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Foster HS, Forkpa M, Van Tienhoven XA, Schwartz N, Srinivas S, Parry S, Mccabe MG. Are Neonatal Birth Weights Reduced in Low-Risk Patients Diagnosed with COVID-19 during Pregnancy? Am J Perinatol 2024. [PMID: 38955216 DOI: 10.1055/a-2358-9710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
OBJECTIVE Studies have shown that the 2019 novel coronavirus disease (COVID-19) may be associated with an increased risk of adverse pregnancy outcomes including preeclampsia, preterm birth, and stillbirth. However, the relationship between COVID-19 and abnormal fetal growth (i.e., low neonatal birth weight) has not been elucidated. Because other viruses affect fetal growth, obstetrical providers began to recommend ultrasound studies during the third trimester to assess fetal growth in patients with COVID-19 during pregnancy. The aim of this study was to determine if neonatal birth weight was different between low-risk patients diagnosed with COVID-19 during pregnancy and low-risk patients without COVID-19 in pregnancy, to ascertain if third trimester growth ultrasound is warranted in this patient population. STUDY DESIGN We performed a retrospective cohort study of low-risk pregnant patients (who had no other indications for sonographic fetal surveillance during the third trimester) with and without COVID-19 during pregnancy. Patient demographics, gestational dating, neonatal birth weights, and corresponding Alexander growth curve birth weight percentiles were collected. The primary outcome was small-for-gestational age (SGA) neonates, defined as birth weight < 10th percentile for gestational age at delivery (SGA10). RESULTS Our cohort (N = 513) included 248 COVID-19-exposed patients and 265 patients who did not have COVID-19 during pregnancy. Gestational age at delivery and average neonatal birth weights were similar in COVID-19-exposed (38 weeks 5 days, 3,266 g) and unexposed patients (38 weeks 4 days, 3,224 g; p = 0.434, 0.358). Rates of SGA10 neonates were similar in the COVID-19-exposed (22/248, 8.9%) and -unexposed (23/265, 8.7%, p = 0.939) groups. Timing and severity of COVID-19 during pregnancy also were not associated with rates of SGA neonates. CONCLUSION In a cohort of low-risk patients, rates of SGA neonates were similar in patients with and without COVID-19 during pregnancy. These findings suggest that ultrasound surveillance to detect fetal growth restriction in low-risk patients with COVID-19 during pregnancy is not warranted. KEY POINTS · COVID-19 may be associated with fetal growth restriction.. · There are normal infant weights in patients with COVID-19 in pregnancy.. · Growth ultrasound is not needed in patients with COVID-19..
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Affiliation(s)
- Hannah S Foster
- Department of Maternal Fetal Medicine, Pregnancy and Perinatal Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Markolline Forkpa
- Department of Maternal Fetal Medicine, Pregnancy and Perinatal Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Nadav Schwartz
- Department of Maternal Fetal Medicine, Pregnancy and Perinatal Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sindhu Srinivas
- Department of Maternal Fetal Medicine, Pregnancy and Perinatal Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Samuel Parry
- Department of Maternal Fetal Medicine, Pregnancy and Perinatal Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Meaghan G Mccabe
- Department of Maternal Fetal Medicine, Pregnancy and Perinatal Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
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Shukla VV, Carper BA, Ambalavanan N, Rysavy MA, Bell EF, Das A, Patel RM, D'Angio CT, Watterberg KL, Cotten CM, Merhar SL, Wyckoff MH, Sánchez PJ, Kumbhat N, Carlo WA. Social distancing and extremely preterm births in the initial COVID-19 pandemic period. J Perinatol 2024; 44:1050-1057. [PMID: 38388715 PMCID: PMC11226398 DOI: 10.1038/s41372-024-01898-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024]
Abstract
HYPOTHESIS Increased social distancing was associated with a lower incidence of extremely preterm live births (EPLB) during the initial COVID-19 pandemic period. STUDY DESIGN Prospective study at the NICHD Neonatal Research Network sites comparing EPLB (220/7-286/7 weeks) and extremely preterm intrapartum stillbirths (EPIS) rates during the pandemic period (March-July, weeks 9-30 of 2020) with the reference period (same weeks in 2018 and 2019), correlating with state-specific social distancing index (SDI). RESULTS EPLB and EPIS percentages did not significantly decrease (1.58-1.45%, p = 0.07, and 0.08-0.06%, p = 0.14, respectively). SDI was not significantly correlated with percent change of EPLB (CC = 0.29, 95% CI = -0.12, 0.71) or EPIS (CC = -0.23, 95% CI = -0.65, 0.18). Percent change in mean gestational age was positively correlated with SDI (CC = 0.49, 95% CI = 0.07, 0.91). CONCLUSIONS Increased social distancing was not associated with change in incidence of EPLB but was associated with a higher gestational age of extremely preterm births. CLINICALTRIALS GOV ID Generic Database: NCT00063063.
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Affiliation(s)
- Vivek V Shukla
- Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Benjamin A Carper
- Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park, NC, USA
| | | | - Matthew A Rysavy
- Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Edward F Bell
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD, USA
| | - Ravi M Patel
- Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Carl T D'Angio
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | | | | | - Stephanie L Merhar
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Myra H Wyckoff
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Pablo J Sánchez
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Neha Kumbhat
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Waldemar A Carlo
- Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, USA
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Cigăran RG, Peltecu G, Mustață LM, Botezatu R. The Psychological Impact on Romanian Women Infected with SARS-CoV-2 during Pregnancy. Healthcare (Basel) 2024; 12:945. [PMID: 38727501 PMCID: PMC11082961 DOI: 10.3390/healthcare12090945] [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: 03/13/2024] [Revised: 04/12/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND It is well-known that the uncertainty about the COVID-19 pandemic has an indirect negative impact on pregnant women's mental health, given the fact that pregnant women are more vulnerable emotionally and psychologically than non-pregnant women. The aim of this study was to evaluate the maternal psychological impact on Romanian women who were infected with SARS-CoV-2 during pregnancy and their concerns and to determine which are the best measures to prevent negative outcomes. METHODS A 40-item questionnaire was created for data collection and was shared on social platforms (Facebook and Instagram) and also with obstetric communities between February 2021 and January 2023. Our cross-sectional survey recruited 317 Romanian pregnant women who suffered from SARS-CoV-2 infection. Among general questions about their life and pregnancy during the pandemic, the survey included questions about their SARS-CoV-2 infection during pregnancy, their concerns and how they perceived this period in order to evaluate their emotional status. RESULTS Of 317 women recruited, 91% of them had a mild to moderate form of COVID-19, and 2% had serious symptoms. Only 9% of women were hospitalized, 4% of women considered that the SARS-CoV-2 infection affected their physical condition to a great extent, and 8% considered to be affected in terms of mental state to a great extent. The main negative feelings of pregnant women during the COVID-19 disease were the fear regarding the possibility of affecting the pregnancy and the concern for their life (51.4%). These increase the risk of developing anxiety or depression. Pregnant women who contracted SARS-CoV-2 infection faced negative feelings, especially those with a severe form of the disease or who recovered with difficulty after the disease. Patients who required hospitalization reported an impairment of the mental state to a great extent and to a very great extent with a frequency of approximately two times and four times higher than non-hospitalized patients, respectively (p < 0.05 and p < 0.001, respectively). Also, giving birth during SARS-CoV-2 and the difficulty of accessing medical services represented a high level of stress. Also, 47% of patients who reported difficulty accessing medical services during the illness evaluated their mental state significantly less favorably. CONCLUSION Preventive measures are essential to minimizing the negative psychological impact of COVID-19 disease during pregnancy among pregnant women. The medical treatment of COVID-19 disease during pregnancy should be prioritized, but emotional and mental health support must also be provided.
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Affiliation(s)
- Ruxandra-Gabriela Cigăran
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania; (R.-G.C.); (G.P.); (L.-M.M.)
| | - Gheorghe Peltecu
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania; (R.-G.C.); (G.P.); (L.-M.M.)
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Laura-Mihaela Mustață
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania; (R.-G.C.); (G.P.); (L.-M.M.)
| | - Radu Botezatu
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania; (R.-G.C.); (G.P.); (L.-M.M.)
