Impact of COVID-19 On the Development of Premature Labor

Background: According to the literature described, the perinatal results of maternal viral infections during pregnancy could lead to different obstetric complications; pregnant women have a higher risk of morbidity and mortality due to physiological changes in their immune system and cardiopulmonary system. has associated pneumonia in pregnant women with premature rupture of membranes before labor, preterm labor, fetal growth restriction, fetal death, and neonatal death. Methodology: A narrative review was carried out in which databases such as pubmed, science direct, scielo, academic google, among others, were used to search for articles, these were taken from indexed journals in first and second languages. The keywords DECS and MeSH, COVID-19, SARS-CoV-2, preterm birth and complications were used. Results: It’s no secret that women who are pregnant due to the same condition are at higher risk of severe illness and death from COVID-19 compared to non-pregnant women of reproductive age, and are at risk of adverse pregnancy outcomes, such as preterm delivery. Studies report that most cases of prematurity are secondary to respiratory complications and are done in order to preserve maternal health.

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SARS-CoV-2 in Pregnancy: Fitting Into the Existing Viral Repertoire

Frontiers in Global Women's Health ◽

10.3389/fgwh.2021.647836 ◽

2021 ◽

Vol 2 ◽

Author(s):

Roopali Rajput ◽

Jitender Sharma

Keyword(s):

Immune System ◽

Viral Infection ◽

Pregnant Women ◽

Preterm Labor ◽

Viral Infections ◽

Treatment Options ◽

Adverse Outcomes ◽

Fetal Health ◽

Fetal Protection ◽

In Pregnancy

The risk of viral infection during pregnancy is well-documented; however, the intervention modalities that in practice enable maternal-fetal protection are restricted by limited understanding. This becomes all the more challenging during pandemics. During many different epidemic and pandemic viral outbreaks, worse outcomes (fetal abnormalities, mortality, preterm labor, etc.) seem to affect pregnant women than what has been evident when compared to non-pregnant women. The condition of pregnancy, which is widely understood as “immunosuppressed,” needs to be re-understood in terms of the way the immune system works during such a state. The immune system gets transformed to accommodate and facilitate fetal growth. The interference of such supportive conversion by viral infection and the risk of co-infection lead to adverse fetal outcomes. Hence, it is crucial to understand the risk and impact of potent viral infections likely to be encountered during pregnancy. In the present article, we review the effects imposed by previously established and recently emerging/re-emerging viral infections on maternal and fetal health. Such understanding is important in devising strategies for better preparedness and knowing the treatment options available to mitigate the relevant adverse outcomes.

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Lactobacillus iners Is Associated with Vaginal Dysbiosis in Healthy Pregnant Women: A Preliminary Study

BioMed Research International ◽

10.1155/2019/6079734 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9

Author(s):

Nengneng Zheng ◽

Renyong Guo ◽

Yinyu Yao ◽

Meiyuan Jin ◽

Yiwen Cheng ◽

...

Keyword(s):

Pregnant Women ◽

Vaginal Microbiota ◽

Second Trimester ◽

Premature Rupture Of Membranes ◽

Third Trimester ◽

Premature Rupture ◽

Significant Difference ◽

Bacterial Marker ◽

Preliminary Study ◽

Adverse Pregnancy

Vaginal dysbiosis has been identified to be associated with adverse pregnancy outcomes, such as preterm delivery and premature rupture of membranes. However, the overall structure and composition of vaginal microbiota in different trimesters of the pregnant women has not been fully elucidated. In this study, the physiological changes of the vaginal microbiota in healthy pregnant women were investigated. A total of 83 healthy pregnant participants were enrolled, who are in the first, second, or third pregnancy trimester. Quantitative real-time PCR was used to explore the abundant bacteria in the vaginal microbiota. No significant difference in the abundance of Gardnerella, Atopobium, Megasphaera, Eggerthella, Leptotrichia/Sneathia, or Prevotella was found among different trimesters, except Lactobacillus. Compared with the first pregnancy trimester, the abundance of L. iners decreased in the second and third trimester while the abundance of L. crispatus was increased in the second trimester. Moreover, we also found that vaginal cleanliness is correlated with the present of Lactobacillus, Atopobium, and Prevotella and leukocyte esterase is associated with Lactobacillus, Atopobium, Gardnerella, Eggerthella, Leptotrichia/Sneathia, and Prevotella. For those whose vaginal cleanliness raised or leukocyte esterase became positive, the richness of L. iners increased, while that of L. crispatus decreased significantly. Our present data indicated that the altered vaginal microbiota, mainly Lactobacillus, could be observed among different trimesters of pregnancy and L. iners could be considered as a potential bacterial marker for evaluating vaginal cleanliness and leukocyte esterase.

