scholarly journals Risk Factors Associated with Coronavirus Disease 2019 (COVID-19) Symptoms and Potential Vertical Transmission During Pregnancy: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Bibita Peter ◽  
Nicholas Ree ◽  
Karen Ferrer ◽  
Laila Younes ◽  
Barbara Lepe ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Disease Severity ◽  
Vertical Transmission ◽  
Retrospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Public Hospitals ◽  
Growing Body ◽  
The Impact

Abstract Objective: The COVID-19 pandemic is of special concern for pregnant women. A growing body of evidence suggests the virus can have a deleterious impact upon outcomes related to birth and newborn health. There is a paucity of published research demonstrating the factors that influence disease severity among those who are pregnant, while a growing body of evidence demonstrates that vertical transmission occurs. Our study investigated the impact of maternal characteristics upon COVID-19 outcomes, as well as whether disease severity impacted pregnancy outcomes. Methods: We conducted a retrospective cohort study of pregnant women with COVID-19 who were admitted to two public hospitals in our state between April-August, 2020. Pregnancy outcomes and clinical, laboratory, and placental data were collected. Results: Thirty-four pregnant women tested positive for SARS-CoV-2. Among them, 55% (19/34) were symptomatic. Of those who were symptomatic, 68% (13/19) presented with fever and cough. Those with symptoms had a statistically significant higher pregestational mean BMI compared with asymptomatic women (35.7±7.9 vs 26.7±6.9, P=0.004). Screening of biochemical records demonstrated that symptomatic women had lower potassium levels compared with those who were asymptomatic (median: 3.70 mEq/L vs 4.30 mEq/L, P=0.009). High BMI (42.4 kg/m2) and low potassium levels (3.0 mEq/L) were observed in the only case of postpartum mortality among the symptomatic women. We did not observe any influence of maternal COVID-19 severity on placental histopathology/infant health or evidence of vertical transmission, regardless of preterm status or duration of fetal exposure. Conclusion: High pregestational BMI and lower potassium levels were associated with the presence of COVID-19 symptoms among pregnant women.

scholarly journals The impact of levothyroxine exposure on delivery outcome in hypothyroid pregnant women (PETAL study): A five-year retrospective cohort study

2021 ◽  
pp. 1753495X2110641
Author(s):  
Diana Oprea ◽  
Nadine Sauvé ◽  
Jean-Charles Pasquier
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Singleton Pregnancy ◽  
Delivery Outcome ◽  
The Impact

Background Hypothyroidism affects 3% of pregnant women, and to date, no studies have addressed the impact levothyroxine-treated hypothyroidism on delivery outcome. Methods This retrospective cohort study was conducted among 750 women with a singleton pregnancy who gave birth between 2015 and 2019. Delivery modes were compared between 250 hypothyroid women exposed to levothyroxine and 500 euthyroid control women. The aim of this study was to determine the impact of levothyroxine exposure on delivery outcome. Results Multiple logistic regression showed no significant association between exposure to levothyroxine and the overall rate of caesarean delivery (aOR 1.1; 95% CI 0.8 to 1.6). Mean TSH concentrations were significantly higher throughout the pregnancy in hypothyroid women despite levothyroxine treatment. Maternal and neonatal outcomes in both groups were not different. Conclusion Hypothyroidism treated with levothyroxine during pregnancy according to local guidelines is not a significant risk factor for caesarean delivery.

Pregnancy outcome following bacteriuria in pregnancy and the significance of nitrites in urinalysis – a retrospective cohort study

2019 ◽  
Vol 47 (6) ◽  
pp. 611-618
Author(s):  
Eviatar Naamany ◽  
Irit Ayalon-Dangur ◽  
Eran Hadar ◽  
Iftach Sagy ◽  
Dafna Yahav ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Urine Culture ◽  
Premature Delivery ◽  
Positive Urine Culture ◽  
Positive Urine ◽  
Adverse Pregnancy

