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Alamoudi RA, Sabbagh HJ, Zeinalddin M, Al-Batayneh OB, Al Bulushi T, AboulHassan MA, Koraitim M, Alkharafi L, Almuqbali B, Alghamdi SM, Bahdila D, Refahee SM, Quritum M, Taqi FF, Albassam B, Ayed M, Embaireeg A, Alnahdi R, AlSharif MT, Aljohar AJ, Abdulhameed FD, Alrejaye NS, Viswapurna PS, Al Halasa T, Basri OA, Bataineh MA, Tantawi ME. COVID-19 vaccine and non-syndromic orofacial clefts in five arab countries. A case-control study. Clin Oral Investig 2024; 28:357. [PMID: 38839609 DOI: 10.1007/s00784-024-05744-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVES Risk factors for non-syndromic orofacial cleft (NSOFCs) include genetic profile and environmental exposure to medication and illnesses during pregnancy. We assessed the association between the COVID-19 vaccination and the incidence of NSOFC across five Middle Eastern countries. MATERIALS AND METHODS This multi-country, hospital-based, case-control study included infants with NSOFCs whose first 3 intrauterine months coincided with the time when pregnant women were allowed to receive COVID-19 vaccination in the countries participating in the study. Newborns with NSOFCs were examined for cleft type and their parents were interviewed for maternal exposures and COVID-19 vaccination. Controls were newborns matched to cases in gender and setting. RESULTS The study recruited 977 (348 children with NSOFCs and 629 controls). Maternal use of nicotine (Adjusted Odds Ratio (AOR): 2.437; P = 0.044) and family history of NSOFC (AOR: 11.059; P < 0.001) increased significantly the AOR of having a child with NSOFC. On the other hand, COVID-19 vaccine administration to pregnant mothers have significantly decreased the AOR of having a child with NSOFC (AOR: 0.337; P = 0.006). CONCLUSION This study suggests that COVID-19 vaccination is not related to NSOFC and might protect against having a child affected with such a congenital anomaly. CLINICAL RELEVANCE The finding of this study is important for healthcare providers for considering COVID-19 vaccination for pregnant woman. Clear communication and education about the potential risks and benefits would be crucial for informed decision-making. The study's results would directly impact pregnant individuals, as they would need accurate information to make informed decisions about their health and the health of their infants.
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Affiliation(s)
- Rana A Alamoudi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, PO Box 80200, Jeddah, 21589, Saudi Arabia
| | - Heba Jafar Sabbagh
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, PO Box 80200, Jeddah, 21589, Saudi Arabia.
| | | | - Ola B Al-Batayneh
- Department of Orthodontics, Pediatric and Community Dentistry, College of Dental Medicine, University of Sharjah, PO Box 27272, Sharjah, United Arab Emirates
- Preventive Dentistry Department, Faculty of Dentistry, Jordan University of Science & Technology, Irbid, 22110, Jordan
| | | | | | - Mohamed Koraitim
- Maxillofacial and Plastic Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Lateefa Alkharafi
- Cleft and Craniofacial Unit, Ministry of Health, Kuwait City, Kuwait
| | | | - Sultan Musaad Alghamdi
- Ministry of Health, Bisha, 67711, Saudi Arabia
- Pediatric Dentistry Department, Bisha Dental Centre, Ministry of Health, Bisha, Saudi Arabia
| | - Dania Bahdila
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, PO Box 80200, Jeddah, 21589, Saudi Arabia
| | | | - Maryam Quritum
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Fatemah Fahad Taqi
- Department of General Dentistry, Ministry of Health, Kuwait City, Kuwait
| | - Bader Albassam
- Department of General Dentistry, Ministry of Health, Kuwait City, Kuwait
| | - Mariam Ayed
- Neonatal Department, Maternity Hospital-Kuwait, Kuwait City, Kuwait
| | - Alia Embaireeg
- Neonatal Department, Maternity Hospital-Kuwait, Kuwait City, Kuwait
| | | | - Mona Talal AlSharif
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Aziza Johar Aljohar
- Department of Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fatma Dawood Abdulhameed
- Pediatric Surgery Department, King Salman Medical City, Maternity and Children's Hospital, Madinah, Saudi Arabia
| | - Najla Sulaiman Alrejaye
- Department of Dentistry, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | | | - Tamara Al Halasa
- Preventive Dentistry Department, Faculty of Dentistry, Jordan University of Science & Technology, Irbid, 22110, Jordan
| | - Osama Adel Basri
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mohammed A Bataineh
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Johnson MS, Skjerdingstad N, Ebrahimi OV, Hoffart A, Johnson SU. Fear of giving birth alone: Experiences of psychological distress, symptoms of anxiety and depression, and coping- strategies of childbearing women during COVID-19. Midwifery 2024; 131:103951. [PMID: 38402661 DOI: 10.1016/j.midw.2024.103951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 12/23/2023] [Accepted: 02/09/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Psychological distress during pregnancy is a well-documented risk factor for adverse maternal outcomes. Distress related to the COVID-19 pandemic may further increase the vulnerability of pregnant women to negative mental health outcomes. AIM To explore the mental health experiences of pregnant women, focusing on mental health outcomes, challenges related to the pandemic, coping strategies, and factors buffering mental health factors during the restricted COVID-19 lockdown period. METHODS A mixed-methods survey study was conducted, examining symptoms of anxiety, depression, and burnout among 21 pregnant women. Qualitative data were gathered through open-ended questions about participants' experiences of challenges, coping strategies and buffering factors amid the pandemic. Symptoms of anxiety, depression and burnout were calculated, and qualitative data was thematically analyzed. RESULTS Approximately one-third (24 %) of the respondents reported clinically significant levels of depression, 19 % reported clinically significant levels of anxiety, and 43 % reported experiencing burnout. All participants reported distress and emotional burden, including fear, worry, stress and anxiety related to the pandemic. Specific concerns such as fear of giving birth alone, fear of the consequences due to lockdown restrictions, insufficient information, disruption of prenatal healthcare services, and fear of miscarriage were prevalent among the participants. Social support, financial stability, stable relationships, adherence to daily routines, reduced stress and social demands, a calmer daily life, physical activity, and less work-related stress including working from home, emerges as buffering factors that aided women in coping with pandemic-related distress. CONCLUSION Healthcare providers should prioritize stability, predictability, and minimizing disruptions to prenatal care. Broad-based screening is crucial to identify women at risk of depression, anxiety, and burnout. Recommendations for clinical pathways aimed at pregnant women are discussed.
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Affiliation(s)
- Miriam S Johnson
- Department of Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway.
| | | | - Omid V Ebrahimi
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Asle Hoffart
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Sverre Urnes Johnson
- Department of Psychology, University of Oslo, Oslo, Norway; Modum Bad Psychiatric Hospital, Vikersund, Norway
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Al-Bdairi AA, Makki HA, Shawki O, Alkhudair SH, Al-Hilli NM, Alkhalidi BA, Alkadhim HK, Shweliyya AA. The Multi-faceted Effects of COVID-19 on Female Reproductive Health: An Updated Narrative Review. Cureus 2024; 16:e57944. [PMID: 38738039 PMCID: PMC11082527 DOI: 10.7759/cureus.57944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 05/14/2024] Open
Abstract
Concerns about the SARS-CoV-2 pandemic's possible impact on sexual and reproductive health have grown significantly. In this narrative review, the latest research on the effects of SARS-CoV-2 infection on several facets of sexual and reproductive health is reviewed. The review starts initially by going through the possible consequences of SARS-CoV-2 on female menstrual cycles. The virus may interfere with the menstrual cycle, which could affect hormone synthesis and endometrial reactions, according to newly available evidence. Menstrual blood loss may be impacted by COVID-19's potential to influence endothelial cell function and systemic hemostasis. Hypothalamic amenorrhea may be brought on by severe COVID-19 disease. There is little research on this subject, although most women resume their regular menstrual cycles after 1-2 months of recuperation. The review also examines how SARS-CoV-2 infection may affect assisted reproductive technology (ART) treatments. There are few clinical data, although some research points to potential effects on embryo quality. Overall, ART results, however, did not materially change from the time before the epidemic. Obstetric problems are more likely when SARS-CoV-2 infection occurs during pregnancy, especially in the third trimester. Even though the maternal death rate is still low, pregnant women, especially those with comorbidities, are more likely to experience serious sickness. The review emphasizes how the COVID-19 vaccine affects menstrual cycles, showing brief, modest modifications without serious health hazards. Also included are the psychological effects of family planning choices during the pandemic. In conclusion, this narrative review offers a thorough assessment of the complicated and changing effects of SARS-CoV-2 on sexual and reproductive health. The different requirements of people and couples during and after the pandemic are highlighted, underscoring the necessity for ongoing study and specialized healthcare practices.
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Affiliation(s)
- Adnan A Al-Bdairi
- Infertility, Assisted Reproductive Technologies, Teba IVF and Genetic Center, Babylon, IRQ
| | - Hayder A Makki
- Pharmacology and Toxicology, College of Pharmacy, University of Babylon, Babylon, IRQ
| | - Osama Shawki
- Gynecology Surgery, School of Medicine, Cairo University, Cairo, EGY
| | - Sallama H Alkhudair
- Fertility, Assisted Reproductive Technology, Alzaitoon Specialized Fertility Center, Baghdad, IRQ
| | - Nadia M Al-Hilli
- Obstetrics and Gynecology, College of Medicine, University of Babylon, Babylon, IRQ
| | - Batool A Alkhalidi
- Obstetrics and Gynecology, College of Medicine, University of Kufa, Najaf, IRQ
| | - Hanan K Alkadhim
- Obstetrics and Gynecology, Iraqi Fertility Society, College of Medicine, University of Babylon, Babylon, IRQ
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Gerges S, Obeid S, Hallit S. Traversing mental health disorders during pregnancy: Lebanese women's experiences of antepartum depression and anxiety. Ir J Med Sci 2023; 192:2949-2959. [PMID: 37081286 PMCID: PMC10117264 DOI: 10.1007/s11845-023-03371-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
INTRODUCTION Over the past few years, Lebanon-a developing country-has faced a plethora of economic and political challenges, with more than half of the general population presenting depressive and anxiety symptoms. However, when it comes to maternal mental health during pregnancy, the last examination in Lebanon dates far back to 2005. Our study's aim was to help delineate the factors associated with Lebanese women's mental health disorders during pregnancy, namely antepartum depression and anxiety. METHODS We launched a cross-sectional study among Lebanese pregnant women (age ≥ 18 years) between June and July 2021, during the COVID-19 lockdown (N = 433). RESULTS In total, 87.8% of the participants experienced depression (mild to severe), where severe depression was observed in 7.9%. In addition, 70.3% had a significant level of anxiety. Increased pregnancy-specific hassles (beta = 0.93), being Muslim compared to Christians (beta = 3.19), being afraid of an existing aggressor (beta = 8.75), urinary tract infections (beta = 2.02), and higher gestational age (beta = 0.07) were significantly associated with higher depression, whereas higher physical activity index (beta = - 0.09) and increased disordered eating attitudes during pregnancy (beta = - 0.27) were significantly associated with less depression, all accounting for 60.4% of the model's variance. Additionally, increased pregnancy-specific hassles (beta = 0.54), being Muslim compared to Christians (beta = 2.42), urinary tract infections (beta = 1.72), and having been emotionally or physically abused (beta = 1.19) were significantly associated with higher levels of anxiety and could predict 49% of the total variance. CONCLUSION Our study has suggested the existence of factors that have additive effects in potentiating the risk for depression and anxiety among Lebanese pregnant women, namely cultural beliefs, pregnancy-related distress, medical complications during pregnancy, and a history of abuse. Therefore, it would be judicious to implement screening programs targeting pregnant women at risk for antepartum depression and anxiety. In addition, high rates of prenatal depression and anxiety were detected among our sample, supporting that recognizing and treating maternal mental health disorders should be prioritized during antenatal care in Lebanon.
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Affiliation(s)
- Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal-Eddib, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
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Ocktariyana, Lestari D. Knowledge, Attitudes, and Anxiety of Midwives Toward Maternal Care During the COVID-19 Pandemic: A Descriptive Study on Midwives Who Experience the Perinatal and Breastfeeding Phases. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:679-683. [PMID: 38205415 PMCID: PMC10775874 DOI: 10.4103/ijnmr.ijnmr_48_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/28/2023] [Accepted: 07/31/2023] [Indexed: 01/12/2024]
Abstract
Background People all over the world, including pregnant women, have experienced stress and anxiety due to the coronavirus disease 2019 (COVID-19) pandemic. Providing services during the pandemic is something that midwives in primary health care cannot avoid. This study assesses a midwife's knowledge, attitude, and anxiety toward providing maternal care during the pandemic. Material and Method A cross-sectional design was used in this study, which involved 183 midwives who provided midwifery services at hospitals and health centers and had experience with the perinatal and breastfeeding phases. Using the Google Forms tool, respondents completed a questionnaire regarding their knowledge, attitudes, and anxiety toward maternal care during the COVID-19 pandemic. Results One hundred eighty-two midwives (99.50%) understood maternal care well during the COVID-19 pandemic. In addition, the maternal care provided during the COVID-19 pandemic was viewed favorably by almost all the participants. The percentage of midwives working in primary care in the perinatal phase who had moderate-to-severe anxiety levels during the COVID-19 pandemic was 17 women (27.42%). Conclusions The knowledge and attitudes of midwives about the COVID-19 pandemic in this study were good, and there was a smaller percentage of midwives with an extreme level of anxiety.
