Metformin Combined LMWH Intervention in 25 Pregnant Women with History of Hyperlipidemia Pancreatitis in Pregnancy

2021 ◽  
Author(s):  
Mei Peng ◽  
Ya-Li Deng ◽  
Ling Yu ◽  
Yan-Ting Nie ◽  
Ting Luo ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Cohort Analysis ◽  
Intervention Group ◽  
Fetal Loss ◽  
Preventive Treatment ◽  
Full Term ◽  
Lipid Lowering ◽  
Neonatal Asphyxia ◽  
In Pregnancy

Objective: To explore the early preventive treatment of hypertriglyceridemia-induced acute pancreatitis (HTGP) in pregnancy. Methods: A retrospective cohort analysis was performed to examine the drug intervention on recurrent HTGP and related pregnancy outcomes among women who had HTGP in their past pregnancy and developed hyperlipidemia during the second pregnancy. Participants were identified through inpatient case records under a single physician at the clinic and divided into two groups. The intervention group was given metformin lipid-lowering combined with low-molecular-weight heparin to prevent thrombosis when hypertriglyceridemia was developed during the pregnancy. In contrast, the non-intervention group includes those who did not receive active drug treatment until they developed recurrent HTGP. Metabolic markers were also examined by comparing them with their respective past pregnancies. Results: All participants experienced elevated triglycerides during their two consecutive pregnancies. No pregnant women developed HTGP in the intervention group (n=12), while 10 of 13 (76.9%) women developed HTGP in the non-intervention group. Thus, the outcome seemed to be markedly different. In the intervention group, 11 women were gestated to term, and one was premature; one of 12 (8.3%) births was neonatal asphyxia; there was no low-weight birth, and the prognosis of mother and baby was favorable. Of 10 women who developed recurrent HTGP in the non-intervention group, four suffered from fetal loss, four had premature, and two had full-term delivery; among the three pregnant women without HTGP, one had a premature and two had full-term births; five of thirteen (38.5%) births were neonatal asphyxia. Conclusion: Pregnant women with HTGP history, if not treated, are likely to develop the condition recurrently during pregnancy, but timely intervention on hypertriglyceridemia with lipid-lowering and thrombosis-preventing seemed complete to reduce the recurrent HTGP and improve the pregnancy outcomes.

scholarly journals The safety of isoniazid tuberculosis preventive treatment in pregnant and postpartum women: systematic review and meta-analysis

2020 ◽  
Vol 55 (3) ◽  
pp. 1901967
Author(s):  
Yohhei Hamada ◽  
Carmen Figueroa ◽  
Mario Martín-Sánchez ◽  
Dennis Falzon ◽  
Avinash Kanchar
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Current Knowledge ◽  
Preventive Treatment ◽  
Adverse Pregnancy Outcomes ◽  
World Health ◽  
Current Evidence ◽  
Drug Discontinuation ◽  
Adverse Pregnancy ◽  
In Pregnancy

BackgroundThe World Health Organization (WHO) recommends tuberculosis (TB) preventive treatment for high-risk groups. Isoniazid preventive therapy (IPT) has been used globally for this purpose for many years, including in pregnancy. This review assessed current knowledge about the safety of IPT in pregnancy.MethodsWe searched PubMed, Embase, CENTRAL, Global Health Library and HIV and TB-related conference abstracts, until May 15, 2019, for randomised controlled trials (RCTs) and non-randomised studies (NRS) where IPT was administered to pregnant women. Outcomes of interest were: 1) maternal outcomes, including permanent drug discontinuation due to adverse drug reactions, any grade 3 or 4 drug-related toxic effects, death from any cause and hepatotoxicity; and 2) pregnancy outcomes, including in utero fetal death, neonatal death or stillbirth, preterm delivery/prematurity, intrauterine growth restriction, low birth weight and congenital anomalies. Meta-analyses were conducted using a random-effects model.ResultsAfter screening 1342 citations, nine studies (of 34 to 51 942 participants) met inclusion criteria. We found an increased likelihood of hepatotoxicity among pregnant women given IPT (risk ratio 1.64, 95% CI 0.78–3.44) compared with no IPT exposure in one RCT. Four studies reported on pregnancy outcomes comparing IPT exposure to no exposure among pregnant women with HIV. In one RCT, adverse pregnancy outcomes were associated with IPT exposure during pregnancy (odds ratio (OR) 1.51, 95% CI 1.09–2.10), but three NRS showed a protective effect.ConclusionsWe found inconsistent associations between IPT and adverse pregnancy outcomes. Considering the grave consequences of active TB in pregnancy, current evidence does not support systematic deferral of IPT until postpartum. Research on safety is needed.

