scholarly journals Coronavirus Disease 2019 Vaccination during Pregnancy

2021 ◽  
Vol 25 (4) ◽  
pp. 231-238
Author(s):  
Seong Hyeon Lee ◽  
Ki Hoon Ahn
Keyword(s):  
Pregnant Women ◽  
Viral Vector ◽  
Absolute Risk ◽  
Academic Community ◽  
Efficacy And Safety ◽  
Female Reproduction ◽  
Mortality And Morbidity ◽  
Messenger Ribonucleic Acid ◽  
Vaccination Recommendations ◽  
Safety Studies

Several vaccines have been developed to combat the coronavirus disease 2019 (COVID-19), including messenger Ribonucleic acid (mRNA, Pfizer-BioNtech, and Moderna) and viral vector (AstraZeneca and Janssen) types. Unfortunately, reports of COVID-19 exposure during pregnancy are scarce, as pregnancy and breastfeeding were among the exclusion criteria in the efficacy and safety studies of major COVID-19 vaccines. The U.S. Centers for Disease Control and Prevention recently included pregnancy as a risk factor for severe COVID-19 infection, although the absolute risk is low. Previous experience in pregnant women with mRNA vaccines is lacking despite such vaccines not using live viruses, being unable to cause disease, not interacting with an individual's DNA, and being unable to cause genetic mutations. In addition, previous studies in animals have not revealed any safety issues with such vaccine types for female reproduction or fetal development. Vaccine-induced antibody titers were equivalent in pregnant and lactating women versus non-pregnant women. Given the data on increased mortality and morbidity associated with COVID-19 during pregnancy, it may be unethical to withhold vaccinations based on a theoretical risk and a lack of clinical research in this population. Additionally, a careful review of the vaccination recommendations for pregnant women by the academic community and government through additional efficacy and safety studies tailored to the situation in Korea is needed.

scholarly journals Vaccines against SARS CoV 2 and the vaccination campaign in Italy

2021 ◽  
Vol 24 (2) ◽  
pp. 137
Author(s):  
Ponziani, M.C.
Keyword(s):  
Viral Genome ◽  
Viral Vector ◽  
Vaccination Campaign ◽  
Spike Protein ◽  
Effective Vaccine ◽  
Efficacy And Safety ◽  
Thrombotic Risk ◽  
Safety Studies ◽  
Key Words Vaccination ◽  
Number Of Individuals

The SARS COV 2 pandemic has created an unprecedented need to manufacture and distribute a safe and effective vaccine to immunize an exceptionally large number of individuals planning diversified vaccination approaches quickly. A few weeks have passed since the sequencing of the viral genome for the design of the first vaccines and a few months for the implementation of the efficacy and safety studies. The article analyzes the types of vaccines available by examining their characteristics, efficacy and safety, also examining some debated issues such as the thrombotic risk of viral vector vaccines. The second part deals with the issue of the vaccination campaign in our country. KEY WORDS vaccination; COVID-19; spike protein; efficacy; safety.

scholarly journals Multidisciplinary Unit Improves Pregnancy Outcomes in Women with Rheumatic Diseases and Hereditary Thrombophilias: An Observational Study

2021 ◽  
Vol 10 (7) ◽  
pp. 1487
Author(s):  
Isabel Añón-Oñate ◽  
Rafael Cáliz-Cáliz ◽  
Carmen Rosa-Garrido ◽  
María José Pérez-Galán ◽  
Susana Quirosa-Flores ◽  
...  
Keyword(s):  
High Risk ◽  
Observational Study ◽  
Medical Care ◽  
Pregnant Women ◽  
Rheumatic Diseases ◽  
Absolute Risk ◽  
University Hospital ◽  
Obstetric Outcomes ◽  
Number Needed To Treat ◽  
Foetal Death