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Affiliation(s)
- Ocktariyana
- Department of Midwifery, Politeknik Kesehatan Kementerian Kesehatan Palembang, Palembang, Indonesia
| | - Dian Lestari
- Department of Midwifery, Politeknik Kesehatan Kementerian Kesehatan Palembang, Palembang, Indonesia
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Akbar Z, Al Azmi E, Husain E, Aldarweesh M, AlMuzayen K, Alhadhoud F, Al Harmi J. The Effects and Outcomes of the COVID-19 Pandemic on Pregnant Women in Kuwait. Med Princ Pract 2023; 32:000534125. [PMID: 37708881 PMCID: PMC10659704 DOI: 10.1159/000534125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/13/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES This retrospective study reports the effects of COVID-19 among hospitalized pregnant women infected with COVID-19 and compares them to a control group. METHODS A multi-center retrospective cohort study, in which data of pregnant women with COVID-19, admitted to five different hospitals in Kuwait, were collected. Two groups were included, the first group were women with COVID-19 who were admitted between March 22, 2020 until December 31, December 2020. The second (control) group included pregnant women without COVID-19, who were admitted between March 1, 2019 and March 21, 2020. Data were collected using a standardized data collection survey, entered using Excel Software and analyzed using Analysis of Variance (ANOVA). RESULTS We compared 764 patients, with confirmed COVID-19 with 765 uninfected control subjects. The majority of pregnant women were diagnosed with COVID-19 infection during the third trimester. Tachycardia was the most frequent sign at admission and dry cough and fever were the most common presenting symptoms. ICU admission and respiratory failure were significantly higher in the COVID-19 group. Cesarean section (CS) rate was higher in the COVID-19 group, with obstetric and maternal complications being the most common indications in comparison to fetal indications in the control group. CONCLUSIONS This study was conducted to identify the effects of COVID-19 in pregnancy. Most patients were asymptomatic. The rate of normal vaginal delivery was higher in the control group. The main indications for Cesarean section in the COVID-19 group were obstetrical and maternal complications compared to fetal complications in the control group. .
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Affiliation(s)
- Zahraa Akbar
- Department of Obstetrics and Gynecology, Maternity Hospital, Kuwait City, Kuwait
| | - Eman Al Azmi
- Department of Obstetrics and Gynecology, Maternity Hospital, Kuwait City, Kuwait
| | - Eelaf Husain
- Department of Obstetrics and Gynecology, Maternity Hospital, Kuwait City, Kuwait
| | - Mariam Aldarweesh
- Department of Obstetrics and Gynecology, Maternity Hospital, Kuwait City, Kuwait
| | - Khaled AlMuzayen
- Department of Obstetrics and Gynecology, Maternity Hospital, Kuwait City, Kuwait
| | - Fatemah Alhadhoud
- Department of Obstetrics and Gynecology, Maternity Hospital, Kuwait City, Kuwait
| | - Jehad Al Harmi
- Department of Obstetrics and Gynecology, College of Medicine, Kuwait University, Jabriya, Kuwait
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Afshar M, Ghahramani L, Asadollahi A, Karimi M, Mobasheri N. Predictors of health behavior compliance for the prevention of Covid-19 based on the extended parallel process model in pregnant women in Iran. Health Care Women Int 2023; 44:1019-1035. [PMID: 36854007 DOI: 10.1080/07399332.2023.2181349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 01/21/2023] [Accepted: 02/13/2023] [Indexed: 03/02/2023]
Abstract
Pregnant women are at higher risk of getting severe Covid-19 disease and consequences on the health status of them and their fetuses. Despite vaccination, all preventive behaviors are emphasized. This study aimed to identify the determinants of Covid-19 preventive health behaviors in pregnant women using Extended Parallel Process Model. This cross-sectional study, was conducted on 175pregnant women. The model fit indices were acceptable. Knowledge had indirect effect on adherence to Covid-19 preventive behaviors trough mediating role of self-efficacy and response efficacy. So, it is suggested that, educational interventions should focus on increasing knowledge.
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Affiliation(s)
- Mohammad Afshar
- Student Research Committee, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Ghahramani
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdolrahim Asadollahi
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Karimi
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Narges Mobasheri
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Ashtari F, Djalalimotlagh S, Farbod Y, Tizmaghz A. A Case Report of an Atypical Neurological Presentation of COVID-19 in Pregnancy. Anesth Pain Med 2023; 13:e134925. [PMID: 38021329 PMCID: PMC10664158 DOI: 10.5812/aapm-134925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/06/2023] [Accepted: 02/22/2023] [Indexed: 12/01/2023] Open
Abstract
Symptomatic patients with coronavirus disease 2019 (COVID-19) mostly have flu-like symptoms. However, neurologic manifestations are common and may be the early findings of COVID-19. Data for COVID-19 do not indicate an increased risk of infection in pregnant individuals, but the risk of disease severity and mortality is high in this patient population. We report a case of a pregnant woman in the 10th gestational week, who presented with neurological symptoms of sudden impairment in walking, balance, speech, and consciousness, started the night before, and a seven-day history of fever, chills, myalgia, and general weakness before admission. The polymerase chain reaction (PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was positive for the cerebrospinal fluid sample a day before the positive nasopharyngeal sample. Axial brain magnetic resonance imaging revealed the involvement of the spinothalamic tract. Following treatment with intravenous immunoglobulin, the patient's neurological condition gradually recovered, except for lower limb muscle strength, and she was discharged from the hospital on the 10th day of admission. This case is unique as it emphasizes the importance of considering COVID-19 when uncommon neurologic manifestations with negative nasopharyngeal PCR are present.
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Affiliation(s)
- Fatemeh Ashtari
- Department of Intensive Care Unit, Iran University of Medical Sciences, Tehran, Iran
| | - Soudabeh Djalalimotlagh
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Yasaman Farbod
- Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Adnan Tizmaghz
- Department of General Surgery, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Grussu P, Jorizzo GJ, Alderdice F, Quatraro RM. Preventing, Mitigating, and Treating Women's Perinatal Mental Health Problems during the COVID-19 Pandemic: A Scoping Review of Reviews with a Qualitative Narrative Synthesis. Behav Sci (Basel) 2023; 13:bs13050358. [PMID: 37232595 DOI: 10.3390/bs13050358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/15/2023] [Accepted: 04/18/2023] [Indexed: 05/27/2023] Open
Abstract
Meeting the mental health needs of perinatal women during the COVID-19 pandemic is a serious concern. This scoping review looks at how to prevent, mitigate or treat the mental health problems faced by women during a pandemic, and lays out suggestions for further research. Interventions for women with pre-existing mental health problems or health problems that develop during the perinatal period are included. The literature in English published in 2020-2021 is explored. Hand searches were conducted in PubMed and PsychINFO using the terms COVID-19, perinatal mental health and review. A total of 13 systematic and scoping reviews and meta-analyses were included. This scoping review shows that every woman should be assessed for mental health issues at every stage of her pregnancy and postpartum, with particular attention to women with a history of mental health problems. In the COVID-19 era, efforts should be focused on reducing the magnitude of stress and a perceived sense of lack of control experienced by perinatal women. Helpful instructions for women with perinatal mental health problems include mindfulness, distress tolerance skills, relaxation exercises, and interpersonal relationship building skills. Further longitudinal multicenter cohort studies could help improve the current knowledge. Promoting perinatal resilience and fostering positive coping skills, mitigating perinatal mental health problems, screening all prenatal and postpartum women for affective disorders, and using telehealth services appear to be indispensable resources. In future, governments and research agencies will need to pay greater attention to the trade-offs of reducing the spread of the virus through lockdowns, physical distancing, and quarantine measures and developing policies to mitigate the mental health impact on perinatal women.
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Affiliation(s)
- Pietro Grussu
- Consultorio Familiare, South Padua District, Azienda ULSS 6 Euganea, Veneto Region, National Health Service, 35042 Este, Italy
| | - Gianfranco J Jorizzo
- Prenatal Medicine, Azienda ULSS 6 Euganea, Veneto Region, National Health Service, 35131 Padova, Italy
| | - Fiona Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
- School of Nursing and Midwifery, Queens University Belfast, Belfast BT9 7BL, UK
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Harville EW, Wood ME, Sutton EF. Social distancing and mental health among pregnant women during the coronavirus pandemic. BMC Womens Health 2023; 23:189. [PMID: 37081476 PMCID: PMC10117246 DOI: 10.1186/s12905-023-02335-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 04/07/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The effect of social distancing due to the COVID-19 pandemic on the mental health of pregnant women is of particular concern, given potential effects on physical health, family functioning, and child development. METHODS Pregnant women were recruited for the "Implications of and Experiences Surrounding being Pregnant during the COVID-19 Pandemic" study at Woman's Hospital in Baton Rouge, Louisiana. Participants enrolled at any point during their pregnancy and surveys were delivered weekly until the participant indicated that she had delivered her baby; a postpartum survey followed four weeks after delivery. This analysis includes 1037 participants with baseline, 596 with follow-up, and 302 with postpartum surveys. Questions on social distancing behaviors were asked at baseline and grouped based on whether they involved social distancing from work, friends and family, or public places. Symptoms of anxiety, stress, depression, and pregnancy-related anxiety were measured. Each type of social distancing was examined as a predictor of mental health using linear model with control for confounders. RESULTS The study population was largely white (84.1%), married (81.8%), and educated (76.2% with a bachelor's or higher degree). Women who were younger, Black, unmarried, or had less education or income reported fewer social distancing behaviors. Mean anxiety score in the highest quartile of overall social distancing was 8.3 (SD 5.6), while in the lowest quartile it was 6.0 (SD 5.0) (p < 0.01), while perceived stress postpartum and pregnancy-related stress were not associated with social distancing. Associations were substantially diminished when controlled for baseline levels of anxiety symptoms. CONCLUSIONS Greater social distancing was associated with more anxiety symptoms, but worse mental health, particularly anxiety, may also have contributed to greater social distancing behaviors.
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Affiliation(s)
- Emily W Harville
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, 1440 Canal St Ste 2001 #8318, New Orleans, LA, 70112-2715, USA.
| | - Moira E Wood
- Tulane University School of Medicine, New Orleans, LA, USA
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Gamberini C, Angeli F, Knight L, Zaami M, Al-Nasiry S, Ambrosino E. Effect of COVID-19 on antenatal care: experiences of medical professionals in the Netherlands. Reprod Health 2023; 20:40. [PMID: 36890561 PMCID: PMC9994402 DOI: 10.1186/s12978-023-01587-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 02/23/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND COVID-19 has greatly affected the delivery of all health care services globally. Antenatal care is one area of care that has been impacted, despite the fact that attending antenatal check-ups is essential for pregnant women and cannot be postponed. Little is known about how exactly ANC provision has changed in the Netherlands, or how the changes have impacted midwives and gynaecologists providing those services. METHODS This study used a qualitative research design to investigate changes in individual and national practice following the onset of the COVID-19 pandemic. The study involved a document analysis of protocols and guidelines for ANC provision to evaluate how those changed following the onset of the COVID-19 pandemic and semi-structured interviews with ANC care providers (i.e., gynaecologists and midwives). RESULTS Guidance was issued by multiple organizations, during the pandemic, on how to approach the risk of infection in pregnant women, recommending several changes to ANC to protect both pregnant women and ANC providers. Both midwives and gynaecologists reported changes in their practice. With less face-to-face consultations happening, digital technologies became critical in the care of pregnant women. Shorter and fewer visits were reported, with midwifery practices adjusting their guidelines further than hospitals. Challenges, with high workloads and lack of personal protective equipment were discussed. CONCLUSIONS The COVID-19 pandemic has had an immense impact on the health care system. This impact has had both negative and positive effects on the provision of ANC in the Netherlands. It is important to learn from the current COVID-19 pandemic and adapt ANC, as well as health care systems as a whole, to be better prepared for future health crises and ensure continuous provision of good quality care.
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Affiliation(s)
- Carlotta Gamberini
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Faculty of Health, Medicine & Life Sciences, Maastricht University, 6229 ER, Maastricht, The Netherlands.,Research School GROW for Oncology and Reproduction, Maastricht University, 6229 ER, Maastricht, The Netherlands
| | - Federica Angeli
- School for Business and Society, University of York, York, YO105DD, UK
| | - Lucia Knight
- Division of Social and Behavioural Sciences, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, 7700, South Africa.,School of Public Health, Community and Health Sciences, University of the Western Cape, Bellville, 7535, South Africa
| | - Mariama Zaami
- Department of Geography and Resource Development, University of Ghana, LG25, Accra, Ghana
| | - Salwan Al-Nasiry
- Research School GROW for Oncology and Reproduction, Maastricht University, 6229 ER, Maastricht, The Netherlands.,Department of Obstetrics and Gynecology, Maastricht University Medical Centre+, 6229 HX, Maastricht, The Netherlands
| | - Elena Ambrosino
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Faculty of Health, Medicine & Life Sciences, Maastricht University, 6229 ER, Maastricht, The Netherlands. .,Research School GROW for Oncology and Reproduction, Maastricht University, 6229 ER, Maastricht, The Netherlands.
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12
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A confirmed COVID-19 in a patient with newly diagnosed hypertension and preexisting type 2 diabetes mellitus: a case report. Ann Med Surg (Lond) 2023; 85:431-434. [PMID: 36923768 PMCID: PMC10010790 DOI: 10.1097/ms9.0000000000000151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/22/2022] [Indexed: 03/18/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) aggravates preexisting diabetes mellitus and contributes to newly discovered hypertension by increasing blood pressure by inhibiting the activity of angiotensin-converting enzyme 2 in the rennin-angiotensin system. Diabetes patients may be more vulnerable to COVID-19 due to chronic comorbidities such as obesity and cardiovascular disease such as hypertension. Case presentation On 23 March 2022, a retired black African woman in her 60s was taken into the emergency room with the chief complaints of frequent midnight urine, hazy vision, headache, fever, and tingling in her hands and feet. A throat swab PCR test that revealed positive results after 28 h was used to confirm COVID-19. Her electrocardiogram showed sinus tachycardia with a heart rate of 105 beats per minute. Fluid resuscitation (0.9% normal saline) of 1000 ml and drip insulin administration commenced as soon as she was brought to an ICU. Clinical discussion In this case report, the patient had been previously diagnosed with type 2 diabetes mellitus. COVID-19 affects the beta cells, forcing them to release insulin and increasing insulin insufficiency, which leads to her blood glucose raising. Type 2 diabetes mellitus is therefore the most frequent comorbidity of COVID-19 in this case report. Conclusion Poor blood glucose management in the case of COVID-19 may increase the pathogen's susceptibility, the likelihood that patients will be admitted to the hospital, and the likelihood that mortality will be enhanced.