Comparison of pregnancy outcomes after second trimester amniocentesis between procedures performed by experts and non-experts

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tanapak Wisetmongkolchai ◽  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
Suchaya Luewan ◽  
Kuntharee Traisrisilp ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Loss Rate ◽  
Fetal Loss ◽  
Adverse Pregnancy Outcomes ◽  
Expert Group ◽  
Second Trimester ◽  
Single Institution ◽  
Adverse Pregnancy ◽  
In Pregnancy ◽  
Singleton Pregnancies

AbstractObjectivesTo compare the rate of fetal loss in pregnancy after second trimester amniocentesis between procedures performed by experts and non-experts and to assess other pregnancy complications as secondary outcomes.MethodsA retrospective cohort study was performed on singleton pregnancies that underwent mid-trimester amniocenteses in a single institution. The fetal loss rates of procedures performed by experts and non-experts were collected and analyzed. Other adverse pregnancy outcomes were also examined.ResultsIn total, 14,450 amniocenteses were performed during the study period. These included 11,357 (78.6%) procedures in the group expert operators and 3,093 (21.4%) procedures in the group non-expert operators. In the non-expert group, the fetal loss rate was slightly increased but not significantly (p=0.24).In addition, the higher number of spontaneous abortions was associated with blood-stained amniotic fluid sample (p<0.001; RR=9.28). Multiple needle insertions also increased in the non-expert group significantly. However, no difference in pregnancy outcomes was found between in single and multiple needle insertions.ConclusionsThe amniocentesis procedures performed by the non-experts was not increase the fetal loss rate. However, the other adverse pregnancy outcomes, including preterm birth, low birth weight and fetal growth restriction were significantly increased in the non-expert group.

scholarly journals Intermittent preventive treatment for malaria in pregnancy: Is directly observed therapy still necessary? A prospective cohort study in a tertiary hospital, Southern Nigeria

2020 ◽  
Vol 4 ◽  
pp. 34-39
Author(s):  
Ubong Akpan ◽  
Udeme Asibong ◽  
Zibrin Okhormbe ◽  
Mabel Ekott ◽  
Saturday Etuk
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Rural Areas ◽  
Venous Blood ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Tertiary Hospital ◽  
Control Group ◽  
Directly Observed Therapy ◽  
In Pregnancy

Objective: Malaria is a major cause of indirect maternal death. In the last two decades several efforts have been made to combat the menace of this disease especially among pregnant women and children in developing countries. Directly observed therapy (DOT) was recommended to enhance the uptake of intermittent preventive treatment (IPT) of malaria with sulfadoxine – pyrimethamine among pregnant women. Due to challenges involved in the practice of DOT especially with regards to shortage of man power and clean water in rural areas, there is need to evaluate impact of DOT on the effectiveness of treatment. Material and Methods: A cohort study was carried out among 320 healthy pregnant women receiving ante natal care with equal assignment of subjects. The study group (160) received two doses of IPT by DOT while 160 matched controls were given prescription for self- drug administration at home. Malaria tests were done using microscopy method and the hemoglobin values determined using centrifuge one month after the second dose of IPT. Umbilical cord blood samples were obtained for a repeat microscopy at delivery. Results: The results showed that there were no statistical significant differences in the venous blood parasitemia, placental parasitemia and anaemia between the DOT group and the control group (P = 0.215; P = 0.100; P = 0.966) respectively. Lower social class was the main predictor of anaemia in pregnancy (P = 0.032). Conclusion: The delivery of IPT through DOT may not influence uptake in some settings. Effort may need to be channeled into ante natal education and women empowerment.

