scholarly journals Toward Using Twitter Data to Monitor COVID-19 Vaccine Safety in Pregnancy: Proof-of-Concept Study of Cohort Identification (Preprint)

2021 ◽  
Author(s):  
Ari Z Klein ◽  
Karen O'Connor ◽  
Graciela Gonzalez-Hernandez
Keyword(s):  
Language Processing ◽  
Pregnancy Outcomes ◽  
Safety Data ◽  
Vaccine Safety ◽  
Epidemiologic Studies ◽  
Twitter Data ◽  
Increased Risk ◽  
Complementary Resource ◽  
Preliminary Study ◽  
In Pregnancy

BACKGROUND COVID-19 during pregnancy is associated with an increased risk of maternal death, intensive care unit admission, and preterm birth; however, many people who are pregnant refuse to receive COVID-19 vaccination because of a lack of safety data. OBJECTIVE The objective of this preliminary study was to assess whether Twitter data could be used to identify a cohort for epidemiologic studies of COVID-19 vaccination in pregnancy. Specifically, we examined whether it is possible to identify users who have reported (1) that they received COVID-19 vaccination during pregnancy or the periconception period, and (2) their pregnancy outcomes. METHODS We developed regular expressions to search for reports of COVID-19 vaccination in a large collection of tweets posted through the beginning of July 2021 by users who have announced their pregnancy on Twitter. To help determine if users were vaccinated during pregnancy, we drew upon a natural language processing (NLP) tool that estimates the timeframe of the prenatal period. For users who posted tweets with a timestamp indicating they were vaccinated during pregnancy, we drew upon additional NLP tools to help identify tweets that reported their pregnancy outcomes. RESULTS We manually verified the content of tweets detected automatically, identifying 150 users who reported on Twitter that they received at least one dose of COVID-19 vaccination during pregnancy or the periconception period. We manually verified at least one reported outcome for 45 of the 60 (75%) completed pregnancies. CONCLUSIONS Given the limited availability of data on COVID-19 vaccine safety in pregnancy, Twitter can be a complementary resource for potentially increasing the acceptance of COVID-19 vaccination in pregnant populations. The results of this preliminary study justify the development of scalable methods to identify a larger cohort for epidemiologic studies.

scholarly journals Toward Using Twitter Data to Monitor Covid-19 Vaccine Safety in Pregnancy

2021 ◽  
Author(s):  
Ari Z Klein ◽  
Karen O'Connor ◽  
Graciela Gonzalez-Hernandez
Keyword(s):  
Language Processing ◽  
Pregnancy Outcomes ◽  
Safety Data ◽  
Vaccine Safety ◽  
Machine Learning Algorithms ◽  
Increased Risk ◽  
Complementary Resource ◽  
Future Work ◽  
To Receive ◽  
In Pregnancy

Background: Coronavirus Disease 2019 (Covid-19) during pregnancy is associated with an increased risk of maternal death, intensive care unit (ICU) admission, and preterm birth; however, many people who are pregnant refuse to receive Covid-19 vaccination because of a lack of safety data. Objective: The objective of this preliminary study was to assess whether we could identify (1) users who have reported on Twitter that they received Covid-19 vaccination during pregnancy or the periconception period, and (2) reports of their pregnancy outcomes. Methods: We searched for reports of Covid-19 vaccination in a large collection of tweets posted by users who have announced their pregnancy on Twitter. To help determine if users were vaccinated during pregnancy, we drew upon a natural language processing (NLP) tool that estimates the timeframe of the prenatal period. For users who posted tweets with a timestamp indicating they were vaccinated during pregnancy, we drew upon additional NLP tools to help identify tweets that report their pregnancy outcomes. Results: Upon manually verifying the content of tweets detected automatically, we identified 150 users who reported on Twitter that they received at least one dose of Covid-19 vaccination during pregnancy or the periconception period. Among the 60 completed pregnancies, we manually verified at least one reported outcome for 45 (75%) of them. Conclusions: Given the limited availability of data on Covid-19 vaccine safety in pregnancy, Twitter can be a complementary resource for potentially increasing the acceptance of Covid-19 vaccination in pregnant populations. Directions for future work include developing machine learning algorithms to detect a larger number of users for observational studies.

