Asymptomatic P. falciparuminfection was found among some of the pregnant women and the presence of the parasites make them 4 times at increased risk of developing anaemia. Anaemia when occurring amongst such women was significantly worsened by increasing parasitaemia.

Download Full-text

The Effect ofAdditional Nanoparticles Supplementation of Indonesian Bay Leaf (SyzigiumPolyanthum) on Blood Pressure in Pregnancy Hypertension

Volume 5 - 2020, Issue 9 - September - International Journal of Innovative Science and Research Technology ◽

10.38124/ijisrt20jul706 ◽

2020 ◽

Vol 5 (7) ◽

pp. 1320-1323

Author(s):

Miftah Nurlaily El Akhlaq ◽

Suharyo Hadisaputro ◽

Suhartono . ◽

Sri Sumarni ◽

M. Choiroel Anwar

Keyword(s):

Blood Pressure ◽

Data Analysis ◽

Pregnant Women ◽

Diastolic Blood Pressure ◽

Intervention Group ◽

Reduce Blood Pressure ◽

Control Group ◽

Pregnancy Hypertension ◽

The Mean ◽

In Pregnancy

Bay leaf (Syzygiumpolyanthum) or Daun Salam is one of the plants that has many benefits, one of them is to reduce blood pressure. The aim of this study is to prove the effect of adding nanoparticles supplementation of bay leaf (Syzygiumpolyanthum) to systolic and diastolic blood pressure in pregnancy hypertension.The study was quasi-experiment. 39 respondents were divided into 19 pregnant women in intervention group and 20 pregnant women in the control group. The intervention was given for 14 days by consumingnifedipine 10mg plus 80mg bay leaf nanoparticle capsules to the intervention group.The results of data analysis showed a decrease in systolic blood pressure (p = 0.000) and diastolic blood pressure (p = 0.004) when compared with the control group, which means that there were differences in the mean systolic and diastolic blood pressure between the two groups after treatment. The addition of bay leaf nanoparticle supplementation 1x80 mg for 14 days affected the decrease in systolic and diastolic blood pressure in pregnancy hypertension. So that the supplementation of bay leaf nanoparticles can be used as adjunctive therapy in pregnancy hypertension

Download Full-text

Glycemia after Betamethasone in Pregnant Women without Diabetes—Impact of Marginal Values in the 75-g OGTT

Healthcare ◽

10.3390/healthcare8010040 ◽

2020 ◽

Vol 8 (1) ◽

pp. 40

Author(s):

Ioannis Kakoulidis ◽

Ioannis Ilias ◽

Anastasia Linardi ◽

Aikaterini Michou ◽

Charalampos Milionis ◽

...

Keyword(s):

Pregnant Women ◽

Tolerance Test ◽

Insulin Dosage ◽

Oral Glucose ◽

Glycemic Profile ◽

Normal Glucose ◽

Marginal Values ◽

The Mean ◽

Monitoring Treatment ◽

In Pregnancy

Betamethasone (BM) administration in pregnancy has been shown to reduce the incidence and severity of neonatal respiratory distress syndrome. Its known diabetogenic impact, combined with placental insulin resistance, leads to a transient increase in glycemia. However, its effect on glucose homeostasis in pregnancy has not been adequately investigated. We closely monitored and assessed the glycemic profile of 83 pregnant women, with normal glucose metabolism, who were given BM during their hospitalization due to threatened premature labor. A significant change in the glycemic profile in most patients was noted, lasting 1.34 ± 1.05 days. Sixty-six of eighty-three women were eventually treated with insulin to maintain glycemia within acceptable limits. The mean ± SD insulin dosage was 12.25 ± 11.28 units/day. The need for insulin therapy was associated with higher BM doses and the presence of marginal values in the 75-g oral glucose tolerance test (OGTT) at 60 min. Our study demonstrates, following BM administration, the need for increased awareness and individualized monitoring/treatment of pregnant women with normal—yet marginal—values in the 75-g OGTT.

Download Full-text