Rheumatic diseases (RD) and hereditary thrombophilias (HT) can be associated with high-risk pregnancies. This study describes obstetric outcomes after receiving medical care at a multidisciplinary consultation (MC) and compares adverse neonatal outcomes (ANOs) before and after medical care at an MC. This study is a retrospective observational study among pregnant women with RD and HT treated at an MC of a university hospital (southern Spain) from 2012 to 2018. Absolute risk reduction (ARR) and number needed to treat (NNT) were calculated. A total of 198 pregnancies were registered in 143 women (112 with RD, 31 with HT), with 191 (96.5%) pregnancies without ANOs and seven (3.5%) pregnancies with some ANOs (five miscarriages and two foetal deaths). Results previous to the MC showed 60.8% of women had more than one miscarriage, with 4.2% experiencing foetal death. MC reduced the ANO rate by AAR = 60.1% (95%CI: 51.6−68.7%). The NNT to avoid one miscarriage was 1.74 (95%CI: 1.5–2.1) and to avoid one foetal death NNT = 35.75 (95CI%: 15.2–90.9). A total of 84.8% of newborns and 93.2% of women did not experience any complication. As a conclusion, the follow-up of RD or HT pregnant women in the MC drastically reduced the risk of ANOs in this population with a previous high risk.

scholarly journals Pharmacogenetics in drug development

2005 ◽  
Vol 360 (1460) ◽  
pp. 1579-1588 ◽  
Author(s):  
Alun D McCarthy ◽  
James L Kennedy ◽  
Lefkos T Middleton
Keyword(s):  
Pharmaceutical Companies ◽  
Efficacy And Safety ◽  
Plasma Drug ◽  
Dose Selection ◽  
Drug Discovery And Development ◽  
Safety Issues ◽  
Drug Choice ◽  
Probability Of Success ◽  
Safety Studies ◽  
Appropriate Therapy

Over the last two decades, identification of polymorphisms that influence human diseases has begun to have an impact on the provision of medical care. The promise of genetics lies in its ability to provide insights into an individual's susceptibility to disease, the likely nature of the disease and the most appropriate therapy. For much of its history, pharmacogenetics (PGx—the use of genetic information to impact drug choice) has been limited to comparatively simple phenotypes such as plasma drug levels. Progress in genetics technologies has broadened the scope of PGx efficacy and safety studies that can be implemented, impacting on a broad spectrum of drug discovery and development activities. Recent PGx data show the ability of this approach to generate information that can be applied to dose selection, efficacy determination and safety issues. This in turn will lead to significant opportunities to affect both the approach to clinical development and the probability of success—the latter being an important aspect for pharmaceutical companies and for the patients who will benefit from these new medicines.

Apixaban and Dalteparin for the Treatment of Venous Thromboembolism in Patients with Different Sites of Cancer

2021 ◽  
Author(s):  
Giancarlo Agnelli ◽  
Andrés Muñoz ◽  
Laura Franco ◽  
Isabelle Mahé ◽  
Benjamin Brenner ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Major Bleeding ◽  
Gastrointestinal Cancer ◽  
Absolute Risk ◽  
Gynecological Cancer ◽  
Risk Difference ◽  
Efficacy And Safety ◽  
Patients With Cancer ◽  
Genitourinary Cancer ◽  
Spectrum Of Patients