The Spectrum of Adverse Pregnancy Outcomes Based on Kidney Disease Diagnoses: A 20-Year Population Study

2019 ◽  
Vol 49 (5) ◽  
pp. 400-409 ◽  
Author(s):  
Alyssa Fitzpatrick ◽  
Kamalesh Venugopal ◽  
Wendy Scheil ◽  
Stephen P. McDonald ◽  
Shilpanjali Jesudason
Keyword(s):  
Preterm Birth ◽  
Caesarean Section ◽  
Pregnancy Outcomes ◽  
Clinical Care ◽  
Vesicoureteric Reflux ◽  
Population Level ◽  
Diagnostic Code ◽  
Benign Condition ◽  
Increased Risk ◽  
In Pregnancy

Background and Objectives: Kidney disorders in pregnancy may be under-recognized and have variable impact on outcomes depending on diagnosis. Population-level data are limited, particularly for Australia, and comparison of impact of different kidney disorders on pregnancy has rarely been assessed. This study examined the prevalence and outcomes of varied kidney disorders using population-level perinatal data from a large cohort. Methods: Women with singleton pregnancies > 20 weeks’ gestation from the South Australian Pregnancy Outcomes Unit (1990–2012). Women with a kidney disorders diagnostic code were grouped into categories (immunological, cystic/genetic, urological, vesicoureteral reflux (VUR), pyelonephritis and “other”). Key pregnancy outcomes were assessed, with adjustment for demographic variables. Results: Kidney disorders were reported in 1,392 (0.3%) of 407,580 births. These pregnancies had increased risk of pregnancy-induced hypertension (OR 2.16, 95% CI 1.82–2.56), induction of labor (RRR vs. spontaneous birth 2.10, 95% CI 1.87–2.36), all Caesarean section (OR 1.31, 95% CI 1.17–1.47) as well as Caesarean section without labor (RRR 1.82, 95% CI 1.57–2.10), preterm birth (< 37 weeks; 2.76, 95% CI 2.40–3.18), low birth weight (< 2,500 g) infants (OR 2.43, 95% CI 2.07–2.84), and neonatal intensive care admission (OR 2.64, 95% CI 2.12–3.29). Diagnostic subgroups demonstrated differing patterns of adverse outcomes, enabling the development of a matrix of risk. Women with immunological renal conditions and VUR had greatest risk overall, and only women with immunological diseases had increased risk of small-for-gestational age < 10th centile (OR 2.36, 95% CI 1.26–4.42). Women with nonchronic urological conditions and pyelonephritis had increased risk of preterm birth, but not other adverse events. VUR conferred particularly increased risk of Caesarean section and induced labor. Conclusions: In a cohort of > 1,300 women with varied kidney disorders, increased adverse obstetric and perinatal events were observed, and the nature and magnitude of risk differed according to diagnosis. In particular, vesicoureteric reflux is not a benign condition in pregnancy. Women with nonchronic conditions still had increased risk of preterm birth. We confirm that women with kidney disorders warrant vigilant and tailored prepregnancy care and clinical care in pregnancy.

scholarly journals Insulin Glulisine in Pregnancy – Experience from Clinical Trials and Post-marketing Surveillance

2015 ◽  
Vol 11 (1) ◽  
pp. 17 ◽  
Author(s):  
Zoran Doder ◽  
Demi Vanechanos ◽  
Manfred Oster ◽  
Wolfgang Landgraf ◽  
Stephen Lin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Trials ◽  
Congenital Malformations ◽  
Safety Data ◽  
Live Births ◽  
Post Marketing Surveillance ◽  
Increased Risk ◽  
Post Marketing ◽  
Insulin Glulisine ◽  
In Pregnancy

