scholarly journals Unique Severe COVID-19 Placental Signature Independent of Severity of Clinical Maternal Symptoms

Viruses ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1670
Author(s):  
Marjolein F. Husen ◽  
Lotte E. van der Meeren ◽  
Robert M. Verdijk ◽  
Pieter L. A. Fraaij ◽  
Annemiek A. van der Eijk ◽  
...  
Keyword(s):  
At Risk ◽  
Pregnancy Outcomes ◽  
Clinical Symptoms ◽  
Pregnancy Termination ◽  
Adverse Pregnancy Outcomes ◽  
Foetal Distress ◽  
Historical Cohort ◽  
Foetal Monitoring ◽  
Adverse Pregnancy ◽  
Prospective Longitudinal

Background: Although the risk for transplacental transmission of SARS-CoV-2 is rare, placental infections with adverse functional consequences have been reported. This study aims to analyse histological placental findings in pregnancies complicated by SARS-CoV-2 infection and investigate its correlation with clinical symptoms and perinatal outcomes. We want to determine which pregnancies are at-risk to prevent adverse pregnancy outcomes related to COVID-19 in the future. Methods: A prospective, longitudinal, multicentre, cohort study. All pregnant women presenting between April 2020 and March 2021 with a nasopharyngeal RT-PCR-confirmed SARS-CoV-2 infection were included. Around delivery, maternal, foetal and placental PCR samples were collected. Placental pathology was correlated with clinical maternal characteristics of COVID-19. Results: Thirty-six patients were included, 33 singleton pregnancies (n = 33, 92%) and three twin pregnancies (n = 3, 8%). Twenty-four (62%) placentas showed at least one abnormality. Four placentas (4/39, 10%) showed placental staining positive for the presence of SARS-CoV-2 accompanied by a unique combination of diffuse, severe inflammatory placental changes with massive perivillous fibrin depositions, necrosis of syncytiotrophoblast, diffuse chronic intervillositis, and a specific, unprecedented CD20+ B-cell infiltration. This SARS-CoV-2 placental signature seems to correlate with foetal distress (75% vs. 15.6%, p = 0.007) but not with the severity of maternal COVID-19 disease. Conclusion: We describe a unique placental signature in pregnant patients with COVID-19, which has not been reported in a historical cohort. We show that the foetal environment can be seriously compromised by disruption of placental function due to local, devastating SARS-CoV-2 infection. Maternal clinical symptoms did not predict the severity of the SARS-CoV-2-related placental signature, resulting in a lack of adequate identification of maternal criteria for pregnancies at risk. Close foetal monitoring and pregnancy termination in case of foetal distress can prevent adverse pregnancy outcomes due to COVID-19 related placental disease.

scholarly journals Climate change is a major stressor causing poor pregnancy outcomes and child development

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1222
Author(s):  
David M. Olson ◽  
Gerlinde A.S. Metz
Keyword(s):  
Climate Change ◽  
Mental Health ◽  
At Risk ◽  
Pregnancy Outcomes ◽  
Allostatic Load ◽  
Developmental Trajectories ◽  
Adverse Pregnancy Outcomes ◽  
Ecological Resilience ◽  
Adverse Pregnancy ◽  
Climate Crisis

The climate crisis is the existential threat of our times and for generations to come. This is no longer a threat but a reality affecting us, our children, and the generations that follow. Pregnant mothers, their fetuses, and their children are among those at greatest risk in every population and every jurisdiction. A timely consideration is the health of racialized groups who are particularly vulnerable owing to the confluence of several risk factors that are compounded by climate change. Included among these are Indigenous communities that are the most directly threatened by climate change. This review discusses the main health challenges faced by mothers, fathers, and their children during the climate crisis, focusing on mental health as a causal factor. Exploration of this topic includes the role of prenatal maternal and paternal stresses, allostatic load, and the effect of degradation of the environment and ecosystems on individuals. These will be examined in relation to adverse pregnancy outcomes and altered developmental trajectories of children. The climate crisis is a health threat multiplier that amplifies the health inequities of the most at-risk populations and individuals. It accelerates the increase in allostatic load of those at risk. The path of tragedy begins with an accumulating allostatic load that overwhelms both individual and socio-ecological resilience. This can lead to worse mental health including depression and anxiety and, in the case of pregnant women and their children, more adverse pregnancy outcomes and impaired developmental trajectories for their newborn children. We argue that there is an urgent need to develop new (or re-discover or re-purpose existing) tools that will predict communities and individuals who are experiencing the highest levels of climate-related hazards and intervene to reduce stress and increase resilience in pre-conceptual women and men, pregnant and post-partum women, and their young children.

scholarly journals 390: Serum screening for aneuploidy generates an enriched population at risk for adverse pregnancy outcomes

2011 ◽  
Vol 204 (1) ◽  
pp. S159
Author(s):  
Kristen Quinn ◽  
Veronique Tache ◽  
Andrew Hull ◽  
Louise Laurent ◽  
Douglas Woelkers
Keyword(s):  
At Risk ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Population At Risk ◽  
Serum Screening ◽  
Adverse Pregnancy

scholarly journals Are Newborns of Immigrant Mothers More at Risk of Poorer Perinatal Health Than Those of Natives-born Mothers? One Size Does Not Fit All. A Population-based Study, Montreal, Quebec.