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Impact of COVID-19 on the placental pathology of pregnant women and their infants: A systematic review protocol

10.31219/osf.io/3f8j7 ◽

2020 ◽

Author(s):

Irina Oltean ◽

Dina El Demellawy

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Clinical Outcomes ◽

Viral Infections ◽

Case Reports ◽

Case Series ◽

Cell Mediated Immunity ◽

Case Control Studies ◽

Antibody Testing ◽

Adverse Pregnancy

Pregnant women are susceptible to viral infections due to physiological changes such as cell-mediated immunity. No severe adverse pregnancy or neonatal outcomes have been consistently reported in COVID-19 positive pregnancy cases. There are controversies around the role of COVID-19 in pregnancy. A systematic review was conducted to examine clinical maternal and neonatal clinical outcomes. Studies were included if they reported COVID-19 infection among pregnant women and/or COVID-19 positive neonates as validated by positive antibody testing or viral testing using Polymerase Chain Reaction. Case series, case reports, case-control studies, and comparative studies were included. 837 records were identified, resulting in 525 records for level I screening. 41 were included after full-text review. Results suggest elevated rates of ICU admission, gestational diabetes, preeclampsia, C-sections, pre-term birth, and CRP in comparison to pregnant women without SARS-CoV-2. Careful monitoring of pregnancies with SARS-CoV-2 to minimize adverse clinical outcomes is recommended.

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Risk Factors and Outcomes of Preterm Premature Rupture of Membranes in a Cohort of 6968 Pregnant Women Prospectively Recruited

Journal of Clinical Medicine ◽

10.3390/jcm8111987 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1987 ◽

Cited By ~ 6

Author(s):

Damien Bouvier ◽

Jean-Claude Forest ◽

Loïc Blanchon ◽

Emmanuel Bujold ◽

Bruno Pereira ◽

...

Keyword(s):

Risk Factors ◽

Gestational Diabetes ◽

Pregnant Women ◽

Preterm Labor ◽

Regression Analyses ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Level Of Education ◽

Preterm Premature Rupture ◽

History Of

We revisited risk factors and outcomes related to the preterm premature rupture of membranes (PPROM). A total of 7866 pregnant women were recruited during 5 years at their first prenatal visit to the perinatal clinic of the institution. We compared three groups (women without prematurity, women with spontaneous preterm labor with intact membranes (sPL with IM), women with PPROM) regarding 60 criteria about characteristics, lifestyle, medical, gynecological, obstetrical history of mothers, medication during pregnancy, events at delivery, and complications in neonates. Logistic regression analyses adjusting for potential confounding factors were used. Of the 6968 women selected, 189 (2.8%) presented a PPROM, and 225 (3.2%) an sPL with IM. The specific risk factors for PPROM were body mass index (BMI) <18.5 kg/m2 (adjusted odds ratio, aOR: 2.00 (1.09–3.67)), history of PPROM (aOR: 2.75 (1.19–6.36)), nulliparity (aOR: 2.52 (1.77–3.60)), gestational diabetes (aOR: 1.87 (1.16–2.99)), and low level of education (aOR: 2.39 (1.20–4.78)). The complications associated with PPROM were abruption placentae, cesarean, APGAR 5′ <4, birth weight <2500 g, stillbirth, neonatal jaundice, and hospitalization of mother and neonates. All these complications were also associated with sPL with IM. Our study confirms some of the risk factors of PPROM and highlights a new one: gestational diabetes. Outcomes of PPROM are related to prematurity.