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Krishnan P, Malik A, Isath A, Bandyopadhyay D, Goel A, Parton L, Chandrasekharan P, Singh M. Nationwide Analysis of the Outcomes and Mortality of Hospitalized Infants with Concomitant Diagnosis of COVID-19. Am J Perinatol 2024; 41:e2727-e2734. [PMID: 37549883 DOI: 10.1055/a-2149-8810] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) generally causes milder illness in the pediatric population. However, infants represent a higher-risk population with evolving symptomatology and severity. There is a paucity of large population-based data on the impact of COVID-19 on hospitalized infants. STUDY DESIGN In this large cohort study, the National Inpatient Sample database was queried for all infant hospital admissions between January and December 2020 in the United States, with and without a diagnosis of COVID-19 based on ICD-10-CM U07. The mortality and morbidity of infants with and without COVID-19 were evaluated. Parent-reported race and outcomes were also analyzed. RESULTS A weighted total of 3,754,236 infants who were hospitalized were identified, of which 4,265 patients (0.11%) had a concomitant diagnosis of COVID-19. Infants with COVID-19 had similar mortality and extracorporeal membrane oxygenation utilization. Infants with concomitant COVID-19 had a higher rate of respiratory failure, congestive heart failure, acute kidney injury, and coagulopathy. Compared with Caucasian infants and Asian infants, Hispanic and African American infants were more likely to have COVID-19 hospital admissions than hospitalizations without COVID-19 diagnosis. Patients with lower median household income represented the majority of the COVID-19 hospitalization. The infants with COVID-19 were more likely to have Medicaid or Medicare insurance and less likely to have private insurance. CONCLUSION In this large cohort of hospitalized infants with COVID-19, the infection was associated with complications, including respiratory failure and endotracheal intubations but not associated with a higher risk for mortality. Infants from racial minorities and lower socioeconomic strata carry the highest burden of COVID-19 infection. KEY POINTS · Infants with COVID-19 represent a higher-risk group with evolving symptomatology and severity.. · Infants with COVID-19 had similar mortality rates and extracorporeal membrane oxygenation utilization as those without COVID-19.. · Racial minorities and lower socioeconomic strata carry the highest burden of COVID-19 infection..
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Affiliation(s)
- Parvathy Krishnan
- Department of Neonatal-Perinatal Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York
| | - Aaqib Malik
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York
| | - Ameesh Isath
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York
| | - Dhrubajyoti Bandyopadhyay
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York
| | - Akshay Goel
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York
| | - Lance Parton
- Department of Neonatal-Perinatal Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York
| | - Praveen Chandrasekharan
- Department of Neonatal-Perinatal Medicine, University at Buffalo, Kaleida Health, UBMD Pediatrics, Buffalo, New York
| | - Meenakshi Singh
- Department of Neonatal-Perinatal Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York
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Khalifeh M, Rubin LG, Dayya D, Cerise J, Skinner K, Maloney M, Walworth C, Petropoulos CJ, Wrin T, Chun K, Weinberger B. SARS-CoV-2 neutralizing antibody titers in maternal blood, umbilical cord blood, and breast milk. J Perinatol 2024; 44:28-34. [PMID: 38092879 DOI: 10.1038/s41372-023-01843-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/16/2023] [Accepted: 11/24/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE We quantified neutralizing SARS-CoV-2 antibody against spike protein (nAb) levels after vaccination and SARS-CoV-2 infection in maternal serum, cord blood, and breast milk and determined whether they correlate with levels of spike protein binding antibody. STUDY DESIGN Women (n = 100) were enrolled on admission for delivery. Previous SARS-CoV-2 infection was defined by anti-nucleocapsid antibodies. Levels of nAb and binding antibodies against spike receptor binding domain were measured in maternal blood, cord blood, and milk. RESULTS Maternal nAb levels were higher after vaccine and infection than vaccine alone but waned rapidly. Levels of nAb in cord blood and milk correlated with maternal levels and were higher in cord blood than maternal. Spike protein binding antibody levels correlated with nAb. CONCLUSION SARS-CoV-2 vaccination near delivery may boost antibody-mediated immunity in the peripartum period. Neutralizing antibodies are passed transplacentally and into milk. Spike protein binding antibody may be a feasible proxy for nAb.
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Affiliation(s)
- Mazen Khalifeh
- Division of Neonatology and Newborn Medicine, Phelps Hospital, Northwell Health, Sleepy Hollow, NY, USA
| | - Lorry G Rubin
- Division of Pediatric Infectious Diseases, Cohen Children's Medical Center, Northwell Health and Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA
| | - David Dayya
- Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital, Northwell Health, Sleepy Hollow, NY, USA
| | - Jane Cerise
- Biostatistics Unit, Office of Academic Affairs, Northwell School, New Hyde Park, NY, USA
| | - Karen Skinner
- Division of Neonatology and Newborn Medicine, Phelps Hospital, Northwell Health, Sleepy Hollow, NY, USA
| | - Mona Maloney
- Division of Neonatology and Newborn Medicine, Phelps Hospital, Northwell Health, Sleepy Hollow, NY, USA
| | - Charles Walworth
- Labcorp-Monogram Biosciences, South San Francisco, CA, 94080, USA
| | | | - Terri Wrin
- Labcorp-Monogram Biosciences, South San Francisco, CA, 94080, USA
| | - Kelly Chun
- Labcorp-Esoterix, Calabasas, CA, 91301, USA
| | - Barry Weinberger
- Division of Neonatal-Perinatal Medicine, Cohen Children's Medical Center, Northwell Health and Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
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6
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Heyward EB, Clark RH, Smith PB, Benjamin DK, Zimmerman KO, Ahmad KA, Blackwell CK, Won H, Ssengonzi R, Belbase A, Ndalama CO, An J, Nwaezeigwe O, Greenberg RG. Trends in COVID-19 diagnoses and outcomes in infants hospitalized in the neonatal intensive care unit. J Perinatol 2024; 44:35-39. [PMID: 37452116 DOI: 10.1038/s41372-023-01725-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Characterize the prevalence of coronavirus disease 2019 (COVID-19) diagnosis among mothers with infants hospitalized in 294 neonatal intensive care units (NICUs), and demographics and outcomes of infants with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure in utero. STUDY DESIGN Cohort study of infants discharged from NICUs 01/2020-09/2021. We defined groups based on infant diagnosis, infant testing, and maternal SARS-CoV-2 infection status. We compared demographics, clinical characteristics, and outcomes. RESULTS Of 150,924 infants, 94% had no COVID-related diagnosis or test; 247 (0.2%) infants tested positive for COVID-19 and were more likely to require mechanical ventilation. Infants with unknown maternal status and negative testing were more commonly premature, outborn, and had longer hospitalizations. CONCLUSION In this large cohort of hospitalized infants, most had no known exposure to COVID-19. Adverse outcomes and mortality were rare. Further studies are needed to evaluate the long-term effects of COVID-19 in this population.
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Affiliation(s)
| | - Reese H Clark
- Pediatrix Center for Research, Education, Quality, and Safety, Sunrise, FL, USA
| | - P Brian Smith
- Department of Pediatrics, Duke University, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
| | - Daniel K Benjamin
- Department of Pediatrics, Duke University, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
| | - Kanecia O Zimmerman
- Department of Pediatrics, Duke University, Durham, NC, USA
- Duke Clinical Research Institute, Durham, NC, USA
| | - Kaashif A Ahmad
- Pediatrix Center for Research, Education, Quality, and Safety, Sunrise, FL, USA
- Pediatrix Neonatology of San Antonio, San Antonio, TX, USA
- Pediatrix Neonatology of Houston, Houston, TX, USA
| | - Courtney K Blackwell
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Hannah Won
- Duke Clinical Research Institute, Durham, NC, USA
| | | | - Avi Belbase
- Duke Clinical Research Institute, Durham, NC, USA
| | | | - Jennifer An
- Duke Clinical Research Institute, Durham, NC, USA
| | | | - Rachel G Greenberg
- Department of Pediatrics, Duke University, Durham, NC, USA.
- Duke Clinical Research Institute, Durham, NC, USA.
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Villar da Motta AS, Ma Y, Sardeli AV, Velasque L. Type of delivery and perinatal outcomes in pregnant women diagnosed with COVID-19: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2024; 292:112-119. [PMID: 37992423 DOI: 10.1016/j.ejogrb.2023.11.019] [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: 10/06/2023] [Revised: 11/12/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND There is paucity in the literature that provides a comprehensive and evidence-based conclusion regarding this topic. OBJECTIVE To compare perinatal outcomes of vaginal and caesarean section delivery in women diagnosed with COVID-19 by meta-analysis of literature. SEARCH STRATEGY The search was conducted on MEDLINE, EMBASE, LILACS, CINAHL, Scopus, Web of Science and Cochrane Database of Systematic Reviews by 25th May 2022. SELECTION CRITERIA The inclusion criteria involved pregnant women diagnosed with COVID-19 who underwent caesarean section and those who had vaginal deliveries. DATA COLLECTION AND ANALYSIS The included studies were meta-analyzed for various outcomes including: Gestational age, maternal intensive care unit admission, maternal death, prematurity, newborn birth weight, newborn intensive care unit admission, Apgar scores, newborn death, and newborn vertical transmission of COVID-19. The meta-analysis was conducted using Comprehensive Meta-Analysis (CMA) software, version 3.3.070. MAIN RESULTS The meta-analyses included 2,566 deliveries (866 caesarean sections and 1,700 vaginal deliveries) and identified that caesarean section was significantly associated with increased prematurity (OR 2.5 [1.7; 3.6], p < 0.001), lower birth weight (-118 g [-170; -66], p < 0.001), and a higher need for maternal (OR 9.54 [5.22; 17.43], p < 0.01) and neonatal intensive care unit intervention (OR 3.67 [2.71; 4.96], p < 0.01) compared to vaginal delivery. CONCLUSION COVID-19 infection alone should not be an indication for caesarean section as there is insufficient evidence that caesarean section reduces mortality, improves birth conditions, or prevents vertical transmission. Additionally, caesarean section is associated with poorer perinatal outcomes compared to vaginal delivery.
