Pregnancy outcomes and effects of antiretroviral drugs in HIV-positive pregnant women: a systematic review

2019 ◽  
Vol 14 (3) ◽  
pp. 197-210
Author(s):  
Fatemeh Abdi ◽  
Zainab Alimoradi ◽  
Farzane Alidost
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Antiretroviral Drugs ◽  
Hiv Positive

scholarly journals Pregnancy and Breastfeeding During COVID-19 Pandemic: A Systematic Review of Published Pregnancy Cases

2020 ◽  
Vol 8 ◽  
Author(s):  
Carina Rodrigues ◽  
Inês Baía ◽  
Rosa Domingues ◽  
Henrique Barros
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Web Of Science ◽  
Study Quality ◽  
Neonatal Deaths ◽  
Live Births ◽  
Milk Samples ◽  
The Impact

Background: The COVID-19 pandemic is an emerging concern regarding the potential adverse effects during pregnancy. This study reviews knowledge on the impact of COVID-19 on pregnancy and describes the outcome of published cases of pregnant women diagnosed with COVID-19.Methods: Searches were conducted in PubMed®, Scopus®, Web of Science®, and MedRxiv® up to 26th June 2020, using PRISMA standards, to identify original published studies describing pregnant women at any gestational age diagnosed COVID-19. There were no date or language restrictions on the search. All identified studies were included irrespective of assumptions on study quality.Results: We identified 161 original studies reporting 3,985 cases of pregnant women with COVID-19 (1,007 discharged while pregnant). The 2,059 published cases with pregnancy outcomes resulted in 42 abortions, 21 stillbirths, and 2,015 live births. Preterm birth occurred in 23% of cases. Around 6% of pregnant women required admission to an intensive care unit and 28 died. There were 10 neonatal deaths. From the 163 cases with amniotic fluid, placenta, and/or cord blood analyzed for the SARS-CoV-2 virus, 10 were positive. Sixty-one newborns were positive for SARS-CoV-2. Four breast milk samples from 92 cases showed evidence of SARS-CoV-2.Conclusion: Emerging evidence suggests that vertical transmission is possible, however, there is still a limited number of reported cases with intrapartum samples. Information, counseling and adequate monitoring are essential to prevent and manage adverse effects of SARS-CoV-2 infection during pregnancy.

scholarly journals Effects of Moringa Oleifera Leaves and Honey Supplementation during Pregnancy on Mothers and Newborns: A Review of the Current Evidence

2020 ◽  
Vol 8 (F) ◽  
pp. 208-214
Author(s):  
Veni Hadju ◽  
Muhammad Dassir ◽  
Andi Sadapotto ◽  
Aliyah Putranto ◽  
Geoffrey Marks ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Moringa Oleifera ◽  
Current Evidence ◽  
Maternal Weight ◽  
Health Food ◽  
Negative Effects ◽  
Nutrient Supplementation ◽  
Moringa Oleifera Leaves

BACKGROUND: Malnutrition in pregnant women has been known to bring effects on the mothers’ and infants’ health. Food or nutrient supplementation is now being used to correct the problems. Moringa Oleifera leaves and honey are the two types of natural supplements used by pregnant women. AIM: This systematic review aimed to evaluate the potential effects of Moringa, honey, and both compared to ironfolic acid supplements given to pregnant women on the pregnancy outcomes. METHODS: A systematic review was conducted to evaluate the extent of the benefits of the supplementation of M. Oleifera, honey, or both against pregnant women. There were seven studies which are conducted in Indonesia on this topic. RESULTS: This review shows that M. Oleifera leaves in the form of extract and powder as well as honey could improve maternal weight and hemoglobin, and baby’s birth weight. Moreover, both interventions could reduce stress and protect mothers and their babies from negative effects of oxidative stress. CONCLUSION: Nevertheless, efforts are needed to formulate a recommended dose as adequate supplements for pregnant women.

Renal Outcomes of Pregnant Patients with Immunoglobulin A Nephropathy: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 49 (3) ◽  
pp. 214-224 ◽  
Author(s):  
Fan Wang ◽  
Jian-Da Lu ◽  
Ying Zhu ◽  
Ting-Ting Wang ◽  
Jun Xue
Keyword(s):  
Systematic Review ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Lupus Nephritis ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
Immunoglobulin A ◽  
Immunoglobulin A Nephropathy ◽  
Renal Outcomes