AbstractEfficacy and safety of anticoagulant treatment for venous thromboembolism (VTE) may vary in patients with different cancer sites. We evaluated the rates of VTE recurrence and major bleeding and the relative efficacy and safety of 6-month treatment with oral apixaban or subcutaneous dalteparin in patients with different cancer sites randomized in the Caravaggio study. Primary cancer was located at gastrointestinal sites in 375 patients (32.5%), lung in 200 (17.3%), breast in 155 (13.4%), genitourinary sites in 139 (12%), gynecological sites in 119 (10.3%), and was hematological in 85 patients (7.4%). Rates of VTE recurrence were 10.9% in patients with gynecological, 8.8% with gastrointestinal, 6.5% with genitourinary, and 5.5% with lung cancer with lower rates in the other sites of cancer. Rates of major bleeding were 7.2% in patients with genitourinary and 4.8% with gastrointestinal cancer, with lower rates in patients with other sites of cancer. The observed absolute risk difference in VTE recurrence in favor of apixaban was 11.9% in patients with gynecological, 5.5% with lung, 3.7% with genitourinary cancer, and 0.6% with gastrointestinal cancer. None of the risk differences was statistically significant. The rates of major bleeding in patients treated with apixaban or dalteparin was similar across patients with different cancer sites. In conclusion, recurrences appear to be more common in patients with gastrointestinal and gynecological cancer and major bleedings in patients with genitourinary and gastrointestinal cancer. Oral apixaban is a valid oral alternative to subcutaneous dalteparin for the treatment of a large spectrum of patients with cancer-associated VTE.

scholarly journals Coping Strategies and Health-Related Quality of Life in Pregnant Women with SARS-CoV-2 Infection

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1113
Author(s):  
Madalina Timircan ◽  
Felix Bratosin ◽  
Iulia Vidican ◽  
Oana Suciu ◽  
Mirela Turaiche ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pregnant Women ◽  
Rural Areas ◽  
Short Form ◽  
Depression Scale ◽  
Morbidity Rate ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Physical Burden

Background and Objectives: As maternal deaths associated with the SARS-CoV-2 infection remain at several times greater than the general population, significant factors that might contribute to the higher mortality and morbidity rate are the psychological impact of the disease and pregnancy itself. Therefore, the current study’s main objective was to assess how pregnant women react and cope with the stress of COVID-19 disease and how it influences their overall health and quality of life in healthcare facilities. Materials and Methods: In this cross-sectional study, we included 304 pregnant women who successfully completed standardized forms to assess our topics of interest, comprising of the Hospital Anxiety and Depression Scale, the Short Form Health Survey-12, the Coping Orientation to Problems Experienced Inventory scale, the CORE-Outcome Measure Questionnaire, and the Quality from the Patient’s Perspective questionnaire. Results: Unemployed, pregnant women living in poverty in the rural areas had higher SARS-CoV-2 infection rates during pregnancy. They faced higher anxiety levels and depression rates, with associated increased physical burden and exhaustion. However, these findings are not influenced by hospital care since it remained unchanged among COVID-19 and non-COVID-19 maternity units, excepting significantly lower technical competence scores of COVID-19 facilities. Conclusions: As the pandemic’s consequences emerge and additional outbreaks occur, care must prioritize the additional physical burden experienced by pregnant women who have contracted COVID-19, as well as psychological, emotional, and mental health support.

scholarly journals Pediatricians adherence to immunoprophylaxis of infectious diseases: current state of the problem

2020 ◽  
Vol 3 (4) ◽  
pp. 290-294
Author(s):  
A.A. Girina ◽  
◽  
F.I. Petrovski ◽  
A.L. Zaplatnikov ◽  
◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Pregnant Women ◽  
Vaccination Coverage ◽  
Professional Education ◽  
Continuing Professional Education ◽  
World Health ◽  
Professional Activity ◽  
Efficacy And Safety ◽  
Adherence Level ◽  
Current State

