scholarly journals Alterations in Vaginal Microbiota among Pregnant Women with COVID-19

2021 ◽  
Author(s):  
Ebru Celik ◽  
Gulin Ozcan ◽  
Cansel Vatansever ◽  
Erxiati Paerhati ◽  
Mert Ahmet Kuskucu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Diversity Index ◽  
Alpha Diversity ◽  
Active Phase ◽  
Adverse Outcomes ◽  
Vaginal Microbiota ◽  
Rrna Gene ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract Background: The maintenance of vaginal microbiota is an important factor to achieve ideal pregnancy outcomes. Coronavirus disease (COVID-19) has been shown to have potential adverse effects on pregnancy and neonatal outcomes. Pregnancy itself is a risk factor for the severity of COVID-19, with an increased risk of intensive care unit (ICU) admission, maternal morbidity, and mortality. the role of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in vaginal microbiome composition in pregnant women with COVID-19 has not yet been investigated. Therefore, we anticipate that COVID-19 may unfavorably affect the composition of the vaginal microbiota, resulting in adverse pregnancy outcomes. We aimed to describe the alterations of the composition of vaginal microbiota in pregnant women with COVID-19.Results: A prospective case-control study was conducted among 19 pregnant women with COVID-19 and 28 healthy controls matched according to the gestational week and age. The vaginal swabs were collected during the active phase of infection and consecutively, within a month after recovering from infection. In three patients, longitudinal samples before, in the course, and after infection were also obtained. The microbiome alterations were examined by 16S rRNA gene sequencing. We indicated that COVID-19 was associated with vaginal dysbiosis during pregnancy, which was indicated by an increased alpha diversity index. There was a significantly decrease in Firmicutes (P=0.007) and Lactobacillus (P=0.019) with an increase in Bacteroidetes (P=0.024) in the COVID-19 group. In the moderate/severe group, increased amounts of Ureaplasma and vanishing of Lactobacillus gasseri were found in women, compared to the asymptomatic or mild group (P=0.001). In longitudinal analysis, elevation of Actinobacteria with reduction of Firmicutes and Bacteroides were indicated during the active phase. Conclusions: The study revealed vaginal dysbiosis with a low abundance of Lactobacillus and an increase in Bacteroidetes in relation to SARS-CoV-2 infection. Vaginal dysbiosis in COVID-19 could be a contributing factor in pregnancy adverse outcomes. Trial registration: clinicaltrials, Registered 15 November 2019, https://www.clinicaltrials.gov/ct2/show/NCT04165252?cond=microbiota&cntry=TR&draw=3&rank=12

scholarly journals Pregnancy outcomes among women with thyrotoxicosis a retrospective cohort study

2021 ◽  
Author(s):  
Panwad Harn-a-morn ◽  
Prapai Dejkhamron ◽  
Theera Tongsong ◽  
Suchaya Luewan
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Low Risk ◽  
Obstetric Outcomes ◽  
Study Group ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
Singleton Pregnancies

Abstract Objective: To compare adverse outcomes between: 1) pregnant women with thyrotoxicosis and low risk pregnancies, 2) pregnant women with thyrotoxicosis requiring no anti-thyroid drug (ATD) and low risk pregnancies, and 3) those treated with methimazole (MMI) and propylthiouracil (PTU)Methods: The medical records of singleton pregnancies with thyrotoxicosis were comprehensively reviewed. Low-risk pregnancies matched for age and parity were randomly recruited as controls. The obstetric outcomes were compared between both groups, and the outcomes of various subgroups of the study group were also compared.Results: A total of 408 pregnant women with thyrotoxicosis were recruited. Compared with the controls, the women of the study group had significantly higher rates of low birth weight (LBW) (23.7% vs 17.7%; p:0.036), preterm birth (19.3% vs 12.3%; p:0.007), preeclampsia (8.5% vs 4.4%; p: 0.019) and cesarean section (21.5% vs 16.0%; p:0.046). In the study group (thyrotoxicosis), 67, 127, and 158 patients were treated with MMI, PTU and no anti-thyroid drug (ATD), respectively. All obstetric outcomes were comparable between the women treated with PTU and those with MMI, and between the controlled and uncontrolled groups. However, women who needed ATD had significantly higher rates of LBW and preterm birth than those without medications.Conclusions: Thyrotoxicosis, whether treated or not needing ATDs, was significantly associated with an increased risk of adverse pregnancy outcomes. Also, active disease, indicated by the need for ATD significantly increased the risk of such adverse outcomes, whereas the patients treated with MMI or PTU had comparable adverse outcomes.

