Acute appendicitis in pregnancy: 50 case series, maternal and neonatal outcomes

AbstractThe objective of this review was to identify the most significant studies reporting on COVID-19 during pregnancy and to provide an overview of SARS-CoV-2 infection in pregnant women and perinatal outcomes. Eligibility criteria included all reports, reviews; case series with more than 100 individuals and that reported at least three of the following: maternal characteristics, maternal COVID-19 clinical presentation, pregnancy outcomes, maternal outcomes and/or neonatal/perinatal outcomes. We included eight studies that met the inclusion criteria, representing 10,966 cases distributed in 15 countries around the world until July 20, 2020. The results of our review demonstrate that the maternal characteristics, clinical symptoms, maternal and neonatal outcomes almost 11,000 cases of COVID-19 and pregnancy described in 15 different countries are not worse or different from the general population. We suggest that pregnant women are not more affected by the respiratory complications of COVID-19, when compared to the outcomes described in the general population. We also suggest that the important gestational shift Th1-Th2 immune response, known as a potential contributor to the severity in cases of viral infections during pregnancy, are counter-regulated by the enhanced-pregnancy-induced ACE2-Ang-(1–7) axis. Moreover, the relatively small number of reported cases during pregnancy does not allow us to affirm that COVID-19 is more aggressive during pregnancy. Conversely, we also suggest, that down-regulation of ACE2 receptors induced by SARS-CoV-2 cell entry might have been detrimental in subjects with pre-existing ACE2 deficiency associated with pregnancy. This association might explain the worse perinatal outcomes described in the literature.

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Maternal and Neonatal Outcomes of Appendicitis in Pregnancy [19D]

Obstetrics and Gynecology ◽

10.1097/01.aog.0000532998.45116.12 ◽

2018 ◽

Vol 131 ◽

pp. 46S

Author(s):

Michelanne Shields ◽

Louisa R. Chatroux ◽

Alyssa R. Hersh ◽

Aaron B. Caughey

Keyword(s):

Neonatal Outcomes ◽

Maternal And Neonatal Outcomes ◽

In Pregnancy

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Amphetamine use in pregnancy: Perinatal approaches to improve maternal and neonatal outcomes

British Journal of Midwifery ◽

10.12968/bjom.2017.25.9.552 ◽

2017 ◽

Vol 25 (9) ◽

pp. 552-555 ◽

Cited By ~ 1

Author(s):

Steffne Nel ◽

Sadie Geraghty

Keyword(s):

Neonatal Outcomes ◽

Amphetamine Use ◽

Maternal And Neonatal Outcomes ◽

In Pregnancy

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Maternal and Neonatal Outcomes Associated with Psychostimulant Use in Pregnancy

International Journal for Population Data Science ◽

10.23889/ijpds.v5i5.1579 ◽

2020 ◽

Vol 5 (5) ◽

Author(s):

Ximena Camacho ◽

Alys Havard ◽

Helga Zoega ◽

Margaret Wilson ◽

Tara Gomes ◽

...

Keyword(s):

