scholarly journals Clinical Characteristics, Maternal and Neonatal Outcomes of COVID-19 Positive Pregnant Mothers at a Tertiary Hospital in Johannesburg, South Africa

2021 ◽  
Author(s):  
Tanusha Devi Ramdin ◽  
Rossella Marina Bandini ◽  
Robin Terance Saggers ◽  
Michael Radomsky ◽  
Mphelekedzeni Mulaudzi ◽  
...  
Keyword(s):  
Birth Weight ◽  
Respiratory Distress ◽  
Clinical Characteristics ◽  
Tertiary Hospital ◽  
Neonatal Outcomes ◽  
Common Symptom ◽  
Middle Income ◽  
Symptomatic Disease ◽  
Novel Coronavirus ◽  
Pregnant Mothers

Abstract Background: The global spread of the novel coronavirus 2019 (COVID-19) has been sudden shock to the world and resulted in many questions that remain unanswered. Limited data has been published in low-middle-income country settings (LMICS) Objectives: To describe the clinical characteristics and outcome of mothers and neonates delivered from COVID-19 positive mothers, and to identify the incidence of COVID-19 positive neonates.Methods: A prospective, descriptive study, from 1 August 2020 to 31 March 2021 conducted at a tertiary hospital, in JohannesburgAll neonates born to mothers that were COVID-19 positive and that required admission to the neonatal unit were included. Informed consent was obtained from mothers prior to enrolment.Results: A total of 111 COVID-19 positive pregnant women delivered neonates at the tertiary hospital. In this study, only 28 of the 111 (25%) neonates born to COVID-19 positive mothers were admitted. The majority of the COVID-19 pregnant mothers were asymptomatic or had mild symptomatic disease (80%). Two (2/111 (2%) mothers required ICU admission and three (3/111 (3%) of them demised. In relation to neonatal outcomes, the majority of the neonates were delivered at a gestational age of 35 weeks with a birth weight of 2400 grams .The most common symptom was respiratory distress (89 %). The one (3%) neonate that tested positive for COVID-19 was born moderately preterm with a low birth weight and respiratory distress syndrome. Two (2/28 (7%) neonates demised, however the cause of death was not related to COVID-19. All the remaining (26/28 (93%) neonates were discharged and were well on follow up. Conclusion: Our study has shown that the risk of neonatal transmission from pregnant COVID-19 mothers is relatively low, and the majority of neonatal disease ranged from asymptomatic to mildly symptomatic disease. Further research efforts are essential to improve neonatal care in LMICS.

scholarly journals Chlamydia trachomatis Screening and Treatment in Pregnancy to Reduce Adverse Pregnancy and Neonatal Outcomes: A Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Kristina N. Adachi ◽  
Karin Nielsen-Saines ◽  
Jeffrey D. Klausner
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Middle Income ◽  
Infant Outcomes ◽  
Adverse Pregnancy

Chlamydial trachomatis infection has been associated with adverse pregnancy and neonatal outcomes such as premature rupture of membranes, preterm birth, low birth weight, conjunctivitis, and pneumonia in infants. This review evaluates existing literature to determine potential benefits of antenatal screening and treatment of C. trachomatis in preventing adverse outcomes. A literature search revealed 1824 studies with 156 full-text articles reviewed. Fifteen studies were selected after fulfilling inclusion criteria. Eight studies focused on chlamydial screening and treatment to prevent adverse pregnancy outcomes such as premature rupture of membranes, preterm birth, low birth weight, growth restriction leading to small for gestational age infants, and neonatal death. Seven studies focused on the effects of chlamydial screening and treatment on adverse infant outcomes such as chlamydial infection including positive mucosal cultures, pneumonia, and conjunctivitis. Given the heterogeneity of those studies, this focused review was exclusively qualitative in nature. When viewed collectively, 13 of 15 studies provided some degree of support that antenatal chlamydial screening and treatment interventions may lead to decreased adverse pregnancy and infant outcomes. However, notable limitations of these individual studies also highlight the need for further, updated research in this area, particularly from low and middle-income settings.

scholarly journals Clinical Characteristics of Coronavirus Disease 2019 (COVID-19): An Updated Systematic Review

2020 ◽  
Author(s):  
Zhangfu Fang ◽  
Fang Yi ◽  
Kang Wu ◽  
Kefang Lai ◽  
Xizhuo Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Characteristics ◽  
Case Fatality ◽  
Admission Rate ◽  
Final Analysis ◽  
Common Symptom ◽  
Laboratory Findings ◽  
Large Patient ◽  
Unbiased Manner ◽  
Novel Coronavirus