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13
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Ayala NK, Lewkowitz AK, Whelan AR, Miller ES. Perinatal Mental Health Disorders: A Review of Lessons Learned from Obstetric Care Settings. Neuropsychiatr Dis Treat 2023; 19:427-432. [PMID: 36865680 PMCID: PMC9971615 DOI: 10.2147/ndt.s292734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
Perinatal mental health has garnered significant attention within obstetrics over the last couple of decades as the long- and short-term morbidities of untreated perinatal mental health disorders on both the mother and fetus/neonate have become increasingly apparent. There have been major strides in increasing screening for perinatal mental health disorders, clinician comfort with prescribing common psychiatric medications, and integrating mental health professionals into prenatal care via health services approaches such as the collaborative care model. Despite these advances, however, gaps still remain in the tools used for screening and diagnosis, obstetric clinician training in diagnosis and management of perinatal mood and anxiety disorders, as well as patient access to mental health care during pregnancy and especially postpartum. Herein we review the state of perinatal mental health from the perspective of the obstetric provider and identify areas of ongoing innovation.
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Affiliation(s)
- Nina K Ayala
- Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island, Providence, RI, USA.,Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Adam K Lewkowitz
- Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island, Providence, RI, USA.,Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Anna R Whelan
- Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island, Providence, RI, USA.,Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Emily S Miller
- Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island, Providence, RI, USA.,Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI, USA
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14
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Muacevic A, Adler JR, Thabet H, Alenezi F. Maternal Outcomes Among Pregnant Women Diagnosed With COVID-19. Cureus 2023; 15:e33887. [PMID: 36819426 PMCID: PMC9934465 DOI: 10.7759/cureus.33887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND COVID-19 has the potential development of negative maternal outcomes for pregnant women. The risk of contracting COVID-19 is high as pregnancy alters the maternal immune system. Therefore, this study aims to assess maternal outcomes among pregnant women with COVID-19 in the Kingdom of Saudi Arabia. METHODS A retrospective study was conducted in three hospitals during the pandemic over four months, from the beginning of December 2019 until the end of March 2020. Data was collected using a structured questionnaire filled by the researcher using computers from the medical records of three hospitals. The sampling was all confirmed cases of pregnant women who delivered while being positive for COVID-19. RESULTS This study has identified a total of 82 pregnant women with confirmed COVID-19 infection over the study period, with ages ranging from 18 to >40 years. The majority of the pregnant women (84.1%) were symptomatic, with fever (48.8%) being the most frequent COVID-19 symptom, followed by cough (42.7%) and shortness of breath (41.5%). Some women (46.3%) had a spontaneous normal vaginal delivery, and 50.2% had a cesarean delivery. The most common adverse pregnancy outcome was premature delivery (36.5%), followed by fetal distress (20.7%), preeclampsia (2.4%), eclampsia (1.2%), and diabetic ketoacidosis (1.2%), as well as the death of three pregnant women. CONCLUSION This study found that infected mothers faced various risks of maternal adverse outcomes. The majority of the pregnant women experienced mild to moderate illness symptoms and were delivered within 14 days of the onset of COVID-19 symptoms. Healthcare providers should provide more attention to pregnant women diagnosed with COVID-19.
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15
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Fathan T, Pudjiadi AH, Putri ND, Permata N, Nursakina Y. Inflammatory and coagulation marker profiles in severe pediatric COVID-19 patients: a systematic review. PAEDIATRICA INDONESIANA 2022. [DOI: 10.14238/pi62.6.2022.411-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Children are susceptible to SARS-CoV-2 infection and often present mild manifestations. However, severe and critical cases have also been reported. The inflammation and coagulation marker profile pattern in these patients along with the white blood cell differential count in critical PICU cases with non-COVID-19 etiology is not entirely clear.
Objective To evaluate the inflammation and coagulation profiles in children presenting with severe/critical SARS-CoV-2 infection.
Methods A systematic search and review of scientific literature was conducted following the PRISMA guidelines using ProQuest, SCOPUS, EBSCOHost, ScienceDirect, Cochrane, EMBASE, and Pubmed databases. All relevant original studies until March 11, 2021, were included. The risk of bias was appraised using the Modified Newcastle Ottawa Scale and JBI Critical Appraisal Checklist tools.
Results We identified 14 studies across 6 countries, including a total sample of 159 severe and critically ill pediatric COVID-19 patients. Most of the subjects showed normal leukocytes, but increased CRP, procalcitonin, ferritin, and IL-6. Studies on coagulation profiles showed normal thrombocytes, PT, aPTT, and inconsistent D-dimer results.
Conclusion Inflammation and coagulation parameters in severe/critically ill children with COVID-19 are atypical. Several inflammatory markers were elevated, including CRP, ferritin, procalcitonin, and IL-6. However, the elevated marker values are still lower compared to non-COVID infection patients. Further investigation of the parameters need to be done in serial examination multicenter studies, which include control subjects.
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16
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Sahu S, Laishram G, Rannaware A, Choudhari SG. Impact of COVID-19 on Pregnancy and Maternal-Neonatal Outcomes: A Narrative Review. Cureus 2022; 14:e31397. [DOI: 10.7759/cureus.31397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/11/2022] [Indexed: 11/14/2022] Open
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17
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Exploring Clinical and Biological Features of Premature Births among Pregnant Women with SARS-CoV-2 Infection during the Pregnancy Period. J Pers Med 2022; 12:jpm12111871. [PMID: 36579593 PMCID: PMC9694165 DOI: 10.3390/jpm12111871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
Studies observed that women infected with SARS-CoV-2 during pregnancy had a higher risk of preterm birth. Although it is likely that COVID-19 during the late trimester of pregnancy can trigger premature birth, prematurity remains a concern, and it is vital to study additional clinical and biological patient factors that are highly associated with this negative pregnancy outcome and allow for better management based on the existing predictors. In order to achieve this goal, the current study retrospectively recruited 428 pregnant patients that were separated into three study groups using a 1:2:4 matching ratio and a nearest-neighbor matching method. Sixty-one pregnant patients had a history of COVID-19 during pregnancy and gave birth prematurely; 124 pregnant patient controls had COVID-19 and gave birth full-term, while the second control group of 243 pregnant patients had a premature birth but no history of COVID-19. It was observed that a symptomatic SARS-CoV-2 infection during the third trimester was significantly more likely to be associated with premature birth. Even though the rate of ICU admission was higher in these cases, the mortality rate did not change significantly in the COVID-19 groups. However, SARS-CoV-2 infection alone did not show statistical significance in determining a premature birth (β = 1.09, CI = 0.94−1.15, p-value = 0.067). Maternal anemia was the strongest predictor for prematurity in association with SARS-CoV-2 infection (β = 3.65, CI = 1.46−5.39, p-value < 0.001), followed by elevated CRP (β = 2.11, CI = 1.20−3.06, p-value < 0.001), and respectively IL-6 (β = 1.92, CI = 1.20−2.47, p-value = 0.001. SARS-CoV-2 infection is associated with an increased risk of preterm birth, as shown by our data. If SARS-CoV-2 infection arises during the third trimester, it is recommended that these patients be hospitalized for surveillance of clinical evolution and biological parameters, such as anemia and high inflammatory markers, which have a multiplicative influence on the pregnancy result.
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18
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Hosseini MS, Jahanshahlou F, Mahmoodpoor A, Sanaie S, Naseri A, Kuchaki Rafsanjani M, Seyedi-Sahebari S, Vaez-Gharamaleki Y, ZehiSaadat M, Rahmanpour D. Pregnancy, peripartum, and COVID-19: An updated literature review. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2022. [DOI: 10.29333/ejgm/12227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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19
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Alesci A, Pergolizzi S, Fumia A, Miller A, Cernigliaro C, Zaccone M, Salamone V, Mastrantonio E, Gangemi S, Pioggia G, Cicero N. Immune System and Psychological State of Pregnant Women during COVID-19 Pandemic: Are Micronutrients Able to Support Pregnancy? Nutrients 2022; 14:nu14122534. [PMID: 35745263 PMCID: PMC9227584 DOI: 10.3390/nu14122534] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/04/2022] [Accepted: 06/16/2022] [Indexed: 02/04/2023] Open
Abstract
The immune system is highly dynamic and susceptible to many alterations throughout pregnancy. Since December 2019, a pandemic caused by coronavirus disease 19 (COVID-19) has swept the globe. To contain the spread of COVID-19, immediate measures such as quarantine and isolation were implemented. These containment measures have contributed to exacerbate situations of anxiety and stress, especially in pregnant women, who are already particularly anxious about their condition. Alterations in the psychological state of pregnant women are related to alterations in the immune system, which is more vulnerable under stress. COVID-19 could therefore find fertile soil in these individuals and risk more severe forms. Normally a controlled dietary regimen is followed during pregnancy, but the use of particular vitamins and micronutrients can help counteract depressive-anxiety states and stress, can improve the immune system, and provide an additional weapon in the defense against COVID-19 to bring the pregnancy to fruition. This review aims to gather data on the impact of COVID-19 on the immune system and psychological condition of pregnant women and to assess whether some micronutrients can improve their psychophysical symptoms.
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Affiliation(s)
- Alessio Alesci
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
- Correspondence: (A.A.); (A.F.); (N.C.)
| | - Simona Pergolizzi
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
| | - Angelo Fumia
- Department of Clinical and Experimental Medicine, University of Messina, 98147 Messina, Italy;
- Correspondence: (A.A.); (A.F.); (N.C.)
| | - Anthea Miller
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy;
| | - Caterina Cernigliaro
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Maria Zaccone
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Vanessa Salamone
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Enza Mastrantonio
- Azienda Sanitaria Provinciale 5 Messina, 98124 Messina, Italy; (C.C.); (M.Z.); (V.S.); (E.M.)
| | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, University of Messina, 98147 Messina, Italy;
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98125 Messina, Italy;
| | - Nicola Cicero
- Department of Biomedical and Dental Science and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
- Correspondence: (A.A.); (A.F.); (N.C.)
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20
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Chao M, Menon C, Elgendi M. A Ranking of the Most Common Maternal COVID-19 Symptoms: A Systematic Review. Front Med (Lausanne) 2022; 9:865134. [PMID: 35774993 PMCID: PMC9239403 DOI: 10.3389/fmed.2022.865134] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 05/23/2022] [Indexed: 11/30/2022] Open
Abstract
As the coronavirus disease 2019 (COVID-19) continues to devastate health systems worldwide, there is particular concern over the health and safety of one high-risk group, pregnant women, due to their altered immune systems. Since health workers regularly rely on symptoms to inform clinical treatment, it became critical to maintain a ranked list of COVID-19 symptoms specific to pregnant women. This systematic review investigated the prevalence of common COVID-19 symptoms in pregnant women and compared the ranked list of symptoms to articles of various sizes. Articles were included if they discussed pregnant women diagnosed with COVID-19 using polymerase chain reaction testing, and women present symptoms of COVID-19 and were published between December 1, 2019, and December 1, 2021; while articles were excluded if they did not report on pregnant women with COVID-19 displaying symptoms of COVID-19. Articles were identified on OVID MedLine and Embase in January of 2022. The risk of bias and quality appraisal was assessed using a nine-item modified Scottish Intercollegiate Guidelines Network checklist for case-control studies. The search results included 78 articles that described 41,513 pregnant women with 42 unique COVID-19 symptoms. When ranked, the most common symptoms were found to be cough (10,843 cases, 16.02%), fever (7,653 cases, 11.31%), myalgia (6,505 cases, 9.61%), headache (5,264 cases, 7.78%), and dyspnea (5,184 cases, 7.66%). When compared to other articles in the literature with sample sizes of n = 23,434, n = 8,207, and n = 651, the ranking largely aligned with those in other articles with large sample sizes and did not align with the results of articles with small sample sizes. The symptom ranking may be used to inform testing for COVID-19 in the clinic. Research is rapidly evolving with the ongoing nature of the pandemic, challenging the generalizability of the results.
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Affiliation(s)
- Melissa Chao
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Carlo Menon
- Biomedical and Mobile Health Technology Laboratory, Department of Health Sciences and Technology, Zurich, Switzerland
| | - Mohamed Elgendi
- Biomedical and Mobile Health Technology Laboratory, Department of Health Sciences and Technology, Zurich, Switzerland
- *Correspondence: Mohamed Elgendi
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21
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Gangi R, Corrias A, Pintus R, Marcialis MA, Fanos V. What to Expect from COVID-19 and from COVID-19 Vaccine for Expecting or Lactating Women. Pediatr Rep 2022; 14:262-275. [PMID: 35736656 PMCID: PMC9228525 DOI: 10.3390/pediatric14020034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/29/2022] [Accepted: 05/10/2022] [Indexed: 12/21/2022] Open
Abstract
Recent studies identified pregnancy as a high-risk condition for the development of maternal-fetal complications in the case of the SARS-CoV-2 infection. Therefore, the scientific community is now considering pregnant women a "fragile" category that should be vaccinated with high priority. The number of pregnant women undergoing hospitalization since summer 2021, including Intensive Care Unit admission, is growing, as well as the risk of preterm birth. Evidence from both animals and humans suggest that, similarly to other vaccines routinely administered in pregnancy, COVID-19 vaccines are not crossing the placenta, do not increase the risk of miscarriage, preterm birth, stillbirth, the birth of small gestational age neonates, as well as the risk of congenital abnormalities. To date, the World Health Organization and scientific literature are promoting and encouraging the vaccination of all pregnant and lactating women. The aim of our narrative review is to present the available literature regarding this issue with the aim to provide appropriate answers to the most frequent requests, doubts, and fears that have led many expecting and lactating women not to become vaccinated during this pandemic period.