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Affiliation(s)
- Alana S Villar da Motta
- Institute of Childcare and Pediatrics, Federal University of Rio de Janeiro, Rio de Janeiro 21941-912, Brazil
| | - Yangmyung Ma
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2SQ, UK.
| | - Amanda V Sardeli
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2SQ, UK
| | - Luciane Velasque
- State Department of Health of Rio de Janeiro, Rio de Janeiro 20031-142, Brazil
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Gholami R, Borumandnia N, Kalhori E, Taheri M, Khodakarami N. The impact of covid-19 pandemic on pregnancy outcome. BMC Pregnancy Childbirth 2023; 23:811. [PMID: 37993814 PMCID: PMC10664522 DOI: 10.1186/s12884-023-06098-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 10/31/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND The acute respiratory disease caused by the coronavirus (COVID-19) has spread rapidly worldwide yet has not been eliminated. The infection is especially deadly in vulnerable populations. The current studies indicate that pregnant women are at greater risk of getting seriously ill. Even though fetuses protect against disease, the additional finding showed that the COVID-19 pandemic could increase fetal and maternal morbidities. In a situation where COVID-19 and new strains of the virus are still not controlled, scientists predicted that the world might experience another pandemic. Consequently, more research about the effects of COVID-19 infection on pregnancy outcomes is needed. This study aimed to compare the pregnancy outcomes of Iranian pregnant women in the first year of the pandemic with the previous year. METHODS This prospective cross-sectional study was performed to compare the pregnancy outcome during the COVID-19 pandemic among Iranian pregnant women who gave birth during the pandemic and one year before the pandemic (2019-2020 and 2020-2021). The sample size was 2,371,332 births registered at hospitals and birth centers platforms. The studied variables include stillbirth, congenital anomaly, birth weight, preeclampsia, gestational diabetes, cesarean section, ICU admission, mean of the gestational age at birth, preterm births, NICU admission, neonatal mortality and the percentage of deliveries with at least one complication such as blood transfusion and postpartum ICU admission. Analyzing data was done by using SPSS version 25 software. RESULTS We found statistical differences between pregnancy and birth outcomes during the COVID-19 pandemic compared to one year before. The risk of preeclampsia, gestational diabetes, cesarean section, preterm birth and NICU admission were clinically significant. Also, there was a significant decrease in mean gestational age. CONCLUSION The COVID-19 pandemic has affected the pregnancy outcome by increasing morbidities and complications during pregnancy, birth, and postpartum. In addition, extensive quarantine outbreaks disrupted the healthcare system and hindered access to prenatal services. It is necessary to develop preventive and therapeutic care protocols for similar pandemic conditions.
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Affiliation(s)
- Roya Gholami
- Department of Midwifery, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Nasrin Borumandnia
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Kalhori
- Iran Scientific Association of Midwifery, Tehran, Iran
| | - Mahshid Taheri
- FBW Gynecology Plus, Ashford, South Australia, Australia
| | - Nahid Khodakarami
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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9
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Lee SH, Jin JH, Yoo JH, Yoon SW. Association between maternal coronavirus disease 2019 and transient tachypnea of the newborn: a single-center study. Clin Exp Pediatr 2023; 66:493-500. [PMID: 37873564 PMCID: PMC10626023 DOI: 10.3345/cep.2023.00563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Limited clinical reports have investigated the effects of maternal coronavirus disease 2019 (COVID-19) on fetuses and neonates. PURPOSE This retrospective study aimed to assess the impact of maternal COVID-19 on neonates during the perinatal period, including neonatal clinical outcomes, versus the outcomes of neonates of mothers without COVID-19. METHODS Neonates born to COVID-19-infected mothers at the National Health Insurance Service Ilsan Hospital between February 2021 and March 2022 were included. Those with gestational age (GA) ≥35+0 weeks who were born within 2 weeks of the maternal infection were matched 1:2 with a control group based on GA. The main outcomes were respiratory diseases, including transient tachypnea of the newborn (TTN), respiratory distress syndrome, meconium aspiration syndrome, the need for respiratory support, and length of hospital stay. Uni- and multivariate logistic regression analyses were performed and adjusted for relevant covariates, including maternal age, obstetric complications (hypertension and gestational diabetes), delivery mode, birth weight, sex, and small-for-gestational-age status. RESULTS The case group comprised 103 neonates (mean GA, 38.5±1.3 weeks; mean birth weight, 3,121±397 g), while the control group included 206 neonates (mean GA, 38.4±1.2 weeks; mean birth weight, 3088±428 g). In the case and control groups, the proportion of cesarean sections was 91% and 40%, respectively, while the proportion of male infants was 56% and 47%, respectively. After adjusting for covariates, the case group had a higher risk of TTN (adjusted odd ratio [AOR], 3.69; 95% confidence interval [CI], 1.69-8.07), noninvasive respiratory ventilator use (AOR, 2.28; 95% CI, 1.05-4.97), and oxygen support (AOR, 4.83; 95% CI, 1.46-15.95). CONCLUSION Newborns born to COVID-19-infected mothers are at increased risk of TTN and may require respiratory support. Close monitoring of respiratory symptoms is crucial in neonates.
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Affiliation(s)
- Sung Hee Lee
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Ju Hyun Jin
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jong Ha Yoo
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Shin Won Yoon
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea
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10
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Yasa B, Memur S, Ozturk DY, Bagci O, Uslu SI, Cetinkaya M. Neonatal Outcomes of Premature Infants Born to Women with the Novel Coronavirus (SARS-CoV-2) Infection: A Case Control Study. Am J Perinatol 2023; 40:1715-1724. [PMID: 34839474 DOI: 10.1055/s-0041-1740177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Novel coronavirus disease 2019 (COVID-19) is a disease associated with atypical pneumonia caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The first cases of COVID-19 were reported in Wuhan at the end of 2019. Transmission usually occurs via infected droplets and close personal contact; the possibility of vertical transmission is still under debate. This retrospective study aimed to analyze clinical characteristics of premature infants born to mothers with symptomatic COVID-19 disease. STUDY DESIGN This case control study compared the clinical and laboratory data of 20 premature infants born to mothers infected with SARS-CoV-2 with sex and gestational age-matched historical controls. RESULTS The median gestational age and birth weight in both groups were similar. Respiratory distress developed in 11 (55.5%) infants in study group and 19 (47.5%) infants in control group. Mechanical ventilation and endotracheal surfactant administration rates were similar. Median duration of hospitalization was 8.5 (2-76) days in study group and 12 days in historical controls. Real-time reverse-transcription polymerase chain reaction tests (RT-PCR) of nasopharyngeal swab samples for SARS-CoV-2 were found to be negative twice, in the first 24 hours and later at 24 to 48 hours of life. No neutropenia or thrombocytopenia was detected in the study group. Patent ductus arteriosus, bronchopulmonary dysplasia, and necrotizing enterocolitis rates were similar between groups. No mortality was observed in both groups. CONCLUSION To the best of our knowledge, this is one of the few studies evaluating the clinical outcomes of premature infants born to SARS-CoV-2 infected mothers. There was no evidence of vertical transmission of SARS-CoV-2 from symptomatic SARS-CoV-2-infected women to the neonate in our cohort. The neonatal outcomes also seem to be favorable with no mortality in preterm infants. KEY POINTS · SARS-CoV-2 pandemic is a challenge for pregnant women.. · Neonatal outcomes of premature infants born to mothers infected with SARS-CoV-2 not well defined.. · SARS-CoV-2 infection seems to have no adverse effect on mortality and morbidity in premature infants..