Birth Outcomes ◽

Neonatal Intensive Care ◽

Low Birthweight ◽

Cohort Analysis ◽

Neonatal Outcomes ◽

Increased Risk ◽

The Usa ◽

Maternal And Neonatal Outcomes ◽

Adverse Pregnancy ◽

In Pregnancy

IntroductionRecent evidence from the USA and Nordic countries suggests a possible association between psychostimulant use during gestation and adverse pregnancy and birth outcomes. Objectives and ApproachWe employed a distributed cohort analysis using linked administrative data for women who gave birth in New South Wales (NSW; Australia) and Ontario (Canada), whereby a common protocol was implemented separately in each jurisdiction. The study population comprised women who were hospitalized for a singleton delivery over an 8 (NSW) and 4 (Ontario) year period, respectively, with the NSW cohort restricted to social security beneficiaries. Psychostimulant exposure was defined as at least one dispensing of methylphenidate, amphetamine, dextroamphetamine or lisdexamfetamine during pregnancy. We examined the risk of maternal and neonatal outcomes among psychostimulant exposed mothers compared with unexposed mothers. ResultsThere were 140,356 eligible deliveries in NSW and 449,499 in Ontario during the respective study periods. Fewer than 1% of these pregnancies were exposed to psychostimulants during gestation, although use was higher in Ontario (0.30% vs 0.11% in NSW). Preliminary unadjusted analyses indicated possible associations between psychostimulant use in pregnancy and higher risks of pre-term birth (relative risk [RR] 1.7, 95% confidence interval [CI] 1.4-2.0 (Ontario); RR 1.8, 95% CI 1.2-2.6 (NSW)) and pre-eclampsia (RR 2.0, 95% CI 1.5-2.6 (Ontario); RR 2.0, 95% CI 1.2-3.5 (NSW)). Similarly, psychostimulant use was associated with higher risks of low birthweight (RR 1.6, 95% CI 1.3-1.9 (Ontario); RR 2.0, 95% CI 1.3-3.0 (NSW)) and admission to neonatal intensive care (RR 2.1, 95% CI 1.9-2.3 (Ontario); RR 1.5, 95% CI 1.1-1.9 (NSW)). Conclusion / ImplicationsUnadjusted analyses indicate an increased risk of adverse maternal and birth outcomes associated with psychostimulant exposure during pregnancy, potentially representing a placental effect. We are currently refining the analyses, employing propensity score methods to adjust for confounding.

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668: Are maternal and neonatal outcomes worse in women with positive HCV antibody screening in pregnancy?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2019.11.683 ◽

2020 ◽

Vol 222 (1) ◽

pp. S425

Author(s):

Elisa T. Bushman ◽

Lakshmi Subramani ◽

Aalok R. Sanjanwala

Keyword(s):

Neonatal Outcomes ◽

Antibody Screening ◽

Hcv Antibody ◽

Maternal And Neonatal Outcomes ◽

In Pregnancy

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A Population-level Analysis of the Differing Effects of Rheumatoid Arthritis and Spondyloarthritis on Peripartum Outcomes

The Journal of Rheumatology ◽

10.3899/jrheum.181320 ◽

2019 ◽

Vol 47 (2) ◽

pp. 197-203 ◽

Cited By ~ 3

Author(s):

Stephanie O. Keeling ◽

Samantha L. Bowker ◽

Anamaria Savu ◽

Padma Kaul

Keyword(s):

Rheumatoid Arthritis ◽

Pregnant Women ◽

Population Level ◽

Nonsteroidal Antiinflammatory Drugs ◽

Neonatal Outcomes ◽

Hypertensive Disorder ◽

Antiinflammatory Drugs ◽

Hypertensive Disorders ◽

Maternal And Neonatal Outcomes ◽

In Pregnancy

Objective.The effects of rheumatoid arthritis (RA) and spondyloarthritis (SpA) on maternal and neonatal outcomes at a population level have not previously been well compared.Methods.A contemporary pregnancy cohort of 312,081 women and corresponding birth events was assembled for the province of Alberta from the random selection of 1 live birth event per woman. We identified 3 groups: (1) no inflammatory arthritis (no IA, n = 308,989), (2) RA (n = 631), and (3) SpA (n = 2461). We compared maternal and neonatal outcomes, comorbid conditions, and medication use among the 3 groups. Multivariable logistic regression models evaluated the independent association between RA and SpA, relative to no IA, and the outcomes of small for gestation age (SGA) and hypertensive disorders during pregnancy.Results.Pregnant women with RA were significantly more likely to have preterm delivery (13.5%), cesarean delivery (33.9%), hypertensive disorders in pregnancy (10.5%), and SGA babies (15.6%), compared to pregnant women with either SpA or no IA. Nonsteroidal antiinflammatory drugs and corticosteroid use were significantly higher in pregnant women with RA compared to the other groups. Women with RA were significantly more likely to have an SGA baby (OR 1.51, 95% CI 1.21–1.88; p < 0.01), and hypertensive disorder in pregnancy (OR 1.51, 95% CI 1.16–1.97; p < 0.01), compared to women with no IA, while no difference was found between women with SpA and those with no IA.Conclusion.Women with RA have a higher risk of worse maternal and neonatal outcomes, whereas the risk of these events is similar between women with and without SpA.

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