2021 ◽  
Author(s):  
Mouctar Sow ◽  
Myriam De Spiegelaere ◽  
Marie-Pierre Sylvestre ◽  
Marie-France Raynault
Keyword(s):  
At Risk ◽  
Pregnancy Outcomes ◽  
Immigrant Women ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Perinatal Health ◽  
Income Quintile ◽  
Low Ses ◽  
Immigrant Mothers ◽  
Adverse Pregnancy

Abstract Background The risk of unfavourable pregnancy outcomes for immigrant mothers varies according to their birthplace, socioeconomic status (SES) and comparison group. This study aims to identify the characteristics of Montreal newborns who are more or less at risk of LBW, prematurity and SGA, according to the mother's birthplace and SES. Methods The analysis focuses on all singleton live births in Montreal between 2003 and 2012 (N=214,620). Logistic regression models were estimated using generalized estimating equations in order to: 1) compare the risk of adverse pregnancy outcomes between Canadian-born and immigrant mothers. The latter were categorised into 8 groups according to world regions; 2) estimate the odds ratio of the association between adverse pregnancy outcomes and the mother's SES (education and income quintile) for each group. Results The risk of LBW, prematurity and SGA vary considerably depending on the mother’s birthplace. For these three outcomes, mothers from the Caribbean and South Asia have a higher prevalence than all other groups. Three other groups compare favourably to Canadian-born mothers: mothers from North Africa, Europe & the USA, and Central and West Asia. The association between SES and unfavourable pregnancy outcomes varies from one group of mothers to another. Among Canadian-born mothers, there is a classic health gradient, with low SES mothers being particularly vulnerable. While income is not associated with the risk of adverse outcomes among immigrant mothers, education is for many groups. The association is however weaker than for Canadian-born mothers. Conclusions It is important to assess the influence of both immigration and SES to better identify the children who are most at risk of experiencing perinatal health concerns. In Montreal, some immigrant women are particularly vulnerable, but so are socioeconomically disadvantaged native Canadian women. Conversely, North African-born mothers with low SES present a particularly low risk. It has also been found that a high level of education reduces the risk among several groups of immigrant women, as opposed to findings in other contexts.

scholarly journals FP337ARE WOMEN WITH A SOLITARY KIDNEY AT RISK FOR ADVERSE PREGNANCY OUTCOMES?

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii181-iii181
Author(s):  
Giorgina Barbara Piccoli ◽  
Rossella Attini ◽  
Gianfranca Cabiddu ◽  
Silvia Parisi ◽  
Marta Nazha ◽  
...  
Keyword(s):  
At Risk ◽  
Pregnancy Outcomes ◽  
Solitary Kidney ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy

scholarly journals Measles and Pregnancy: Immunity and Immunization—What Can Be Learned from Observing Complications during an Epidemic Year

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Rosalia Ragusa ◽  
Armando Platania ◽  
Mario Cuccia ◽  
Gaetano Zappalà ◽  
Gabriele Giorgianni ◽  
...  
Keyword(s):  
Health Care ◽  
At Risk ◽  
Immune Response ◽  
Pregnant Women ◽  
Health Care Workers ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcomes ◽  
Measles Outbreak ◽  
Care Workers ◽  
Adverse Pregnancy

Measles is a highly contagious airborne disease. Unvaccinated pregnant women are not only at risk of infection but also at risk of severe pregnancy complications. As measles causes a dysregulation of the entire immune system, we describe immunological variations and how immune response mechanisms can lead to adverse pregnancy outcomes. We evaluated data during the measles outbreak reported in the province of Catania, Italy, from May 2017 to June 2018. We controlled hospital discharge records for patients admitted to hospital obstetric wards searching the measles diagnostic code. We have indicated the case as “confirmed” when the IgM was found to be positive with the ELISA method. We registered 843 cases of measles and 51% were females (430 cases). 24 patients between the ages of 17 and 40 had measles while they were pregnant. Adverse pregnancy outcomes included 2 spontaneous abortions, 1 therapeutic abortion, 1 foetal death, and 6 preterm deliveries. Respiratory complications were more prevalent in pregnant women (21%) than in nonpregnant women with measles (9%). 14 health care workers (1.7%) were infected with measles, and none of these had been previously vaccinated. Immune response mechanisms were associated with adverse pregnancy outcomes in women with measles. To reduce the rate of measles complications, gynaecologists should investigate vaccination history and antibody test results in all women of childbearing age. During a measles outbreak, gynaecologists and midwives should be active proponents of vaccination administration and counteract any vaccine hesitancy not only in patients but also among health care workers.