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Affiliation(s)
- Beril Yasa
- Neonatology Department, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Seyma Memur
- Neonatology Department, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Dilek Y Ozturk
- Neonatology Department, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Onur Bagci
- Neonatology Department, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Sait I Uslu
- Neonatology Department, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
| | - Merih Cetinkaya
- Neonatology Department, Istanbul Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey
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11
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Gaur P, Darwin KC, Kohn JR, Uribe KA, Shippey E, Eke AC. The relationship between COVID-19 vaccination status in pregnancy and birthweight. Am J Obstet Gynecol MFM 2023; 5:101057. [PMID: 37330010 PMCID: PMC10268810 DOI: 10.1016/j.ajogmf.2023.101057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/04/2023] [Accepted: 06/12/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Despite findings that maternal COVID-19 infection in pregnancy is associated with low birthweight (weight of ≤2500 g), previous studies demonstrate no difference in low birthweight risk between COVID-19 vaccinated and unvaccinated pregnant persons. Few studies, however, have examined the association between unvaccinated, incomplete vaccination, and complete vaccination on low birthweight, and they have been limited by small sample sizes and lack of adjustment for covariates. OBJECTIVE We sought to address key limitations of prior work and evaluate this association between unvaccinated, incomplete, and complete COVID-19 vaccination status in pregnancy and low birthweight. We predicted a protective association of vaccination on low birthweight that varies by number of doses received. STUDY DESIGN We performed a population-based retrospective study using the Vizient clinical database, which included data from 192 hospitals in the United States. Our sample included pregnant persons who delivered between January 2021 and April 2022 at hospitals that reported maternal vaccination data and birthweight at delivery. Pregnant persons were categorized into 3 groups as follows: unvaccinated; incompletely vaccinated (1 dose of Pfizer or Moderna); or completely vaccinated (1 dose of Johnson & Johnson or ≥2 doses of Moderna or Pfizer). Demographics and outcomes were analyzed using standard statistical tests. We performed multivariable logistic regression to account for potential confounders between vaccination status and low birthweight in the original cohort. Propensity score matching was used to reduce bias related to the likelihood of vaccination, and the multivariable logistic regression model was then applied to the propensity score-matched cohort. Stratification analysis was performed for gestational age and race and ethnicity. RESULTS Of the 377,995 participants, 31,155 (8.2%) had low birthweight, and these participants were more likely to be unvaccinated than those without low birthweight (98.8% vs 98.5%, P<.001). Incompletely vaccinated pregnant persons were 13% less likely to have low birthweight neonates compared to unvaccinated persons (odds ratio, 0.87; 95% confidence interval, 0.73-1.04), and completely vaccinated persons were 21% less likely to have low birthweight neonates (odds ratio, 0.79; 95% confidence interval, 0.79-0.89). After controlling for maternal age, race or ethnicity, hypertension, pregestational diabetes, lupus, tobacco use, multifetal gestation, obesity, use of assisted reproductive technology, and maternal or neonatal COVID-19 infections in the original cohort, these associations remained significant for only complete vaccination (adjusted odds ratio, 0.80; 95% confidence interval, 0.70-0.91) and not incomplete vaccination (adjusted odds ratio, 0.87; 95% confidence interval, 0.71-1.04). In the propensity score-matched cohort, pregnant persons who were completely vaccinated against COVID-19 were 22% less likely to have low birthweight neonates compared to unvaccinated and incompletely vaccinated individuals (adjusted odds ratio, 0.78; 95% confidence interval, 0.76-0.79). CONCLUSION Pregnant persons who were completely vaccinated against COVID-19 were less likely to have low birthweight neonates compared to unvaccinated and incompletely vaccinated individuals. This novel association was observed among a large population after adjusting for confounders of low birthweight and factors influencing the likelihood of receiving the COVID-19 vaccine.
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Affiliation(s)
- Priyanka Gaur
- Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD (Drs Gaur and Uribe).
| | - Kristin C Darwin
- Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD (Drs Darwin, Kohn, and Eke)
| | - Jaden R Kohn
- Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD (Drs Darwin, Kohn, and Eke)
| | - Katelyn A Uribe
- Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD (Drs Gaur and Uribe)
| | | | - Ahizechukwu C Eke
- Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD (Drs Darwin, Kohn, and Eke); Division of Clinical Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD (Dr Eke)
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12
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Zehra SM, Parkar S, Kazi Z, Pethani A, Malik A, Mirza A, Abro F, Jabbar HA, Saleem AF. Impact of COVID-19 on feto-maternal and neonatal health in Karachi, Pakistan, A retrospective cohort study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002139. [PMID: 37566567 PMCID: PMC10420353 DOI: 10.1371/journal.pgph.0002139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/15/2023] [Indexed: 08/13/2023]
Abstract
Scientific literature suggests that pregnant women are at greater risk of acquiring a more severe form of COVID-19 exposing both mother and child to a higher risk of obstetric and neonatal complications. These include increased hospitalization rates, ICU admissions, or ventilatory support among pregnant women when compared to COVID-19 negative pregnant womenA case-control study was conducted at the Aga Khan University Hospital, Karachi, Pakistan with the objective of evaluating the clinical presentation of COVID-19 in pregnancy and its effect on maternal and neonatal outcomes. Data was retrospectively collected from April 2020 till January 2022 of obstetric patients with COVID-19 positive cases and were compared with COVID-19 negative cases from the same time. A total of 491 women were included in the study, 244 cases and 247 controls. The most common complication amongst cases was gestational diabetes mellitus (n = 59, 24%), followed by gestational hypertension (n = 16, 31.7%), pre-eclampsia (n = 13, 5%) Pre-rupture of membrane (85.7%). Amongst the COVID positive mothers the most common presenting complaints were fever followed by dry cough, headache, and shortness of breath. It was observed that COVID-19 did not result in increased adverse maternal or neonatal outcomes compared to COVID-19 negative mothers.
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Affiliation(s)
| | - Sadia Parkar
- Department of Paediatrics, Aga Khan University Hospital, Karachi, Pakistan
| | - Zaubina Kazi
- Department of Paediatrics, Aga Khan University Hospital, Karachi, Pakistan
| | - Asma Pethani
- Department of Paediatrics, Aga Khan University Hospital, Karachi, Pakistan
| | - Ayesha Malik
- Department of Obstetrics & Gynaecology, Aga Khan University Hospital, Karachi, Pakistan
| | - Adnan Mirza
- Department of Paediatrics, Aga Khan University Hospital, Karachi, Pakistan
| | - Falak Abro
- Department of Paediatrics, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Ali Faisal Saleem
- Department of Paediatrics, Aga Khan University Hospital, Karachi, Pakistan
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13
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Reznik SE, Vuguin PM, Cohen A, Khoury R, Loudig O, Balakrishnan R, Fineberg SA, Hughes F, Harigopal M, Charron MJ. SARS-CoV-2 Infection in Unvaccinated High-Risk Pregnant Women in the Bronx, NY, USA Is Associated with Decreased Apgar Scores and Placental Villous Infarcts. Biomolecules 2023; 13:1224. [PMID: 37627289 PMCID: PMC10452574 DOI: 10.3390/biom13081224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/28/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
Babies born to severe acute respiratory syndrome corona virus-2 (SARS-CoV-2)-infected mothers are at greater risk for perinatal morbidity and more likely to receive a neurodevelopmental diagnosis in the first year of life. However, the effect of maternal infection on placental function and neonatal outcomes varies depending upon the patient population. We set out to test our hypothesis that maternal SARS-CoV-2 infection in our underserved, socioeconomically disadvantaged, mostly unvaccinated, predominantly African American and Latina population in the Bronx, NY would have effects evident at birth. Under IRB approval, 56 SARS-CoV-2-positive patients infected during the "first wave" of the pandemic with alpha and beta strains of the virus, 48 patients infected during the "second wave" of the pandemic with delta and omicron strains and 61 negative third-trimester high-risk patients were randomly selected from Montefiore Medical Center (MMC), Bronx, NY. In addition, two positive cases from Yale New Haven Hospital, CT were included as controls. All 104 placentas delivered by SARS-CoV-2-positive mothers were uninfected by the virus, based on immunohistochemistry, in situ hybridization, and qPCR analysis. However, placental villous infarcts were significantly increased in first-wave cases compared to second-wave cases or negative controls. Significantly lower Apgar scores at 1 min and 5 min were observed in neonates born to infected mothers with severe symptoms. These findings suggest that even without entering the placenta, SARS-CoV-2 can affect various systemic pathways, culminating in altered placental development and function, which may adversely affect the fetus, especially in a high-risk patient population such as ours. These results underline the importance of vaccination among pregnant women, particularly in low-resource areas.