Background: Is the prognosis of immunoglobulin A nephropathy (IgAN) influenced by pregnancy and delivery? The answer to this question still remains to be a controversial topic. Here, we undertook a systematic review and meta-analysis to obtain the overall estimate of potential effect of IgAN and pregnancy on each other. Methods: We systematically searched MEDLINE, EMBASE, Chinese Biological Medicine and Cochrane for cohort and case-control studies; a total of 1,378 articles were reviewed and 9 studies were included in the end. OR and mean difference (MD) were calculated with a random-effects model, kidney events and pregnancy outcomes were analyzed respectively. Results: The key finding of the meta-analysis of 145 renal events in 1,198 participants was that there was no difference in renal outcomes (defined as doubling of serum creatinine (SCr), 50% decline in glomerular filtration rate [GFR] and end-stage kidney disease) of pregnant women compared with non-pregnant women who had IgAN (OR 0.90; 95% CI 0.59–1.37; p = 0.63). Subgroup analysis indicated that there was no significant difference between the 2 groups according to sample size, follow-up year, age, level of SCr and proteinuria at baseline. There was no difference in the change of the eGFR/creatinine clearance rate (mL/min/1.73 m2 per year) in IgAN patients with pregnancy compared with non-pregnancy (MD –0.11 mL/min; 95% CI –0.50–0.27; p = 0.57) as well. Women with IgAN had a higher likelihood of pregnancy outcomes compared with the Chinese general population, while they had a lower risk of preterm delivery, preeclampsia and low birth weight compared with those who had lupus nephritis or diabetic nephropathy. Conclusions: Pregnancy did not accelerate kidney disease deterioration in women with IgAN in stages of chronic kidney disease 1–3. Moreover, patients with IgAN had a relatively low risk of adverse pregnancy events compared with those with lupus nephritis or diabetic nephropathy.

scholarly journals COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases

2020 ◽  
Vol 9 (11) ◽  
pp. 3441
Author(s):  
Ramy Abou Ghayda ◽  
Han Li ◽  
Keum Hwa Lee ◽  
Hee Won Lee ◽  
Sung Hwi Hong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Mode Of Delivery ◽  
Maternal Mortality Ratio ◽  
Case Series ◽  
Neonatal Outcomes ◽  
Treatment Modalities ◽  
Adverse Pregnancy

(1) Background: Until now, several reports about pregnant women with confirmed coronavirus disease 2019 (COVID-19) have been published. However, there are no comprehensive systematic reviews collecting all case series studies on data regarding adverse pregnancy outcomes, especially association with treatment modalities. (2) Objective: We aimed to synthesize the most up-to-date and relevant available evidence on the outcomes of pregnant women with laboratory-confirmed infection with COVID-19. (3) Methods: PubMed, Scopus, MEDLINE, Google scholar, and Embase were explored for studies and papers regarding pregnant women with COVID-19, including obstetrical, perinatal, and neonatal outcomes and complications published from 1 January 2020 to 4 May 2020. Systematic review and search of the published literature was done using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). (4) Results: In total, 11 case series studies comprising 104 pregnant women with COVID-19 were included in our review. Fever (58.6%) and cough (30.7%) were the most common symptoms. Other symptoms included dyspnea (14.4%), chest discomfort (3.9%), sputum production (1.0%), sore throat (2.9%), and nasal obstruction (1.0%). Fifty-two patients (50.0%) eventually demonstrated abnormal chest CT, and of those with ground glass opacity (GGO), 23 (22.1%) were bilateral and 10 (9.6%) were unilateral. The most common treatment for COVID-19 was administration of antibiotics (25.9%) followed by antivirals (17.3%). Cesarean section was the mode of delivery for half of the women (50.0%), although no information was available for 28.8% of the cases. Regarding obstetrical and neonatal outcomes, fetal distress (13.5%), pre-labor rupture of membranes (9.6%), prematurity (8.7%), fetal death (4.8%), and abortion (2.9%) were reported. There are no positive results of neonatal infection by RT-PCR. (5) Conclusions: Although we have found that pregnancy with COVID-19 has significantly higher maternal mortality ratio compared to that of pregnancy without the disease, the evidence is too weak to state that COVID-19 results in poorer maternal outcome due to multiple factors. The number of COVID-19 pregnancy outcomes was not large enough to draw a conclusion and long-term outcomes are yet to be determined as the pandemic is still unfolding. Active and intensive follow-up is needed in order to provide robust data for future studies.

scholarly journals Adverse pregnancy outcomes in women with diabetes-related microvascular disease and risks of disease progression in pregnancy: A systematic review and meta-analysis

PLoS Medicine ◽  
2021 ◽  
Vol 18 (11) ◽  
pp. e1003856
Author(s):  
Sophie Relph ◽  
Trusha Patel ◽  
Louisa Delaney ◽  
Soha Sobhy ◽  
Shakila Thangaratinam
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
Microvascular Disease ◽  
Adverse Pregnancy ◽  
In Pregnancy