Lipid disorders in pregnancy

2021 ◽  
Vol 27 ◽  
Author(s):  
Anastasios Liberis ◽  
Stamatis Petousis ◽  
Panagiotis Tsikouras
Keyword(s):  
Pregnant Women ◽  
Low Density Lipoprotein ◽  
Safety Data ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Disorders ◽  
Severe Hypertriglyceridemia ◽  
History Of ◽  
Lipid Lowering Agents ◽  
In Pregnancy

: Dyslipidemia represents a major risk factor for cardiovascular disease. In addition, severe hypertriglyceridemia is an important cause of acute pancreatitis. Accordingly, the increase in serum lipid levels that are observed during pregnancy have potentially important implications. The management of dyslipidemia in pregnancy is further complicated by the lack of safety data during this period for most of the lipid-lowering agents. In the present review, we discuss the most important lipid disorders in pregnant women and their management. Pregnancy is characterized by increases in both low-density lipoprotein cholesterol (LDL-C) and triglyceride levels, which might result in severe complications both for the mother and the fetus. Accordingly, LDL-C and triglyceride levels should be monitored during pregnancy, particularly in women with a history of dyslipidemia. Diet is the mainstay of management of dyslipidemia in pregnant women and apheresis can also be considered in patients with homozygous familial hypercholesterolemia or severe hypertriglyceridemia. However, there is a pressing need for studies that with evaluate the safety of lipid-lowering agents during pregnancy.

scholarly journals A Socio-Ecological Approach To Understanding The Factors Influencing The Uptake Of Intermittent Preventive Treatment Of Malaria In Pregnancy (IPTp) In South Western Nigeria.

2020 ◽  
Author(s):  
Gertrude Nsorma Nyaaba ◽  
Atinuke O Olaleye ◽  
Mary O Obiyan ◽  
Oladapo Walker ◽  
Dilly OC Anumba
Keyword(s):  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
Healthcare Providers ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
Bed Nets ◽  
Public Healthcare ◽  
Birth Attendants ◽  
Faith Based ◽  
In Pregnancy

Abstract Background: Malaria in pregnancy (MiP) remains a key cause of poor maternal and neonatal health outcomes. Two key strategies globally promoted to address MiP require pregnant women in malaria-endemic regions to sleep under insecticide-treated bed nets (ITNs) and take at least three doses of intermittent preventive treatment (IPTp) during pregnancy. Particularly in the African region where weak health systems grapple with prevailing socio-cultural and traditional practices, several multilevel factors influence the effective uptake of these strategies. This study explores the factors for the poor uptake of IPTp and use of ITNs in lower socio-economic communities in Nigeria. Methods: We conducted semi-structured interviews (SSI) and focus group discussions (FGD) with a total of 201 key stakeholders in 6 communities in Ogun State, South-western Nigeria. Twelve SSIs were conducted with traditional birth attendants (TBAs), faith-based birth attendants and healthcare providers operating in public health facilities. Community leaders (7), pregnant women (30) and 20 caregivers were also individually interviewed. Sixteen FGDs were conducted with multi- and first- time pregnant women grouped by location and pregnancy experiences. A thematic approach were used for data analysis. Results: At the individual and social levels, there is high general awareness of MiP, its consequences and ITNs but a low awareness of IPTp, with type of antenatal care (ANC) provider being a key factor influencing access to IPTp. Choice of type of ANC provider, which facilitates access to IPTp and ITNs, is influenced by experiences of relatives with ANC providers, attitudes of ANC providers and community perceptions of the type of ANC providers. Concurrent use of multiple ANC providers and ANC providers’ relationships further influence acceptability and coverage for IPTp and ITN use. At the health sector level, there is low awareness about preventive malarial strategies including IPTp among TBAs and faith-based birth attendants, in contrast to high IPTp awareness among public healthcare providers. Conclusion: The findings highlight several factors that influence the utilisation of IPTp services and call for greater synergy and sensitisation between the three groups of healthcare providers towards improving access to and acceptability of IPTp for improving maternal and child outcomes.

scholarly journals Schistosomiasis among pregnant women in the Njombe-Penja health district, Littoral region of Cameroon: A cross sectional study

2019 ◽  
Author(s):  
Calvin Tonga ◽  
Charlie Ngo Bayoi ◽  
Flore Chanceline Tchanga ◽  
Jacqueline Félicité Yengue ◽  
Godlove Bunda Wepnje ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Haemoglobin Concentration ◽  
Epidemiological Data ◽  
Adverse Pregnancy Outcomes ◽  
Health District ◽  
Blood Levels ◽  
Childbearing Age ◽  
Adverse Pregnancy ◽  
In Pregnancy