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Affiliation(s)
- Roberta Gangi
- School of Pediatrics, University of Cagliari, 09124 Cagliari, Italy; (R.G.); (A.C.)
| | - Angelica Corrias
- School of Pediatrics, University of Cagliari, 09124 Cagliari, Italy; (R.G.); (A.C.)
| | - Roberta Pintus
- Department of Surgery, University of Cagliari and Neonatal Intensive Care Unit, AOU di Cagliari, 09124 Cagliari, Italy; (M.A.M.); (V.F.)
- Correspondence:
| | - Maria Antonietta Marcialis
- Department of Surgery, University of Cagliari and Neonatal Intensive Care Unit, AOU di Cagliari, 09124 Cagliari, Italy; (M.A.M.); (V.F.)
| | - Vassilios Fanos
- Department of Surgery, University of Cagliari and Neonatal Intensive Care Unit, AOU di Cagliari, 09124 Cagliari, Italy; (M.A.M.); (V.F.)
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22
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Saberi H, Ghorashi Z, Loripoor M. Comparison of pregnancy outcome during pandemic of COVID-19 and non-pandemic situations, Yazd, Iran, in 2019-2020. J OBSTET GYNAECOL 2022; 42:1937-1943. [PMID: 35603710 DOI: 10.1080/01443615.2022.2054685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to compare the pregnancy outcomes during pandemic and non-pandemic COVID-19 in women referred to health service centres in Yazd. This descriptive study was performed based on the information obtained from all pregnant women referred to comprehensive health service centres in Yazd city using census method, between March 21 2019 and December 21 2019 and between March 20 2020 and December 20 2020. The pregnant mothers' information, including their pregnancy outcome, and maternal and neonatal complications, was extracted from the electronic health information system of Yazd city. The obtained data were analysed by Chi-Square test. No significant difference was found between non-pandemic and pandemic COVID-19 situations in most variables. As well, maternal and neonatal death were equally observed in both non-pandemic and pandemic COVID-19 situations. Wanted pregnancy, post term birth, multiple pregnancy and caesarean section rates were found to be higher in pandemic than non-pandemic COVID-19 (p<.001). Reported abortion, screening for foetal anueploidy in the first and second trimesters as well as the number of episodes of prenatal care during COVID-19 pandemic were significantly lower than those of non-pandemic period (p<.001). The outcome of pregnancy during the pandemic was not significantly different from that of non-pandemic situation.Impact StatementWhat is already known on this subject? Studies already showed COVID-19 in pregnancy alter the maternal and neonatal outcomes in different degrees compared with pregnant individuals without COVID-19. However, it is not clear that pregnancy outcome dose alter during pandemic of COVID-19 compared to non-pandemic situations in general population?What do the results of this study add? The results of this study revealed that the outcome of pregnancy during pandemic was not significantly different from that of non-pandemic situation.What are the implications of these findings for clinical practice and/or further research? According to results of this study, we can ensure pregnant women in the situation of pandemic COVID-19 that they are not in greater risk. We suggest future research should be done for comparison of pregnancy outcome in the situation of delta variant pandemic with non-pandemic COVID-19.
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Affiliation(s)
- Hengameh Saberi
- Department of Midwifery, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zohreh Ghorashi
- Department of Midwifery, School of Nursing and Midwifery, Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Marzeyeh Loripoor
- Department of Midwifery, School of Nursing and Midwifery, Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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23
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Ghafoor H, Abdus samad A, Bel Khair AOM, Ahmed O, Khan MNA. Critical Care Management of Severe COVID-19 in Pregnant Patients. Cureus 2022; 14:e24885. [PMID: 35572463 PMCID: PMC9097928 DOI: 10.7759/cureus.24885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 12/15/2022] Open
Abstract
Since December 2019, the coronavirus disease (COVID-19) pandemic has had a disastrous impact worldwide. COVID-19 is caused by the SARS-CoV-2 virus and was declared a pandemic by the WHO on March 11, 2020. The virus has been linked to a wide range of respiratory illnesses, ranging from mild symptoms to acute pneumonia and severe respiratory distress syndrome. Pregnant women are more vulnerable to COVID-19 complications owing to the physiological and immunological changes caused by pregnancy. According to the CDC, pregnant patients with COVID-19 are commonly hospitalized and often require admission to ICUs and ventilator support. Therefore, it is especially important for pregnant women to adhere to disease prevention measures to lower the risk of contracting the disease. In addition, the guidelines of several clinical societies and local health authorities should be followed when caring for pregnant women with suspected or confirmed COVID-19. In this review article, we discuss the epidemiology of COVID-19 during delivery, its effect on the physiological and immunological changes during pregnancy, the classification of COVID-19 severity, maternal and fetal risks, antenatal care, respiratory management, treatment/medication safety, timing and mode of delivery, anesthetic considerations, and the outcome of critically ill pregnant patients with COVID-19, as well as their post-delivery care and weaning from mechanical ventilation.
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24
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Apanga PA, Kumbeni MT, Sakeah JK, Olagoke AA, Ajumobi O. The moderating role of partners' education on early antenatal care in northern Ghana. BMC Pregnancy Childbirth 2022; 22:391. [PMID: 35513775 PMCID: PMC9070613 DOI: 10.1186/s12884-022-04709-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early antenatal care (ANC) is essential for improving maternal and child health outcomes. The primary aims of this study were to 1) estimate the association between partners' education attainment and early ANC, and 2) determine whether partners' level of education modified the relationship between mothers' education, mothers' age, planned pregnancy, employment status and early ANC. METHODS Data were obtained from a cross-sectional study conducted from April to May 2021 among 519 mothers with a live birth in the past year in the Nabdam district in the Upper East Region in northern Ghana. Generalized estimating equations were used to assess whether partners' level of education modified the relationship between mothers' education, mothers' age, planned pregnancy, employment status and early ANC. Effect modification was assessed on the additive and multiplicative scales using adjusted prevalence ratios (aPR) and corresponding 95% confidence intervals. RESULTS Mothers whose partners had secondary or higher education had a 26% higher prevalence of early ANC compared to mothers whose partners had less than a secondary level of education (aPR: 1.26, 95% CI: 1.05,1.51). There was evidence of effect modification by partners' education on the relationship between planned pregnancy and early ANC on both the additive (Relative excess risk due to interaction [RERI]: 0.61, 95% CI: 0.07,0.99), and multiplicative (ratio of PRs: 1.64, 95% CI: 1.01,2.70) scales. Among mothers whose partners had less than secondary education, mothers who had teenage pregnancy (i.e., aged 18-19 years old during pregnancy) were less likely to have early ANC compared to those who did not have teenage pregnancy (aPR: 0.71, 95% CI: 0.53,0.97). Among mothers whose partners had a secondary or higher education, early ANC was more prevalent among employed mothers compared to those who were unemployed (aPR: 1.27, 95% CI: 1.02,1.57). CONCLUSIONS Our findings suggest that whilst mothers whose partners had a secondary or higher education were more likely to initiate early ANC, supporting such women to plan their pregnancies can further increase the coverage of early ANC.
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Affiliation(s)
| | - Maxwell Tii Kumbeni
- Oregon State University, College of Public Health and Human Sciences, Corvallis, USA
| | - James Kotuah Sakeah
- University of Ottawa, School of Epidemiology and Public Health, Ottawa, Canada
| | - Ayokunle A Olagoke
- University of Illinois at Chicago, School of Public Health, Chicago, USA
| | - Olufemi Ajumobi
- University of Nevada, Reno, School of Public Health, Reno, USA
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Llamas-Clark EF, Singson RB, Heralde FM, Lumandas MU, Villanueva-Uy MET, Cagayan MSFS, Regencia ZJG, Baja ES. Risk factors of COVID-19 vertical transmission among pregnant and non-pregnant Filipinos in Metro Manila: a multicentre cohort study protocol. BMJ Open 2022; 12:e053389. [PMID: 35470182 PMCID: PMC9039156 DOI: 10.1136/bmjopen-2021-053389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The novel (COVID-19 was first reported to have originated in Wuhan, China, in December 2019. This new strain, SARS-CoV-2, has spread rapidly worldwide, prompting the WHO to declare the COVID-19 outbreak a global pandemic. The main objective of this cohort study is to determine the risk factors of COVID-19, the modes of COVID-19 vertical transmission, and the maternal and fetal outcomes among non-pregnant and pregnant women and their fetuses. METHODS AND ANALYSIS This is a multicentre epidemiological study that will involve a prospective cohort. COVID-19 status among consulting non-pregnant and pregnant women in public hospitals in Manila, Philippines, will be determined and monitored for 6-12 months. Swab specimens from the nasopharynx, cervix, rectum, amniotic fluid, placenta, cord blood and breastmilk will be collected during consult and admission for reverse transcription-PCR (RT-PCR) testing. Blood will be collected during the postdelivery period to monitor the women and their neonates for any undue development and determine the antibody development to indicate an infective or non-infective state. Evidence of vertical transmission will be explored with the presence or absence of the virus using the maternal and fetal neonatal RT-PCR and lateral flow antibody status. Descriptive and inferential statistics will be done, including the associations between exposures and risk factors, description of clinical characteristics, and the COVID-19 status of the participants. ETHICS AND DISSEMINATION The Single Joint Research Ethics Board of the Department of Health has approved this protocol (SJREB 2020-30). The study results will be disseminated through conference presentations, peer-reviewed articles, and various stakeholder public forums and activities.
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Affiliation(s)
- Erlidia F Llamas-Clark
- Department of Obstetrics and Gynecology, College of Medicine, University of the Philippines Manila, City of Manila, Philippines
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, City of Manila, Metro Manila, Philippines
| | - Rebecca B Singson
- Department of Obstetrics and Gynecology, St. Luke's Medical Center, Taguig City, Philippines
| | - Francisco M Heralde
- Department of Molecular Biology and Biochemistry, College of Medicine, University of the Philippines Manila, City of Manila, Philippines
| | - Mayan U Lumandas
- Department of Virology, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Maria Esterlita T Villanueva-Uy
- Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines Manila, City of Manila, Metro Manila, Philippines
| | - Maria Stephanie Fay S Cagayan
- Department of Pharmacology and Toxicology, College of Medicine, University of the Philippines Manila, City of Manila, Philippines
| | - Zypher Jude G Regencia
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, City of Manila, Metro Manila, Philippines
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, City of Manila, Philippines
| | - Emmanuel S Baja
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, City of Manila, Metro Manila, Philippines
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, City of Manila, Philippines
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Chowdhury S, Bappy MH, Desai S, Chowdhury S, Patel V, Chowdhury MS, Fonseca A, Sekzer C, Zahid S, Patousis A, Gerothanasi A, Masenga MJ. COVID-19 and Pregnancy. Discoveries (Craiova) 2022; 10:e147. [PMID: 36438440 PMCID: PMC9683860 DOI: 10.15190/d.2022.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 06/16/2023] Open
Abstract
It is of greatest concern how COVID-19 is affecting pregnancy, mothers, and babies. Scientists are studying the impact of COVID-19 on pregnant women and babies and are understanding a little more every day. Reports show that there is an increased risk in pregnant women compared to nonpregnant women to get more serious illness due to COVID-19. Researchers are also investigating COVID-19 and its potential impact on a fetus. There are exceedingly rare cases of COVID-19 transmission to the fetus, and newborns can pick up COVID-19 when exposed. Vaccines are proved to be safe for pregnant women and help prevent both mother and the fetus from getting COVID-19 and are also highly effective to prevent COVID-19 infection, critical sickness, and fatalities in general. There are specific guidelines for labor and delivery during the COVID-19 pandemic which are to be imposed and followed to achieve safer and healthier childbirth. In this article, the overall influence of COVID-19 in pregnancy, its pathophysiology, effects on placenta and neonates, maternal and perinatal features and outcomes, the role of vaccination, available treatment options, and the guidelines to be followed during the pandemic are discussed based on the available scientific evidence.
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Affiliation(s)
| | | | | | | | - Vraj Patel
- Smt. NHL Municipal Medical College, Ahmedabad, India
| | | | | | | | - Samina Zahid
- Khyber Girls Medical College, Peshawar, Pakistan
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Wesołowska A, Orczyk-Pawiłowicz M, Bzikowska-Jura A, Gawrońska M, Walczak B. Protecting Breastfeeding during the COVID-19 Pandemic: A Scoping Review of Perinatal Care Recommendations in the Context of Maternal and Child Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3347. [PMID: 35329035 PMCID: PMC8949921 DOI: 10.3390/ijerph19063347] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/05/2022] [Accepted: 03/08/2022] [Indexed: 12/14/2022]
Abstract
The objective of this scoping review is to determine to what extent the recommendations on perinatal care protect breastfeeding during the COVID-19 pandemic. The review follows the PRISMA ScR Extension guidelines. The research was conducted in Scopus, Medline via Pubmed, and Web of Science databases from 1 March 2020 to 31 May 2021, using 392 combinations of keywords. We searched for reviews and original papers published in English providing recommendations on delivery mode, companion during labor, the possibility of skin-to-skin contact (SSC), breastfeeding, and visitors policy. After screening, 86 out of 8416 publications qualified for data extraction. The majority of them indicated that COVID-19 infection is not a sufficient reason for a cesarean section; however, on a national level, cesarean births in severely ill patients were overrepresented. A significant number of recommendations deprived mothers of the necessary support during their labor and stay in the maternity ward. A shared decision-making model was hardly visible. Only the earliest COVID-19 recommendations suspended direct breastfeeding; in later publications, decisions were related to the mother's health, but other options of natural feeding were rarely discussed.
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Affiliation(s)
- Aleksandra Wesołowska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Department of Medical Biology, Medical University of Warsaw, Litewska 14/16, 00-575 Warsaw, Poland; (A.W.); (A.B.-J.)