Pregnancies complicated by gestational diabetes or pre-existing type 1 or type 2 diabetes mellitus are associated with a higher rate of adverse outcomes compared with pregnancies in the background population. These outcomes include miscarriage, pre-term delivery, pre-eclampsia, perinatal mortality and congenital malformations. Insulin glulisine (ApidraR, Sanofi) is a rapid-acting insulin analogue indicated for the treatment of adults, adolescents and children 6 years or older with diabetes mellitus where treatment with insulin is required. Here, all post-marketing and clinical trials safety data with insulin glulisine in pregnancy available to Sanofi up to June 2014 are summarised together with the findings of a comprehensive literature search. Cumulatively, a total of 303 pregnancy exposures to insulin glulisine were received. Of these 303 pregnancy exposures, there were 116 live births, 12 spontaneous abortions, two late foetal intra-uterine deaths (>28 weeks), three elective abortions and 170 cases without a known pregnancy outcome. There were six cases of congenital malformations; of these, there were five live births; in the other case a live birth was not confirmed. The congenital malformations reported to date do not reveal a pattern of defects. In conclusion, the evidence to date does not suggest a causal association between insulin glulisine and an increased risk of pregnancy complications or congenital malformations.

scholarly journals Ondansetron and pregnancy: Understanding the data

2015 ◽  
Vol 9 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Debra Kennedy
Keyword(s):  
Birth Defects ◽  
Pregnancy Outcomes ◽  
Safety Data ◽  
First Trimester ◽  
Common Condition ◽  
Off Label ◽  
Increased Risk ◽  
Practical Guidelines ◽  
Potential Risks ◽  
Adverse Pregnancy

Nausea and vomiting of pregnancy (NVP) is a common condition affecting 75% of pregnant women. NVP generally commences early in the first trimester, peaking in severity between 7 and 12 weeks and in over 90% symptoms will have abated by week 20. Thus, the time when women are most likely to have NVP and require treatment coincides with the embryonic period when there is maximum susceptibility to any teratogenic risk. Following the thalidomide tragedy of 55 years ago there is a particular awareness and sensitivity about these potential risks, especially in relation to any medication used to treat NVP. Despite several studies showing no clear benefits of ondansetron over other NVP treatments such as doxylamine, and the paucity of safety data, the off-label prescribing and use of ondansetron to treat NVP has increased significantly worldwide. Albeit based on limited human pregnancy data, ondansetron has not been associated with a significantly increased risk of birth defects or other adverse pregnancy outcomes. This review attempts to highlight some of the difficulties in interpreting the available data and the need to follow practical guidelines regarding treatment of NVP.

Pregnancy outcomes in DMARD-exposed patients with juvenile idiopathic arthritis—results from a JIA biologic registry

Rheumatology ◽  
2019 ◽  
Author(s):  
Paula Drechsel ◽  
Katrin Stüdemann ◽  
Martina Niewerth ◽  
Gerd Horneff ◽  
Rebecca Fischer-Betz ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Observation Study ◽  
Patient Interviews ◽  
Increased Risk ◽  
Patient Reported ◽  
Male Patients ◽  
Adverse Pregnancy ◽  
Reported Data ◽  
Long Term Observation ◽  
In Pregnancy

Abstract Objectives To investigate the courses and outcomes of pregnancies involving JIA patients who were exposed to DMARDs. Methods In the Juvenile arthritis MTX/Biologics long-term Observation study, pregnant patients or male patients with pregnant partners were identified. Standardized patient interviews were conducted, and the course and outcome of pregnancy were assessed. Prospectively collected physician- and patient-reported data were also considered in the analysis. Results The study sample included 152 pregnancies in 98 women with JIA and 39 pregnancies involving 21 male patients as partners. The majority of patients had polyarticular-onset/-course JIA (61%). The average age of patients at first pregnancy was 24.1 (4.5) years, and their mean disease duration was 13.8 (5.9) years. Patients had been exposed to DMARDs for 9.5 (5.6) years, and 90% of these patients had received biologics before. Half of the pregnancies occurred during DMARD exposure, mostly with etanercept. Significant differences in pregnancy outcomes between DMARD-exposed and -unexposed pregnancies were not observed. Spontaneous abortion (13.1%) and congenital anomaly (3.6%) rates were not suggestive of increased risk compared with expected background rates. However, the rates of premature birth (12.3%) and caesarean section (37.7%) were slightly above those in the German birthing population. The disease activity of female patients remained relatively stable in pregnancy, with mean cJADAS-10 scores of 5.3, 7.1 and 5.6 in each trimester, respectively. Conclusion Young adults with JIA often become pregnant or become fathers of children while still being treated with DMARDs. Data suggest no increased risk of major adverse pregnancy outcomes.