AbstractBackgroundSchistosomiasis is a Neglected Tropical Disease with endemic foci in Cameroon. Epidemiological data on schistosomiasis in pregnancy are scarce in the country. This study is about schistosomiasis among pregnant women in the Njombe-Penja health district, where schistosomiasis was reported since 1969.MethodologyOverall, 282 pregnant women were enrolled upon informed consent at first antenatal consultation. A questionnaire was administered to document socio-economic and obstetric information. Stool and terminal urine samples were collected and analysed using the Kato-Katz/formol-ether concentration techniques and centrifugation method respectively. Haemoglobin concentration was measured with finger prick blood, using a URIT-12® electronic haemoglobinometer.Principal findingsThe overall prevalence of schistosomiasis was 31.91%. Schistosoma guineensis, S. haematobium and S. mansoni infections were found in 0.35%, 04.96% and 28.01% of participants respectively. Co-infection with 2 species of Schistosoma was found in 04.44% of these women. The prevalence of schistosomiasis was significantly higher in younger women (≤20) and among residents of Njombe. All S. haematobium infected women were anemic and infection was associated with significantly lower haemoglobin levels (p=0.02).ConclusionThe prevalence of schistosomiasis is high in pregnant women of the Njombe-Penja health district, with possible adverse pregnancy outcomes. Female of childbearing age should be considered for mass drug administration.Author summaryPregnant women are known to be more vulnerable to infectious diseases and in their case, at least two lives are at risk. Although schistosomiasis remains a major public health issue in Cameroon, epidemiological data on schistosomiasis in pregnancy are scarce. These data are of high interest for informed decision-making. We examined stools and urines from 282 women of the Njombe-Penja Health district and measured their blood levels. Overall, 31.91% of women were infected, mostly younger ones and those living in the town of Njombe. Three species of Schistosoma parasite were identified. Women having urinary schistosomiasis had lower blood levels. These results show that the prevalence of schistosomiasis is high in pregnant women of Njombe. Also, because of the anemia it induces, the disease can lead to adverse pregnancy outcomes on the woman and her foetus. Treating female of childbearing age would cure the disease and prevent adverse outcomes.

scholarly journals Factors Associated with Anemia in Pregnancy in Cascades Region in Burkina Faso

2015 ◽  
pp. 663-664
Author(s):  
Ilboudo Bernard ◽  
Savadogo G. Léon Blaise ◽  
Kinda Maurice ◽  
Guiguemde T. Robert ◽  
Dramaix-wilmet Michèle ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Anemia In Pregnancy ◽  
Prevalence Of Anemia ◽  
In Pregnancy

Objectives: To analyze the factors associated with anemia in pregnancy in the Cascades region in Burkina Faso. Methods: A cross-sectional study was carried out in antenatal clinics of the Cascades region in Burkina Faso during one month from May to June 2012. We collected data on socio-demographics and health characteristics of pregnant women attending these clinics. Hemoglobin was measured to assess anemia. Factors associated with anemia were identified through a multivariate analysis. Results: A total of 1763 pregnant women, irrespectively of pregnancy stage, were enrolled. The mean (SD) hemoglobin level was 10.6 (1.4) g/dl. The prevalence of anemia in pregnancy was 58.9%, 3.2% of them being severe. Factors associated with anemia were the absence of intermittent preventive treatment of malaria with sulfadoxin-pyrimetamin (OR = 1.3, 95% CI: 1.0-1.7), number of pregnancies >6 (OR = 1.4, 95% CI: 1.1-1.9). Moderate consumption of local alcohol extracted from Palmyra was associated with a lower prevalence of anemia (OR = 0.7, 95% CI: 0.5-0.9). Surprisingly, anemia was not associated with supplementation with folic acid + iron (p = 0.60). Conclusions: Interventions which aim to reduce the prevalence of anemia in pregnancy in Burkina Faso should improve the coverage of the intermittent preventive treatment of malaria and support the limitation of births.

scholarly journals The Effect ofAdditional Nanoparticles Supplementation of Indonesian Bay Leaf (SyzigiumPolyanthum) on Blood Pressure in Pregnancy Hypertension