Background The rise in the global prevalence of diabetes, particularly among younger people, has led to an increase in the number of pregnant women with preexisting diabetes, many of whom have diabetes-related microvascular complications. We aimed to estimate the magnitude of the risks of adverse pregnancy outcomes or disease progression in this population. Methods and findings We undertook a systematic review and meta-analysis on maternal and perinatal complications in women with type 1 or 2 diabetic microvascular disease and the risk factors for worsening of microvascular disease in pregnancy using a prospective protocol (PROSPERO CRD42017076647). We searched major databases (January 1990 to July 2021) for relevant cohort studies. Study quality was assessed using the Newcastle–Ottawa Scale. We summarized the findings as odds ratios (ORs) with 95% confidence intervals (CIs) using random effects meta-analysis. We included 56 cohort studies involving 12,819 pregnant women with diabetes; 40 from Europe and 9 from North America. Pregnant women with diabetic nephropathy were at greater risk of preeclampsia (OR 10.76, CI 6.43 to 17.99, p < 0.001), early (<34 weeks) (OR 6.90, 95% CI 3.38 to 14.06, p < 0.001) and any preterm birth (OR 4.48, CI 3.40 to 5.92, p < 0.001), and cesarean section (OR 3.04, CI 1.24 to 7.47, p = 0.015); their babies were at increased risk of perinatal death (OR 2.26, CI 1.07 to 4.75, p = 0.032), congenital abnormality (OR 2.71, CI 1.58 to 4.66, p < 0.001), small for gestational age (OR 16.89, CI 7.07 to 40.37, p < 0.001), and admission to neonatal unit (OR 2.59, CI 1.72 to 3.90, p < 0.001) than those without nephropathy. Diabetic retinopathy was associated with any preterm birth (OR 1.67, CI 1.27 to 2.20, p < 0.001) and preeclampsia (OR 2.20, CI 1.57 to 3.10, p < 0.001) but not other complications. The risks of onset or worsening of retinopathy were increased in women who were nulliparous (OR 1.75, 95% CI 1.28 to 2.40, p < 0.001), smokers (OR 2.31, 95% CI 1.25 to 4.27, p = 0.008), with existing proliferative disease (OR 2.12, 95% CI 1.11 to 4.04, p = 0.022), and longer duration of diabetes (weighted mean difference: 4.51 years, 95% CI 2.26 to 6.76, p < 0.001) than those without the risk factors. The main limitations of this analysis are the heterogeneity of definition of retinopathy and nephropathy and the inclusion of women both with type 1 and type 2 diabetes. Conclusions In pregnant women with diabetes, presence of nephropathy and/or retinopathy appear to further increase the risks of maternal complications.

scholarly journals Burden of Asymptomatic Bacteriuria Amongst Nigerian Pregnant Women: A Protocol for Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Daniel N Onwusulu ◽  
Helen Chioma Okoye ◽  
Emmanuel O Nna ◽  
Samuel Onuka ◽  
Amaka Obiageli Nnamani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
Asymptomatic Bacteriuria ◽  
Cochrane Library ◽  
Categorical Variables ◽  
Pooled Prevalence ◽  
Associated Risk Factors

Abstract BackgroundAsymptomatic bacteriuria can be a cause of adverse pregnancy and neonatal outcomes if undetected and untreated. Pregnant women are usually routinely screened with urine cultures at antenatal booking. However, the exact burden of asymptomatic bacteriuria in Nigeria is unknown. Our protocol is aimed at determining the pooled prevalence of asymptomatic bacteriuria amongst Nigerian pregnant women as well as the associated risk factors and pregnancy outcomes.MethodsNine databases: PubMed, African Journal Online, Google Scholar, Cochrane Library, CINAHL, Embase, ResearchGate, Scopus, and Web of Science will be searched using a search strategy that is developed by combinations of MeSH terms, keywords, text words, and entry terms. Only observational studies published or retrievable in the English Language will be included. Studies must be conducted in Nigeria. The primary measurable outcome of this study is the prevalence of asymptomatic bacteriuria in pregnant women. Identified studies will be screened, selected, and deduplicated in DistillerSR. Data items will be extracted into predefined forms in the DistillerSR. Reports including Prisma flow chart, quality scores, risk of bias, and study outcomes will be generated in DistillerSR. Extracted data items will be exported into the Comprehensive Meta-analysis Software version 3 for quantitative analysis. Methodological, clinical, and statistical heterogeneity will be assessed for all the studies. Publication bias will be assessed using Funnel plots. There will be a subgroup analysis of pooled prevalence using categorical variables. The primary outcome will be expressed in pooled prevalence, standard error, variance, and 95% CI of variance. Quantitative risk factors and pregnancy outcomes will be used used for meta-regression. The reporting of the systematic review and meta-analysis will be according to PRISMA 2015 Statement.DiscussionThe pooled prevalence of asymptomatic bacteriuria in Nigeria will be examined in relation to associated risk factors and pregnancy outcomes. The study will be published in a peer-reviewed scientific journal.Trial Registration NumberThis protocol is registered with the Prospective Register of Systematic Reviews (PROSPERO) with registration number CRD42020213810