- Human Milk Bank Foundation, Podkowy Str. 128 J, 04-937 Warsaw, Poland;
| | - Magdalena Orczyk-Pawiłowicz
- Department of Biochemistry and Immunochemistry, Division of Chemistry and Immunochemistry, Wroclaw Medical University, M. Skłodowskiej-Curie 48/50, 50-369 Wrocław, Poland;
| | - Agnieszka Bzikowska-Jura
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Department of Medical Biology, Medical University of Warsaw, Litewska 14/16, 00-575 Warsaw, Poland; (A.W.); (A.B.-J.)
| | - Małgorzata Gawrońska
- Human Milk Bank Foundation, Podkowy Str. 128 J, 04-937 Warsaw, Poland;
- Faculty of Sociology, University of Warsaw, Karowa 18, 00-927 Warsaw, Poland
| | - Bartłomiej Walczak
- Institute of Applied Social Sciences, University of Warsaw, Nowy Świat 69, 00-927 Warsaw, Poland
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Atarod Z, Zamaniyan M, Moosazadeh M, Valadan R, Soleimanirad SM, Gordani N. Investigation of vaginal and rectal swabs of women infected with COVID-19 in two hospitals covered by Mazandaran University of Medical Sciences, 2020. J OBSTET GYNAECOL 2022; 42:2225-2229. [PMID: 35260029 DOI: 10.1080/01443615.2022.2036966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Due to the emergence of COVID-19 virus worldwide and need to identify ways of transmitting the virus, we conducted a cross-sectional study from July to November 2020 on 80 women with COVID-19 infection was confirmed by nasopharyngeal proper time polymerase chain reaction (RT-PCR). We investigated SARS-CoV-2 in their vaginal and rectal swabs. The results showed that (n = 6, 7.5%) patients had positive rectal PCR and (n = 10, 12.5%) had positive vaginal PCR. There was a statistically significant relationship between positive rectal test and positive vaginal test (p=.001). Positive rectal PCR was significantly higher in women over 60 years old than in other age groups (p=.004).Impact StatementWhat is already known on this subject? In the past studies, the presence of the virus in the vagina and rectum was less or not confirmed.What do the results of this study add? The results of our study showed that the COVID-19 virus can infect the vagina and rectum of women.What are the implications of these findings for clinical practice and/or further research? This finding should be considered in sexual transmission and mother to child transmission and also vaginal colonisation, especially at the time of delivery.
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Affiliation(s)
- Zoleikha Atarod
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Marzieh Zamaniyan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Department of Epidemiology, Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Valadan
- Department of Immunology, Molecular and Cell Biology Research Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Mohsen Soleimanirad
- Department of Family Health, Population and School Management, Mazandaran University of Medical Sciences, Sari, Iran
| | - Noushin Gordani
- Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
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Ruiz-Roman R, Martinez-Perez C, Gil Prados I, Cristóbal I, Sánchez-Tena MÁ. COVID-19 and Pregnancy: Citation Network Analysis and Evidence Synthesis. JMIR Pediatr Parent 2022; 5:e29189. [PMID: 35044301 PMCID: PMC8989383 DOI: 10.2196/29189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 12/22/2021] [Accepted: 01/03/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND COVID-19 spread quickly around the world shortly after the first outbreaks of the new coronavirus disease at the end of December 2019, affecting all populations, including pregnant women. OBJECTIVE The aim of this study was to analyze the relationship between different publications on COVID-19 in pregnancy and their authors through citation networks, as well as to identify the research areas and to determine the publication that has been the most highly cited. METHODS The search for publications was carried out through the Web of Science database using terms such as "pregnancy," "SARS-CoV-2," "pregnant," and "COVID-19" for the period between January and December 2020. Citation Network Explorer software was used for publication analysis and VOSviewer software was used to construct the figures. This approach enabled an in-depth network analysis to visualize the connections between the related elements and explain their network structure. RESULTS A total of 1330 publications and 5531 citation networks were identified in the search, with July being the month with the largest number of publications, and the United States, China, and England as the countries with the greatest number of publications. The most cited publication was "Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records" by Chen and colleagues, which was published in March 2020. Six groups identified as being close in the citation network reflect multidisciplinary research, including clinical characteristics and outcomes in pregnancy, vertical transmission, delivery mode, and psychological impacts of the pandemic on pregnant women. CONCLUSIONS Thousands of articles on COVID-19 have been published in several journals since the disease first emerged. Identifying relevant publications and obtaining a global view of the main papers published on COVID-19 and pregnancy can lead to a better understanding of the topic. With the accumulation of scientific knowledge, we now know that the clinical features of COVID-19 during pregnancy are generally similar to those of infected nonpregnant women. There is a small increase in frequency of preterm birth and cesarean birth, related to severe maternal illness. Vaccination for all pregnant women is recommended. Several agents are being evaluated for the treatment of COVID-19, but with minimal or no information on safety in pregnancy. These results could form the basis for further research. Future bibliometric and scientometric studies on COVID-19 should provide updated information to analyze other relevant indicators in this field.
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Affiliation(s)
- Rebeca Ruiz-Roman
- Department of Gynecology and Obstetrics, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Inés Gil Prados
- Department of Gynecology and Obstetrics, Hospital Clínico San Carlos, Madrid, Spain
| | - Ignacio Cristóbal
- Department of Gynecology and Obstetrics, Hospital Clínico San Carlos, Madrid, Spain.,Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Miguel Ángel Sánchez-Tena
- Instituto Superior de Educação e Ciências, Lisboa, Portugal.,Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
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30
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Kim TE, Kim H, Ahn KH, Joo E, Kim HJ, Park JY, Oh KJ, Jung YH, Lee H, Choi CW, Jung J, Park KU. Investigation for SARS-CoV-2 vertical transmission in a COVID-19 pregnant woman: a case report. J OBSTET GYNAECOL 2022; 42:1561-1563. [PMID: 35164648 DOI: 10.1080/01443615.2022.2027893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Tae Eun Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Hyojeong Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Kwang Hee Ahn
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Eunwook Joo
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Hyeon Ji Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Jee Yoon Park
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyung Joon Oh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Hwa Jung
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Hyunju Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.,Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chang Won Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.,Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jongtak Jung
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyoung Un Park
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea
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Ghosh MD, Datta MR, Singh V, Choudhary A. Analysis of Pregnant Women Recovered From Antenatal SARS-CoV-2 Infection: An Observational Study. Cureus 2022; 14:e22094. [PMID: 35295360 PMCID: PMC8917808 DOI: 10.7759/cureus.22094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 11/18/2022] Open
Abstract
Background and objective The global health care system is facing the challenge of diagnosing and treating the ongoing coronavirus disease 2019 (COVID-19) pandemic. Pregnant women belong to a vulnerable group, and the effect of the virus on the mother and fetus is not well established. The aim of the study was to understand the maternal and fetal outcomes after recovery from antenatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods This was a retrospective observational study conducted at Tata Main Hospital, Jamshedpur, India. It included all COVID-19-negative pregnant women who had delivered between 1st January 2021 and 31st August 2021 and had tested positive in the antenatal period (by reverse transcription-polymerase chain reaction (RT-PCR)), the details of which are available in the hospital database. Results A total of 53 women were included in our study who had tested positive in the antenatal period and had turned negative during delivery. Out of the 53 women, 5.7% were infected in the first trimester, 34% in the second trimester, and 60.3% were positive in the third trimester. We found an asymptomatic subgroup in 52.8% of women and mild symptoms in 41.5% of women. Two women were admitted in their antenatal period with moderate COVID-19 disease and one with severe. Preterm births between 34 weeks and 37 weeks were seen in 26.4% of women. Vaginal delivery accounted for 30.2% of cases. The most common indications for cesarean section were fetal distress (17%), previous cesarean section (17%), and unwillingness for vaginal delivery. Out of the 53 pregnant women included in the study, acute respiratory distress syndrome (ARDS) was seen in two women- one diagnosed intraoperatively during cesarean section and the other was diagnosed on the first postoperative day. Conclusion The study showed that pregnant women infected with SARS-CoV-2 usually have no/mild symptoms, and they recover well and have favorable maternal and neonatal outcomes. However, perinatal vigilance is advisable in these cases, as there is a risk of developing respiratory morbidity.
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Afiyah RK, Umamah F, Sari RY, Hasina SN, Sulistyorini S, Prasetyo B, Supatmi S. Self-Screening as an Effort to Prevent the Risk of Exposure to COVID-19 in Pregnant Women. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Pregnant women in the era of the COVID-19 pandemic were listed as one of the vulnerable groups at risk of being infected with COVID-19 because during pregnancy there were changes in gestational physiology and immunological changes in the body’s system. Changes in the immune system that occur during pregnancy can make pregnant women more susceptible to coronavirus infection and more at risk of experiencing severe and fatal disease symptoms.
AIM: The purpose of this study was to analyze the effect of self-screening on behavior to prevent the risk of being exposed to COVID-19 in pregnant women.
METHODS: This type of research is experimental using a randomized controlled trial research design. This research was conducted for 2 weeks in August–September 2021. The population of this study was pregnant women in Surabaya. The sampling technique used consecutive sampling technique and was divided into two groups, namely, the intervention group with 39 respondents and the control group with 39 respondents. Data analysis used the Wilcoxon signed ranks test with a significance value of p < 0.05. The questionnaire used in this study was designed using a reference and behavioral theory approach with a reliability of 0.89 and a validity test that obtained a Cronbach alpha value of 0.86.
RESULTS: The average behavior to prevent the risk of being exposed to COVID-19 before conducting a self-screening intervention in the intervention group was 1.92 (the behavior to prevent the risk of being exposed to COVID-19 was sufficient) and in the control group was 1.85 (the behavior to prevent the risk of being exposed to COVID-19 was sufficient) with p = 0.596 which means there is no difference in the average behavior to prevent the risk of being exposed to COVID-19, while after being given the self-screening intervention the average prevention behavior in the intervention group is 2.46 (the behavior to prevent the risk of being exposed to COVID-19 is good) and in the control group is 2.05 (the behavior of preventing the risk of being exposed to COVID-19 is good) with p = 0.000 which means that there is a difference in the average behavior of preventing the risk of being exposed to COVID-19 in the intervention group and the control group after being given a self-screening intervention.
CONCLUSION: In general, this study proves that self-screening can foster behavior to prevent the risk of being exposed to COVID-19 in pregnant women.
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Ferreira G, Blasina F, Rodríguez Rey M, Anesetti G, Sapiro R, Chavarría L, Cardozo R, Rey G, Sobrevia L, Nicolson GL. Pathophysiological and molecular considerations of viral and bacterial infections during maternal-fetal and -neonatal interactions of SARS-CoV-2, Zika, and Mycoplasma infectious diseases. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166285. [PMID: 34624499 PMCID: PMC8492386 DOI: 10.1016/j.bbadis.2021.166285] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 09/14/2021] [Accepted: 10/01/2021] [Indexed: 01/04/2023]
Abstract
During pregnancy, a series of physiological changes are determined at the molecular, cellular and macroscopic level that make the mother and fetus more susceptible to certain viral and bacterial infections, especially the infections in this and the companion review. Particular situations increase susceptibility to infection in neonates. The enhanced susceptibility to certain infections increases the risk of developing particular diseases that can progress to become morbidly severe. For example, during the current pandemic caused by the SARS-CoV-2 virus, epidemiological studies have established that pregnant women with COVID-19 disease are more likely to be hospitalized. However, the risk for intensive care unit admission and mechanical ventilation is not increased compared with nonpregnant women. Although much remains unknown with this particular infection, the elevated risk of progression during pregnancy towards more severe manifestations of COVID-19 disease is not associated with an increased risk of death. In addition, the epidemiological data available in neonates suggest that their risk of acquiring COVID-19 is low compared with infants (<12 months of age). However, they might be at higher risk for progression to severe COVID-19 disease compared with older children. The data on clinical presentation and disease severity among neonates are limited and based on case reports and small case series. It is well documented the importance of the Zika virus infection as the main cause of several congenital anomalies and birth defects such as microcephaly, and also adverse pregnancy outcomes. Mycoplasma infections also increase adverse pregnancy outcomes. This review will focus on the molecular, pathophysiological and biophysical characteristics of the mother/placental-fetal/neonatal interactions and the possible mechanisms of these pathogens (SARS-CoV-2, ZIKV, and Mycoplasmas) for promoting disease at this level.
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Affiliation(s)
- Gonzalo Ferreira
- Laboratory of Ion Channels, Biological Membranes and Cell Signaling, Dept. of Biophysics, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay,Corresponding author
| | - Fernanda Blasina
- Dept. of Neonatology, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Marianela Rodríguez Rey
- Dept. of Neonatology, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Gabriel Anesetti
- Dept. of Histology and Development, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Rosana Sapiro
- Dept. of Histology and Development, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Luisina Chavarría
- Laboratory of Ion Channels, Biological Membranes and Cell Signaling, Dept. of Biophysics, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Romina Cardozo
- Laboratory of Ion Channels, Biological Membranes and Cell Signaling, Dept. of Biophysics, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Grazzia Rey
- Dept. of Clinical Ginecology and Obstetrics B, Facultad de Medicina, Universidad de la Republica, Uruguay
| | - Luis Sobrevia
- Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrics, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile,Department of Physiology, Faculty of Pharmacy, Universidad de Sevilla, Seville E-41012, Spain,Medical School, Faculty of Medicine, Sao Paulo State University (UNESP), Brazil,University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston, QLD 4029, Australia,Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, 9713GZ Groningen, The Netherlands
| | - Garth L. Nicolson
- Department of Molecular Pathology, The Institute for Molecular Medicine, Huntington Beach, CA, USA
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Koire A, Mittal L, Erdei C, Liu CH. Maternal-fetal bonding during the COVID-19 pandemic. BMC Pregnancy Childbirth 2021; 21:846. [PMID: 34963458 PMCID: PMC8713042 DOI: 10.1186/s12884-021-04272-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The pregnant population experienced unique COVID-19 physical and psychosocial stressors such as direct health concerns related to the virus and loss of access to resources since the COVID-19 emerged as a global pandemic in early 2020. Despite these COVID-19-related stress and concerns, the maternal experience of bonding with their unborn children has not been well studied. This work aimed to study the association between mental health history, current mental health symptoms, psychological factors, COVID-19-related worries, and self-reported maternal-fetal bonding of pregnant women. METHODS This online, survey-based cross-sectional study focused on women pregnant during the pandemic and assessed 686 women using data collected from May 19, 2020 to October 3, 2020. Enrolled respondents completed assessments in which they self-reported maternal-fetal bonding, mental health symptomatology, psychological factors, and COVID-19-related worries regarding health, pregnancy, and resources. RESULTS Depressive symptoms in pregnant women were associated with lower quality maternal-fetal bonding, while a higher level of anxiety was positively associated with bonding; however, past history of depression or generalized anxiety diagnosis did not appear to be as relevant as active symptomatology. Maternal resilience, but not distress tolerance, appeared to be a protective factor resulting in improved bonding. Higher levels of worry regarding impact of COVID-19 on health were significantly associated with improved bonding, while worries regarding the impact of COVID-19 on the pregnancy or resources were not significantly associated with bonding. The study also found associations between different sociodemographic variables and bonding, including a strong positive association between first time motherhood and bonding and a negative association between higher education and income and bonding. CONCLUSIONS This study was the first to report potential protective and risk factors to the maternal-fetal bonding process in women pregnant during the COVID-19 pandemic. Unique COVID-19 concerns exist; however, anxiety and COVID-19 concerns do not appear to undermine maternal-fetal bonding while active depressive symptomatology may negatively influence bonding; interventions increasing maternal resilience may be particularly valuable.