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Affiliation(s)
- Sandra E. Reznik
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Obstetrics and Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Pharmaceutical Sciences, St. John’s University, Queens, NY 11439, USA
| | - Patricia M. Vuguin
- Department of Pediatrics, Columbia University Vagelos College of Physicians & Surgeons, New York, NY 10032, USA
| | - Alexa Cohen
- Department of Obstetrics and Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Rasha Khoury
- Obstetrics and Gynecology and Divisions of Complex Family Planning and Maternal Fetal Medicine, Boston University School of Medicine, Boston, MA 02118, USA
| | - Olivier Loudig
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
| | - Ridin Balakrishnan
- Department of Pathology, Louisiana School of Medicine, LSU Health, New Orleans, LA 70112, USA
| | - Susan A. Fineberg
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Francine Hughes
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Malini Harigopal
- Department of Pathology, Yale University School of Medicine, New Haven, CT 06519, USA
| | - Maureen J. Charron
- Department of Obstetrics and Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Medicine and the Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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14
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Dinh A, Drouet F, Dechartres A, Yordanov Y, Duran C, Schmidt N, Banzet A, Perrier MH, Mosquet N, Lescure FX, Jourdain P, Nizard J, Masingue X. Pregnant women with mild COVID-19 followed in community setting by telemedicine, and factors associated with unfavorable outcome. PLoS One 2023; 18:e0288845. [PMID: 37535653 PMCID: PMC10399733 DOI: 10.1371/journal.pone.0288845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/05/2023] [Indexed: 08/05/2023] Open
Abstract
OBJECTIVES Few is known on pregnant women with mild COVID-19 managed in a community setting with a telemedicine solution, including their outcomes. The objective of this study is to evaluate the adverse fetal outcomes and hospitalization rates of pregnant COVID-19 outpatients who were monitored with the Covidom© telemedicine solution. METHODS A nested study was conducted on pregnant outpatients with confirmed COVID-19, who were managed with Covidom© between March and November 2020. The patients were required to complete a standard medical questionnaire on co-morbidities and symptoms at inclusion, and were then monitored daily for 30 days after symptom onset. Adverse fetal outcome was defined as a composite of preterm birth, low birthweight, or stillbirth, and was collected retrospectively through phone contact with a standardized questionnaire. RESULTS The study included 714 pregnant women, with a median age of 32.0 [29.0-35.0] and a median BMI of 23.8 [21.3-27.0]. The main comorbidities observed were smoking (53%), hypertension (19%). The most common symptoms were asthenia (45.6%), cough (40.3%) and headache (25.7%), as well as anosmia (28.4%) and agueusia (32.3%). Adverse fetal outcomes occurred in 64 (9%) cases, including 38 (5%) preterm births, 33 (5%) low birthweights, and 6 (1%) stillbirths. Hospitalization occurred in 102 (14%) cases and was associated with adverse fetal outcomes (OR 2.4, 95% CI 1.3-4.4). CONCLUSIONS Our study suggests that adverse fetal outcomes are rare in pregnant women with mild COVID-19 who are monitored at home with telemedicine. However, hospitalization for COVID-19 and pregnancy-induced hypertension are associated with a higher risk of adverse fetal outcome.
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Affiliation(s)
- Aurélien Dinh
- Infectious Disease, Raymond-Poincaré University Hospital APHP, Garches, France
| | - Florian Drouet
- Covidom Regional Telemedicine Platform, APHP, Great Paris area, France
| | - Agnes Dechartres
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Université, AP-HP, Paris, France
- Département de Santé Publique, Hôpital Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Youri Yordanov
- Emergency Department, University Hospital Saint Antoine, APHP, Paris, France
| | - Clara Duran
- Infectious Disease, Raymond-Poincaré University Hospital APHP, Garches, France
| | - Nicolas Schmidt
- Covidom Regional Telemedicine Platform, APHP, Great Paris area, France
| | - Amélie Banzet
- Covidom Regional Telemedicine Platform, APHP, Great Paris area, France
| | | | - Nathalie Mosquet
- Covidom Regional Telemedicine Platform, APHP, Great Paris area, France
| | | | - Patrick Jourdain
- Cardiology Department, University Hospital of Kremlin Bicêtre, APHP, Le Kremlin Bicêtre, France
| | - Jacky Nizard
- Department of Obstetrics and Gynecology, Pitié-Salpétrière University Hospital, Sorbonne Université, APHP, Paris, France
| | - Xavier Masingue
- Covidom Regional Telemedicine Platform, APHP, Great Paris area, France
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15
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Heaney S, Galeotti M, Aventin Á. Pregnancy loss following miscarriage and termination of pregnancy for medical reasons during the COVID-19 pandemic: a thematic analysis of women's experiences of healthcare on the island of Ireland. BMC Pregnancy Childbirth 2023; 23:529. [PMID: 37480006 PMCID: PMC10360341 DOI: 10.1186/s12884-023-05839-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/09/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Losing a baby during pregnancy can be a devastating experience for expectant parents. Many report dedicated, compassionate healthcare provision as a facilitator of positive mental health outcomes, however, healthcare services have been severely impacted during the COVID-19 pandemic. AIM To explore women's experiences of healthcare service provision for miscarriage and termination of pregnancy for medical reasons (TFMR) on the island of Ireland during the COVID-19 pandemic. METHODS Findings combine data from elements of two separate studies. Study 1 used a mixed methods approach with women who experienced miscarriage and attended a hospital in Northern Ireland. Study 2 was qualitative and examined experiences of TFMR in Northern Ireland and Ireland. Data analysed for this paper includes open-ended responses from 145 women to one survey question from Study 1, and semi-structured interview data with 12 women from Study 2. Data were analysed separately using Thematic Analysis and combined for presentation in this paper. RESULTS Combined analysis of results indicated three themes, (1) Lonely and anxiety-provoking experiences; (2) Waiting for inadequate healthcare; and (3) The comfort of compassionate healthcare professionals. CONCLUSIONS Women's experiences of healthcare provision were negatively impacted by COVID-19, with the exclusion of their partner in hospital, and delayed services highlighted as particularly distressing. Limited in-person interactions with health professionals appeared to compound difficulties. The lived experience of service users will be helpful in developing policies, guidelines, and training that balance both the need to minimise the risk of infection spread, with the emotional, psychological, and physical needs and wishes of parents. Further research is needed to explore the long-term impact of pregnancy loss during a pandemic on both parents and health professionals delivering care.
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Affiliation(s)
- Suzanne Heaney
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Martina Galeotti
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
| | - Áine Aventin
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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16
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Movahedi M, Siahafshari KM, Hajhashemi M, Khorvash F, Saeidi M, Allameh Z. Evaluation of Maternal and Fetal Outcomes in Pregnant Women with COVID-19 based on Different Trimesters. Adv Biomed Res 2023; 12:165. [PMID: 37564445 PMCID: PMC10410429 DOI: 10.4103/abr.abr_173_22] [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: 05/25/2022] [Revised: 07/06/2022] [Accepted: 07/16/2022] [Indexed: 08/12/2023] Open
Abstract
Background COVID-19 is the leading cause of the recent pandemic in the globe. This disease might have different effects on the maternal and fetal outcomes in pregnancy. The aim of this study was to assess these outcomes in pregnant women with COVID-19 infections in different trimesters. Materials and Methods This is a prospective cohort study that was performed in February 2020 to August 2021 in Isfahan on 430 pregnant women with definite diagnosis of COVID-19 infection admitted to our medical centers. The included cases were followed based on the gestational age in which they were diagnosed with COVID-19 infection. Patients were divided into three groups (first, second, and third trimesters) based on COVID-19 infection. Results The frequency of requiring mechanical ventilation was higher in mothers with COVID-19 in the second trimester (P = 0.049) and the frequency of PIH was significantly higher in mothers with COVID-19 in the third trimester compared to other women (P = 0.009). Fetal growth restriction (FGR) was also observed in 22 patients (5.3%) that was mostly observed with COVID-19 in the third trimester (P = 0.012). Oligohydramnios and fetal distress leading to C/S were observed in 19 patients (4.6%) and 12 patients (2.9%), respectively. The majority of maternal mortality was among cases with COVID-19 infection in the third trimester (44.4%). Conclusion We observed higher maternal and fetal complications in women especially those in the third trimester. Our results were in line with the findings of previous studies. Women with COVID-19 infection in the third trimester had highest frequencies of preterm labor and FGR.