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Preterm Labor, Premature Rupture of Membranes and Intrauterine Fetal Death

A Comprehensive Textbook of Midwifery and Gynecological Nursing ◽

10.5005/jp/books/12492_32 ◽

2015 ◽

pp. 396-396

Author(s):

Annamma Jacob

Keyword(s):

Preterm Labor ◽

Fetal Death ◽

Intrauterine Fetal Death ◽

Premature Rupture Of Membranes ◽

Premature Rupture

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Historical Analysis of the Risk of Hepatitis E and Its Complications in Pregnant Women in Nepal, 1996–1998

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.20-1007 ◽

2021 ◽

Author(s):

Robert McNair Scott ◽

Brittany L. Kmush ◽

Kundu Norkye ◽

Meera Hada ◽

Mrigendra Prasad Shrestha ◽

...

Keyword(s):

Pregnant Women ◽

Preterm Delivery ◽

Maternal Death ◽

Fetal Death ◽

Historical Analysis ◽

Hepatitis E ◽

Antenatal Clinic ◽

Reproductive Age ◽

Intrauterine Fetal Death ◽

Prospective Risk

Hepatitis E (HE) during pregnancy can be fatal; there are no prospective risk estimates for HE and its complications during pregnancy. We followed 2,404 pregnant women for HE and pregnancy outcomes from 1996 to 1998. Subjects from Nepal were enrolled at an antenatal clinic with pregnancy of ≤ 24 weeks. Most women (65.1%) were anti-HE virus negative. There were 16 cases of HE (6.7 per 1,000); three mothers died (18.8%) having had intrauterine fetal death (IUFD). Thirteen mothers survived: five preterm and seven full-term deliveries, one IUFD. HE among seronegative women was the sole cause of maternal death and increased the risk of IUFD (relative risk [RR]: 10.6; 95% confidence interval [CI]: 4.29–26.3) and preterm delivery (RR: 17.1, 95% CI 7.56–38.5). HE vaccination of females in at-risk regions before or as they attain reproductive age would reduce their risk for preterm delivery, IUFD, and maternal death.

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Association between the COVID-19 pandemic and the risk for adverse pregnancy outcomes: a cohort study

BMJ Open ◽

10.1136/bmjopen-2020-047900 ◽

2021 ◽

Vol 11 (2) ◽

pp. e047900

Author(s):

Min Du ◽

Jie Yang ◽

Na Han ◽

Min Liu ◽

Jue Liu

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Time Trends ◽

Foetal Distress ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Gestational Weight ◽

Excessive Gestational Weight Gain ◽

Adverse Pregnancy ◽

Beijing China

ObjectivesThe secondary impacts of the COVID-19 pandemic on adverse maternal and neonatal outcomes remain unclear. In this study, we aimed to evaluate the association between the COVID-19 pandemic and the risk for adverse pregnancy outcomes.DesignWe conduced retrospective analyses on two cohorts comprising 7699 pregnant women in Beijing, China, and compared pregnancy outcomes between the pre-COVID-2019 cohort (women who delivered from 20 May 2019 to 30 November 2019) and the COVID-2019 cohort (women who delivered from 20 January 2020 to 31 July 2020). The secondary impacts of the COVID-2019 pandemic on pregnancy outcomes were assessed by using multivariate log-binomial regression models, and we used interrupted time-series (ITS) regression analysis to further control the effects of time-trends.SettingOne tertiary-level centre in Beijing, ChinaParticipants7699 pregnant women.ResultsCompared with women in the pre-COVID-19 pandemic group, pregnant women during the COVID-2019 pandemic were more likely to be of advanced age, exhibit insufficient or excessive gestational weight gain and show a family history of chronic disease (all p<0.05). After controlling for other confounding factors, the risk of premature rupture of membranes and foetal distress was increased by 11% (95% CI, 1.04 to 1.18; p<0.01) and 14% (95% CI, 1.01 to 1.29; p<0.05), respectively, during the COVID-2019 pandemic. The association still remained in the ITS analysis after additionally controlling for time-trends (all p<0.01). We uncovered no other associations between the COVID-19 pandemic and other pregnancy outcomes (p>0.05).ConclusionsDuring the COVID-19 pandemic, more women manifested either insufficient or excessive gestational weight gain; and the risk of premature rupture of membranes and foetal distress was also higher during the pandemic.