scholarly journals Pregnancy Outcomes among Women with Graves’ Hyperthyroidism: A Retrospective Cohort Study

2021 ◽  
Vol 10 (19) ◽  
pp. 4495
Author(s):  
Panwad Harn-a-morn ◽  
Prapai Dejkhamron ◽  
Theera Tongsong ◽  
Suchaya Luewan
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Low Risk ◽  
Obstetric Outcomes ◽  
Increased Risk ◽  
Adverse Pregnancy

Objective: The primary objectives of this study are to compare the rates of preterm birth; fetal growth restriction and low birth weight between the following groups: (1) pregnant women treated for thyrotoxicosis and low-risk pregnancies; (2) between pregnant women with thyrotoxicosis with no need of medication and low-risk pregnancies; and (3) between those treated with MMI and PTU. Methods: The medical records of singleton pregnancies with thyrotoxicosis were comprehensively reviewed. Low-risk pregnancies matched for age and parity were randomly recruited as controls. The obstetric outcomes were compared between both groups; the outcomes of various subgroups of the thyrotoxicosis group were also compared. Results: A total of 408 pregnant women with thyrotoxicosis were recruited. Compared with the controls; the women of the thyrotoxicosis group had significantly higher rates of low birth weight (LBW) (23.7% vs. 17.7%; p: 0.036), preterm birth (19.3% vs. 12.3%; p: 0.007), preeclampsia (8.5% vs. 4.4%; p: 0.019) and cesarean section (21.5% vs. 16.0%; p: 0.046). In the thyrotoxicosis group; 67; 127; and 158 patients were treated with MMI; PTU and no anti-thyroid drug (ATD), respectively. All obstetric outcomes were comparable between the women treated with PTU and those with MMI; and between the controlled and uncontrolled groups. However, women who needed ATD had significantly higher rates of LBW and preterm birth than those without medications. Conclusions: Thyrotoxicosis, whether treated or not needing ATDs, was significantly associated with an increased risk of adverse pregnancy outcomes. Also, active disease, indicated by the need for ATD significantly increased the risk of such adverse outcomes; whereas the patients treated with MMI or PTU had comparable adverse outcomes.

scholarly journals The Paradoxical Effects of Hurricane Katrina on Births and Adverse Birth Outcomes

2020 ◽  
Vol 110 (10) ◽  
pp. 1466-1471
Author(s):  
Emily W. Harville ◽  
Xu Xiong ◽  
Maya David ◽  
Pierre Buekens
Keyword(s):  
Black Women ◽  
Hurricane Katrina ◽  
Pregnancy Outcomes ◽  
White Women ◽  
Vital Statistics ◽  
Adverse Outcomes ◽  
High Risk Women ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
Number Of Births

Objectives. To review the trends in pregnancy outcomes after Hurricane Katrina and assess effects of the disaster on research and public health related to pregnant women. Methods. We reexamined the 2004–2006 vital statistics data from Alabama, Louisiana, and Mississippi, assessing what the risk of adverse pregnancy outcomes in the population would have been under varying risk scenarios. Results. We saw a reduction in number of births as well as in low birth weight and preterm birth. If the number of births had stayed constant and the relative higher risk in the “missing” births had been between 17% and 100%, the storm would have been associated with an increased risk instead of a decrease. Because the relative decline in births was larger in Black women, the higher risk in the “missing” births required to create a significant increase associated with the storm was generally not as great as for White women. Conclusions. Higher exposure to Katrina may have produced a reduction in births among high-risk women in the region rather than increasing adverse outcomes among those who did give birth.