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Affiliation(s)
- Minoo Movahedi
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Khadijeh M. Siahafshari
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Hajhashemi
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzin Khorvash
- Infectious Diseases Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Milad Saeidi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Allameh
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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17
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Subramaniam V, Ng BK, Phon SE, Muhammad Rafi'uddin H, Wira Sorfan AR, Siti Hajar AA, Nor Azlin MI. Outcomes of Pregnancy in COVID-19-Positive Mothers in a Tertiary Centre. Life (Basel) 2023; 13:1491. [PMID: 37511865 PMCID: PMC10381457 DOI: 10.3390/life13071491] [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: 06/13/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND COVID-19 is an emerging global pandemic with potential adverse effects during pregnancy. This study aimed to determine the adverse maternal and foetal outcomes due to COVID-19 infection. We also compared maternal and neonatal outcomes with regard to the timing of diagnosis (first and second trimester vs. third and fourth trimester); early COVID-19 (stage I and II) vs. severe-stage COVID-19 (III, IV, and V); and lastly, women who were partially vaccinated vs. unvaccinated. METHODS This was a retrospective study conducted in HCTM from January 2021 to January 2022. All pregnant women admitted for COVID-19 infections were recruited. The patients' records were traced. Adverse maternal and neonatal outcomes were documented and analysed. RESULTS There were 172 pregnant women recruited into this study. We excluded twenty-four patients with incomplete data and nine women who delivered elsewhere. The final 139 patients were available for data analysis. The majority of women were in their third trimester of pregnancy (87.8%); however, only 5.0% and 7.2% were in the first and second trimesters, respectively. The study population had a median BMI of 29.1 kg/m2 and almost half of them had never received a COVID-19 vaccination. A sub-analysis of data concerning adverse maternal and foetal outcomes comparing early vs. severe stages of COVID-19 infection showed that severe-stage disease increased the risk of preterm birth (54.5% vs. 15.4%, p < 0.001) and preterm birth before 34 weeks (31.9% vs. 2.6%, p < 0.001) significantly. The severe-stage disease also increased NICU admission (40.9% vs. 15.4%, p = 0.017) with lower birth weight (2995 g vs. 2770 g, p = 0.017). The unvaccinated mothers had an increased risk of preterm birth before 34 weeks and this was statistically significant (11.6% vs. 2.9%, p = 0.048). CONCLUSIONS Adverse pregnancy outcomes such as ICU admission or patient death could occur; however, the clinical course of COVID-19 in most women was not severe and the infection did not significantly influence the pregnancy. The risk of preterm birth before 34 weeks was higher in a more severe-stage disease and unvaccinated mother. The findings from this study can guide and enhance antenatal counselling of women with COVID-19 infection, although they should be interpreted with caution in view of the very small number of included cases of patients in the first and second trimesters.
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Affiliation(s)
- Vigneshwaran Subramaniam
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Beng Kwang Ng
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Su Ee Phon
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Hamizan Muhammad Rafi'uddin
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Abd Razak Wira Sorfan
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Abd Azman Siti Hajar
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Mohamed Ismail Nor Azlin
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
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18
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Slimene N, Bennasrallah C, Abroug H, Charrada I, Dhouib W, Zemni I, Fredj MB, Loussaief C, Sriha AB. COVID-19 during pregnancy: case report and literature review. Pan Afr Med J 2023; 45:9. [PMID: 37346923 PMCID: PMC10280957 DOI: 10.11604/pamj.2023.45.9.26980] [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: 11/14/2020] [Accepted: 11/23/2020] [Indexed: 06/23/2023] Open
Abstract
The current coronavirus disease 2019 (COVID-19) pneumonia pandemic, caused by the newly discovered coronavirus is a serious public health emergency and a highly infectious disease. Evidence to date suggests that there are groups of people who are at a higher risk of getting severe COVID-19 disease such as pregnant women and their fetuses. We reported 4 cases of pregnant women with COVID-19 admitted in the national containment center, Tunisia (3 imported cases and one local case). The age range of the patients was 27-35 years and the range of gestational weeks at admission was 16 weeks to 32 weeks. None of the patients had underlying diseases. All four cases were totally asymptomatic and presented no complications. Two of them gave birth one by vaginal and the other by cesarean delivery, neonates presented no symptoms and no adverse outcomes. The current report does not present significant differences in the disease prognosis in the pregnant women´s group compared with the general women´s population. Careful observation, data collection and consecutive research are necessary.
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Affiliation(s)
- Nadia Slimene
- Department of Family Medicine, University of Monastir, Monastir, Tunisia
| | - Cyrine Bennasrallah
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Hela Abroug
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Ines Charrada
- Department of Endocrinology and Internal Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Wafa Dhouib
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Imen Zemni
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Manel Ben Fredj
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Chawki Loussaief
- Department of Infectiology, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Asma Belguith Sriha
- Department of Family Medicine, University of Monastir, Monastir, Tunisia
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
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19
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Matyas M, Valeanu M, Hasmasanu M, Voina B, Tutu A, Zaharie GC. The Effect of Maternal SARS-CoV-2 Infection on Neonatal Outcome. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050771. [PMID: 37238319 DOI: 10.3390/children10050771] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023]
Abstract
(1) Background: Neonates born to SARS-CoV-2 positive mothers are at risk of infection, as well as adverse outcomes due to the infection. The aim of our study was to analyze the impact of maternal SARS-CoV-2 infection on neonatal outcome. (2) Methods: We conducted a prospective, longitudinal study. We collected data on maternal symptomatology upon admission and their correlation with the development of the infant. Through a questionnaire we analyzed the impact on breastfeeding of the separation of the mother from the newborn, as well as the maternal psycho-emotional effect. (3) Results: Ninety infants were enrolled in the study, from one twin pregnancy and the rest singleton pregnancies. Out of the 89 mothers, 34 showed symptoms. Neonates from mothers with anosmia and ageusia had a higher value of WBC and lymphocytes (p = 0.06 and p = 0.04). Breastfeeding was started in 57.3% of mothers after their discharge from hospital and only 41.6% of the whole study group continued at the follow-up visit. Mothers who described a negative experience during hospitalization associated a 2.42 times higher risk of not continuing breastfeeding. (4) Conclusion: None of the infants enrolled in the study had SARS-CoV-2 infection either at birth or within the first two months of life. Breastfeeding was started with more than half newborns after discharge from hospital. The negative experience generated by the separation from their babies influenced breastfeeding.
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Affiliation(s)
- Melinda Matyas
- Neonatology Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj Napoca, Romania
| | - Madalina Valeanu
- Medical Informatics and Biostatistics Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj Napoca, Romania
| | - Monica Hasmasanu
- Neonatology Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj Napoca, Romania
| | - Bianca Voina
- Neonatology Department, County Emergency Hospital, 400006 Cluj Napoca, Romania
| | - Adelina Tutu
- Neonatology Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj Napoca, Romania
| | - Gabriela C Zaharie
- Neonatology Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj Napoca, Romania
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20
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Yao XD, Li Y, Jiang H, Ma J, Wen J. COVID-19 pandemic and neonatal birth weight: a systematic review and meta-analysis. Public Health 2023; 220:10-17. [PMID: 37201437 DOI: 10.1016/j.puhe.2023.04.009] [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: 11/29/2022] [Revised: 02/16/2023] [Accepted: 04/18/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVES Lockdown was implemented in many countries during the pandemic, which led to myriad changes in pregnant women's lives. However, the potential impacts of the COVID-19 pandemic on neonatal outcomes remain unclear. We aimed to evaluate the association between the pandemic and neonatal birth weight. STUDY DESIGN This was a systematic review and meta-analysis of the previous literature. METHODS We searched the MEDLINE and Embase databases up to May 2022 and extracted 36 eligible studies that compared neonatal birth weight between the pandemic and the prepandemic period. The following outcomes were included: mean birth weight, low birth weight (LBW), very low birth weight (VLBW), macrosomia, small for gestational age (SGA), very small for gestational age (VSGA), and large for gestational age (LGA). Statistical heterogeneity among studies was assessed to determine whether a random effects model or fixed effects model was conducted. RESULTS Of the 4514 studies identified, 36 articles were eligible for inclusion. A total of 1,883,936 neonates during the pandemic and 4,667,133 neonates during the prepandemic were reported. We identified a significant increase in mean birth weight (pooled mean difference [95% confidence interval (CI)] = 15.06 [10.36, 19.76], I2 = 0.0%, 12 studies) and a reduction in VLBW (pooled OR [95% CI] = 0.86 [0.77, 0.97], I2 = 55.4%, 12 studies). No overall effect was identified for other outcomes: LBW, macrosomia, SGA, VSGA, and LGA. There was publication bias for mean birth weight with a borderline significance (Egger's P = 0.050). CONCLUSION Pooled results showed the pandemic was significantly associated with an increase in mean birth weight and a reduction in VLBW, but not for other outcomes. This review provided clues about the indirect effects of the pandemic on neonatal birth weight and more healthcare measures needed to improve neonatal long-term health.
