scholarly journals Pregnancy and Birth Outcomes during the Early Months of the COVID-19 Pandemic: The MOACC-19 Cohort

2021 ◽  
Vol 18 (20) ◽  
pp. 10931
Author(s):  
Marta Rodríguez-Díaz ◽  
Jéssica Alonso-Molero ◽  
María J. Cabero-Perez ◽  
Javier Llorca ◽  
Trinidad Dierssen-Sotos ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Hypertension ◽  
High Risk Group ◽  
Rt Pcr ◽  
Northern Spain ◽  
Abruptio Placentae ◽  
Pregnancy And Birth Outcomes ◽  
The Impact ◽  
Level Hospital ◽  
Pregnancy And Birth

The new coronavirus, SARS-CoV-2, is devastating for specific groups of patients, but currently there is not enough information concerning its effects on pregnant women. The purpose of this study is to identify the impact of SARS-CoV-2 infection on pregnancy and the consequences that it could cause. We studied a cohort of pregnant ladies who were tested for SARS-CoV-2 infection by RT-PCR and classified as infected or not infected. The recruitment was carried out in the HUMV hospital, a third-level hospital located in Santander, northern Spain. It started on 23 March 2020 and ended on 14 October 2020. Data from our cohort were compared to another cohort recruited in 2018 at the same hospital. We found that gestational hypertension, placental abruptio, and home exposure to an infected person, among other variables, could be associated with SARS-CoV-2 infection. In conclusion, we consider pregnant women a high-risk group of patients towards a possible SARS-CoV-2 infection, especially those who present with conditions such as gestational hypertension or obesity; moreover, we think that SARS-CoV-2 infection could increase the possibilities of having an abruptio placentae, although this result was found in only a few women, so it requires further confirmation.

scholarly journals Prevalence, incidence and associated risk factors of STIs during pregnancy in South Africa

2020 ◽  
pp. sextrans-2020-054631
Author(s):  
Dorothy Chiwoniso Nyemba ◽  
Andrew Medina-Marino ◽  
Remco P H Peters ◽  
Jeffrey D Klausner ◽  
Phuti Ngwepe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Syndromic Management ◽  
Younger Age ◽  
Pregnancy And Birth Outcomes ◽  
Adverse Pregnancy ◽  
Associated Risk Factors ◽  
Pregnancy And Birth

ObjectiveSTIs during pregnancy increase adverse pregnancy and birth outcomes and may increase HIV risk. STI syndromic management is standard of care in South Africa. Our study evaluated the prevalence and incidence of STIs in pregnant women and the associated risk factors.MethodsWe combined data from two prospective observational studies of pregnant women enrolled while attending their first antenatal clinic (ANC) visit in Tshwane District and Cape Town. Women ≥18 years were tested at first ANC visit and at their first postpartum visit for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis using Xpert assays (Cepheid, USA). We evaluated the prevalence and incidence of STI and the associated risk factors using multivariable regression models.ResultsWe enrolled 669 pregnant women, 64% (n=427) from Tshwane District and 36% (n=242) from Cape Town; 80% (n=534) were women living with HIV (WLHIV) and 20% (n=135) without HIV. At enrolment, 37% (n=250) were diagnosed with at least one STI, of which 76% (n=190) were asymptomatic. STI prevalence was 40% (n=213) in WLHIV and 27% (n=37) in women without HIV (p=0.01). Baseline STI infection was associated with younger age (OR=0.95 per year, 95% CI 0.92 to 0.98), higher gestational age (adjusted OR (aOR)=1.03 per week, 95% CI 1.00 to 1.05), single relationship status (aOR=1.53, 95% CI 1.09 to 2.15) and HIV status (aOR=1.86, 95% CI 1.17 to 2.95). Of 419 participants with no STI at baseline, 21 had an incident STI during follow-up, with a mean follow-up time of 140 days. The incidence rate of STI during pregnancy and early post partum was 15 infections per 100 women-years (95% CI 9 to 23). Younger age was associated with STI incidence.ConclusionOur study shows high prevalence and incidence of STIs in pregnancy, especially in WLHIV, demonstrating the need for STI screening in ANC to prevent adverse pregnancy and birth outcomes. Most STI cases were asymptomatic and would have gone untreated with syndromic management. Aetiological STI screening is urgently needed to reduce the burden of STIs in pregnancy.

scholarly journals Reappraisal of Gestational Weight Gain Recommendations in Obese Pregnant Women: A Population-Based Study of 337,590 Births