AbstractOBJECTIVEClinical characteristics of novel coronavirus disease (COVID-19) have been described in numerous studies but yielded varying results. We aimed to conduct a systematic review on scientific literatures and to synthesize critical data on clinical traits of COVID-19 from its initial outbreak to pandemic.METHODSSystematic searches were conducted to identify retrospective observational study that contained clinical characteristics on COVID-19 through multiple databases. Two reviewers independently evaluated eligible publications. Data on clinical characteristics of COVID-19 were extracted and analyzed.RESULTSSeventy-two retrospective studies demonstrating the clinical characteristics of COVID-19 were included. A total of 3470 COVID-19 patients were synthesized to the final analysis in an unbiased manner. The most common symptom was fever (2878 [83.0%]), and 63.4% of the patients presented fever as onset symptom. There were 2528 [88.2%] of 2866 cases had abnormal lung findings on chest CT scan. Laboratory findings showed that 1498 [62.8%] of 2387 cases had lymphopenia, and 1354 [64.8%] of 2091 cases had an increased level of C-reactive protein (CRP). A total of 185 [11.5%] patients were admitted to intensive care unit (ICU) while the overall case fatality rate (CFR) was 3.7%. Compared to patients admitted outside of Hubei, China, those from Hubei had a significant higher ICU admission rate (21.9% vs. 2.5%, p<0.001). Also, CFR attributed to COVID-19 was significantly higher in Hubei than that of non-Hubei admissions (10.4% vs. 0.6%, p<0.001).INTERPRETATIONThis large patient-based systematic review presents a more precise profiling of the COVID-19 from its outbreak to current pandemic. Dynamic evolvements of COVID-19 are needed to be characterized in future studies.

scholarly journals Neurocysticercosis in Children with Seizures: A Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Murli Manohar Gupta ◽  
Nagendra Chaudhary ◽  
Santosh Pathak ◽  
Nikhil Agrawal ◽  
Jaydev Yadav ◽  
...  
Keyword(s):  
Ct Scan ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Focal Seizures ◽  
Magnetic Resonance Imaging Mri ◽  
Considerable Morbidity

Background. Neurocysticercosis (NCC), a common cause of seizures in children from low and middle income countries (LMICs), if not diagnosed and treated early enough may lead to considerable morbidity and mortality. There is a lack of data on the prevalence of NCC and its clinical characteristics among those with seizure in South-Western Nepal. Aims and Objectives. To study the prevalence and clinical characteristics of NCC in children with seizures. Material and Methods. All children admitted to Universal College of Medical Sciences, a tertiary hospital in South-Western Nepal with seizures during 2014–16, were tested for NCC. NCC was diagnosed by neuroimaging [computerized tomography (CT) scan or magnetic resonance imaging (MRI)]. We used logistic regression to test the association between NCC with participants’ characteristics and clinical symptoms. Results. Among 4962 in-patient children, 168 (104 boys and 64 girls) had seizures (138 with generalized tonic clonic seizures (GTCS) and 30 with focal seizures). 43% of children with seizures had CT scan confirmed NCC. The prevalence of NCC in the oldest children (13–16 years) was significantly greater (57.1% versus 15.6%) compared to the youngest (0–4 years) one (p<0.001). Among 72 children with NCC, the proportions of children with vesicular, calcified, and colloidal stages were 76% (n=35), 18% (n=13), and 6% (n=2), respectively. Children with focal seizures had 13% more NCC compared to those with GTCS but the result was statistically not significant. The adjusted odds of having NCC among 5–8 years, 9–12 years, and 13–16 years children were 6.6 (1.78–24.60), 11.06 (2.74–44.60), and 14.47 (3.13–66.96), respectively, compared to 0–4-year-old children. Reoccurrence of seizures within the first 3 months of taking antiepileptic drug in those with NCC was approximately 3 times higher compared to those without NCC (11% versus 4%, p=0.084). Conclusions. This study shows that NCC contributes significantly to higher prevalence of seizures in children in South-Western region of Nepal.

scholarly journals Clinical profile and outcome of respiratory distress in newborns admitted in rural tertiary health care centre of Maharashtra, India

2019 ◽  
Vol 6 (2) ◽  
pp. 713
Author(s):  
Vinayak Y. Kshirsagar ◽  
Ashok Y. Kshirsagar ◽  
Rajsinh V. Mohite
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Apgar Score ◽  
Research Centre ◽  
Common Symptom ◽  
Health Care Centre ◽  
Severe Respiratory Distress ◽  
New Born

