scholarly journals Laboratory Effects of COVID-19 Infection in Pregnant Women and Their Newborns: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2 ◽  
Author(s):  
Clark Zhang ◽  
Haitao Chu ◽  
Y. Veronica Pei ◽  
Jason Zhang
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Meta Analysis ◽  
Digital Object Identifier ◽  
Respiratory Pathogens ◽  
Neonatal Complications ◽  
Pregnant Mothers

Amidst the COVID-19 pandemic, there is a need for further research on its manifestation in pregnant women, since they are particularly prone to respiratory pathogens, like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), due to physiological changes during pregnancy. Its effects on infants born to mothers with COVID-19 are also not well-studied, and more evidence is needed on vertical transmission of the disease from mother to infant and on the transmission of IgG/IgM antibodies between mother and infant. We aim to systematically review and evaluate the effects of COVID-19 among SARS-CoV-2-positive pregnant women in late pregnancy and neonates with SARS-CoV-2-positive pregnant mothers using blood assays to find indicators of maternal and neonatal complications. We searched for original published articles in Google Scholar, Medline (PubMed), and Embase databases to identify articles in the English language from December 2019 to July 20, 2020. Duplicate entries were searched by their titles, authors, date of publication, and Digital Object Identifier. The selected studies were included based on patient pregnancy on admission, pregnant mothers with laboratory-confirmed COVID-19 virus, maternal/neonatal complications, and blood test results. We excluded duplicate studies, articles where full text was not available, other languages than English, opinions, and perspectives. The meta-analysis using the Generalized Linear Mixed model was conducted using the “meta” and “metaprop” packages in R code. Of the 1,642 studies assessed for eligibility, 29 studies (375 mothers and neonates) were included. Preterm birth rate was 34.2%, and cesarean section rate was 82.7%. Maternal laboratory findings found elevated neutrophils (71.4%; 95% CI: 38.5–90.9), elevated CRP (67.7%; 95%: 50.6–81.1), and low hemoglobin (57.3%; 95% CI: 26.0–87.8). We found platelet count, lactate dehydrogenase, and procalcitonin to be less strongly correlated with preterm birth than between high neutrophil counts (P = 0.0007), low hemoglobin (P = 0.0188), and risk of preterm birth. There is little evidence for vertical transmission. Elevated procalcitonin levels (23.2%; 95% CI: 8.4–49.8) are observed in infants born to mothers with COVID-19, which could indicate risk for neonatal sepsis. These infants may gain passive immunity to COVID-19 through antibody transfer via placenta. These results can guide current obstetrical care during the current SARS-CoV-2 pandemic.

scholarly journals Transitioning from Distribution of Iron-Folic Acid Supplements to Multiple Micronutrient Supplements for Pregnant Women (OR25-02-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Reina Engle-Stone ◽  
Stephen Vosti ◽  
Laura Meinzen-Dick ◽  
Sika Kumordzie
Keyword(s):  
Folic Acid ◽  
Preterm Birth ◽  
Cost Effectiveness ◽  
Burkina Faso ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Transition Costs ◽  
Multiple Micronutrient ◽  
Iron Folic Acid ◽  
The Cost

Abstract Objectives We aimed to estimate the potential effects, costs, and cost-effectiveness of a programmatic transition from distribution of iron-folic acid (IFA) tablets to distribution of multiple micronutrient supplements (MMS) to pregnant woman, using Bangladesh and Burkina Faso as case studies. Methods For each country, we developed an 11-year predictive model using baseline demographic information from the Lives Saved Tool and effect sizes from a recent meta-analysis of trials of MMS compared to IFA supplementation during pregnancy. We predicted the number of cases of stillbirth, infant mortality, and adverse birth outcomes (low birth weight, small-for-gestational age, and preterm birth) and DALYs averted by replacing IFA with MMS at current levels of IFA coverage (∼50% nationally in Bangladesh; ∼10% in Burkina Faso). We estimated initial program transition costs and the annual marginal cost of MMS compared to IFA supplements, and calculated cost-effectiveness measures for scenarios with varied numbers of tablets received and consumed by pregnant women. Results In Bangladesh, immediate replacement of IFA with MMS at current coverage (assuming all covered pregnancies receive 180 tablets) was predicted to avert >73,800 deaths and >178,500 cases of preterm birth over 11 years at a cost of $5.0 to $14.2 per DALY averted; costs would increase by ∼9% with the addition of programmatic transition costs. In Burkina Faso, the same scenario would avert >5700 deaths and >6600 cases of preterm birth over 11 years at a cost of $3.6 to $15.5 per DALY averted. Assuming that benefits of supplementation accrue only above a given threshold (e.g., 180 tablets per pregnancy), accounting for supplement consumption above or below this threshold (e.g., consumption of 30 tablets or 270 tablets) could substantially reduce the cost-effectiveness of the IFA-MMS switch in comparison with a scenario in which all covered pregnancies consume exactly 180 tablets, although cost per DALY averted remained below $105 in all scenarios. Conclusions This modeling analysis suggests that the cost per DALY averted by transitioning from IFA to MMS is low relative to other prenatal interventions designed to save lives. Improvements in program delivery and supplement adherence would improve the cost-effectiveness of replacing IFA with MMS. Funding Sources Sight and Life; Sackler Institute for Nutrition Science.