Obesity Facts ◽  
2020 ◽  
Vol 13 (4) ◽  
pp. 333-348
Author(s):  
Roland Devlieger ◽  
Lieveke Ameye ◽  
Tinne Nuyts ◽  
Régine Goemaes ◽  
Annick Bogaerts
Keyword(s):  
Weight Gain ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Maternal Obesity ◽  
Population Based ◽  
Population Based Study ◽  
Gestational Weight ◽  
Obese Class ◽  
Pregnancy And Birth Outcomes ◽  
Pregnancy And Birth

<b><i>Background and Objective:</i></b> Maternal obesity is an epidemic health problem that is aggravated by excessive gestational weight gain (GWG) and postpartum weight retention. Current US Institute of Medicine (now US National Academy of Medicine) guidelines (2009) for GWG need to be evaluated against the current rise in obesity in the general and pregnant population. We wanted to study the relation between GWG and pregnancy and birth outcomes and to relate this to the current recommendations for GWG. <b><i>Methods:</i></b> Population-based study. We performed an epidemiological analysis in a cohort of Belgian pregnant women with singleton live births at term (≥37 weeks) between 2009 and 2014 (<i>n</i> = 337,590). Logistic regression was used to determine the optimal GWG in relation to relevant pregnancy and birth outcomes. <b><i>Results:</i></b> The prevalence of maternal obesity significantly increased from 10.3% in 2009 to 11.4% in 2014. The mean (SD) body mass index at the start of the pregnancy significantly increased from 23.9 (4.5) in 2009 to 24.2 (4.6) in 2014. Excessive GWG was frequent, especially in overweight (56.8%) and obese (52.9%) pregnant women. In the logistic regression model, the amount of GWG associated with the lowest incidence of both large-for-gestational-age and small-for-gestational-age infants was 21 kg in underweight women, 14 kg in normal weight, 8 kg in overweight, 0 kg in obese class I, –4 kg in obese class II and –5 kg in obese class III. <b><i>Conclusion:</i></b> The prevalence of maternal obesity has risen in Belgium between 2009 and 2014. Current GWG guidelines, based on historic observational data, are probably too liberal for class II and III obese women in which better outcomes are being predicted for lower weight gain than recommended.

scholarly journals Clinical evolution of COVID-19 during pregnancy at different altitudes: a population-based study

2020 ◽  
Author(s):  
Juan Alonso Leon-Abarca ◽  
Maria Teresa Pena-Gallardo ◽  
Jorge Soliz ◽  
Roberto Alfonso Accinelli
Keyword(s):  
Pregnant Women ◽  
Case Fatality ◽  
Population Based ◽  
Reproductive Age ◽  
Rt Pcr ◽  
Population Based Study ◽  
Icu Admission ◽  
The Impact ◽  
Prevalence Ratios ◽  
Binomial Models

Background: The impact of influenza and various types of coronaviruses (SARS-CoV and MERS-CoV) on pregnancy has been reported. However, the current pandemic caused by SARS-CoV-2 continues to reveal important data for understanding its behavior in pregnant women. Methods: We analyzed the records of 326,586 non-pregnant women of reproductive age and 7,444 pregnant women with no other risk factor who also had a SARS-CoV-2 RT-PCR result to estimate adjusted prevalence (aP) and adjusted prevalence ratios (aPR) of COVID-19 and its requirement of hospitalization, intubation, ICU admission and case-fatality rates. Adjustment was done through Poisson regressions for age and altitude of residence and birth. Generalized binomial models were used to generate probability plots to display how each outcome varied across ages and altitudes. Results: Pregnancy was independently associated with a 15% higher probability of COVID-19 (aPR: 1.15), a 116% higher probability of its following admission (aPR: 2.169) and a 127% higher probability of ICU admission (aPR: 2.275). Also, pregnancy was associated with 84.2% higher probability of developing pneumonia (aPR: 1.842) and a 163% higher probability of its following admission (aPR: 2.639). There were no significant differences in COVID-19 case-fatality rates between pregnant and non pregnant women (1.178, 95% CI: 0.68-1.67). Conclusion: Pregnancy was associated with a higher probability of COVID-19, developing of pneumonia, hospitalization, and ICU admission. Our results also suggest that the risk of COVID-19 and its related outcomes, except for intubation, decrease with altitude. Keywords: COVID-19, SARS-CoV-2, pregnancy, reproductive age, altitude

scholarly journals Diet quality before or during pregnancy and the relationship with pregnancy and birth outcomes: the Australian Longitudinal Study on Women’s Health

2016 ◽  
Vol 19 (16) ◽  
pp. 2975-2983 ◽  
Author(s):  
Ellie Gresham ◽  
Clare E Collins ◽  
Gita D Mishra ◽  
Julie E Byles ◽  
Alexis J Hure
Keyword(s):  
Longitudinal Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Women's Health ◽  
Birth Outcomes ◽  
Diet Quality ◽  
Gestational Hypertension ◽  
Australian Longitudinal Study ◽  
Pregnancy And Birth Outcomes ◽  
Pregnancy And Birth