Background: Respiratory distress is most common symptom complexes seen in newborn infants lead to high mortality. The objectives were to study various etiological factors, maternal and neonatal risk factors for development of respiratory distress along with need for CPAP, mechanical ventilation and surfactant to assess the immediate clinical outcome in newborns.Methods: The study was conducted at Krishna Hospital and Medical Research Centre, Karad in period of January to August 2018. A total of 100 neonates who were admitted in NICU within 72 hours of life were studied by clinical examination and relevant investigations. The severity of distress was assessed by Silverman-Anderson scoring, Downe’s scoring and APGAR scoring respectively for neonates.Results: It was observed that max, 90% of the distress cases were of respiratory in origin and high severity of distress was observed among 27% newborns. The proportion of respiratory distress was higher, 51% in males and low APGAR score was reported in 14% cases. Among respiratory etiology of respiratory distress, high proportion was of TTNB 35.55%. The maternal and new born factors like maternal age >30 years (32%), gestational age 28-30 weeks (87.5%), gravid 2 and 3 mothers (35%), female gender (32.6%), low birth weight (70%) developed severe distress respectively. The recovery rate of respiratory distress due to respiratory etiology was of 88.8%.Conclusions: Transient tachypnoea of new-born is the most common cause among new-borns with respiratory distress. New-borns with low gestational age, low birth weight baby, low APGAR score is more prone to develop severe respiratory distress.

scholarly journals Comparison of the Clinical Characteristics of 2019 Novel Coronavirus Disease and Avian Influenza A (H1N1) Complicated with Acute Respiratory Distress Syndrome1

2021 ◽  
Author(s):  
Cui-yun Zuo ◽  
Ding-hui Wu ◽  
Hui Yang ◽  
Hai-bin Chen ◽  
Ming-yao Ke
Keyword(s):  
Avian Influenza ◽  
Respiratory Distress ◽  
Clinical Outcomes ◽  
Influenza A ◽  
Clinical Characteristics ◽  
H1n1 Influenza ◽  
Dynamic Monitoring ◽  
Upper Respiratory Tract ◽  
Influenza A H1n1 ◽  
Novel Coronavirus

Abstract Objective: Both 2019 novel coronavirus disease (COVID-19) and avian influenza A (H1N1) are serious acute respiratory diseases with a predisposition to acute respiratory distress syndrome (ARDS). Our aim was to compare the clinical characteristics of patients with COVID-19 and H1N1 influenza complicated with ARDS.Methods: We retrospectively studied data of 12 patients with ARDS (7 with COVID-19; 5 with H1N1 influenza) who were managed at The Second Affiliated Hospital of Xiamen Medical College and Xinglin Branch of the First Affiliated Hospital of Xiamen University between December 20, 2019 and February 29, 2020. We extracted the clinical information and outcomes from the hospital medical charts.Results: Patients with COVID-19 were older and were more likely to have underlying diseases. Low-to-moderate fever was more frequent and upper respiratory tract symptoms were less common in COVID-19 patients. Chest computed tomography of patients with COVID-19 more frequently revealed bilateral nodular patchy ground-glass opacities in the subpleural and central lobular regions. Heart disorders and pleural effusion were less frequent, and coagulopathy was more common in patients with COVID-19. The average duration of stay in the respiratory intensive care unit was longer in patients with COVID-19. The disease severity and clinical outcomes did not differ significantly between the two groups.Conclusion: Older age, higher comorbidity frequency, abnormal coagulation responses, longer hypoxemia duration, pulmonary fibrosis, and poorer clinical outcomes are the main characteristics in patients with COVID-19 who have ARDS. This calls for closer dynamic monitoring and more rigorous follow-up.

scholarly journals Neonatal Outcomes of Large-for-Gestational Age Infants with or without Gestational Diabetes Mellitus

2018 ◽  
Vol 16 (2) ◽  
pp. 25-30
Author(s):  
Taslima Begum ◽  
Gulshan Ara Begum ◽  
Mahmood A Chowdhury ◽  
Wazir Ahmed ◽  
Md Badrudddoza
Keyword(s):  
Blood Glucose ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Respiratory Distress ◽  
Hospital Stay ◽  
Gestational Age ◽  
Neonatal Outcomes ◽  
Large For Gestational Age ◽  
Infants Of Diabetic Mothers ◽  
Diabetic Mothers