2020 ◽  
Vol 5 (7) ◽  
pp. 1320-1323
Author(s):  
Miftah Nurlaily El Akhlaq ◽  
Suharyo Hadisaputro ◽  
Suhartono . ◽  
Sri Sumarni ◽  
M. Choiroel Anwar
Keyword(s):  
Blood Pressure ◽  
Data Analysis ◽  
Pregnant Women ◽  
Diastolic Blood Pressure ◽  
Intervention Group ◽  
Reduce Blood Pressure ◽  
Control Group ◽  
Pregnancy Hypertension ◽  
The Mean ◽  
In Pregnancy

Bay leaf (Syzygiumpolyanthum) or Daun Salam is one of the plants that has many benefits, one of them is to reduce blood pressure. The aim of this study is to prove the effect of adding nanoparticles supplementation of bay leaf (Syzygiumpolyanthum) to systolic and diastolic blood pressure in pregnancy hypertension.The study was quasi-experiment. 39 respondents were divided into 19 pregnant women in intervention group and 20 pregnant women in the control group. The intervention was given for 14 days by consumingnifedipine 10mg plus 80mg bay leaf nanoparticle capsules to the intervention group.The results of data analysis showed a decrease in systolic blood pressure (p = 0.000) and diastolic blood pressure (p = 0.004) when compared with the control group, which means that there were differences in the mean systolic and diastolic blood pressure between the two groups after treatment. The addition of bay leaf nanoparticle supplementation 1x80 mg for 14 days affected the decrease in systolic and diastolic blood pressure in pregnancy hypertension. So that the supplementation of bay leaf nanoparticles can be used as adjunctive therapy in pregnancy hypertension

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 Cohort profile: molecular signature in pregnancy (MSP): longitudinal high-frequency sampling to characterise cross-omic trajectories in pregnancy in a resource-constrained setting

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e041631
Author(s):  
Tobias Brummaier ◽  
Basirudeen Syed Ahamed Kabeer ◽  
Pornpimon Wilaisrisak ◽  
Mupawjay Pimanpanarak ◽  
Aye Kyi Win ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
High Frequency ◽  
Molecular Signature ◽  
Resource Constrained ◽  
Targeted Interventions ◽  
Frequency Sampling ◽  
High Frequency Sampling ◽  
In Pregnancy

PurposeA successful pregnancy relies on the interplay of various biological systems. Deviations from the norm within a system or intersystemic interactions may result in pregnancy-associated complications and adverse pregnancy outcomes. Systems biology approaches provide an avenue of unbiased, in-depth phenotyping in health and disease. The molecular signature in pregnancy (MSP) cohort was established to characterise longitudinal, cross-omic trajectories in pregnant women from a resource constrained setting. Downstream analysis will focus on characterising physiological perturbations in uneventful pregnancies, pregnancy-associated complications and adverse outcomes.ParticipantsFirst trimester pregnant women of Karen or Burman ethnicity were followed prospectively throughout pregnancy, at delivery and until 3 months post partum. Serial high-frequency sampling to assess whole blood transcriptomics and microbiome composition of the gut, vagina and oral cavity, in conjunction with assessment of gene expression and microbial colonisation of gestational tissue, was done for all cohort participants.Findings to date381 women with live born singletons averaged 16 (IQR 15–18) antenatal visits (13 094 biological samples were collected). At 5% (19/381) the preterm birth rate was low. Other adverse events such as maternal febrile illness 7.1% (27/381), gestational diabetes 13.1% (50/381), maternal anaemia 16.3% (62/381), maternal underweight 19.2% (73/381) and a neonate born small for gestational age 20.2% (77/381) were more often observed than preterm birth.Future plansResults from the MSP cohort will enable in-depth characterisation of cross-omic molecular trajectories in pregnancies from a population in a resource-constrained setting. Moreover, pregnancy-associated complications and unfavourable pregnancy outcomes will be investigated at the same granular level, with a particular focus on population relevant needs such as effect of tropical infections on pregnancy. More detailed knowledge on multiomic perturbations will ideally result in the development of diagnostic tools and ultimately lead to targeted interventions that may disproportionally benefit pregnant women from this resource-limited population.Trial registration numberNCT02797327.

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