scholarly journals Effectiveness of Prenatal Vitamin D Deficiency Screening and Treatment Program: A Stratified Randomized Field Trial

2018 ◽  
Vol 103 (8) ◽  
pp. 2936-2948 ◽  
Author(s):  
Maryam Rostami ◽  
Fahimeh Ramezani Tehrani ◽  
Masoumeh Simbar ◽  
Razieh Bidhendi Yarandi ◽  
Sonia Minooee ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Treatment Program ◽  
Pregnancy Outcomes ◽  
Pregnancy Complications ◽  
Screening Program ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Adverse Pregnancy ◽  
Screening Site

Abstract Context Despite evidence on the association between hypovitaminosis D and adverse pregnancy outcomes and the positive impact of vitamin D supplementation, no evidence exists supporting a universal screening program in pregnancy as part of routine prenatal care. Objective We sought to determine the effectiveness of a prenatal screening program on optimizing 25-hydroxyvitamin D [25(OH)D] levels and preventing pregnancy complications. Also, to identify a safe regimen, we compared several regimens in a subgroup of vitamin D–deficient pregnant women. Design Two cities of Masjed-Soleyman and Shushtar from Khuzestan province, Iran, were selected as the screening and nonscreening arms, respectively. Within the screening arm, a randomized controlled trial was conducted on 800 pregnant women. Setting Health centers of Masjed-Soleyman and Shushtar cities. Patients or Participants Pregnant women aged 18 to 40 years. Intervention Women with moderate [25(OH)D, 10 to 20 ng/mL] and severe [25(OH)D, <10 ng/mL] deficiency were randomly divided into four subgroups and received vitamin D3 (D3) until delivery. Main Outcome Measure Maternal concentration of 25(OH)D at delivery and rate of pregnancy complications Results After supplementation, only 2% of the women in the nonscreening site met the sufficiency level (>20 ng/mL) vs 53% of the women in the screening site. Adverse pregnancy outcomes, including preeclampsia, gestational diabetes mellitus, and preterm delivery, were decreased by 60%, 50%, and 40%, respectively, in the screening site. A D3 injection in addition to monthly 50,000 IU maintenance therapy contributed the most to achievement of sufficient levels at delivery. Conclusions A prenatal vitamin D screening and treatment program is an effective approach in detecting deficient women, improving 25(OH)D levels, and decreasing pregnancy adverse outcomes.

Sleep and pregnancy

2018 ◽  
Author(s):  
Michele L. Okun
Keyword(s):  
Sleep Disturbance ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Lifestyle Changes ◽  
Sleep Maintenance ◽  
Increased Risk ◽  
Exogenous Factors ◽  
Adverse Pregnancy

Pregnant women experience a greater degree of sleep disturbance than their non-pregnant counterparts. Complaints range from sleep maintenance issues to excessive daytime sleepiness. Emerging evidence suggests that there is variability in sleep patterns and complaints which manifest differently among pregnant women. Moreover, it is well accepted that sleep disturbance can dysregulate normal immune and endocrine processes that are critically important to the health and progression of gestation. A possible consequence of sleep disturbance is an increased risk for adverse pregnancy outcomes. Then again, many endogenous and exogenous factors, including pregnancy-related physiological, hormonal, and anatomic changes, as well as lifestyle changes, can impact the degree and chronicity of sleep disturbance. Alas, there is still much to learn in terms of what women can/should expect with regard to the timing, degree, frequency, and/or severity of a specific pregnancy-related sleep disturbance(s), despite the number of published studies evaluating what sleep during pregnancy encompasses.

scholarly journals Maternal urinary levels of trichloroacetic acid and association with adverse pregnancy outcomes