AbstractObjectiveTo assess whether diet quality before or during pregnancy predicts adverse pregnancy and birth outcomes in a sample of Australian women.DesignThe Dietary Questionnaire for Epidemiological Studies was used to calculate diet quality using the Australian Recommended Food Score (ARFS) methodology modified for pregnancy.SettingA population-based cohort participating in the Australian Longitudinal Study on Women’s Health (ALSWH).SubjectsA national sample of Australian women, aged 20–25 and 31–36 years, who were classified as preconception or pregnant when completing Survey 3 or Survey 5 of the ALSWH, respectively. The 1907 women with biologically plausible energy intake estimates were included in regression analyses of associations between preconception and pregnancy ARFS and subsequent pregnancy outcomes.ResultsPreconception and pregnancy groups were combined as no significant differences were detected for total and component ARFS. Women with gestational hypertension, compared with those without, had lower scores for total ARFS, vegetable, fruit, grain and nuts/bean/soya components. Women with gestational diabetes had a higher score for the vegetable component only, and women who had a low-birth-weight infant had lower scores for total ARFS and the grain component, compared with those who did not report these outcomes. Women with the highest ARFS had the lowest odds of developing gestational hypertension (OR=0·4; 95 % CI 0·2, 0·7) or delivering a child of low birth weight (OR=0·4; 95 % CI 0·2, 0·9), which remained significant for gestational hypertension after adjustment for potential confounders.ConclusionsA high-quality diet before and during pregnancy may reduce the risk of gestational hypertension for the mother.

scholarly journals Cohort profile: the Jundiaí Zika cohort (JZC), a pregnancy and birth cohort in São Paulo state, Brazil

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e027947 ◽  
Author(s):  
Nuria Sanchez Clemente ◽  
Manoela Rodrigues ◽  
Ana Paula Pascalicchio ◽  
Rosa Estela Gazeta ◽  
Danila Vedovello ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Birth Cohort ◽  
Zika Virus ◽  
Sao Paulo ◽  
São Paulo ◽  
Rt Pcr ◽  
Long Term Outcomes ◽  
Data Set ◽  
Pregnancy And Birth

PurposeThe Jundiaí Zika Cohort (JZC) is a prospective pregnancy and birth cohort setup in the State of São Paulo, Brazil, to investigate the epidemic of cases of microcephaly and other neurological disorders, presumed to be associated with Zika virus (ZIKV) infection.ParticipantsA total of 748 women with high-risk pregnancies were recruited in the period of March 2016 to August 2017.Findings to dateBaseline sociodemographic and medical data were collected at recruitment from 737 pregnant women. Biological samples (ie, blood, saliva and urine) were collected from 695 of the pregnant women (94.3%), of whom 53 (7.6%) were ZIKV-positive on subsequent testing by reverse transcription polymerase chain reaction (RT-PCR) in urine. Biological sample (ie, blood, saliva, urine and cerebrospinal fluid) were collected within 10 days of birth from 409 (57.4%) of the liveborn infants, of whom 19 (4.6%) were ZIKV-positive on subsequent testing by RT-PCR in urine. All remaining biological specimens, as well as colostrum, umbilical cord and placental samples, have been stored in a secure biorepository. Antenatal and postnatal imaging studies and neonatal anthropometry were carried out.Future plansThe JZC provides a unique data set which will continue to be explored to study the effects of pregnancy comorbidities on Zika virus infection during pregnancy, the long-term outcomes of children with congenital Zika infection and how physiotherapy and group interventions can improve outcomes for congenitally-infected children. All women in the cohort have reached the end of their pregnancy and currently the oldest children are 2 years old. The study will continue until all the children reach their third birthday (April 2021).

scholarly journals Sexually transmitted infections in pregnant women from sub-Saharan Africa

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Bongekile Ngobese ◽  
Nathlee S. Abbai
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Sub Saharan Africa ◽  
Sexually Transmitted ◽  
Women Living With Hiv ◽  
Pregnancy And Birth Outcomes ◽  
Sub Saharan ◽  
Stis And Hiv ◽  
Living With Hiv ◽  
Pregnancy And Birth