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Affiliation(s)
- X D Yao
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China; Department of Obstetrics and Gynaecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Y Li
- Department of Obstetrics and Gynaecology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - H Jiang
- Department of Obstetrics and Gynaecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - J Ma
- Department of Obstetrics and Gynaecology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - J Wen
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
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21
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Ahmed AK, Sijercic VC, Sayad R, Ruthig GR, Abdelwahab SF, El-Mokhtar MA, Sayed IM. Risks and Preventions for Pregnant Women and Their Preterm Infants in a World with COVID-19: A Narrative Review. Vaccines (Basel) 2023; 11:vaccines11030640. [PMID: 36992224 DOI: 10.3390/vaccines11030640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/05/2023] [Accepted: 03/11/2023] [Indexed: 03/17/2023] Open
Abstract
(1) Background and Aim: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is linked to increasing cases of coronavirus disease 2019 (COVID-19) around the world. COVID-19 infections have an important impact on pregnancy, preterm birth (PTB) and delivery. Although several complications have been reported in infected pregnant women, the effect of infection on PTB is controversial. The purpose of this study was to summarize the existing literature on the effects and complications of COVID-19 on the health of pregnant women and preterm babies and its impact on the incidence of PTB. We also discuss the effect of current COVID-19 vaccines during pregnancy. (2) Methods: We carried out a systematic search of MEDLINE, Embase, and PubMed for studies on preterm births associated with COVID-19. (3) Results and Conclusions: We discovered contradictory results regarding the prevalence of PTB during the pandemic compared to earlier years. While most studies indicated an increase in PTBs with COVID-19, some indicated a decline in the preterm delivery rate during this time. During pregnancy, COVID-19 infection can increase the incidence of cesarean section, stillbirth, ICU admission, preeclampsia/eclampsia, and mortality rates. In the treatment of pregnant women with severe COVID-19, methylprednisolone was favored over prednisolone, and a brief course of dexamethasone is advised for pregnant women with anticipated PTB to accelerate the development of the fetal lung. Generally, vaccination for COVID-19 in pregnant and lactating women stimulates anti-SARS-CoV2 immune responses, and it does not result in any noteworthy negative reactions or outcomes for the mother or baby.
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Affiliation(s)
| | | | - Reem Sayad
- Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Gregory R Ruthig
- Department of Biology, North Central College, Naperville, IL 60540, USA
| | - Sayed F Abdelwahab
- Department of Pharmaceutics and Industrial Pharmacy, College of Pharmacy, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Mohamed A El-Mokhtar
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
- Microbiology and Immunology Department, Faculty of Pharmacy, Sphinx University, Assiut 71515, Egypt
| | - Ibrahim M Sayed
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
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22
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Lalor JG, Sheaf G, Mulligan A, Ohaja M, Clive A, Murphy-Tighe S, Ng ED, Shorey S. Parental experiences with changes in maternity care during the Covid-19 pandemic: A mixed-studies systematic review. Women Birth 2023; 36:e203-e212. [PMID: 35973917 PMCID: PMC9364727 DOI: 10.1016/j.wombi.2022.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/01/2022] [Accepted: 08/08/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, pregnant women were identified as a high-risk and vulnerable group. To reduce risk of transmission, maternity healthcare services were modified to limit exposure but maintain services for pregnant women. However, the change in hospital practice may have compromised quality maternal care standards. Therefore, this review aims to explore parental experiences and views with maternity care received from healthcare institutions during the COVID-19 pandemic. METHODS A mixed studies systematic review was conducted. Six electronic databases (Medline, CINAHL, Embase, PsycInfo, Web of Science, and Maternity and Infant Care) were searched for qualitative, observational, and mixed method studies from the year 2019 to February 2022. Study quality was appraised using the Mixed Methods Appraisal Tool. Quantitative findings were converted to narrative findings. Data was synthesised thematically using a convergent synthesis design. RESULTS Fifty-eight articles were included. Four themes were generated: (1) Distress associated with COVID-19 regulations (perception of hospital restrictions, confusion with ever changing policies), (2) adaptability with maternity services (prenatal: changes in birth plans, prenatal: altered antenatal appointments, education, and care, intrapartum: medicalization of birth, postpartum: varied views on care received and Breastfeeding woes, postpartum: skin-to-skin contact and mother infant bonding) (3) importance of support persons, and (4) future direction for maternity services. CONCLUSIONS Parental experiences highlighted how maternity care during the COVID-19 pandemic did not adhere to WHO standards of quality maternity care. This calls for healthcare institutions to continuously appraise the implementation of restrictive practices that deviate from evidence-based frameworks underpinning quality care.
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Affiliation(s)
- Joan Gabrielle Lalor
- School of Nursing and Midwifery, Trinity College Dublin, 24 D’Olier St, Dublin 2, Ireland
| | - Greg Sheaf
- The Library of Trinity College Dublin, Dublin 2, Ireland
| | - Andrea Mulligan
- School of Law, Trinity College Dublin, House 39, New Square, Dublin 2, Ireland
| | - Magdalena Ohaja
- School of Nursing and Midwifery, National University of Ireland Galway, Ireland
| | - Ashamole Clive
- School of Nursing and Midwifery, Trinity College Dublin, 24 D’Olier St, Dublin 2, Ireland
| | | | - Esperanza Debby Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, 117597, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, 117597, Singapore.
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23
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De Brabandere L, Hendrickx G, Poels K, Daelemans W, Van Damme P, Maertens K. Influence of the COVID-19 pandemic and social media on the behaviour of pregnant and lactating women towards vaccination: a scoping review. BMJ Open 2023; 13:e066367. [PMID: 36764726 PMCID: PMC9922880 DOI: 10.1136/bmjopen-2022-066367] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Pregnant women, foetuses and infants are at risk of infectious disease-related complications. Maternal vaccination is a strategy developed to better protect pregnant women and their offspring against infectious disease-related morbidity and mortality. Vaccines against influenza, pertussis and recently also COVID-19 are widely recommended for pregnant women. Yet, there is still a significant amount of hesitation towards maternal vaccination policies. Furthermore, contradictory messages circulating social media impact vaccine confidence. OBJECTIVES This scoping review aims to reveal how COVID-19 and COVID-19 vaccination impacted vaccine confidence in pregnant and lactating women. Additionally, this review studied the role social media plays in creating opinions towards vaccination in these target groups. ELIGIBILITY CRITERIA Articles published between 23 November 2018 and 18 July 2022 that are linked to the objectives of this review were included. Reviews, articles not focusing on the target group, abstracts, articles describing outcomes of COVID-19 infection/COVID-19 vaccination were excluded. SOURCES OF EVIDENCE The PubMed database was searched to select articles. Search terms used were linked to pregnancy, lactation, vaccination, vaccine hesitancy, COVID-19 and social media. CHARTING METHODS Included articles were abstracted and synthesised by one reviewer. Verification was done by a second reviewer. Disagreements were addressed through discussion between reviewers and other researchers. RESULTS Pregnant and lactating women are generally less likely to accept a COVID-19 vaccine compared with non-pregnant and non-nursing women. The main reason to refuse maternal vaccination is safety concerns. A positive link was detected between COVID-19 vaccine willingness and acceptance of other vaccines during pregnancy. The internet and social media are identified as important information sources for maternal vaccination. DISCUSSION AND CONCLUSION Vaccine hesitancy in pregnant and lactating women remains an important issue, expressing the need for effective interventions to increase vaccine confidence and coverage. The role social media plays in vaccine uptake remains unclear.
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Affiliation(s)
- Larissa De Brabandere
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, University of Antwerp, Wilrijk, Belgium
| | - Greet Hendrickx
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, University of Antwerp, Wilrijk, Belgium
| | - Karolien Poels
- Department of Communication Studies, University of Antwerp, Antwerpen, Belgium
| | - Walter Daelemans
- Department of Linguistics, Computational Linguistics and Psycholinguistics Research Centre, University of Antwerp, Antwerpen, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, University of Antwerp, Wilrijk, Belgium
| | - Kirsten Maertens
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, University of Antwerp, Wilrijk, Belgium
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24
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Sessa R, Filardo S, Masciullo L, Di Pietro M, Angeloni A, Brandolino G, Brunelli R, D’Alisa R, Viscardi MF, Anastasi E, Porpora MG. SARS-CoV-2 Infection in Pregnancy: Clues and Proof of Adverse Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2616. [PMID: 36767980 PMCID: PMC9915124 DOI: 10.3390/ijerph20032616] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/26/2023] [Accepted: 01/29/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) represents one of the most threatening viral infections in the last decade. Amongst susceptible individuals, infected pregnant women might be predisposed to severe complications. Despite the extensive interest in SARS-CoV-2 research, the clinical course of maternal infection, the vertical transmission and the neonatal outcomes have not been completely understood yet. The aim of our study was to investigate the association between SARS-CoV-2 infection, obstetric outcomes and vertical transmission. METHODS A prospective observational study was performed, enrolling unvaccinated pregnant patients positive for SARS-CoV-2 (cases) and matched with uninfected pregnant women (controls). Maternal and neonatal nasopharyngeal swabs, maternal and cord blood, amniotic fluid and placenta tissue samples were collected; blood samples were tested for anti-S and anti-N antibodies, and histologic examination of placental tissues was performed. RESULTS The cases showed a significant association with the development of some obstetric complications, such as intrauterine growth restriction and pregnancy-associated hypothyroidism and diabetes, as compared to controls; their newborns were more likely to have a low birth weight and an arterial umbilical pH less than 7. The viral genome was detected in maternal and cord blood and placental samples in six cases. CONCLUSIONS Pregnant women positive for SARS-CoV-2 infection are more likely to develop severe obstetric outcomes; their newborns could have a low birth weight and arterial pH. Vertical transmission seems a rare event, and further investigation is strongly needed.