Background: Infants are considered Large for Gestational Age (LGA)if their birth weight is greater than the 90th percentile for gestational age. Birth weight is influenced by a number of factors with maternal diabetes being one of the most common risk factor affecting birth weight. They have an increased risk for adverse perinatal outcomes. The aim of the present study was to compare the neonatal outcomes of LGA infants delivered by women with and without gestational diabetes mellitus.Methods: This is a prospective study of all live-born LGA infants of 37 weeks of gestation with a birth weight of 4000g admitted at Neonatal ward of Chattagram Maa Shishu-O-General Hospital (CMSOGH) between 1st August 2013 to 31st July 2014. Type of sampling was purposive convenient sampling. A total of 51 neonatal patients were included. Data was collected in case record form. Data collected for the mothers included age, parity, gestational age and mode of delivery. Data for the infants include sex, birth weight, birth length and laboratory test. Outcomes were compared between infants of diabetic mothers (Group A) and infants of non- diabetic mothers (Group B). Then data was analyzed by SPSS 17.0 program and presented by tabular method, diagram and chart.Results: Among fifty one study subjects, thirty were Infants of Diabetic Mothers (IDMs) while twenty one were non- IDMs. 19 (63.3%) of the IDMs were male while 11 (36.7%) were female. Among the 21 non-IDMs 10 (47.6%) were male and 11 (52.4%) were female. Male to female ratio was 1.4:1. 5 (16.7%) of the IDMs were delivered vaginally while 25 (83.3%) were delivered by Caesarian Section (CS) where as 8 (38.1%) of the non- IDMs were delivered vaginally while 13 (61.9%) were delivered by CS. Respiratory distress was the most common morbidity affecting 70% of the IDMs and 66.7% of the non-IDMs. TTN accounted for the majority of the respiratory distress cases, occurring in 17 of the IDMs and 12 of the non-IDMs. Regarding analysis of other clinical features, convulsion (63.3%) was present more in IDMs than in non-IDMs (52.4%) cyanosis was found more in IDMs (60%) than non-IDMs (38.1%). Hypoglycemia was found more in IDMs than in non-IDMs. Mean glucose values were 41.06±19.91mg/dl for IDMs and 53.06±28.96mg/dl for the non-IDMs (p=0.001). Hyperbilirubinemia was more frequently observed in IDMs than in non- IDMs. About 17 (56.6%) of the IDMs and 7(33.3%) of the non-IDMs developed jaundice during the period of hospital stay. Polycythemia was not observed in both the groups but PCV was higher in IDMs (53.96±6.36) compared to non-IDMs (50.50±8.76). Hypocalcemia was not peculiar to a specific group. Five of the IDMs had congenital anomaly, of which three of them had cardiac anomaly. One of the non-IDM was suffering from ventricular septal defect. Birth asphyxia was observed more in non-IDMs (71.4%) than in IDMs (53.3%).One of the IDMs and two of the non-IDMs sustained a brachial plexus injury following vaginal delivery. On an average, IDMs had a longer duration of hospital stay. Outcome was more fatal in IDMs. About six (20%) of IDMs died compared to two (9.5%) of the non-IDMs. That was found statistically significant (p=<0.05).Conclusion: LGA babies with diabetic mother had more adverse outcome in terms of mortality and blood glucose level. More concentration is needed to control blood glucose of mother during pregnancy. Also extra care for the babies is needed to avoid fatal neonatal outcomes.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 25-30

scholarly journals The relationship between birth intervals and adverse maternal and neonatal outcomes in six low and lower-middle income countries

2020 ◽  
Vol 17 (S2) ◽  
Author(s):  
Melissa Bauserman ◽  
Kayla Nowak ◽  
Tracy L. Nolen ◽  
Jackie Patterson ◽  
Adrien Lokangaka ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Death ◽  
Very Low Birth Weight ◽  
Neonatal Outcomes ◽  
Middle Income ◽  
Maternal Characteristics ◽  
Middle Income Countries ◽  
Increased Risk ◽  
Maternal And Neonatal Outcomes