2019 ◽  
Vol 17 (6) ◽  
pp. 884-895 ◽  
Author(s):  
Funanani Mashau ◽  
Esper Jacobeth Ncube ◽  
Kuku Voyi
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Premature Birth ◽  
Trichloroacetic Acid ◽  
Adverse Pregnancy Outcomes ◽  
Potential Health ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract The current study aimed to determine the association between trichloroacetic acid (TCAA) levels and adverse pregnancy outcomes among third-trimester pregnant women who were exposed to chlorinated drinking water. A total of 205 pregnant women who participated in the disinfection by-products exposure and adverse pregnancy outcome study in South Africa were randomly asked to participate in this study by providing their morning urine sample voids. Samples were analysed for urinary creatinine and TCAA. Furthermore, participants gave individual data using a structured questionnaire. The mean (median) concentration of creatinine-adjusted urinary TCAA was 2.34 (1.95) μg/g creatinine. Elevated levels of creatinine-adjusted TCAA concentrations showed an increased risk of premature birth, small for gestational age (SGA) and low birth weight. There was no significant statistical correlation observed between creatinine-adjusted TCAA concentrations and the total volume of cold water ingested among the study population. No statistically significant association was observed between creatinine-adjusted urinary TCAA and premature birth, SGA and low birth weight newborns among the study subjects. However, the urinary TCAA concentrations identified in this study suggest potential health risks towards women and foetus. Therefore, further studies are warranted to prevent further adverse pregnancy outcomes.

Risk factors for adverse pregnancy outcomes in women with intrahepatic cholestasis of pregnant women

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 57-61
Author(s):  
Yu B Uspenskaya ◽  
A A Sheptulin ◽  
I V Kuznetsova ◽  
E P Gitel ◽  
N V Goncharenko ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Prognostic Markers ◽  
Adverse Pregnancy Outcomes ◽  
Fetal Hypoxia ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
High Level

Intrahepatic cholestasis of pregnant women (ICPW) is associated with an increased risk of complications of pregnancy. Objective prognostic markers of adverse pregnancy outcomes except for a high level of bile acids (BA) in the mother's blood serum, exceeding 40 μmol/l, do not currently exist. However, the determination of the BA levels is not available in all laboratories, which indicates the need to search for other informative prognostic markers of complications of pregnancy in patients with ICPW. Objective: to determine the risk factors for adverse pregnancy outcomes in ICPW. Materials and methods. A prospective study included 97 pregnant women diagnosed with ICPW. The diagnosis was established with an increase in the serum level of the BA in excess of 10 μmol/l. Patients underwent clinical and laboratory examinations with assessment of biochemical markers of liver damage, antioxidant status (determination of superoxide dismutase, glutathione peroxidase, selenium, zinc level). Biochemical indices and severity of pruritus were assessed at the time of diagnosis of ICPW, after 1 and 2 weeks of treatment with ursodeoxycholic acid (UDCA) at a dose of 500 mg to 2 g per day. In the study of perinatal outcomes, the term of delivery, the method of delivery, the presence of signs of intrauterine fetal hypoxia, the state of the fetus at the time of birth were taken into account. Results of the study. In the observed group of patients, the incidence of preterm birth was 31.9%, intrauterine fetal hypoxia 29.9%, pre-eclampsia 23.7%, the need for a cesarean section due to the development of pregnancy complications arose in 40 (41.2%) cases. The risk factors for complications of pregnancy in patients with ICPW were: early onset and longer duration of ICPW, reactivation of cholestasis after its regression against the background of UDCA treatment and less effective treatment of skin itching in patients with manifest forms of ICPW. The laboratory markers of adverse pregnancy outcomes were a high level of maternal total serum BA and a low efficiency of its reduction against the background of treatment, a slow rate of decrease in hepatic transaminase activity against the background of treatment, a low level of antioxidant protection enzymes. The use of sex hormones during pregnancy promoted more frequent development of preeclampsia and increased the frequency of indications for cesarean delivery. The conclusion. Patients with early manifestation of ICPW and reactivation of cholestasis after its regression on the background of treatment, low effectiveness of treatment of pruritus, and also taking drugs of sex hormones require special attention and active management in connection with an increased risk of complications of pregnancy. It is advisable to carry out dynamic monitoring of the level of BA, hepatic transaminases and antioxidant enzymes in dynamics against the backdrop of treatment with ICPW to assess the effectiveness of treatment and timely prediction of possible complications of pregnancy.