Hormones in HIV- Pregnant Women

2018 ◽  
Vol 3 (02) ◽  
Author(s):  
Dr. Asha Mishra ◽  
Dr. Madhuri A. Agnihotri ◽  
Dr. Rekha Ratnani
Keyword(s):  
Immune System ◽  
Pregnant Women ◽  
Hormone Level ◽  
Follicle Stimulating Hormone ◽  
Antiretroviral Drugs ◽  
Hiv Positive ◽  
Child Transmission ◽  
Women And Hiv ◽  
Bidirectional Interactions ◽  
Pregnancy Hormones

Background - HIV infected pregnant women are placed on antiretroviral drugs for treatment and to avoid maternal to child transmission of HIV. This effect of HIV infection on pregnancy hormones within 24 weeks of pregnancy compare with normal pregnant women. Aims and Objectives - estimate testosterone, Luteinizing hormone (LH), Follicle-stimulating hormone (FSH) and Prolactin (Prl) in HIV pregnant women compare to normal Healthy pregnant women. Result - The level of hormones in normal pregnant women and HIV positive pregnant women. Hormone level in HIV pregnant women were significantly decreased found compare to normal pregnant women. Conclusion: On the basis of our study we concluded that the hormone levels were significantly decreased found in HIV pregnant women due to hormones are affected by HIV / AIDs. The bidirectional interactions between hormones and the immune system contribute to both the outcome of pregnancy and female susceptibility to disease.

Pregnancy outcomes in women with significant valve disease: a systematic review and meta-analysis

Heart ◽  
2020 ◽  
Vol 106 (7) ◽  
pp. 512-519 ◽  
Author(s):  
Robin Alexandra Ducas ◽  
David A Javier ◽  
Rohan D’Souza ◽  
Candice K Silversides ◽  
Wendy Tsang
Keyword(s):  
Systematic Review ◽  
Heart Disease ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Pulmonary Oedema ◽  
Pregnancy Outcomes ◽  
Neonatal Death ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Fetal Outcomes

ObjectiveTo perform a systematic review and meta-analysis of maternal/fetal outcomes in pregnant women with moderate/severe native valvular heart disease (VHD) from medium/higher Human Development Index (HDI) countries.MethodsOvidSP platform databases were searched (1985-January 2019) to identify studies reporting pregnancy outcomes in women with moderate/severe VHD. The primary maternal outcome was maternal mortality. The primary fetal/neonatal outcome was stillbirth and neonatal death. Pooled incidences and 95% confidence intervals (CI) of maternal/fetal outcomes could only be calculated from studies involving mitral stenosis (MS) or aortic stenosis (AS).ResultsTwelve studies on 646 pregnancies were included. Pregnant women with severe MS had mortality rates of 3% (95% CI, 0% to 6%), pulmonary oedema 37% (23%–51%) and new/recurrent arrhythmias 16% (1%–25%). Their stillbirth, neonatal death and preterm birth rates were 4% (1%–7%), 2% (0%–4%), and 18% (7%–29%), respectively. Women with moderate MS had mortality rates of 1%(0%–2%), pulmonary oedema 18% (2%–33%), new/recurrent arrhythmias 5% (1%–9%), stillbirth 2% (1%–4%) and preterm birth 10%(2%–17%).Pregnant women with severe AS had a risk of mortality of 2% (0%–5%), pulmonary oedema 9% (2%–15%), and new/recurrent arrhythmias 4% (0%–7%). Their stillbirth, neonatal death and preterm birth rates were 2% (0%–5%), 3% (0%–6%) and 14%(4%–24%), respectively. No maternal/neonatal deaths were reported in moderate AS, however women experienced pulmonary oedema (8%; 0%–20%), new/recurrent arrhythmias (2%; 0%–5%), and preterm birth (13%; 6%–20%).ConclusionsWomen with moderate/severe MS and AS are at risk for adverse maternal and fetal/neonatal outcomes. They should receive preconception counseling and pregnancy care by teams with pregnancy and heart disease experience.

A Ten-Year Review of Antenatal Complications and Pregnancy Outcomes Among HIV-Positive Pregnant Women

2016 ◽  
Vol 38 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Mark H. Yudin ◽  
Daniela Caprara ◽  
S. Jay MacGillivray ◽  
Marcelo Urquia ◽  
Rajiv R. Shah
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Hiv Positive
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