In 2019, the World Health Organization (WHO) for the first time included refusal of vaccination in the list of ten global threats to humanity, since a decrease in vaccination coverage can trigger breakouts of many preventable infectious diseases. Aim: to clarify the causes for insufficient doctors’ adherence to immunoprophylaxis of infectious diseases and to develop measures for eliminating these causes. Patients and Methods: an open pilot online survey of 175 pediatricians working in medical institutions of the Khanty-Mansiysk Autonomous Okrug–Yugra (KMAO-Yugra) was conducted. The questionnaire contained 14 questions about the respondents’ attitude to various aspects of vaccinal prevention, as well as the level of respondent training on this topic. At the same time, a point scale was used to evaluate the provisions offered to the respondent for analysis (the minimum score is 0 points, the maximum score is 5 points). Results: 71–76% of respondents were convinced of the vaccination efficacy and safety. The main reasons for the lack of adherence to immunoprophylaxis of infectious diseases among the surveyed pediatricians were the insufficient level of knowledge due to the lack of continuous medical education on vaccinal prevention during the entire period of professional activity (25% of hospital-based physicians, 20% of doctors of educational institutions, 16% of health officials and 9% of general practitioners) and the use of information obtained from unofficial sources presented in the global Internet (25% of respondents). The study found that 13% of the physicians surveyed were not familiar with the recommendations for vaccination of pregnant women against influenza, and 24% were not informed about the possibilities, efficacy and safety of pregnant women vaccination against pertussis. Methods to increase the pediatricians’ adherence level to vaccination are outlined, the key among which is mandatory periodic professional development in immunoprophylaxis of infectious diseases in the system of continuing professional education. Conclusion: almost every fifth pediatrician of the KMAO-Yugra surveyed has an insufficient adherence level to immunoprophylaxis of infectious diseases. The article outlines the methods to increase the pediatricians’ adherence level to vaccination. KEYWORDS: vaccination, pediatrician, immunoprophylaxis, continuing professional education, vaccination coverage, continuing education, adherence to vaccination. FOR CITATION: Girina A.A., Petrovski F.I., Zaplatnikov A.L. Pediatricians adherence to immunoprophylaxis of infectious diseases: current state of the problem. Russian Journal of Woman and Child Health. 2020;3(4):290–294. DOI: 10.32364/2618-8430-2020-3-4-290-294.

Assessment of Prevalence of Hypertension in pregnant women with its Complications: A Cross Sectional Study

2021 ◽  
pp. 3805-3808
Author(s):  
Hemalatha S. ◽  
S. M. Shaheedha ◽  
Ramakrishna Borra
Keyword(s):  
Pregnant Women ◽  
Cross Sectional Study ◽  
World Health ◽  
Chronic Hypertension ◽  
Pregnancy Induced Hypertension ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Gynecology And Obstetrics ◽  
Induced Hypertension ◽  
History Of

Introduction: World Health Organization has reported that pregnancy induced hypertension is one of the main causes for mortality and morbidity in maternal and fetal deaths. About 60% of deaths accounted of eclampsia. Aims and Objectives: To diagnose for hypertension in pregnant women. To evaluate the knowledge of pregnancy induced hypertension among the pregnant women. To investigate the complications reported in Pregnancy induced hypertension (PIH) women, during and after labor. Study area and period: The present study was conducted in Chittoor government hospital, Chittoor, during the period of Jan 2016 and Dec 2017. The information and materials required for the study have been collected from the gynecology and obstetrics departments of the respective hospital. Results: During the study period of Jan 2016 and Dec 2017, about 2234 number of pregnant women have visited the obstetrics and gynecology department. All the 2234 pregnant women were tested for blood pressure. Among which 198 women were found to have hypertension, which may be of early onset PIH or chronic hypertension (HTN). Different variables of the study population like period of gestation [<20 weeks, ≥20 weeks], previous cesarean section if present, previous preterm delivery if present, hypertension in previous pregnancy, history of paternal hypertension, history of abortions if have been, history of any still births, family history of PIH have been noted and reported in table 2. More than 8% of women were found to been falling in <20 weeks of gestational age (GA). Conclusion: The study included 2234 pregnant women, in which 198 women were diagnosed with hypertension. Thus, prior investigation and identification hypertension in pregnant women helps in better management of PIH and to overcome the complications that are reported due to PIH during and after labor. Better knowledge and treatment is required for managing hypertension in maternal women in gynecology and obstetrics department for maternal and fetal care.