scholarly journals Epidemic Profile of Maternal Syphilis in China in 2013

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Lixia Dou ◽  
Xiaoyan Wang ◽  
Fang Wang ◽  
Qian Wang ◽  
Yaping Qiao ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Congenital Syphilis ◽  
Adverse Pregnancy Outcomes ◽  
Syphilis Infection ◽  
Increased Risk ◽  
Late Treatment ◽  
Adverse Pregnancy ◽  
Maternal Syphilis ◽  
Epidemiological Characteristics

Objective. The aim of this study was to investigate the epidemiological characteristics and adverse pregnancy outcomes of pregnant women with syphilis infection in China.Methods. Data were from China’s Information System of Prevention of Mother-to-Child Transmission of Syphilis Management. Women who were registered in the system and delivered in 2013 were included in the analysis.Results. A total of 15884 pregnant women with syphilis infection delivered in China in 2013. 79.1% of infected women attended antenatal care at or before 37 gestational weeks; however, 55.4% received no treatment or initiated the treatment after 37 gestational weeks. 14.0% of women suffered serious adverse pregnancy outcomes including stillbirth/neonatal death, preterm delivery/low birth weight, or congenital syphilis in newborns. High maternal titer (≥1 : 64) and late treatment (>37 gestational weeks)/nontreatment were significantly associated with increased risk of congenital syphilis and the adjusted ORs were 1.88 (95% CI 1.27 to 2.80) and 3.70 (95% CI 2.36 to 5.80), respectively.Conclusion. Syphilis affects a great number of pregnant women in China. Large proportions of women are not detected and treated at an early pregnancy stage. Burden of adverse pregnancy outcomes is high among infected women. Comprehensive interventions still need to be strengthened to improve uptake of screening and treatment for maternal syphilis.

scholarly journals Impact of the Length of Interpregnancy Interval on Obstetric Outcomes

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S S T Mohammed ◽  
S A Ashoush ◽  
K H Sweedan ◽  
R R Ali
Keyword(s):  
Risk Factor ◽  
Pregnancy Outcomes ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Adverse Outcomes ◽  
Obstetric Outcomes ◽  
Fetal Survival ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
The Impact

Abstract Background Inter-pregnancy interval (IPI) is defined as the period between the last delivery and conception of the current pregnancy. Both short and long intervals between pregnancies have been associated with an increased risk of variable adverse outcomes, such as preterm birth, low birth weight (LBW), small size for gestational age, and perinatal death. Aim of the Work To assess the impact of IPI as a risk factor for adverse pregnancy and perinatal outcomes. Patients and Methods This study was held in Ain Shams University Maternity Hospital on 1719 patients ranging between the ages of 18-35 years. They were divided into three groups according to the length of their IPI [444 patients in group p1 (6-18 months), 847 patients in group p2 (18-48) and 428 patients in group p3 (> 48 months)]. The aim of this study was to assess the impact of IPI as a risk factor for adverse pregnancy and perinatal outcomes. Results The incidence of LBW among patients with IPI 6-18 months was 11.5%, 12.5% among those with IPI 18-48 months and 16.8% among those with IPI > 48 months. It was also found that the rate of short IPI decreases with age, being more common among the younger age, lower parity groups. The incidence of gestational DM increased with longer IPI. Parity, previous miscarriages, cesarean sections and preterm labor were all significantly associated with the length of IPI. Conclusion This study confirms that both shorter and longer IPIs are associated with increased risks of adverse pregnancy outcomes. This study provides critical information relevant for improving pregnancy outcomes and fetal survival.

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