Abstract Background Due to high fertility rates in some low and lower-middle income countries, the interval between pregnancies can be short, which may lead to adverse maternal and neonatal outcomes. Methods We analyzed data from women enrolled in the NICHD Global Network Maternal Newborn Health Registry (MNHR) from 2013 through 2018. We report maternal characteristics and outcomes in relationship to the inter-delivery interval (IDI, time from previous delivery [live or stillborn] to the delivery of the index birth), by category of 6–17 months (short), 18–36 months (reference), 37–60 months, and 61–180 months (long). We used non-parametric tests for maternal characteristics, and multivariable logistic regression models for outcomes, controlling for differences in baseline characteristics. Results We evaluated 181,782 women from sites in the Democratic Republic of Congo, Zambia, Kenya, Guatemala, India, and Pakistan. Women with short IDI varied by site, from 3% in the Zambia site to 20% in the Pakistan site. Relative to a 18–36 month IDI, women with short IDI had increased risk of neonatal death (RR = 1.89 [1.74, 2.05]), stillbirth (RR = 1.70 [1.56, 1.86]), low birth weight (RR = 1.38 [1.32, 1.44]), and very low birth weight (RR = 2.35 [2.10, 2.62]). Relative to a 18–36 month IDI, women with IDI of 37–60 months had an increased risk of maternal death (RR 1.40 [1.05, 1.88]), stillbirth (RR 1.14 [1.08, 1.22]), and very low birth weight (RR 1.10 [1.01, 1.21]). Relative to a 18–36 month IDI, women with long IDI had increased risk of maternal death (RR 1.54 [1.10, 2.16]), neonatal death (RR = 1.25 [1.14, 1.38]), stillbirth (RR = 1.50 [1.38, 1.62]), low birth weight (RR = 1.22 [1.17, 1.27]), and very low birth weight (RR = 1.47 [1.32,1.64]). Short and long IDIs were also associated with increased risk of obstructed labor, hemorrhage, hypertensive disorders, fetal malposition, infection, hospitalization, preterm delivery, and neonatal hospitalization. Conclusions IDI varies by site. When compared to 18–36 month IDI, women with both short IDI and long IDI had increased risk of adverse maternal and neonatal outcomes. Trial registration The MNHR is registered at NCT01073475.

scholarly journals Epidemiological, Clinical Characteristics and Outcome of Medical Staff Infected with COVID-19 in Wuhan, China: A Retrospective Case Series Analysis

2020 ◽  
Author(s):  
Jie Liu ◽  
Liu Ouyang ◽  
Pi Guo ◽  
Haisheng Wu ◽  
Peng Fu ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Medical Staff ◽  
Clinical Characteristics ◽  
Cox Regression ◽  
Discharge Rate ◽  
Case Series ◽  
Time Interval ◽  
Common Symptom ◽  
Duration Of Symptoms ◽  
Novel Coronavirus

SummaryBackgroundsSince December 2019, a novel coronavirus epidemic has emerged in Wuhan city, China and then rapidly spread to other areas. As of 20 Feb 2020, a total of 2,055 medical staff confirmed with coronavirus disease 2019 (COVID-19) caused by SARS-Cov-2 in China had been reported. We sought to explore the epidemiological, clinical characteristics and prognosis of novel coronavirus-infected medical staff.MethodsIn this retrospective study, 64 confirmed cases of novel coronavirus-infected medical staff admitted to Union Hospital, Wuhan between 16 Jan, 2020 to 15 Feb, 2020 were included. Two groups concerned were extracted from the subjects based on duration of symptoms: group 1 (≤10 days) and group 2 (>10 days). Epidemiological and clinical data were analyzed and compared across groups. The Kaplan-Meier plot was used to inspect the change in hospital discharge rate. The Cox regression model was utilized to identify factors associated with hospital discharge.FindingsThe median age of medical staff included was 35 years old. 64% were female and 67% were nurses. None had an exposure to Huanan seafood wholesale market or wildlife. A small proportion of the cohort had contact with specimens (5%) as well as patients in fever clinics (8%) and isolation wards (5%). Fever (67%) was the most common symptom, followed by cough (47%) and fatigue (34%). The median time interval between symptoms onset and admission was 8.5 days. On admission, 80% of medical staff showed abnormal IL-6 levels and 34% had lymphocytopenia. Chest CT mainly manifested as bilateral (61%), septal/subpleural (80%) and ground-glass (52%) opacities. During the study period, no patients was transferred to intensive care unit or died, and 34 (53%) had been discharged. Higher body mass index (BMI) (≥ 24 kg/m2) (HR 0.14; 95% CI 0.03-0.73), fever (HR 0.24; 95% CI 0.09-0.60) and higher levels of IL-6 on admission (HR 0.31; 95% CI 0.11-0.87) were unfavorable factors for discharge.InterpretationIn this study, medical staff infected with COVID-19 have relatively milder symptoms and favorable clinical course, which may be partly due to their medical expertise, younger age and less underlying diseases. Smaller BMI, absence of fever symptoms and normal IL-6 levels on admission are favorable for discharge for medical staff. Further studies should be devoted to identifying the exact patterns of SARS-CoV-2 infection among medical staff.

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