scholarly journals EFFECT OF MATERNAL HIV IMMUNE RECONSTITUTION INFLAMMATORY RESPONSE SYNDROME ON THE RISK OF ADVERSE PREGNANCY-FETAL OUTCOMES IN HIV-1 POSITIVE, ART NAIVE PREGNANT WOMEN OF REPRODUCTIVE AGE IN SELECTED HOSPITALS, NAIROBI, KENYA

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Muthuka John Kyalo ◽  
Yeri Kombe ◽  
Makokha Anzelimo ◽  
Michael Kiptoo
Keyword(s):  
Inflammatory Response ◽  
Pregnant Women ◽  
Immune Reconstitution ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Fetal Outcomes ◽  
Art Initiation ◽  
Maternal Hiv ◽  
Adverse Pregnancy ◽  
Hiv 1

Background: Immune reconstitution inflammatory response syndrome (IRIS) is a recovery disease that may be triggered after starting ARV therapy in some individuals. The incidence of adverse pregnancy-fetal outcomes with IRIS has not been studied in Kenya among pregnant women, with focus only, on improved immune response and PMTCT after ART initiation. The indirect effect of ART, the maternal HIV - IRIS on pregnancy outcome has not been elucidated. More than 10% of the global burden of disease is due to pregnancy complications and adverse pregnancy and related birth outcomes and despite recent advances in obstetric medicine, pregnancy complications and adverse birth outcomes are a growing public health concern and economic burden on the health-care system. This has substantial burden of adverse pregnancy-fetal outcomes with prevalence of preterm birth, low birth weight, and small gestational age infants of 19.8%, 14.2%, and 12.6%, respectively, and of still birth and neonatal mortalityat1.9% and 0.4%, respectively. The aim of this study was to evaluate the effect of maternal HIV immune reconstitution inflammatory response syndrome on the risk of adverse pregnancy-fetal outcomes in HIV-1 positive; ART initiated pregnant women of reproductive age in selected hospitals, Nairobi, Kenya. Methodology: The study was conducted among 204 HIV-1 positive, ART initiated pregnant women of reproductive age in selected hospitals, Nairobi, Kenya. A prospective cohort study design was used where the subjects were recruited and followed from the end of first trimester for six and half months after they were confirmed to be HIV positive, and put on ARV treatment using a pretested data collection tool. Bivariate analyses with chi-square test to establish the association between the variables at p-value < 0.05. Logistic regression analysis was performed to identify independent outcome predictors. Adjusted relative risk at 95% confidence interval was determined. Results: The study indicated that, adverse pregnancy-fetal outcome cumulative incidence was 26.47% among women diagnosed with IRIS compared to 10.78% among women not diagnosed with IRIS. The incidence rate estimate was 0.012 and 0.0045 per person’s week respectively with a rate ratio of 012/.0045=2.7. Women with IRIS had 2.46 times the risk of experiencing an adverse pregnancy-fetal outcome compared to those who did not [OR=3; 95%CI: 1.4-6.4; P=.004]. LBW cumulative incidence was the highest with 11 (10.8%) among IRIS exposed women and 3 (2.9%) among non-IRIS exposed women and same case with PTB 8 (7.8%) and 3 (2.9%) respectively. Conclusion: There was a significant relationship of maternal HIV-immune reconstitution inflammatory response syndrome diagnosis with adverse pregnancy-fetal outcomes as a result of ART initiation among HIV-1 positive, pregnant women of reproductive age. This study observes that, being diagnosed with maternal HIV-IRIS following ART initiation during pregnancy among ART naive women is associated with experiencing an adverse pregnancy outcome. This should be a concern in clinical practice as IRIS has self-resolution, it may on the other hand affect pregnancy outcome negatively. PMTCT should integrate monitoring of suspected IRIS cases using the latest defined criteria for its diagnosis in pregnant women starting ant-retroviral therapy especially in resource limited areas. <p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0658/a.php" alt="Hit counter" /></p>

scholarly journals Incidence and predictors of adverse pregnancy outcomes with maternal HIV-1 immune reconstitution inflammatory response syndrome among women within reproductive age in selected hospitals, Nairobi, Kenya (A prospective cohort study)