SEROPREVALENCE OF HEPATITIS E VIRUS (HEV) INFECTION AMONG PREGNANT WOMEN IN SOUTH INDIA

2021 ◽  
pp. 28-31
Author(s):  
Nivedhitha E ◽  
Selvi R ◽  
Kayalvili KK ◽  
Arul selvan S ◽  
Duraivel M
Keyword(s):  
Drinking Water ◽  
Pregnant Women ◽  
Hepatitis E Virus ◽  
South India ◽  
Educational Status ◽  
Hepatitis E ◽  
Elisa Test ◽  
Public Health Issue ◽  
Water Type ◽  
Mortality And Morbidity

Background: Hepatitis E virus (HEV) infection poses a major public health issue in countries with poor drinking water supply, inadequate rd sanitation and improper disposal of human excretes. It causes fulminant hepatitis in pregnant women during 3 trimester with a high mortality rate of 20-30%. Aim:The aim of the study was to estimate the seroprevalence of HEVinfection among pregnant women in South India. Materials and methods: Atotal of 200 asymptomatic, pregnant women were included in the study was evaluated using a questionnaire form. 5ml of blood samples were collected from them and serum was separated to detect for the presence of HEV-antibodies and HEV-RNA by ELISA test and RT-PCR test respectively. Results: The prevalence of HEV-antibodies was found to be 11.5%. HEV-RNA was not present in any participants. A very high statistical signicance was seen associated with the risk factors such as educational status, source of drinking water, type of toilet system used, and the habit of hand washing after using toilets (P<0.01). Conclusion: Even though the prevalence of HEV among the pregnant women is low, periodic assessment and screening of the pregnant women should be done. Encouraging the public sector to strictly adhere to the personal hygienic measures will denitely have an impact in the maternal as well as perinatal mortality and morbidity

Venous thromboembolism in pregnant and puerperal women in Denmark 1995–2005

2011 ◽  
Vol 106 (08) ◽  
pp. 304-309 ◽  
Author(s):  
Rie Adser Virkus ◽  
Ellen Christine Leth Løkkegaard ◽  
Thomas Bergholt ◽  
Ulla Mogensen ◽  
Jens Langhoff-Roos ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Pregnant Women ◽  
Incidence Rate Ratio ◽  
Absolute Risk ◽  
National Registry ◽  
Postnatal Period ◽  
Western World ◽  
Medical Products ◽  
National Cohort ◽  
The Absolute

SummaryVenous thromboembolism (VTE) is the leading cause of maternal death in the Western world, and the risk increases during pregnancy and puerperal period. It was the objective of the present study to estimate the absolute and the relative risk of VTE at different weeks of gestation and in the postnatal period as compared to non-pregnant women. This was a historical controlled national cohort study. The National Registry of Patients identified relevant diagnoses. These data were linked to The National Registry of Medical Products Statistics for information about current use of oral contraceptives. Danish women 15 to 49 years old during the period January 1995 through December 2005 were included in the study. In total 819,751 pregnant women were identified of whom 727 had a diagnosis of VTE. The absolute risk of VTE per 10,000 pregnancy-years increased from 4.1 (95% CI, 3.2 to 5.2) during week 1–11 up to 59.0 (95% CI: 46.1 to 76.4) in week 40 and decreased in the puerperal period from 60.0 (95% CI:47.2–76.4) during the first week after birth to 2.1 (95% CI:1.1 to 4.2) during week 9–12 after birth. Compared with non-pregnant women, the incidence rate ratio rose from 1.5 (95% CI:1.1 to1.9) in week 1–11, to 21.0 (95%CI16.7 to 27.4) in week 40 and 21.5 (95% CI:16.8 to 27.6) in the first week after delivery, declining to 3.8 (95% CI:2.5 to 5.8) 5–6 weeks after delivery. In conclusion, the risk of VTE increases almost exponentially through pregnancy and reaches maximum just after delivery and is no longer significantly increased six weeks after delivery.

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