scholarly journals Maternal and neonatal response to COVID-19

2020 ◽  
Vol 319 (2) ◽  
pp. E315-E319 ◽  
Author(s):  
Thea N. Golden ◽  
Rebecca A. Simmons
Keyword(s):  
Preterm Birth ◽  
Severe Acute Respiratory Syndrome ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Newborn Health ◽  
Maternal And Newborn Health ◽  
Placental Infection ◽  
Neonatal Response ◽  
Maternal Disease ◽  
Maternal And Newborn

The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to maternal and newborn health has yet to be determined. Several reports suggest pregnancy does not typically increase the severity of maternal disease; however, cases of preeclampsia and preterm birth have been infrequently reported. Reports of placental infection and vertical transmission are rare. Interestingly, despite lack of SARS-CoV-2 placenta infection, there are several reports of significant abnormalities in placenta morphology. Continued research on pregnant women infected with SARS-CoV-2 and their offspring is vitally important.

Bivariate Random-effects Meta-analysis of Sensitivity and Specificity with SAS PROC GLIMMIX

2010 ◽  
Vol 49 (01) ◽  
pp. 54-64 ◽  
Author(s):  
J. Menke
Keyword(s):  
Sensitivity And Specificity ◽  
Random Effects ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Meta Analysis ◽  
Empirical Evaluation ◽  
Test Accuracy ◽  
Random Effects Model ◽  
Operating Characteristics ◽  
Meta Analyses

Summary Objectives: Meta-analysis allows to summarize pooled sensitivities and specificities from several primary diagnostic test accuracy studies. Often these pooled estimates are indirectly obtained from a hierarchical summary receiver operating characteristics (HSROC) analysis. This article presents a generalized linear random-effects model with the new SAS PROC GLIMMIX that obtains the pooled estimates for sensitivity and specificity directly. Methods: Firstly, the formula of the bivariate random-effects model is presented in context with the literature. Then its implementation with the new SAS PROC GLIMMIX is empirically evaluated in comparison to the indirect HSROC approach, utilizing the published 2 x 2 count data of 50 meta-analyses. Results: According to the empirical evaluation the meta-analytic results from the bivariate GLIMMIX approach are nearly identical to the results from the indirect HSROC approach. Conclusions: A generalized linear mixed model with PROC GLIMMIX offers a straightforward method for bivariate random-effects meta-analysis of sensitivity and specificity.

scholarly journals Seroepidemiology and associated risk factors of hepatitis B and C virus infections among pregnant women attending maternity wards at two hospitals in Swabi, Khyber Pakhtunkhwa, Pakistan

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255189
Author(s):  
Muhammad Israr ◽  
Fawad Ali ◽  
Arif Nawaz ◽  
Muhammad Idrees ◽  
Aishma Khattak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Hepatitis B ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Educational Level ◽  
Khyber Pakhtunkhwa ◽  
History Of ◽  
Associated Risk Factors ◽  
Pregnant Mothers

Background & aim Hepatitis B and C infections are global issues that are associated with a massive financial burden in developing countries where vertical transmission is the major mode and remains high. This cross-sectional study was designed to investigate the seroepidemiology and associated risk factors of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among 375 pregnant women attending antenatal care health facilities at Bacha Khan Medical Complex (BKMC) Shahmansoor and District Head Quarter (DHQ) Hospital Swabi, Khyber Pakhtunkhwa, Pakistan. Methodology From a total of 375 pregnant women selected using systematic random sampling from both hospitals, 10 ml of blood samples were collected and alienated serum was examined for indicators identification through the Immuno-Chromatographic Test (ICT) and 3rd Generation Enzyme-Linked Immunosorbent Assay (ELISA). A pre-structured questionnaire was used to collect the socio-demographic data and possible risk factors. The data was analyzed via SPSS 23.0 statistical software. A chi-square analysis was performed to determine the association between variables. P-value < 0.05 was set statistically significant. Results The overall frequency of HBV and HCV among 375 pregnant women involved in the study was 3.7% and 2.1% respectively. None of the pregnant women were co-infected with HBV and HCV. Dental extraction (P = 0.001) and blood transfusion (P = 0.0005) were significantly allied with HBV infection while surgical procedure (P = 0.0001) was significantly associated with HCV infection. Moreover the sociodemographic characteristics: residential status (P = 0.017) and educational level (P = 0.048) were found significant risk factors of HBsAg and maternal age (P = 0.033) of anti-HCV, respectively. Conclusion & recommendation HBV and HCV infections are intermediary endemic in the study area. A higher prevalence of HBV was detected among pregnant mothers with a history of dental extraction, history of blood transfusion, resident to the urban area and low educational level. The age and surgical procedures were the potential risk factors found significantly associated with HCV positivity among pregnant mothers in our setup. Future negotiations to control vertical transmission should include routine antenatal screening for these infections early in pregnancy and the requirement of efficient preventive tools including the birth dose of the hepatitis B vaccine in combination with hepatitis B immune globulins to the neonate.