2020 ◽  
Author(s):  
John Kyalo Muthuka ◽  
Yeri Kombe ◽  
Anselimo Makokha ◽  
Michael Kiptoo
Keyword(s):  
Viral Load ◽  
Pregnant Women ◽  
General Health ◽  
Immune Reconstitution ◽  
Reproductive Age ◽  
Adjusted Relative Risk ◽  
Fetal Outcomes ◽  
Hiv Rna ◽  
Maternal Hiv ◽  
Adverse Pregnancy

Abstract Background: With enhanced rollout of anti-retroviral therapy (ART) following prevention of mother to child transmission (PMTCT) and the associated burden of opportunistic infections in developing countries, human immunodeficiency virus-immune reconstitution inflammatory syndrome (HIV-IRIS) may remain a public health area of major concern especially, in pregnancy. Ascertaining the association between maternal HIV infection and adverse maternal and birth related outcomes could be conflicted by the relationship between maternal-HIV- IRIS and the adverse pregnancy-fetal outcomes (APFOs) in HIV-infected mothers. We sought to estimate the incidence and determine possible predictors for adverse pregnancy-fetal outcomes with maternal-HIV-IRIS in ART naïve HIV infected pregnant women. Methodology: Subjects grouped in to IRIS exposed and non-IRIS exposed were followed from the end of first trimester for six and half months. Chi-square test was used to establish the association between the variables at p-value < 0.05. Regression analysis was performed to identify independent predictors of APFOs. Adjusted Relative Risk at 95% confidence interval was determined. Results: The IRIS exposed pregnant women, had a 26.47% adverse pregnancy-fetal outcomes cumulative incidence compared to 10.78% among IRIS non-exposed women. The APFO incidence rate estimate was 0.012 and 0.0045 per person’s week respectively. IRIS cases had 2.46 times the risk of experiencing an APFO compared to those who did not [OR=3; 95%CI: 1.4-6.4; P=.004], at bivariate analysis, not sustained at the multivariate analysis [AOR=1.6; 95%CI: 0.4-5.8; P = .508]. Multiple logistic regression dropped maternal HIV-IRIS and revealed; HIV-RNA viral load at baseline of above 50 copies/ml [AOR=2.7; 95%CI: 1.2-6.3; P=.017], Maternal placental syndrome(MPS) characterized by hypertensive event [AOR=0.1; 95%CI:0.0-1.0; P = .052] and mother’s general health during delivery [AOR= 4; 95%CI: 4.0:1.8-9.1;P=.001] as independent predictors of APFOs. Conclusion: There is a higher incidence of APFOs among maternal HIV-IRIS diagnosed pregnant women as compared to non-HIV maternal IRIS diagnosed pregnant women. In particular, MPS characterized by an hypertensive event, HIV-RNA viral load at baseline of above 50 copies/ml and mother’s general health during delivery are key predictors of an adverse pregnancy outcome. Interventions to reduce the associated risk predictors identified in this analysis should be studied for their effects on reducing APFOs.

scholarly journals Miscarriage and Anti TPO antibodies

2018 ◽  
Vol 8 (2) ◽  
pp. 1408-1411
Author(s):  
Santosh Pradhan ◽  
Keyoor Gautam
Keyword(s):  
Pregnant Women ◽  
Early Pregnancy ◽  
Thyroid Dysfunction ◽  
Reproductive Age ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Women Of Reproductive Age ◽  
Fetal Outcomes ◽  
Autoimmune Thyroid ◽  
Thyroglobulin Antibody

Autoimmune thyroid disorders are common in women of reproductive age. Anti-TPO antibody and thyroglobulin antibody are frequently found to be associated. Anti-TPO antibodies are responsible for the activation of complement and are thought to be significantly involved in thyroid dysfunction. In early pregnancy women with anti TPO antibodies are prone to develop subclinical or overt hypothyroidism leading to adverse obstetric and fetal outcomes. An association between the risk of a miscarriage and anti TPO antibodies has also been reported even in absence of overt thyroid dysfunction. However, screening for these antibodies and Levothyroxin supplement in anti TPO antibodies -positive euthyroid pregnant women has not been established yet.

scholarly journals High burden of anemia among pregnant women in Tanzania: a call to address its determinants

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Bruno F. Sunguya ◽  
Yue Ge ◽  
Linda Mlunde ◽  
Rose Mpembeni ◽  
Germana Leyna ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Pregnant Women ◽  
Reproductive Age ◽  
Gis Mapping ◽  
Demographic And Health Surveys ◽  
Health Coverage ◽  
Nutritional Knowledge ◽  
Women Of Reproductive Age ◽  
Anemia In Pregnancy ◽  
In Pregnancy