Background: Sexually transmitted infections (STIs) are a major health problem in most countries of the world, particularly in developing countries where the resources and technology to diagnose and treat them are limited. Currently, there is limited data on STIs and risk factors for these infections in pregnant women living with human immunodeficiency virus (HIV), especially in sub-Saharan Africa (SSA). This review provides data on the prevalence and risk factors for STIs in pregnant women living with HIV from SSA. This review also describes the association between STIs and HIV on pregnancy and birth outcomes as well as highlights the importance of laboratory-based diagnosis of STIs.Method: An electronic search of online databases was used to find and collect relevant research articles connected to the prevalence, adverse pregnancy and birth outcomes, health complications and risk factors associated with STIs and HIV in pregnant women from SSA. The search was limited to articles published in English. Relevant studies were identified by searching literature from January 2001 to date. The search yielded 4709 results.Results: In SSA, STIs are highly prevalent in pregnant women and are widely known to be linked with an increased risk of poor maternal and neonatal outcomes. These infections are often asymptomatic and highly prevalent in pregnant women. The screening of STIs in pregnant women living with HIV can reduce the risk of mother-to-child transmission (MTCT) and screening and treatment for STIs can also prevent adverse perinatal outcomes. It is important to recognise regional and national STI epidemics in order to promote STI prevention and control interventions considering the test and treat approach as opposed to syndromic management.Conclusion: This review highlights the need to use diagnostic screening methods instead of syndromic STI management in SSA. Moreover, more research into effective prevention and treatment measures for STIs in pregnant women is urgently required.

scholarly journals Praegnatio Perturbatio – Impact of Endocrine Disrupting Chemicals

2021 ◽  
Author(s):  
Vasantha Padmanabhan ◽  
Wenhui Song ◽  
Muraly Puttabyatappa
Keyword(s):  
Risk Factor ◽  
Birth Outcomes ◽  
Pregnancy Outcomes ◽  
Endocrine Disrupting Chemicals ◽  
Adverse Pregnancy Outcomes ◽  
Endocrine Disrupting ◽  
Pregnancy And Birth Outcomes ◽  
Adverse Pregnancy ◽  
The Impact ◽  
Pregnancy And Birth

Abstract The burden of adverse pregnancy outcomes such as preterm birth and low birth weight is considerable across the world. Several risk factors for adverse pregnancy outcomes have been identified. One risk factor for adverse pregnancy outcomes that is receiving considerable attention in recent years is gestational exposure to endocrine disrupting chemicals (EDCs). Humans are exposed to multitude of environmental chemicals with known endocrine disrupting properties and evidence suggest that exposure to these EDCs have the potential to disrupt maternal-fetal environment culminating in adverse pregnancy and birth outcomes. This review addresses the impact of maternal and fetal exposure to environmental EDCs of natural and man-made chemicals in disrupting the maternal-fetal milieu in human leading to adverse pregnancy and birth outcomes - a risk factor for adult onset non-communicable diseases, the role lifestyle and environmental factors play in mitigating or amplifying the effects of EDCs, the underlying mechanisms and mediaries involved, and the research directions to focus future investigations on to help alleviate the adverse effects from EDC exposures.

scholarly journals COVID-19 in Pregnant Women and Neonates: A Systematic Review of the Literature with Quality Assessment of the Studies

Pathogens ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 485 ◽  
Author(s):  
Giulia Trippella ◽  
Martina Ciarcià ◽  
Marta Ferrari ◽  
Chiara Buzzatti ◽  
Ilaria Maccora ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Critical Appraisal ◽  
Review Of The Literature ◽  
Rt Pcr ◽  
Milk Samples ◽  
Negative Results ◽  
Moderate Disease ◽  
Quality Assessments ◽  
The Impact

The SARS-CoV-2 virus emerged in December 2019 and then spread globally. Little is still known about the impact of COVID-19 on pregnant women and neonates. A review of the literature was performed according to the PRISMA guideline recommendations, searching the MEDLINE and EMBASE databases. Studies’ quality assessments were performed using the JBI Critical Appraisal Checklist. A total of 37 studies were included, involving 275 pregnant women with COVID-19 and 248 neonates. The majority of pregnant women presented with mild to moderate symptoms, only 10 were admitted in the ICU, and one died. Two stillbirths were reported and the incidence of prematurity was 28%. Sixteen neonates were tested positive for SARS-CoV-2 by RT-PCR, and nine of them were born from mothers infected during pregnancy. Neonatal outcomes were generally good: all the affected neonates recovered. RT-PCR for SARS-CoV-2 yielded negative results on amniotic fluid, vaginal/cervical fluids, placenta tissue, and breast milk samples. SARS-CoV-2 infection in pregnant women appeared associated with mild or moderate disease in most cases, with a low morbidity and mortality rate. The outcomes of neonates born from infected women were mainly favorable, although neonates at risk should be closely monitored. Further studies are needed to investigate the possibility of vertical transmission.

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