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Affiliation(s)
- Amanda Koire
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Carmina Erdei
- Harvard Medical School, Boston, MA, USA.,Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Cindy H Liu
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA. .,Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA.
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Jakimiuk AJ, Januszewski M, Santor-Zaczynska M, Jakimiuk AA, Oleksik T, Pokulniewicz M, Wierzba W. Absence of SARS-CoV-2 RNA in Peritoneal Fluid During Surgery in Pregnant Women Who Are COVID-19 Positive. J Minim Invasive Gynecol 2021; 28:2047-2051. [PMID: 34144207 PMCID: PMC8205274 DOI: 10.1016/j.jmig.2021.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/27/2021] [Accepted: 06/09/2021] [Indexed: 01/08/2023]
Abstract
STUDY OBJECTIVE Coronavirus disease 2019 (COVID-19) infection poses significant risks during surgical interventions. We investigated the intraperitoneal presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients who are COVID-19 positive. DESIGN A prospective group study. SETTING Department of Obstetrics and Gynecology designated for patients with COVID-19, Central Clinical Hospital of the Ministry of Interior, Warsaw. PATIENTS Overall, 65 pregnant women with COVID-19 infection underwent cesarian section. The diagnosis was confirmed either by positive antigen test or by positive reverse transcriptase-polymerase chain reaction assay performed within no more than 13 days before the operation. INTERVENTIONS On the day of the operation, a nasopharyngeal swab was taken, and peritoneal fluid was collected at the beginning of the operation. Both the nasopharyngeal swab and peritoneal fluid samples were tested for SARS-CoV-2. MEASUREMENTS AND MAIN RESULTS A total of 65 pregnant women with COVID-19 infection were enrolled in the study. The SARS-CoV-2 ribonucleic acid test by nasopharyngeal swab produced positive results in 34 patients. In this group as well as in 31 nonconfirmed patients, all peritoneal fluid samples tested negative for SARS-CoV-2 ribonucleic acid. CONCLUSION These results suggest a low risk of COVID-19 transmission from the peritoneal cavity at the time of laparoscopy or laparotomy.
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Affiliation(s)
- Artur J Jakimiuk
- Center for Reproductive Health, Institute of Mother and Child (Dr. J. Jakimiuk); Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior and Administration (Drs. J. Jakimiuk, Januszewski, Santor-Zaczynska, Oleksik, Pokulniewicz, and Wierzba); Department of Plastic Surgery, Central Clinical Hospital of the Ministry of Interior and Administration (Dr. A. Jakimiuk); University of Humanities and Economics, Lodz, Satellite Campus in Warsaw (Dr. Wierzba), Warsaw, Poland.
| | - Marcin Januszewski
- Center for Reproductive Health, Institute of Mother and Child (Dr. J. Jakimiuk); Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior and Administration (Drs. J. Jakimiuk, Januszewski, Santor-Zaczynska, Oleksik, Pokulniewicz, and Wierzba); Department of Plastic Surgery, Central Clinical Hospital of the Ministry of Interior and Administration (Dr. A. Jakimiuk); University of Humanities and Economics, Lodz, Satellite Campus in Warsaw (Dr. Wierzba), Warsaw, Poland
| | - Malgorzata Santor-Zaczynska
- Center for Reproductive Health, Institute of Mother and Child (Dr. J. Jakimiuk); Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior and Administration (Drs. J. Jakimiuk, Januszewski, Santor-Zaczynska, Oleksik, Pokulniewicz, and Wierzba); Department of Plastic Surgery, Central Clinical Hospital of the Ministry of Interior and Administration (Dr. A. Jakimiuk); University of Humanities and Economics, Lodz, Satellite Campus in Warsaw (Dr. Wierzba), Warsaw, Poland
| | - Alicja A Jakimiuk
- Center for Reproductive Health, Institute of Mother and Child (Dr. J. Jakimiuk); Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior and Administration (Drs. J. Jakimiuk, Januszewski, Santor-Zaczynska, Oleksik, Pokulniewicz, and Wierzba); Department of Plastic Surgery, Central Clinical Hospital of the Ministry of Interior and Administration (Dr. A. Jakimiuk); University of Humanities and Economics, Lodz, Satellite Campus in Warsaw (Dr. Wierzba), Warsaw, Poland
| | - Tomasz Oleksik
- Center for Reproductive Health, Institute of Mother and Child (Dr. J. Jakimiuk); Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior and Administration (Drs. J. Jakimiuk, Januszewski, Santor-Zaczynska, Oleksik, Pokulniewicz, and Wierzba); Department of Plastic Surgery, Central Clinical Hospital of the Ministry of Interior and Administration (Dr. A. Jakimiuk); University of Humanities and Economics, Lodz, Satellite Campus in Warsaw (Dr. Wierzba), Warsaw, Poland
| | - Marek Pokulniewicz
- Center for Reproductive Health, Institute of Mother and Child (Dr. J. Jakimiuk); Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior and Administration (Drs. J. Jakimiuk, Januszewski, Santor-Zaczynska, Oleksik, Pokulniewicz, and Wierzba); Department of Plastic Surgery, Central Clinical Hospital of the Ministry of Interior and Administration (Dr. A. Jakimiuk); University of Humanities and Economics, Lodz, Satellite Campus in Warsaw (Dr. Wierzba), Warsaw, Poland
| | - Waldemar Wierzba
- Center for Reproductive Health, Institute of Mother and Child (Dr. J. Jakimiuk); Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior and Administration (Drs. J. Jakimiuk, Januszewski, Santor-Zaczynska, Oleksik, Pokulniewicz, and Wierzba); Department of Plastic Surgery, Central Clinical Hospital of the Ministry of Interior and Administration (Dr. A. Jakimiuk); University of Humanities and Economics, Lodz, Satellite Campus in Warsaw (Dr. Wierzba), Warsaw, Poland
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Molina-Vega M, Gutiérrez-Repiso C, Lima-Rubio F, Suárez-Arana M, Linares-Pineda TM, Cobos Díaz A, Tinahones FJ, Morcillo S, Picón-César MJ. Impact of the Gestational Diabetes Diagnostic Criteria during the Pandemic: An Observational Study. J Clin Med 2021; 10:4904. [PMID: 34768425 PMCID: PMC8585066 DOI: 10.3390/jcm10214904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To analyze the effect of applying alternative diagnostic criteria for gestational diabetes mellitus (GDM) during the COVID-19 pandemic on GDM prevalence and obstetrical and perinatal outcomes, in comparison to usual diagnostic approaches. METHODS Data from women referred to GDM diagnosis from 1 September to 30 November 2019 were retrospectively collected (2019-group). The same data from the same period in 2020 were prospectively collected (2020-group). In both cases, a two-step diagnostic approach was used, the first step being a screening test (1 h 50 goral glucose tolerance test, OGTT). In 2019 it was followed by a 100 gr OGTT for diagnosis. In 2020, this was replaced by a blood test for the measurement of plasma glucose and HbA1c, according to alternative GDM diagnostic criteria during the COVID-19 pandemic. RESULTS From 237 women in the 2019 group, 40 (16.9%) were diagnosed with GDM, while from 255 women in the 2020 group, 37 (14.5%) had GDM (p = 0.470). More women in the 2020 group, in comparison to the 2019 group, were nulligravid (41.9% vs. 47.2%, p = 0.013), had a personal history of GDM (11.4% vs. 4.6%, p = 0.013) and had macrosomia in previous pregnancies (10.2% vs. 2.1%, p = 0.001). Obstetrical and perinatal outcomes were similar when comparing women with GDM to non-GDM women in the 2019 and 2020 groups and between GDM women and non-GDM women. CONCLUSION In a Spanish population, GDM prevalence during the COVID-19 pandemic using the alternative diagnostic criteria was similar to that found in 2019 using the usual diagnostic criteria. Despite women referred for GDM diagnosis during the pandemic having more GDM risk factors, obstetrical and perinatal outcomes were comparable to those observed before the pandemic.
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Affiliation(s)
- María Molina-Vega
- Departmento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (M.M.-V.); (M.J.P.-C.)
- Laboratorio de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (C.G.-R.); (F.L.-R.); (T.M.L.-P.)
| | - Carolina Gutiérrez-Repiso
- Laboratorio de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (C.G.-R.); (F.L.-R.); (T.M.L.-P.)
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Fuensanta Lima-Rubio
- Laboratorio de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (C.G.-R.); (F.L.-R.); (T.M.L.-P.)
| | - María Suárez-Arana
- Departmento de Obstetricia y Ginecología, Hospital Regional Universitario de Málaga, IBIMA, 29009 Málaga, Spain;
| | - Teresa María Linares-Pineda
- Laboratorio de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (C.G.-R.); (F.L.-R.); (T.M.L.-P.)
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Andrés Cobos Díaz
- Laboratorio de Análisis Clínico, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain;
| | - Francisco J. Tinahones
- Departmento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (M.M.-V.); (M.J.P.-C.)
- Laboratorio de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (C.G.-R.); (F.L.-R.); (T.M.L.-P.)
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - Sonsoles Morcillo
- Departmento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (M.M.-V.); (M.J.P.-C.)
- Laboratorio de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (C.G.-R.); (F.L.-R.); (T.M.L.-P.)
- Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición, Instituto Salud Carlos III, 28029 Madrid, Spain
| | - María J. Picón-César
- Departmento de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain; (M.M.-V.); (M.J.P.-C.)
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Gupta N, Nigam A, Bedi N, Bhardwaj N, Panesar S. Effect of coronavirus-19 infection on maternal and perinatal outcome: A case control study. Obstet Med 2021; 15:125-129. [DOI: 10.1177/1753495x211041482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Coronavirus 2019 virus infections has an impact on the obstetric population. Methods: We performed a single centre, prospective case-control study in a tertiary care centre during the first wave of the pandemic, over a period of six months. All Labouring women who were tested positive for SARS-CoV2 on the date of admission were included in the study (cases). As a control, SARS-CoV2 negative women who delivered before and after the corona virus-positive delivery were included. Results: The control group were significantly younger than the cases ( p = 0.001). The odds of spontaneous labour were observed to be significantly higher among the cases as compared to the control group ( p = 0.002). The likelihood of NICU admission was significantly higher among the cases as compared to the control group on applying Fischer exact test ( p < 0.001) Conclusion: SARS-CoV2 positive mothers are more likely to deliver neonates with feeding difficulties and requiring NICU admission, compared to SARS-CoV2 negative mothers.
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Affiliation(s)
- Nidhi Gupta
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Science and Research and Hakeem Abdul Hameed Centenary Hospital, Delhi, India
| | - Aruna Nigam
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Science and Research and Hakeem Abdul Hameed Centenary Hospital, Delhi, India
| | - Nidhi Bedi
- Department of Paediatrics, Hamdard Institute of Medical Science and Research and Hakeem Abdul Hameed Centenary Hospital, Delhi, India
| | - Neha Bhardwaj
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Science and Research and Hakeem Abdul Hameed Centenary Hospital, Delhi, India
| | - Sanjeet Panesar
- Department of Community Medicine, RML Hospital, Delhi, India
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Häussl A, Ehmann E, Pacher A, Knödl K, Huber T, Neundlinger L, Osmanovic A, Plank-Straner A, Walter P, Schüssler S, Schoberer D. Psychological, physical, and social effects of the COVID-19 pandemic on hospital nurses. Int Nurs Rev 2021; 68:482-492. [PMID: 34582576 PMCID: PMC8653222 DOI: 10.1111/inr.12716] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 08/24/2021] [Indexed: 11/28/2022]
Abstract
Aim The study aim was to explore the physical, mental, and social effects of the COVID‐19 pandemic on Austrian nurses working in hospitals. Background The COVID‐19 pandemic required nurses to work extremely hard and over long periods, which can have physical, psychological, and social consequences. Methods This study was carried out using a qualitative descriptive design and data was collected through individual interviews using an interview guide. A qualitative content analysis was conducted taking both deductive and inductive approaches. Findings Eighteen nurses (average age of 34.7 years) participated in the study. Their general attitude and feelings regarding working during the COVID‐19 pandemic in the hospital setting were positive. Several behavioral changes in the nurses’ daily working and private daily lives were reported. Psychological impacts included the fear of infecting someone at home, insomnia, and sadness. Headaches, diarrhea, muscle tension, skin redness, and increased sweating were identified as the most common physical impacts. In terms of social impact, all nurses mentioned social isolation and the increased use of (new) media. Conclusions Working with people suffering from COVID‐19 had psychological and physical effects on caregivers. Caregivers felt socially isolated in their private environments; however, they often compensated for this isolation by using social media. Implications for nursing and implications for nursing policy Staff perceived the provision of sufficient information, regular team meetings, and the employer's positive reinforcement as supportive, enhancing their feelings of security. We recommend providing more psychological support and making structural adjustments in daily clinical practice to counteract the negative effects of working during a pandemic.