Abstract Background The association between bacteriuria and adverse pregnancy outcomes has been extensively described. The current practice of screening all pregnant women for bacteriuria is challenged by recent studies. We aimed to evaluate pregnancy outcomes among women with a positive urine culture, to assess the significance of positive urinary nitrites in this setting. Methods This was a retrospective cohort study at the emergency department (ED) of the Helen Schneider Hospital for Women, Israel, during 2014–2018. This included all gravida women >18 years old within the 20th week of pregnancy or above, admitted to the ED with diverse complains, who had urinalysis collected and subsequently had a positive urine culture. Clinical and obstetric characteristics were stratified by positive vs. negative nitrites in urinalysis. The primary outcome was premature delivery, and the secondary outcomes were a composite outcome of all recorded pregnancy complications and the significance of urinalysis in predicting urinary tract infection (UTI). Results Overall, 874 pregnant women with a positive urine culture were included. Of them, 721 (79%) patients had a negative nitrite in their urine exam (NNU-group) and 153 (21%) had a positive nitrite in their urine exam (PNU-group). Escherichia coli was the most common pathogen, with significantly higher rates of growth in the PNU-group vs. NNU-group [129 (84.3%) vs. 227 (38.4%), P < 0.001]. Premature delivery was recorded with no association of symptomaticity or nitrite status. Among symptomatic women with classic symptoms of UTI, PNU was significantly associated with decreased risk for major peripartum complications [odds ratio (OR) with 95% confidence interval (CI) of 0.22 (0.05–0.94)]. Conclusion Our findings support that PNU among symptomatic pregnant women with UTI-related symptoms was associated with lower risk of developing major adverse obstetrical outcomes.

scholarly journals Impact of treatment for bacterial vaginosis on prematurity among Brazilian pregnant women: a retrospective cohort study

2005 ◽  
Vol 123 (3) ◽  
pp. 108-112 ◽  
Author(s):  
Rodrigo Pauperio Soares de Camargo ◽  
José Antonio Simões ◽  
José Guilherme Cecatti ◽  
Valéria Moraes Nader Alves ◽  
Sebastian Faro
Keyword(s):  
Cohort Study ◽  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Low Risk ◽  
Perinatal Complications ◽  
Prenatal Care Visit ◽  
History Of ◽  
The Impact

CONTEXT AND OBJECTIVE: Bacterial vaginosis has been associated with prematurity and other perinatal complications. However, the efficacy of the treatment for preventing such complications has not yet been well established. The objective of this study was to evaluate the impact of treatment for bacterial vaginosis on a low-risk population of Brazilian pregnant women, in order to prevent prematurity and other perinatal complications. DESIGN AND SETTING: Observational retrospective cohort study, at the Obstetric and Gynecology Department, Universidade Estadual de Campinas (Unicamp). METHODS: Vaginal bacterioscopy results from 785 low-risk pregnant women were studied. Three different groups of women were identified: 580 without bacterial vaginosis during pregnancy, 134 with bacterial vaginosis treated using imidazoles (metronidazole, tinidazole, or secnidazole) during pregnancy, and 71 with bacterial vaginosis not treated during pregnancy. The diagnosis of bacterial vaginosis was based on Nugent's criteria, from the vaginal bacterioscopy performed during the first prenatal care visit. RESULTS: The frequency of prematurity was 5.5% among the women without bacterial vaginosis, 22.5% among those with untreated bacterial vaginosis and 3.7% among those with treated bacterial vaginosis. The risk ratios for perinatal complications were significantly higher in the group with untreated bacterial vaginosis: premature rupture of membranes, 7.5 (95% CI: 1.9-34.9); preterm labor, 3.4 (95% CI: 1.4-8.1); preterm birth, 6.0 (95% CI: 1.9-19.7); and low birth weight, 4.2 (95% CI: 1.2-14.3). CONCLUSION: The treatment of bacterial vaginosis significantly reduced the rates of prematurity and other perinatal complications among these low-risk Brazilian pregnant women, regardless of the history of previous preterm delivery.

scholarly journals Pregnancy outcomes with Primary Sjogren's syndrome among Chinese women: a retrospective cohort study

2019 ◽  
Author(s):  
Jinfeng Xu ◽  
Daijuan Chen ◽  
Yuan Tian ◽  
Bing Peng
Keyword(s):  
Logistic Regression ◽  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort ◽  
Primary Sjögren’S Syndrome ◽  
Odds Ratios ◽  
Primary Sjogren’S Syndrome ◽  
Adverse Pregnancy

Abstract Background Data on pregnancy outcomes in Primary Sjogren's syndrome (pSS) women are scarce, and results have been conflicting. The aim of our study is to analyze the adverse pregnancy outcome in patients with pSS. Methods This was a retrospective cohort study conducted at a tertiary medical center located in Chengdu, Sichuan, China, from May 2013 to November 2018. The relevant medical records of all pregnant women were retrospectively reviewed. Logistic regression analyses were performed to compute crude odds ratios (crude OR) with 95% confidence intervals (CI) for maternal and fetal outcomes. Adjusted odds ratios (aOR) were estimated by logistic regression adjusted for confounders. Results Women with pSS had a significantly higher incidence of pre-eclampsia (aOR 11.49, 95% CI 1.65-79.98), PPROM (aOR 5.09, 95% CI 1.14-22.63). Compared to general population, pregnant women with pSS were at increased risks of fetal loss (aOR 15.06, 95%CI 1.19 to 191.11), and a higher risk of fetal growth restriction (aOR 15.69, 95%CI 1.61 to 153.33), preterm birth (aOR 5.52, 95%CI 1.83 to 16.65), a cesarean section (aOR 6.53, 95%CI 3.18 to 13.42) and a neonatal intensive care unit admission (aOR 12.86, 95%CI 1.88 to 87.82) after adjusting for confounding factors. The rate of congenital heart block in the pSS group was 4.7%. Conclusions Pregnant women with pSS were at increased risk of having adverse pregnancy outcomes. Women with pSS require prenatal counseling to explain the risks involved and well control of pSS condition before conception and a close antenatal monitoring should be performed by both rheumatologists and obstetricians.