Abstract Background Anemia in pregnancy is behind a significant burden of maternal mortality and poor birth outcomes globally. Efforts to address it need evidence on trends and its pertinent factors as they vary from one area to another. Methods We pooled data of 23,203 women of reproductive age whose hemoglobin levels were measured from two Tanzania Demographic and Health Surveys (TDHS). Of them, 2,194 women were pregnant. Analyses employed descriptive analyses to determine the burden of anemia, its characteristics, and severity; GIS mapping to determine the regional changes of anemia between 2005 and 2015; and logistic regression to determine the remaining determinants of anemia among pregnant women using Stata 15. Results The burden of anemia among pregnant women in Tanzania has remained unprecedently high, and varies between regions. There was no significant decline of anemia in general between the two periods after adjusting for individual, households, reproductive, and child characteristics [AOR = 0.964, 95% CI = 0.774–1.202, p = 0.747). Anemia is currently prevalent in 57% of pregnant women in Tanzania. The prevalence is more likely to be higher among women aged 15–19 years than those aged between 20–34 years. It is more likely to be prevalent among those within large families, with no formal education, food insecurity, lack of health insurance, had no antimalaria during pregnancy, and had low frequency of ANC attendance. On the other hand, delivery in a health facility may be potentially protective against anemia. Conclusions Anemia in pregnancy remained persistently high and prevalent among 57% of pregnant women in Tanzania. Efforts to address anemia are crucial and need to be focused in regions with increasing burden of anemia among pregnant women. It is imperative to address important risk factors such as food insecurity, strengthening universal health coverage, empowering women of reproductive age with education and especially nutritional knowledge and advocating for early antenatal booking, attendance, and facility delivery.

Venlafaxine prescription claims among insured women of reproductive age and pregnant women, 2011–2016

2021 ◽  
Author(s):  
April D. Summers ◽  
Kayla N. Anderson ◽  
Elizabeth C. Ailes ◽  
Scott D. Grosse ◽  
William V. Bobo ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Reproductive Age ◽  
Women Of Reproductive Age

scholarly journals Prevalence and Associated Factors of Vitamin A Deficiency among Children and Women in Senegal

2020 ◽  
Vol 8 (2) ◽  
pp. 1-11
Author(s):  
Mane Hélène Faye ◽  
Nicole Idohou-Dossou ◽  
Abdou Badiane ◽  
Anta Agne-Djigo ◽  
Papa Mamadou DD Sylla ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Logistic Regression ◽  
Vitamin A ◽  
Pregnant Women ◽  
Vitamin A Deficiency ◽  
Plasma Concentrations ◽  
Reproductive Age ◽  
Subclinical Inflammation ◽  
Women Of Reproductive Age ◽  
Factors Associated

Background: Like many developing countries, Senegal does not have data on the extent of vitamin A deficiency (VAD) that is representative of its population. The present survey was conducted to fill this gap and to identify factors associated with VAD, prior to the introduction of a large-scale vitamin A oil fortification program. Procedures: A nationwide representative cross-sectional survey involving 1887 children 12 to 59 months old and 1316 women of reproductive age (WRA) was conducted. Blood samples were collected and plasma concentrations of retinol (PR), C-reactive protein (CRP), and alpha-1-acidglycoprotein were measured. PR was adjusted for subclinical inflammation using the BRINDA regression methodology. Multivariate logistic regression was used to identify factors associated with VAD. Findings: The adjusted prevalence of VAD (PR ≤ 0.7 μmol/L) in children was 15.3% and differed by age group, area of residence, and socioeconomic status and half of them had subclinical inflammation. Among WRA, VAD was low (2.3%) and 18.1% had vitamin A insufficiency (VAI). Pregnant women were more affected by VAI (28.4%) and Dakar had lower figures compared with other cities and rural strata. Prevalence of VAI decreased with increasing wealth quintile. In logistic regression, abnormal CRP, poverty, scarce consumption of poultry, oysters, melon, red palm oil, palm kernel oil, Saba senegalensis fruit pulp (Maad) and cowpea, frequent consumption of leeks and consumption of Leptadenia hastata leaves (Mbuum tiakhat), were associated with VAD in children. For women, lower socioeconomic status, fair or poor health status and anemia were negatively associated with VAI. Conclusions: In Senegal, VAD is a moderate public health problem in children and slight among women. Particular attention should be paid to children older than 23 months, pregnant women, rural populations, and poorest households. Nutritional interventions should be implemented alongside morbidity prevention and control. Keywords: vitamin A deficiency, children 12-59 months, women of reproductive age, Senegal.