scholarly journals PSVIII-10 Effects of enzyme supplementation in corn distiller’s dried grains with solubles (DDGS) diets on growth performance in broilers: a meta-analysis

2020 ◽  
Vol 98 (Supplement_3) ◽  
pp. 211-211
Author(s):  
Jae-Cheol Jang ◽  
Zhikai Zeng ◽  
Pedro E Urriola ◽  
Gerald C Shurson
Keyword(s):  
Growth Performance ◽  
Fixed Effects ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Meta Analysis ◽  
Growth Responses ◽  
Exogenous Enzymes ◽  
The Mean ◽  
Enzyme Supplementation ◽  
Mean Differences

Abstract The objective of this study was to conduct a meta-analysis to quantitatively summarize the growth responses of broilers fed cDDGS and the efficacy of various types of dietary enzyme supplementation. A total of 12 publications with 69 observations were included in the database. Individual observations were analyzed using a multivariable linear mixed model. The mean differences (MD) of BWG, FI, and gain efficiency (G/F) were calculated by subtracting either the enzyme response in corn-soybean meal (CSB) or CSB+cDDGS based diets to the control, and was expressed as a percentage (MD = (enzyme – control)/control ×100%). A type of exogenous enzymes (xylanase; protease; carbohydrases; cocktail = proteases + carbohydrases), and feeding phase (starter = d 0 to d 21; finisher = d 21 to d 42 or 49; overall = d 0 to d 42 or more) were included as fixed effects. Dietary enzyme inclusion showed significant improvement on BWG (3.19%, P &lt; 0.01) and G/F (5.69%, P &lt; 0.01) in broilers fed cDDGS diet. However, no significant enzyme responses were observed in broilers fed CSB diet on growth performance. Broilers fed cDDGS diet had increased (P &lt; 0.01) BWG with the addition of protease (3.32 %) and cocktail (3.27 %), whereas addition of xylanased improved (P &lt; 0.01) G/F by (3.56 %) and carbohydrases (1.90 %). Broilers fed cDDGS diet with enzyme supplementation showed greater improvement in BWG (3.71 %, P &lt; 0.01) and G/F (3.78 %, P &lt; 0.01) at finisher phase compared with starter phase. Likewise, Broilers fed CSB diet with enzyme supplementation increased BWG (9.40 %, P &lt; 0.01) and G/F (3.11 %, P &lt; 0.01) at finisher phase. In conclusion, supplementation of xylanase and carbohydrases in cDDGS diet improved G/F, and the enzyme response can be maximized when fed during the finisher phase diet compared with the starter phase diet.

scholarly journals Interventions to improve birth outcomes of pregnant women living in low- and middle-income countries: a systematic review and network meta-analysis

2020 ◽  
Vol 3 ◽  
pp. 1657
Author(s):  
Jay J. H. Park ◽  
Ofir Harari ◽  
Ellie Siden ◽  
Michael Zoratti ◽  
Louis Dron ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Low Birthweight ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Adverse Birth Outcomes ◽  
Middle Income ◽  
Middle Income Countries