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Affiliation(s)
- Alfred Häussl
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Eva Ehmann
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Angelika Pacher
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Katrin Knödl
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Teresa Huber
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Lydia Neundlinger
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Asmir Osmanovic
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | | | - Petra Walter
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Sandra Schüssler
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Daniela Schoberer
- Institute of Nursing Science Medical University of Graz, Graz, Austria
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Aldika Akbar MI, Gumilar KE, Tjokroprawiro BA, Ulhaq RA. Successful management of a pregnant woman with COVID-19 and multiple severe complications. BMJ Case Rep 2021; 14:14/9/e243594. [PMID: 34531234 PMCID: PMC8449948 DOI: 10.1136/bcr-2021-243594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We report a case of a 36-year-old gravida 2 para 1 woman at 38 weeks of gestation. A caesarean section was performed for severe pre-eclampsia, intrauterine growth restriction and oligohydramnios. The patient suffered postoperative bleeding, and exploratory laparotomy was performed. Uterine atonia, Couvelaire uterus and left adnexal haematoma were found, requiring a supracervical hysterectomy. As COVID-19 pneumonia and superimposed bacterial infection developed, the patient was mechanically ventilated in the intensive care unit. Remdesivir and meropenem were initially administered, but were changed to levofloxacin and ciprofloxacin following antibiotic sensitivity tests. Blood culture grew Enterococcus galinarum. Meanwhile, bleeding of the incisional wound occurred, which was controlled by the cessation of heparin therapy and regular wound care. With intensive monitoring and multidisciplinary management, the patient’s condition improved, and she was discharged from the hospital on day 25 from admission.
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Affiliation(s)
| | - Khanisyah Erza Gumilar
- Department of Obstetrics and Gynecology, Medical Faculty, Universitas Airlangga, Surabaya, Indonesia
| | | | - Renata Alya Ulhaq
- Midwifery Study Program, Medical Faculty, Universitas Airlangga, Surabaya, Indonesia
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Hutner LA, Yeaton-Massey A, Toscano M, Coulehan J, Hage B, Gopalan P, Doyle MA, Olgun M, Frew J, Nagle-Yang S, Osborne LM, Miller ES. Cultivating mental health education in obstetrics and gynecology: a call to action. Am J Obstet Gynecol MFM 2021; 3:100459. [PMID: 34403822 DOI: 10.1016/j.ajogmf.2021.100459] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/21/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
Mental health disorders are common and have a significantly negative impact on the health and well-being of women. For example, perinatal mental health disorders such as anxiety and depression are widely understood to be the most common complications of pregnancy and childbirth. Untreated mental health disorders are associated with significant obstetrical and psychiatric sequelae and have a long-lasting impact on neonatal and childhood outcomes. As front-line providers for women during times of elevated risk of psychiatric morbidity, such as pregnancy and postpartum, obstetricians and gynecologists are compelled to have familiarity with such disorders. Yet, a wide gap exists between the level of education in mental health disorders that obstetrician and gynecologist providers receive and the clinical need thereof. The objectives of this commentary are to describe the urgent need for mental health education for obstetricians and gynecologists providers and to introduce our vision for a concise, evidence-based and accessible set of digital educational materials designed to convey core concepts in women's reproductive mental health.
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Affiliation(s)
| | - Amanda Yeaton-Massey
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA (Dr Yeaton-Massey).
| | - Marika Toscano
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY (Dr Toscano)
| | - Jeanne Coulehan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University, New York, NY (Ms Coulehan)
| | - Brandon Hage
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA (Drs Hage and Gopalan)
| | - Priya Gopalan
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA (Drs Hage and Gopalan)
| | - Marley A Doyle
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE (Dr Doyle)
| | - Melisa Olgun
- Wesleyan University, Middletown, CT, Yale Law (Ms Olgun)
| | - Julia Frew
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH (Dr Frew)
| | - Sarah Nagle-Yang
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO (Dr Nagle-Yang)
| | - Lauren M Osborne
- Departments of Psychiatry and Behavioral Sciences and Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD (Dr Osborne)
| | - Emily S Miller
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Miller)
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Kazemi SN, Hajikhani B, Didar H, Hosseini SS, Haddadi S, Khalili F, Mirsaeidi M, Nasiri MJ. COVID-19 and cause of pregnancy loss during the pandemic: A systematic review. PLoS One 2021; 16:e0255994. [PMID: 34379700 PMCID: PMC8357105 DOI: 10.1371/journal.pone.0255994] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/27/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction The association between Coronavirus Disease 2019 (COVID-19) and abortion has been debated since the beginning of the COVID-19 pandemic. We aimed to conduct this systematic review to understand better the potential effects of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) on fetal loss in infected mothers presented with abortion following this infection. Methods We included articles published in PubMed/Medline, Web of Science, clinicaltrials.gov, and Embase databases in 2019 and 2020 through a comprehensive search via appropriate keywords, including COVID-19 and abortion synonyms. All studies with the abortion data in COVID-19 confirmed pregnant females were collected. Results Out of 208 potentially relevant articles, 11 articles were eligible to include in the systematic review. The included reports were published because of the following reasons: (1) First-trimester miscarriage; (2) Late miscarriage; (3) complication of COVID-19 infection in pregnancy; (4) COVID-19 disease in artificial pregnancy. First-trimester abortion was found in 5 studies, and second-trimester abortion in 7 studies. Two patients acquired infection during the hospital stay while they were referred for abortion. Reports related to abortion in pregnant females with COVID-19 show that most miscarriages due to COVID-19 in the first trimester were due to placental insufficiency. Conclusions There is an increased risk of abortion in mothers with a positive test result of SARS-CoV-2, which several case reports and case series have identified during the pandemic. Placental inflammation during the viral infection may result in fetal growth retardation and induce abortion. There has not been any consistent evidence of vertical transmission of the virus from mother to fetus, which requires further investigation.
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Affiliation(s)
- Seyyedeh Neda Kazemi
- Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- * E-mail: (SNK); (MJN)
| | - Bahareh Hajikhani
- Department of Microbiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Didar
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sareh Sadat Hosseini
- Department of Microbiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Haddadi
- Department of Medicine, Division of Pulmonary and Critical Care, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Farima Khalili
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Mirsaeidi
- Department of Medicine, Division of Pulmonary and Critical Care, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Mohammad Javad Nasiri
- Department of Microbiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- * E-mail: (SNK); (MJN)
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Assessment of Postpartum Depression in Adolescents Who Delivered during COVID-19 Social Restrictions: The Experience of a Tertiary Hospital from Bucharest, Romania. Healthcare (Basel) 2021; 9:healthcare9070807. [PMID: 34206891 PMCID: PMC8307397 DOI: 10.3390/healthcare9070807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 11/17/2022] Open
Abstract
In the context of the viral spread of COVID-19 in 2020, Romanian authorities declared national confinement for two months. Our country faces a public health issue regarding adolescent pregnancy. This study assessed the predisposition of teenage mothers to postpartum depression and the influence of the viral pandemic on their emotional status. This study enrolled patients 10 to 19 years old who delivered in our department between March-December 2020. Teenagers were attributed to the "lockdown group" (n = 30) and the "open group" (n = 171). All study participants agreed to take an interview based on a three-part questionnaire, including the Edinburgh Postnatal Depression Scale (EPDS). In the "lockdown group", 16.67% of patients felt stressed over the last year compared to 11.11% of individuals in the "open group", but there was no statistically significant difference between groups regarding overall EPDS scores (z value 0.51, Mann-Whitney U test). Predictable variables for postpartum depression were the use of cigarettes (OR = 1.08, 95% CI: 1.00-1.16), intended pregnancies (OR = 0.25, 95% CI: 0.09-0.68, p = 0.007) and absence of stressors in the last year (OR = 0.07, 95% CI: 0.02-0.30, p = 0.0002). More adolescents were stressed during confinement compared to those who delivered in the following time period; this aspect did not interfere with depression screening scores. A planned pregnancy, even during adolescence, can serve as a protective factor for postpartum depression.
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Pattanashetti L, Patil S, Nyamgouda S, Bhagiratha M, Gadad P. COVID-19 and pregnant women - An overview on diagnosis, treatment approach with limitation, and clinical management. Monaldi Arch Chest Dis 2021; 91. [PMID: 34121377 DOI: 10.4081/monaldi.2021.1785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/15/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease or more popularly called COVID-19 is known to be caused by a novel coronavirus 2. The COVID-19 has been identified to be originated from Wuhan, Hubei, China. This pandemic started in December 2019, and since then it has spread across the world within a short period. The health and family welfare ministry of the Government of India reported 227,546 active, 9,997,272 discharged cases, and 150,114 deaths due to COVID-19 as of 06 January 2021. Indian Council of Medical Research (ICMR) reports that the cumulative testing status of SARS-CoV-2 (COVID-19) was 931,408 up to November 03, 2020. Currently, no specific anti-viral drug for COVID-19 management is recommended in the current scenario. Vulnerable populations such as pregnant women affected by COVID-19 infection need to be recognized and followed up for effective handling concerning morbidity and mortality. At present, very few case reports on COVID-19 infected pregnant women have been published in India and there is no proven exclusive treatment protocol. This article summarizes a review of signs and symptoms, etiopathogenesis, risk factors, diagnosis, and possible management of COVID-19 infection in pregnant women. This overview may be useful for health care providers for practical approach and limitation of drugs used in the current management and considers the choice of drugs with their special attention given to adverse effects to improvise maternal health, pregnancy, and birth outcomes.
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Affiliation(s)
- Laxmi Pattanashetti
- Department of Pharmacology, KLE College of Pharmacy, Hubli (A constituent unit of KLE Academy of Higher Education and Research, Belagavi), Karnataka.
| | - Santosh Patil
- Department of Pharmacology, KLE College of Pharmacy, Hubli (A constituent unit of KLE Academy of Higher Education and Research, Belagavi), Karnataka.
| | - Sanath Nyamgouda
- Department of Pharmacy Practice, KLE College of Pharmacy, Hubli (A constituent unit of KLE Academy of Higher Education and Research, Belagavi, Karnataka.
| | - Mahendrakumar Bhagiratha
- Department of Pharmacy Practice, KLE College of Pharmacy, Hubli (A constituent unit of KLE Academy of Higher Education and Research, Belagavi, Karnataka.
| | - Pramod Gadad
- Department of Pharmacology, KLE College of Pharmacy, Hubli (A constituent unit of KLE Academy of Higher Education and Research, Belagavi), Karnataka.
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Afari HA, Davis EF, Sarma AA. Echocardiography for the Pregnant Heart. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021; 23:55. [PMID: 34075291 PMCID: PMC8160078 DOI: 10.1007/s11936-021-00930-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 01/22/2023]
Abstract
Purpose of review Pregnancy is associated with significant hemodynamic changes, making it a potentially high-risk period for women with underlying cardiovascular disease. Echocardiography remains the preferred modality for diagnosis and monitoring of pregnant women with cardiovascular disease as it is widely available and does not require radiation. This paper reviews the role of echocardiography along the continuum of pregnancy in at-risk patients, with a focus on key cardiac disease states in pregnancy. Recent findings In the preconception stage, risk stratification scores such as CARPREG II, ZAHARA and the modified WHO remain central to counseling and planning. As such, echocardiography serves an important role in assessing the severity of pre-existing structural disease. Among women with pre-existing cardiovascular disease who become pregnant-as well as those who develop cardiovascular symptoms during pregnancy-echocardiography is a key imaging tool for assessment of hemodynamic and structural changes and is recommended as the first-line imaging modality when appropriate by both the American College of Obstetricians and Gynecologists (ACOG) and the Food and Drug Administration (FDA). However, routine screening intervals during pregnancy for various cardiac lesions are not well defined, resulting in clinical heterogeneity in care. Summary Echocardiography is the imaging modality of choice for defining, risk stratifying, and monitoring cardiovascular changes throughout pregnancy. Once identified, at-risk patients should receive careful individual counseling and follow-up with a multidisciplinary team. Echocardiography serves as a widely available tool for serial monitoring of pregnant women with cardiovascular disease throughout pregnancy and the postpartum period.
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Affiliation(s)
| | - Esther F. Davis
- Department of Medicine, Division of Cardiology, Massachusetts General Hospital, Boston, MA USA
| | - Amy A. Sarma
- Department of Medicine, Division of Cardiology, Massachusetts General Hospital, Boston, MA USA
- Harvard Medical School, Boston, MA USA
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COVID-19 Disease During Pregnancy and Peripartum Period: A Cardiovascular Review. Curr Probl Cardiol 2021; 47:100888. [PMID: 34127288 PMCID: PMC8106961 DOI: 10.1016/j.cpcardiol.2021.100888] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/02/2021] [Indexed: 02/07/2023]
Abstract
Pregnancy with various physiological effects on cardiovascular system, makes mothers with borderline cardiovascular reserve at significant risk for adverse events during labor and early postpartum period. Cardiac imaging modalities, have shown that Coronavrus Disease 2019 disease is associated with subclinical myocardial injury in significant numbers of infected people, even in mild or asymptomatic disease and previous healthy ones. Herein, we have discussed the cardiovascular aspects of prepartum pregnant women with Coronavrus Disease 2019, especially patients with moderate to severe illness. Also, we have proposed how to handle the hemodynamic load during labor and the first 48 hours postpartum in the hypoxemic overloaded parturients with possible subclinical myocardial injury.