scholarly journals Prognosis Associated with Sub-Types of Hyperglycaemia in Pregnancy

2021 ◽  
Vol 10 (17) ◽  
pp. 3904
Author(s):  
Emmanuel Cosson ◽  
Sid Ahmed Bentounes ◽  
Charlotte Nachetergaele ◽  
Narimane Berkane ◽  
Sara Pinto ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Insulin Requirement ◽  
Large For Gestational Age ◽  
Gestational Weight ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
In Pregnancy

We aimed to compare pregnancy outcomes in 4665 women according to the following types of hyperglycaemia in pregnancy sub-types: (i) normoglycaemia, (ii) gestational diabetes mellitus (GDM), (iii) diabetes in pregnancy (DIP), (iv) early-diagnosed (i.e., <22 weeks of gestation) GDM (eGDM), and (v) early-diagnosed DIP (eDIP). The prevalence of normoglycaemia, eGDM, eDIP, GDM, and DIP was 76.4%, 10.8%, 0.6%, 11.7%, and 0.6%, respectively. With regard to pregnancy outcomes, gestational weight gain (11.5 ± 5.5, 9.0 ± 5.4, 8.3 ± 4.7, 10.4 ± 5.3, and 10.1 ± 5.0 kg, p < 0.0001) and insulin requirement (none, 46.0%, 88.5%, 25.5%, and 51.7%; p < 0.001) differed according to the glycaemic sub-types. eGDM and eDIP were associated with higher rates of infant malformation. After adjustment for confounders, with normoglycaemia as the reference, only GDM was associated with large-for-gestational-age infant (odds ratio 1.34 (95% interval confidence 1.01–1.78) and only DIP was associated with hypertensive disorders (OR 3.48 (1.26–9.57)). To conclude, early-diagnosed hyperglycaemia was associated with an increased risk of malformation, suggesting that it was sometimes present at conception. Women with GDM, but not those with eGDM, had an increased risk of having a large-for-gestational-age infant, possibly because those with eGDM were treated early and therefore had less gestational weight gain. Women with DIP might benefit from specific surveillance for hypertensive disorders.

scholarly journals Ulipristal acetate and pregnancy outcome—an observational study

2020 ◽  
Vol 35 (4) ◽  
pp. 751-758
Author(s):  
Jenny Katharina Wagner ◽  
Katarina Dathe ◽  
Christof Schaefer ◽  
Maria Hoeltzenbein
Keyword(s):  
Observational Study ◽  
Pregnancy Outcome ◽  
Birth Defects ◽  
Pregnancy Outcomes ◽  
Conflicts Of Interest ◽  
Termination Of Pregnancy ◽  
Ulipristal Acetate ◽  
Live Births ◽  
Increased Risk ◽  
In Pregnancy