Background: Improving the health of pregnant women is important to prevent adverse birth outcomes, such as preterm birth and low birthweight. We evaluated the comparative effectiveness of interventions under the domains of micronutrient, balanced energy protein, deworming, maternal education, and water sanitation and hygiene (WASH) for their effects on these adverse birth outcomes. Methods: For this network meta-analysis, we searched for randomized clinical trials (RCTs) of interventions provided to pregnant women in low- and middle-income countries (LMICs). We searched for reports published until September 17, 2019 and hand-searched bibliographies of existing reviews. We extracted data from eligible studies for study characteristics, interventions, participants’ characteristics at baseline, and birth outcomes. We compared effects on preterm birth (<37 gestational week), low birthweight (LBW; <2500 g), and birthweight (continuous) using studies conducted in LMICs. Results: Our network meta-analyses were based on 101 RCTs (132 papers) pertaining to 206,531 participants. Several micronutrients and balanced energy food supplement interventions demonstrated effectiveness over standard-of-care. For instance, versus standard-of-care, micronutrient supplements for pregnant women, such as iron and calcium, decreased risks of preterm birth (iron: RR=0.70, 95% credible interval [Crl] 0.47, 1.01; calcium: RR=0.76, 95%Crl 0.56, 0.99). Daily intake of 1500kcal of local food decreased the risks of preterm birth (RR=0.36, 95%Crl 0.16, 0.77) and LBW (RR=0.17, 95%Crl 0.09, 0.29), respectively when compared to standard-of-care. Educational and deworming interventions did not show improvements in birth outcomes, and no WASH intervention trials reported on these adverse birth outcomes. Conclusion: We found several pregnancy interventions that improve birth outcomes. However, most clinical trials have only evaluated interventions under a single domain (e.g. micronutrients) even though the causes of adverse birth outcomes are multi-faceted. There is a need to combine interventions that of different domains as packages and test for their effectiveness. Registration: PROSPERO CRD42018110446; registered on 17 October 2018.

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 Effect of per Capita Income on the Relationship between Periodontal Disease during Pregnancy and the Risk of Preterm Birth and Low Birth Weight Newborn. Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (21) ◽  
pp. 8015
Author(s):  
Carmen Alba Moliner-Sánchez ◽  
José Enrique Iranzo-Cortés ◽  
José Manuel Almerich-Silla ◽  
Carlos Bellot-Arcís ◽  
José Carmelo Ortolá-Siscar ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Periodontal Disease ◽  
Pregnant Women ◽  
Capita Income ◽  
Meta Analysis ◽  
Income Level ◽  
Per Capita Income ◽  
Per Capita

This work analyzed the available evidence in the scientific literature about the risk of preterm birth and/or giving birth to low birth weight newborns in pregnant women with periodontal disease. A systematic search was carried out in three databases for observational cohort studies that related periodontal disease in pregnant women with the risk of preterm delivery and/or low birth weight, and that gave their results in relative risk (RR) values. Eleven articles were found, meeting the inclusion criteria. Statistically significant values were obtained regarding the risk of preterm birth in pregnant women with periodontitis (RR = 1.67 (1.17–2.38), 95% confidence interval (CI)), and low birth weight (RR = 2.53 (1.61–3.98) 95% CI). When a meta-regression was carried out to relate these results to the income level of each country, statistically significant results were also obtained; on the one hand, for preterm birth, a RR = 1.8 (1.43–2.27) 95% CI was obtained and, on the other hand, for low birth weight, RR = 2.9 (1.98–4.26) 95% CI. A statistically significant association of periodontitis, and the two childbirth complications studied was found, when studying the association between these results and the country’s per capita income level. However, more studies and clinical trials are needed in this regard to confirm the conclusions obtained.

scholarly journals Use of metabolomics for predicting spontaneous preterm birth in asymptomatic pregnant women: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e026033 ◽  
Author(s):  
Renato T Souza ◽  
Rafael Bessa Galvão ◽  
Debora Farias Batista Leite ◽  
Renato Passini Jr ◽  
Philip Baker ◽  
...  
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Research Question ◽  
Case Control Studies ◽  
Spontaneous Preterm Birth ◽  
Ethical Approval ◽  
Registration Number ◽  
Review Protocol

IntroductionPreterm birth (PTB) is the leading cause of neonatal mortality and short- and long-term morbidity. The aetiology and pathophysiology of spontaneous PTB (sPTB) are still unclear, which makes the identification of reliable and accurate predictor markers more difficult, particularly for unscreened or asymptomatic women. Metabolomics biomarkers have been demonstrated to be potentially accurate biomarkers for many disorders with complex mechanisms such as PTB. Therefore, we aim to perform a systematic review of metabolomics markers associated with sPTB. Our research question is ‘What is the performance of metabolomics for predicting spontaneous preterm birth in asymptomatic pregnant women?’Methods and analysisWe will focus on studies assessing metabolomics techniques for predicting sPTB in asymptomatic pregnant women. We will conduct a comprehensive systematic review of the literature from the last 10 years. Only observational cohort and case-control studies will be included. Our search strategy will be carried out by two independent reviewers, who will scan title and abstract before carrying out a full review of the article. The scientific databases to be explored include PubMed, MedLine, ScieLo, EMBASE, LILACS, Web of Science, Scopus and others.Ethics and disseminationThis systematic review protocol does not require ethical approval. We intend to disseminate our findings in scientific peer-reviewed journal, the Preterm SAMBA study open access website, specialists’ conferences and to our funding agencies.PROSPERO registration numberCRD42018100172.

Sign in / Sign up

Export Citation Format

Share Document