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Effect of COVID-19 on Mortality of Pregnant and Postpartum Women: A Systematic Review and Meta-Analysis

Journal of Pregnancy ◽

10.1155/2021/8870129 ◽

2021 ◽

Vol 2021 ◽

pp. 1-33

Author(s):

Leila Karimi ◽

Somayeh Makvandi ◽

Amir Vahedian-Azimi ◽

Thozhukat Sathyapalan ◽

Amirhossein Sahebkar

Keyword(s):

Systematic Review ◽

Cesarean Section ◽

Pregnant Women ◽

Meta Analysis ◽

Gastrointestinal Symptoms ◽

Severe Illness ◽

Postpartum Women ◽

Presenting Symptoms ◽

Increased Risk ◽

Adverse Pregnancy

Background. Based on what is known at this time, pregnant women are at an increased risk of severe illness from COVID-19 compared to nonpregnant women. Additionally, pregnant women with COVID-19 might have an increased risk of adverse pregnancy outcomes. To investigate the effects of coronavirus disease 2019 (COVID-19) on mortality of pregnant and postpartum women, we performed a systematic review of available published literature on pregnancies affected by COVID-19. Methods. Web of Science, SCOPUS, and MEDLINE- databases were searched for original studies concerning the effect of COVID-19 on mortality of pregnant and postpartum women published by July 10, 2020. Meta-analyses of proportions were used to combine data and report pooled proportions. Results. 117 studies with a total of 11758 pregnant women were included. The age ranged between 15 and 48 years. Most subjects were infected with SARS-CoV-2 in the third trimester. Disease severity was not reported in 1125 subjects. Maternal mortality was 1.3%. In 100% of fatal cases with adequate data, fever alone or with cough was one of the presenting symptoms. Also, dyspnea (58.3%) and myalgia (50%) were the most common symptoms. Sore throat (8.3%) and gastrointestinal symptoms (anorexia, nausea) (8.3%) were rare. The rate of comorbidities was 20% among COVID-19 deaths. The majority of COVID-19-infected women who died had cesarean section (58.3%), 25% had a vaginal delivery, and 16.7% of patients were not full term. Conclusion. COVID-19 infection in pregnant women was associated with higher rates (and pooled proportions) of cesarean section and mortality. Because new data are continuously being generated and published, the findings of this study can be complete and updated with new researches. The results of this study can guide and improve prenatal counseling of COVID-19-infected pregnant women.

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Oral Anaerobic Microflora and Pregnancy Complication

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7601 ◽

2021 ◽

Vol 9 (B) ◽

pp. 1681-1685

Author(s):

Irena Andonova ◽

Vasil Iliev

Keyword(s):

Bacterial Vaginosis ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Preterm Labor ◽

Bacterial Flora ◽

Anaerobic Bacteria ◽

Adverse Pregnancy Outcomes ◽

Obstetric Outcomes ◽

Control Group ◽

Adverse Pregnancy

Bacterial vaginosis and periodontal diseases share very similar pathogenesis. Each of these diseases occurs when healthy microbiome changes to predominately anaerobic bacterial flora. Bacterial vaginosis is proven factor for adverse pregnancy outcomes. In recent years it has been hypothesized that infection from distant sites of the fetoplacental unit may also elicit an inflammatory response in utero. Aim: The study is designed to determine whether the presence of specific oral anaerobic bacteria in subgingival sulcus of mother increase the risk of adverse obstetric outcomes. Material and Methods: Case-control study. Control group: 50 patients who gave birth to neonate whit normal birth weight at term. Group cases: I group - 40 pregnant women who were hospitalized with signs of preterm labor. II - 20 pregnant women, who have an ultrasound diagnosis of fetal growth retardation. Sub-gingival microbiological paper-point swab was taken in all patients. Results: The total number of isolated oral anaerobic bacteria was statistically significantly higher in the cases group compared to control group p <0.01. In our study, pregnant women who tested positive for Porphyrmonas gingivalis for 6.65 times were more likely to have preterm labor compare with pregnant women with negative oral swabs (95.0% CI: 1.38-32.11 / p <0.05), and for 2,79 times more likely to have fetus with intrauterine growth restriction (95.0% CI: 1.10-7.91 / p <0.05 Conclusions: The study confirmed the hypothesis of a statistically significant association between oral anaerobic infection and adverse pregnancy outcomes. In the future, more studies are needed to investigate the role of the microbial load, maternal immune response, pathophysiological pathway that leads to negative pregnancy outcome.

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