scholarly journals Samba II PCR testing for COVID-19 in pregnant women: a retrospective cohort study and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruiling Xu ◽  
Tara Alicia Pauley ◽  
Hannah Missfelder-Lobos ◽  
Richard John Haddon ◽  
Ravindra Kumar Gupta ◽  
...  
Keyword(s):  
Cohort Study ◽  
Literature Review ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Turnaround Time ◽  
Maternity Unit ◽  
Asymptomatic Carriage ◽  
Positive Rate ◽  
The Impact

Abstract Background Asymptomatic carriage of COVID-19 in pregnant women has been reported and could lead to outbreaks in maternity units. We sought to ascertain the impact of rapid isothernal nucleic acid based testing for COVID-19 in an unselected cohort of pregnant women attending our maternity unit. We also assessed the correlation between community prevalence and asymptomatic carriage. Methods Data for the retrospective cohort study were collected from a large UK tertiary maternity unit over a 4-week period using computerised hospital records. Literature searches were performed across multiple repositories. COVID-19 prevalence was extracted from online repositories. Results Nasopharyngeal and oropharyngeal swabs were obtained from 457/465 (98%) women during the study period. The median turnaround time for results was 5.3 h (interquartile range (IQR) 2.6–8.9 h), with 92% of the results returned within 24 h. In our cohort, only one woman tested positive, giving a screen positive rate of 0.22% (1/457; 95% CI: 0.04–1.23%). One woman who tested negative developed a fever postnatally following discharge but was lost to follow-up. From our literature review, we did not find any correlation between asymptomatic carriage in pregnant women and the reported regional prevalence of COVID-19. Conclusions Testing using the SAMBA-II machine was acceptable to the vast majority of pregnant women requiring admission and had a low turnaround time. Asymptomatic carriage is low, but not correlated to community prevalence rates. Screening pregnant women on admission will remain an important component in order to minimise nosocomial infection.

scholarly journals A retrospective cohort study of risk factors and pregnancy outcomes in 14,014 Chinese pregnant women

Medicine ◽  
2018 ◽  
Vol 97 (33) ◽  
pp. e11748 ◽  
Author(s):  
Yuan-Yuan Yang ◽  
Yi-Hua Fang ◽  
Xue Wang ◽  
Ying Zhang ◽  
Xiao-Jun Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Pregnancy Outcomes ◽  
Retrospective Cohort

scholarly journals Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection During Pregnancy In China: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Ming-Zhu Yin ◽  
Li-juan Zhang ◽  
Guang-Tong Deng ◽  
Chao-Fei Han ◽  
Min-Xue Shen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Clinical Symptoms ◽  
Prognostic Index ◽  
Anal Swab ◽  
Novel Coronavirus

SummaryBackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been identified as the cause of the ongoing worldwide epidemic of Coronavirus Disease 2019 (COVID-19) in China and worldwide. However, there were few studies about the effects of SARS-CoV-2 infection on pregnant women.MethodsIn this retrospective cohort study, we enrolled 31 pregnant women and 35 non-pregnant women from Jan 28 to Feb 28, 2020 to evaluate the effects of SARS-CoV-2 infection during pregnancy. Inflammatory indices were used to assess the severity of COVID-19. Evidence of vertical transmission was determined by laboratory confirmation of SARS-CoV-2 in amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples.FindingsCompared with non-pregnant women, pregnant women had a significantly lower proportion of fever (54·8% vs. 87·5%, p= 0.006), a shorter average interval from onset to hospitalization (7·80 ±7·0d vs. 13·2 ± 8·2d, p= 0.005), and a higher proportion of severe or critical COVID-19 (32·3% vs. 11·4%, p=0.039). Neutrophil-to-lymphocyte ratio (NLR) and systematic immune-inflammation-based prognostic index (SII) were significantly higher on admission in severe/critical pneumonia group than moderate pneumonia group. We could not detect the presence of SARS-CoV-2 by RT-PCR in amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples.InterpretationThe clinical symptoms of COVID-19 in pregnant women were insidious and atypical, compared with those in non-pregnant patients. SII and NLR could be a useful marker to evaluate the severity of COVID-19. There was no evidence of vertical transmission during pregnancy with SARS-CoV-2 infection.FundingNational Natural Science Foundation of China and Research Funds for the Central Universities.Research in contextEvidence before this studyWe searched PubMed, Embase and Web of science for articles published up to March 1st, 2020, using the keywords (“novel coronavirus” OR “2019 novel coronavirus” OR “2019-nCoV” OR COVID-19 OR SARS-CoV-2) AND (pregnancy OR “maternal infection” OR “fetal infection”) AND “Cohort studies”.We identified no published cohort studies on pregnant women with the 2019 novel coronavirus disease (COVID-19) infection.Added value of this studyFor this retrospective cohort study, we reviewed clinical records, laboratory findings, and chest CT scans from 31 pregnant women and 35 non-pregnant women from Jan 28 to Feb 28, 2020 to evaluate the effects of SARS-CoV-2 infection during pregnancy. Inflammatory indices were used to assess the severity of COVID-19. Evidence of vertical transmission was determined by laboratory confirmation of SARS-CoV-2 in amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples. Compared with non-pregnant women, pregnant women had a significantly lower proportion of fever (54·8% vs. 87·5%, p= 0.006), a shorter average interval from onset to hospitalization (7·80 ±7·0d vs. 13·2 ± 8·2d, p= 0.005), and a higher proportion of severe or critical COVID-19 (32·3% vs. 11·4%, p=0.039). Neutrophil-to-lymphocyte ratio (NLR) and systematic immune-inflammation-based prognostic index (SII) were significantly higher on admission in severe/critical pneumonia group than moderate pneumonia group. Amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples were tested for SARS-CoV-2 by RT-PCR and all results were negative.Implications of all the available evidenceThe clinical symptoms of COVID-19 in pregnant women were insidious and atypical, compared with those in non-pregnant patients. SII and NLR could be a useful marker to evaluate the severity of COVID-19. There was no evidence of vertical transmission during pregnancy with SARS-CoV-2 infection.

scholarly journals Incidence and Outcomes of Acute Kidney Injury in Patients Admitted to Hospital With COVID-19: A Retrospective Cohort Study

2021 ◽  
Vol 8 ◽  
pp. 205435812110277
Author(s):  
Tyler Pitre ◽  
Angela (Hong Tian) Dong ◽  
Aaron Jones ◽  
Jessica Kapralik ◽  
Sonya Cui ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Disease Severity ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
Icu Admission

Background: The incidence of acute kidney injury (AKI) in patients with COVID-19 and its association with mortality and disease severity is understudied in the Canadian population. Objective: To determine the incidence of AKI in a cohort of patients with COVID-19 admitted to medicine and intensive care unit (ICU) wards, its association with in-hospital mortality, and disease severity. Our aim was to stratify these outcomes by out-of-hospital AKI and in-hospital AKI. Design: Retrospective cohort study from a registry of patients with COVID-19. Setting: Three community and 3 academic hospitals. Patients: A total of 815 patients admitted to hospital with COVID-19 between March 4, 2020, and April 23, 2021. Measurements: Stage of AKI, ICU admission, mechanical ventilation, and in-hospital mortality. Methods: We classified AKI by comparing highest to lowest recorded serum creatinine in hospital and staged AKI based on the Kidney Disease: Improving Global Outcomes (KDIGO) system. We calculated the unadjusted and adjusted odds ratio for the stage of AKI and the outcomes of ICU admission, mechanical ventilation, and in-hospital mortality. Results: Of the 815 patients registered, 439 (53.9%) developed AKI, 253 (57.6%) presented with AKI, and 186 (42.4%) developed AKI in-hospital. The odds of ICU admission, mechanical ventilation, and death increased as the AKI stage worsened. Stage 3 AKI that occurred during hospitalization increased the odds of death (odds ratio [OR] = 7.87 [4.35, 14.23]). Stage 3 AKI that occurred prior to hospitalization carried an increased odds of death (OR = 5.28 [2.60, 10.73]). Limitations: Observational study with small sample size limits precision of estimates. Lack of nonhospitalized patients with COVID-19 and hospitalized patients without COVID-19 as controls limits causal inferences. Conclusions: Acute kidney injury, whether it occurs prior to or after hospitalization, is associated with a high risk of poor outcomes in patients with COVID-19. Routine assessment of kidney function in patients with COVID-19 may improve risk stratification. Trial registration: The study was not registered on a publicly accessible registry because it did not involve any health care intervention on human participants.

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