Pregnancy stress, healthy pregnancy and birth outcomes – the need for early preventative approaches in pregnant Australian Indigenous women: a prospective longitudinal cohort study

2019 ◽  
Vol 10 (1) ◽  
pp. 31-38
Author(s):  
B. L. Mah ◽  
K. G. Pringle ◽  
L. Weatherall ◽  
L. Keogh ◽  
T. Schumacher ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Pregnancy Outcomes ◽  
Stress Disorder ◽  
Adverse Pregnancy Outcomes ◽  
Indigenous Women ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Adverse Pregnancy ◽  
Prospective Longitudinal

AbstractAdverse pregnancy outcomes including prematurity and low birth weight (LBW) have been associated with life-long chronic disease risk for the infant. Stress during pregnancy increases the risk of adverse pregnancy outcomes. Many studies have reported the incidence of adverse pregnancy outcomes in Indigenous populations and a smaller number of studies have measured rates of stress and depression in these populations. This study sought to examine the potential association between stress during pregnancy and the rate of adverse pregnancy outcomes in Australian Indigenous women residing in rural and remote communities in New South Wales. This study found a higher rate of post-traumatic stress disorder, depression and anxiety symptoms during pregnancy than the general population. There was also a higher incidence of prematurity and LBW deliveries. Unfortunately, missing post-traumatic stress disorder and depressive symptomatology data impeded the examination of associations of interest. This was largely due to the highly sensitive nature of the issues under investigation, and the need to ensure adequate levels of trust between Indigenous women and research staff before disclosure and recording of sensitive research data. We were unable to demonstrate a significant association between the level of stress and the incidence of adverse pregnancy outcomes at this stage. We recommend this longitudinal study continue until complete data sets are available. Future research in this area should ensure prioritization of building trust in participants and overestimating sample size to ensure no undue pressure is placed upon an already stressed participant.

scholarly journals A Strategic Program for Risk Assessment and Intervention to Mitigate Environmental Stressor-Related Adverse Pregnancy Outcomes in the Indian Population

2021 ◽  
Vol 3 ◽  
Author(s):  
Divyanu Jain ◽  
Ajay K. Jain ◽  
Gerlinde A. S. Metz ◽  
Nina Ballanyi ◽  
Abha Sood ◽  
...  
Keyword(s):  
Risk Assessment ◽  
At Risk ◽  
Pregnancy Outcomes ◽  
Local Level ◽  
Adverse Pregnancy Outcomes ◽  
Environmental Stressors ◽  
World Health ◽  
Strategic Program ◽  
Adverse Pregnancy ◽  
Health Organization

The Problem: Global environmental stressors of human health include, but are not limited to, conflict, migration, war, natural disasters, climate change, pollution, trauma, and pandemics. In combination with other factors, these stressors influence physical and mental as well as reproductive health. Maternal stress is a known factor for adverse pregnancy outcomes such as preterm birth (PTB); however, environmental stressors are less well-understood in this context and the problem is relatively under-researched. According to the WHO, major Indian cities including New Delhi are among the world's 20 most polluted cities. It is known that maternal exposure to environmental pollution increases the risk of premature births and other adverse pregnancy outcomes which is evident in this population.Response to the Problem: Considering the seriousness of this problem, an international and interdisciplinary group of researchers, physicians, and organizations dedicated to the welfare of women at risk of adverse pregnancy outcomes launched an international program named Optimal Pregnancy Environment Risk Assessment (OPERA). The program aims to discover and disseminate inexpensive, accessible tools to diagnose women at risk for PTB and other adverse pregnancy outcomes due to risky environmental factors as early as possible and to promote effective interventions to mitigate these risks. OPERA has been supported by the Worldwide Universities Network, World Health Organization (WHO) and March of Dimes USA.Addressing the Problem: This review article addresses the influence of environmental stressors on maternal-fetal health focusing on India as a model population and describes the role of OPERA in helping local practitioners by sharing with them the latest risk prediction and mitigation tools. The consequences of these environmental stressors can be partially mitigated by experience-based interventions that build resilience and break the cycle of inter- and-transgenerational transmission. The shared knowledge and experience from this collaboration are intended to guide and facilitate efforts at the local level in India and other LMIC to develop strategies appropriate for the jurisdiction for improving pregnancy outcomes in vulnerable populations.

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