Abstract STUDY QUESTION Is the failure of the selective progesterone receptor modulator ulipristal acetate (UPA) as emergency contraception (EC; 30 mg, single) or inadvertent exposure for myoma treatment (5 mg/d) in pregnancy associated with a higher risk of birth defects, spontaneous abortion (SAB) or elective termination of pregnancy (ETOP)? SUMMARY ANSWER We did not find an increased risk for birth defects, SABs or ETOPs after UPA exposure during implantation and early embryogenesis. WHAT IS KNOWN ALREADY Pregnancy outcome data after exposure to UPA are very limited. In cases of EC failure or unplanned pregnancy during myoma treatment, women need well-grounded risk assessment to minimize anxiety and prevent unjustified termination of pregnancy. STUDY DESIGN, SIZE, DURATION Observational study of prospectively ascertained pregnancies from the German Embryotox institute with UPA exposure (EC, n = 95; myoma, n = 7). Four retrospectively reported pregnancy outcomes were evaluated separately. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 226 requests on ulipristal were directed to the German Embryotox institute during the study period 2010–2018. Outcomes of pregnancies exposed—(i) precycle, (ii) preconceptional or (iii) first trimester—were ascertained using standardized questionnaires. Descriptive statistics were applied. MAIN RESULTS AND THE ROLE OF CHANCE Failed EC with UPA resulted in 95 prospectively ascertained pregnancies, of which 56 had completed follow-up: 37 live births, 7 SABs and 12 ETOPs. There was no major birth defect. Just 34% of women had taken UPA during the fertile window. Seven prospectively enrolled pregnancies were treated for myoma and had known pregnancy outcomes: five healthy live births and two SABs. Among the four retrospectively reported pregnancies after EC, there was one child diagnosed with Beckwith-Wiedemann syndrome (BWS). LIMITATIONS, REASONS FOR CAUTION Our limited sample size does not allow concluding safety of UPA use in pregnancy. WIDER IMPLICATIONS OF THE FINDINGS We provide a preliminary basis for reassuring women who wish to carry their pregnancy to term after EC or myoma treatment with UPA. However, because of the report of a BWS after UPA exposure, a possible epigenetic effect could not be excluded and requires further evaluation. STUDY FUNDING/COMPETING INTEREST(S) This work was performed with financial support from the German Federal Institute for Drugs and Medical Devices (BfArM). All authors declare that they have no conflicts of interest. TRIAL REGISTRATION NUMBER Registered with the German Clinical Trial Register (DRKS00015155).

Pharmacokinetics and Safety of the Integrase Inhibitors Elvitegravir and Dolutegravir in Pregnant Women With HIV

2019 ◽  
Vol 53 (8) ◽  
pp. 833-844 ◽  
Author(s):  
Binh Nguyen ◽  
Michelle M. Foisy ◽  
Christine A. Hughes
Keyword(s):  
Pregnant Women ◽  
English Language ◽  
Data Extraction ◽  
Plasma Concentrations ◽  
Safety Data ◽  
First Trimester ◽  
Pharmacokinetic Data ◽  
Increased Risk ◽  
Women With Hiv ◽  
In Pregnancy

Objective: To synthesize data on the pharmacokinetics and safety of dolutegravir and elvitegravir in pregnant women living with HIV. Data Sources: A PubMed, EMBASE, Web of Science, and Google Scholar literature search (January 2010 to December 2018) was performed using the search terms dolutegravir, elvitegravir, women, pregnant*, and HIV. Additional reports were identified from conference abstracts and review of reference lists. Study Selection and Data Extraction: English-language studies reporting pharmacokinetic and/or safety data in pregnant women receiving dolutegravir or elvitegravir/cobicistat were included. Data Synthesis: A total of 17 studies were selected. Studies demonstrated a modest decrease in dolutegravir concentrations in pregnancy. Preliminary data suggest an increased risk of neural tube defects when dolutegravir is used at the time of conception. Available pharmacokinetic data in pregnant women showed significantly reduced plasma concentrations of elvitegravir/cobicistat which may increase the risk of virological failure. Current guidelines recommend that dolutegravir should not be initiated in women who have the potential to become pregnant or women in their first trimester of pregnancy and elvitegravir/cobicistat should be avoided during pregnancy. Relevance to Patient Care and Clinical Practice: This review highlights pharmacokinetic and safety data for dolutegravir and elvitegravir/cobicistat in pregnant women. Clinicians need to be aware of these data to convey the risks and benefits of using these agents in women of child-bearing potential. Conclusions: Changes in guideline recommendations reflect emerging data regarding the use of dolutegravir and elvitegravir/cobicistat in pregnancy. Until further information is available, raltegravir or other first-line agents are recommended for women with HIV planning to become pregnant.

Sign in / Sign up

Export Citation Format

Share Document