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Chen G, Liao Q, Ai J, Yang B, Bai H, Chen J, Liu F, Cao Y, Liu H, Li K. Immune Response to COVID-19 During Pregnancy. Front Immunol 2021; 12:675476. [PMID: 34012458 PMCID: PMC8126657 DOI: 10.3389/fimmu.2021.675476] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/13/2021] [Indexed: 12/16/2022] Open
Abstract
Pregnant women are generally more susceptible to viral infection. Although the impact of SARS-CoV-2 on pregnant women remains to be determined, evidence indicates that risks of adverse clinical outcomes are similar in pregnancy to the general population. Here we analyzed clinical symptoms and outcomes of 20 pregnant and 299 reproductive-aged non-pregnant female COVID-19 patients who were hospitalized during the same period. Laboratory measurements were compared among mild cases and healthy pregnant women. Our study found that pregnant patients showed enhanced innate immune response evident by higher neutrophils and C-reactive protein. Cytokines, chemokines, and growth factors (CCGFs) profiles from 11 pregnant and 4 non-pregnant COVID-19 patients and 10 healthy pregnant female patients, and lymphocyte subsets analysis of 7 pregnant patients and 19 non-pregnant patients, indicate suppressed cytokine storm and potential enhanced CD8+ T cell and NK cell activity in pregnant patients with COVID-19, which may be essential in contributing to the unique anti-SARS-CoV-2 response in pregnancy.
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Affiliation(s)
- Ge Chen
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiuyue Liao
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jihui Ai
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bin Yang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hualin Bai
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Chen
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fengyuan Liu
- Biological Sciences Greenhouse, College of Art & Sciences, The Ohio State University, Columbus, OH, United States
| | - Yang Cao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Haiyi Liu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kezhen Li
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Di Mascio D, Buca D, Berghella V, Khalil A, Rizzo G, Odibo A, Saccone G, Galindo A, Liberati M, D'Antonio F. Counseling in maternal-fetal medicine: SARS-CoV-2 infection in pregnancy. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2021; 57:687-697. [PMID: 33724545 PMCID: PMC8251147 DOI: 10.1002/uog.23628] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/25/2021] [Accepted: 03/10/2021] [Indexed: 02/05/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a zoonotic coronavirus that crossed species to infect humans, causing coronavirus disease 2019 (COVID-19). Despite a potentially higher risk of pregnant women acquiring SARS-CoV-2 infection compared with the non-pregnant population (particularly in some ethnic minorities), no additional specific recommendations to avoid exposure are needed in pregnancy. The most common clinical symptoms and laboratory signs of SARS-CoV-2 infection in pregnancy are fever, cough, lymphopenia and elevated C-reactive protein levels. Pregnancy is associated with a higher risk of severe SARS-CoV-2 infection compared with the non-pregnant population, including pneumonia, admission to the intensive care unit and death, even after adjusting for potential risk factors for severe outcomes. The risk of miscarriage does not appear to be increased in women with SARS-CoV-2 infection. Evidence with regards to preterm birth and perinatal mortality is conflicting, but these risks are generally higher only in symptomatic, hospitalized women. The risk of vertical transmission, defined as the transmission of SARS-CoV-2 from the mother to the fetus or the newborn, is generally low. Fetal invasive procedures are considered to be generally safe in pregnant women with SARS-CoV-2 infection, although the evidence is still limited. In pregnant women with COVID-19, use of steroids should not be avoided if clinically indicated; the preferred regimen is a 2-day course of dexamethasone followed by an 8-day course of methylprednisolone. Non-steroidal anti-inflammatory drugs may be used if there are no contraindications. Hospitalized pregnant women with severe COVID-19 should undergo thromboprophylaxis throughout the duration of hospitalization and at least until discharge, preferably with low molecular weight heparin. Hospitalized women who have recovered from a period of serious or critical illness with COVID-19 should be offered a fetal growth scan about 14 days after recovery from their illness. In asymptomatic or mildly symptomatic women who have tested positive for SARS-CoV-2 infection at full term (i.e. ≥ 39 weeks of gestation), induction of labor might be reasonable. To date, there is no clear consensus on the optimal timing of delivery for critically ill women. In women with no or few symptoms, management of labor should follow routine evidence-based guidelines. Regardless of COVID-19 status, mothers and their infants should remain together and breastfeeding, skin-to-skin contact, kangaroo mother care and rooming-in throughout the day and night should be practiced, while applying necessary infection prevention and control measures. Many pregnant women have already undergone vaccination, mostly in the USA where the first reports show no significant difference in pregnancy outcomes in pregnant women receiving SARS-CoV-2 vaccination during pregnancy compared with the background risk. Vaccine-generated antibodies were present in the umbilical cord blood and breast milk samples of pregnant and lactating women who received the mRNA COVID-19 vaccine. Based on the available limited data on the safety of the COVID-19 vaccine in pregnancy, it seems reasonable to offer the option of vaccination to pregnant women after accurate counseling on the potential risk of a severe course of the disease and the unknown risk of fetal exposure to the vaccine. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- D. Di Mascio
- Department of Maternal and Child Health and Urological Sciences“Sapienza” University of RomeRomeItaly
| | - D. Buca
- Center for High‐Risk Pregnancy and Fetal Care, Department of Obstetrics and GynecologyUniversity of ChietiChietiItaly
| | - V. Berghella
- Department of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaPAUSA
| | - A. Khalil
- Fetal Medicine UnitSt George's University Hospitals NHS Foundation Trust, University of LondonLondonUK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research InstituteSt George's University of LondonLondonUK
| | - G. Rizzo
- Division of Maternal and Fetal Medicine, Ospedale Cristo ReUniversity of Rome Tor VergataRomeItaly
- Department of Obstetrics and GynecologyThe First I.M. Sechenov Moscow State Medical UniversityMoscowRussia
| | - A. Odibo
- Division of Maternal Fetal MedicineUniversity of South FloridaTampaFLUSA
| | - G. Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of MedicineUniversity of Naples Federico IINaplesItaly
| | - A. Galindo
- Fetal Medicine Unit – Maternal and Child Health and Development Network, Department of Obstetrics and GynecologyUniversity Hospital 12 de Octubre, 12 de Octubre Research Institute, Complutense University of MadridMadridSpain
| | - M. Liberati
- Center for High‐Risk Pregnancy and Fetal Care, Department of Obstetrics and GynecologyUniversity of ChietiChietiItaly
| | - F. D'Antonio
- Center for High‐Risk Pregnancy and Fetal Care, Department of Obstetrics and GynecologyUniversity of ChietiChietiItaly
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Naveed M, Naeem M, ur Rahman M, Gul Hilal M, Kakakhel M, Ali G, Hassan A. Review of potential risk groups for coronavirus disease 2019 (COVID-19). New Microbes New Infect 2021; 41:100849. [PMID: 33614041 PMCID: PMC7879740 DOI: 10.1016/j.nmni.2021.100849] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/17/2021] [Accepted: 02/01/2021] [Indexed: 01/08/2023] Open
Abstract
The current pandemic of coronavirus disease 19 (COVID-19) is a global issue caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Studies have revealed that this virus results in poorer consequences and a higher rate of mortality in older adults and those with comorbidities such as cardiovascular disease, hypertension, diabetes and prolonged respiratory illness. In this review, we discuss in detail the potential groups at risk of COVID-19 and outline future recommendations to mitigate community transmission of COVID-19. The rate of COVID-19 was high in healthcare workers, smokers, older adults, travellers and pregnant women. Furthermore, patients with severe medical complications such as heart disease, hypertension, respiratory illness, diabetes mellitus and cancer are at higher risk of disease severity and mortality. Therefore, special effort and devotion are needed to diminish the threat of SARS-CoV-2 infection. Proper vaccination, use of sanitizers for handwashing and complete lockdown are recommended to mitigate the chain of COVID-19 transmission.
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Affiliation(s)
- M. Naveed
- Institute of Microbiology, School of Life Sciences, Lanzhou University, Tianshui Road No. 222, Lanzhou, 730000, China
| | - M. Naeem
- Department of Microbiology, University of Swabi, Khyber PakhtunKhwa, Pakistan
| | - M. ur Rahman
- College of Life Sciences, Northwest University, Xian, Shaanxi Province, 710069, China
| | - M. Gul Hilal
- Institute of Occupational and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - M.A. Kakakhel
- MOE Key Laboratory of Cell Activities and Stress Adaptations, School of Life Sciences, Lanzhou University, Lanzhou, 730000, China
| | - G. Ali
- MOE Key Laboratory of Cell Activities and Stress Adaptations, School of Life Sciences, Lanzhou University, Lanzhou, 730000, China
| | - A. Hassan
- Bioengineering College of Chongqing University, Chongqing, China
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Latorre G, Martinelli D, Guida P, Masi E, De Benedictis R, Maggio L. Impact of COVID-19 pandemic lockdown on exclusive breastfeeding in non-infected mothers. Int Breastfeed J 2021; 16:36. [PMID: 33865408 PMCID: PMC8052849 DOI: 10.1186/s13006-021-00382-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/06/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has posed several challenges to the provision of newborn nutrition and care interventions including maternal support, breastfeeding and family participatory care. Italy was the first country to be exposed to SARS-CoV-2 in Europe. One of the measures adopted by the Italian government during COVID-19 pandemic was the total lockdown of the cities with complete confinement at home. We aimed to examine the impact of the lockdown caused by COVID-19 pandemic on exclusive breastfeeding in non-infected mothers. METHODS We prospectively enrolled 204 mother-baby dyads during lockdown (9 March to 8 May 2020) that we compared to previously studied 306 mother-baby dyads admitted during the year 2018. To reduce the possible effect of confounding factors on exclusive breastfeeding, a 1:1 matching was performed by using an automatized procedure of stratification that paired 173 mother-baby dyads. Feeding modality was collected at discharge, 30 and 90 days of newborn's life. Exclusive breastfeeding was considered when the infant received only breast milk and no other liquids or solids were given with the exception of vitamins, minerals or medicines. RESULTS At discharge 69.4% of infants were exclusively breastfed during lockdown versus 97.7% of control group, 54.3% at 30 days vs 76.3 and 31.8% vs 70.5% at 90 days (p < 0.001). The proportion of breastfeeding remaining exclusive from discharge to 30-day was similar between groups (about 80%), but it was lower in lockdown group than in control cohort (58.5% vs 92.4%, p < 0.001) from 30- to 90-days. CONCLUSIONS Lockdown and home confinement led to a decrease of exclusively breastfeeding in the studied population. Considering the timing to shift from exclusive to non-exclusive breastfeeding, differences between study groups were concentrated during hospital stay and from 30- to 90 days of a newborn's life, confirming that the hospital stay period is crucial in continuing exclusive breastfeeding at least for the first 30 days, but no longer relevant at 90 days of life.
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Affiliation(s)
- Giuseppe Latorre
- Neonatology and Neonatal Intensive Care Unit, Ecclesiastical General Hospital F. Miulli, Acquaviva delle Fonti, Italy.
| | - Domenico Martinelli
- Neonatology and Neonatal Intensive Care Unit, Ecclesiastical General Hospital F. Miulli, Acquaviva delle Fonti, Italy
| | - Pietro Guida
- Neonatology and Neonatal Intensive Care Unit, Ecclesiastical General Hospital F. Miulli, Acquaviva delle Fonti, Italy
| | - Ester Masi
- Neonatology and Neonatal Intensive Care Unit, Ecclesiastical General Hospital F. Miulli, Acquaviva delle Fonti, Italy
| | - Roberta De Benedictis
- Neonatology and Neonatal Intensive Care Unit, Ecclesiastical General Hospital F. Miulli, Acquaviva delle Fonti, Italy
| | - Luca Maggio
- Department of Woman and Child Health and Public Health, Child Health Area, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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Pountoukidou A, Potamiti-Komi M, Sarri V, Papapanou M, Routsi E, Tsiatsiani AM, Vlahos N, Siristatidis C. Management and Prevention of COVID-19 in Pregnancy and Pandemic Obstetric Care: A Review of Current Practices. Healthcare (Basel) 2021; 9:467. [PMID: 33920781 PMCID: PMC8071177 DOI: 10.3390/healthcare9040467] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 02/06/2023] Open
Abstract
Constant accumulation of data results in continuous updates of guidelines and recommendations on the proper management of pregnant women with COVID-19. This study aims to summarize the up-to-date information about the prevention and management of suspected/confirmed SARS-CoV-2 infection in obstetric patients and obstetric care during prenatal, intrapartum, and postpartum periods. We conducted a comprehensive literature search in PubMed for relevant English-written full-text reviews. We also included relevant guidelines and recommendations. In women with a low risk for infection and uncomplicated pregnancy, elective and non-urgent appointments should be postponed or completed through telehealth. Vaccination should be discussed and distance and personal hygiene preventive measures should be recommended. Routine ultrasound examinations should be adjusted in order to minimize exposure to the virus. Standardized criteria should evaluate the need for admission. Women with moderate/high-risk for infection should be isolated and tested with RT-PCR. The mode and timing of delivery should follow routine obstetric indications. In case of infection, glucocorticoids are recommended in critically ill pregnant women, after individualized evaluation. During labor and concomitant infection, the duration of the first two stages should be reduced as possible to decrease aerosolization, while minimization of hemorrhage is essential during the third stage. Close maternal monitoring and adequate oxygenation when necessary always remain a prerequisite. Discharge should be considered on the first or second day postpartum, also depending on delivery mode. Breastfeeding with protective equipment is recommended, as its benefits outweigh the risks of neonatal infection. Recommendations are currently based on limited available data. More original studies on infected pregnant women are needed to establish totally evidence-based protocols of care for these patients.
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Affiliation(s)
- Argyro Pountoukidou
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
| | - Maria Potamiti-Komi
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
| | - Vrisiis Sarri
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
| | - Michail Papapanou
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
| | - Eleni Routsi
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
| | - Anna Maria Tsiatsiani
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
| | - Nikolaos Vlahos
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece
| | - Charalampos Siristatidis
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (A.P.); (M.P.-K.); (V.S.); (M.P.); (E.R.); (A.M.T.); (N.V.)
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece
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