scholarly journals ‘After they finish their meals, I have my meal from the leftovers; I have to adjust:” Examining How Gender Norms Affect Anemia Rates in Odisha India (P04-122-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Erica Sedlander ◽  
Chandni Ladwa ◽  
Sameera Talegawkar ◽  
Rohini Ganjoo ◽  
Rajiv Rimal
Keyword(s):  
Folic Acid ◽  
Focus Group ◽  
Pregnant Women ◽  
Gender Norms ◽  
Reproductive Age ◽  
Deficiency Anemia ◽  
Women Of Reproductive Age ◽  
Iron Supplements ◽  
Rich Food ◽  
Iron Folic Acid

Abstract Objectives Half of women of reproductive age in India have iron deficiency anemia compared to only 23% of men. Most research focuses on biological reasons for this discrepancy and access to iron-folic acid and iron-rich foods. However, recent research in India shows that inequitable gender norms may affect a woman's ability or desire to take iron supplements and to eat iron-rich food. The objective of this study is to examine how and why gender norms may be affecting high and persistent rates of anemia in India. Methods We conducted 25 key informant interviews and 16 focus group discussions with women of reproductive age, adolescents, husbands and mothers-in-law (n = 148) in Odisha, India. We purposively sampled key informants and randomly sampled focus group participants. We analyzed the data using applied thematic analysis in Nvivo software. Results Our data shows that unequal gender norms impact behaviors that are directly related to high rates of anemia. Women are often serving their husband, children, and in-laws first and “adjusting” to whatever is leftover which may be poor in nutritional qualities and less iron rich. Men are also the main breadwinners but often spend their money on alcohol, money that could be spent on iron-rich food for the household. Women reported that extreme fatigue is a normal part of being a woman and that a woman's plight is to take care of her family at any cost. Given that fatigue, the primary symptom of anemia is normalized; women may be less likely to seek treatment. Women tend to prioritize the health of their family over her own which could affect her ability or desire to go to the health center to get tested for anemia or to obtain iron supplements. Pregnant women are more likely to take iron supplements for the health of the baby, not her own health. While non-pregnant women of reproductive age who were not diagnosed with anemia were not focused on preventive health, only major illnesses and thus, were not taking supplements at all. Conclusions More upstream barriers, like gender norms, may be impinging on a woman's ability to take iron folic acid and to eat iron rich foods. Understanding how gender norms contribute to anemia could change the narrative from a biomedical issue to a social justice issue. Funding Sources The Bill and Melinda Gates Foundation. Supporting Tables, Images and/or Graphs

Seroincidence of HIV-1 infection in African women of reproductive age

AIDS ◽  
1994 ◽  
Vol 8 (7) ◽  
pp. 983-986 ◽  
Author(s):  
Valeriane Leroy ◽  
Philippe Van de Perre ◽  
Philippe Lepage ◽  
Joseph Saba ◽  
François Nsengumuremyi ◽  
...  
Keyword(s):  
Reproductive Age ◽  
African Women ◽  
Women Of Reproductive Age ◽  
Hiv 1

scholarly journals Endometrium and polycystic ovary syndrome

2018 ◽  
Vol 67 (4) ◽  
pp. 60-66
Author(s):  
Pavel P Yakovlev ◽  
Igor Yu Kogan
Keyword(s):  
Endometrial Cancer ◽  
Polycystic Ovary Syndrome ◽  
Pregnancy Outcomes ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome ◽  
Endocrine Disorder ◽  
Increased Risk ◽  
Adverse Pregnancy

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Patients with PCOS present with several endometrial abnormalities possibly explaining some of the adverse endometrium-related outcomes in these women. PCOS is inconsistently associated adverse pregnancy outcomes and an increased risk of endometrial cancer. The purpose of this review is to systematize the available data on endometrial dysfunction associated with PCOS. (For citation: Yakovlev PP, Kogan IYu. Endometrium and polycystic ovary syndrome. Journal of Obstetrics and Women’s Diseases. 2018;67(4):60-66. doi: 10.17816/JOWD67460-66).

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