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Affiliation(s)
- Rosa Sessa
- Microbiology Section, Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Simone Filardo
- Microbiology Section, Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Luisa Masciullo
- Department of Maternal and Child Health and Urology, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Marisa Di Pietro
- Microbiology Section, Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Antonio Angeloni
- Department of Experimental Medicine, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Gabriella Brandolino
- Department of Maternal and Child Health and Urology, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Roberto Brunelli
- Department of Maternal and Child Health and Urology, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Rossella D’Alisa
- Department of Maternal and Child Health and Urology, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Maria Federica Viscardi
- Department of Maternal and Child Health and Urology, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Emanuela Anastasi
- Department of Experimental Medicine, “Sapienza” University of Rome, 00161 Rome, Italy
| | - Maria Grazia Porpora
- Department of Maternal and Child Health and Urology, “Sapienza” University of Rome, 00161 Rome, Italy
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25
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Delanerolle G, McCauley M, Hirsch M, Zeng Y, Cong X, Cavalini H, Sajid S, Shetty A, Rathod S, Shi JQ, Hapangama DK, Phiri P. The prevalence of mental ill-health in women during pregnancy and after childbirth during the Covid-19 pandemic: a systematic review and Meta-analysis. BMC Pregnancy Childbirth 2023; 23:76. [PMID: 36709255 PMCID: PMC9883834 DOI: 10.1186/s12884-022-05243-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/24/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND This systematic review aims to explore the prevalence of the impact of the COVID-19, MERS, and SARS pandemics on the mental health of pregnant women. METHODS All COVID-19, SARS and MERS studies that evaluated the mental health of pregnant women with/without gynaecological conditions that were reported in English between December 2000 - July 2021 were included. The search criteria were developed based upon the research question using PubMed, Science Direct, Ovid PsycINFO and EMBASE databases. A wide search criterion was used to ensure the inclusion of all pregnant women with existing gynaecological conditions. The Newcastle-Ottawa-Scale was used to assess the risk of bias for all included studies. Random effects model with restricted maximum-likelihood estimation method was applied for the meta-analysis and I-square statistic was used to evaluate heterogeneity across studies. The pooled prevalence rates of symptoms of anxiety, depression, PTSD, stress, and sleep disorders with 95% confidence interval (CI) were computed. RESULTS This systematic review identified 217 studies which included 638,889 pregnant women or women who had just given birth. There were no studies reporting the mental health impact due to MERS and SARS. Results showed that women who were pregnant or had just given birth displayed various symptoms of poor mental health including those relating to depression (24.9%), anxiety (32.8%), stress (29.44%), Post Traumatic Stress Disorder (PTSD) (27.93%), and sleep disorders (24.38%) during the COVID-19 pandemic. DISCUSSION It is important to note that studies included in this review used a range of outcome measures which does not allow for direct comparisons between findings. Most studies reported self-reported measure of symptoms without clinical diagnoses so conclusions can be made for symptom prevalence rather than of mental illness. The importance of managing mental health during pregnancy and after-delivery improves the quality of life and wellbeing of mothers hence developing an evidence-based approached as part of pandemic preparedness would improve mental health during challenging times. OTHER The work presented in this manuscript was not funded by any specific grants. A study protocol was developed and published in PROSPERO (CRD42021235356) to explore several key objectives.
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Affiliation(s)
- Gayathri Delanerolle
- Nuffield Department of Primary Health Care Sciences, Uuniversity of Oxford, Oxford, UK
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Mary McCauley
- Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | - Martin Hirsch
- University College London, London, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Yutian Zeng
- Southern University of Science and Technology, Shenzhen, China
| | - Xu Cong
- Southern University of Science and Technology, Shenzhen, China
| | - Heitor Cavalini
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Sana Sajid
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Ashish Shetty
- University College London, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Shanaya Rathod
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Jian Qing Shi
- Southern University of Science and Technology, Shenzhen, China
- National Center for Applied Mathematics, Shenzhen, China
| | | | - Peter Phiri
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK.
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
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26
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Reis ZSN, Pires MC, Ramos LEF, Sales TLS, Pereira PD, Martins KPMP, Garbini AF, dos Reis Gomes AG, Pessoa BP, Matos CC, Cimini CCR, Rempel C, Ponce D, Aranha FFMG, Anschau F, Crestani GP, Grizende GMS, Bastos GAN, dos Santos Goedert GM, Menezes LSM, Carneiro M, Tolfo MF, Corrêa MAM, Maciel de Amorim M, Guimarães Júnior MH, Durães PAA, da Silva Rosa PM, de Lima Martelli PJ, Santos Charão de Almeida R, Martins RC, Alvarenga SP, Boersma E, Pessoa de Aguiar RAL, Marcolino MS. Mechanical ventilation and death in pregnant patients admitted for COVID-19: a prognostic analysis from the Brazilian COVID-19 registry score. BMC Pregnancy Childbirth 2023; 23:18. [PMID: 36627576 PMCID: PMC9830611 DOI: 10.1186/s12884-022-05310-w] [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: 11/02/2021] [Accepted: 12/14/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The assessment of clinical prognosis of pregnant COVID-19 patients at hospital presentation is challenging, due to physiological adaptations during pregnancy. Our aim was to assess the performance of the ABC2-SPH score to predict in-hospital mortality and mechanical ventilation support in pregnant patients with COVID-19, to assess the frequency of adverse pregnancy outcomes, and characteristics of pregnant women who died. METHODS This multicenter cohort included consecutive pregnant patients with COVID-19 admitted to the participating hospitals, from April/2020 to March/2022. Primary outcomes were in-hospital mortality and the composite outcome of mechanical ventilation support and in-hospital mortality. Secondary endpoints were pregnancy outcomes. The overall discrimination of the model was presented as the area under the receiver operating characteristic curve (AUROC). Overall performance was assessed using the Brier score. RESULTS From 350 pregnant patients (median age 30 [interquartile range (25.2, 35.0)] years-old]), 11.1% had hypertensive disorders, 19.7% required mechanical ventilation support and 6.0% died. The AUROC for in-hospital mortality and for the composite outcome were 0.809 (95% IC: 0.641-0.944) and 0.704 (95% IC: 0.617-0.792), respectively, with good overall performance (Brier = 0.0384 and 0.1610, respectively). Calibration was good for the prediction of in-hospital mortality, but poor for the composite outcome. Women who died had a median age 4 years-old higher, higher frequency of hypertensive disorders (38.1% vs. 9.4%, p < 0.001) and obesity (28.6% vs. 10.6%, p = 0.025) than those who were discharged alive, and their newborns had lower birth weight (2000 vs. 2813, p = 0.001) and five-minute Apgar score (3.0 vs. 8.0, p < 0.001). CONCLUSIONS The ABC2-SPH score had good overall performance for in-hospital mortality and the composite outcome mechanical ventilation and in-hospital mortality. Calibration was good for the prediction of in-hospital mortality, but it was poor for the composite outcome. Therefore, the score may be useful to predict in-hospital mortality in pregnant patients with COVID-19, in addition to clinical judgment. Newborns from women who died had lower birth weight and Apgar score than those who were discharged alive.
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Affiliation(s)
- Zilma Silveira Nogueira Reis
- grid.8430.f0000 0001 2181 4888Department of Gynecology and Obstetrics, University Hospital. Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil
| | - Magda Carvalho Pires
- grid.8430.f0000 0001 2181 4888Department of Statistics, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil
| | - Lucas Emanuel Ferreira Ramos
- grid.8430.f0000 0001 2181 4888Department of Statistics, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil
| | - Thaís Lorenna Souza Sales
- grid.428481.30000 0001 1516 3599Universidade Federal de São João del-Rei, R. Sebastião Gonçalves Coelho, 400, Chanadour, Divinópolis, MG 35501-296 Brazil
| | - Polianna Delfino Pereira
- grid.8430.f0000 0001 2181 4888Department of Internal Medicine, Medical School, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil ,Institute for Health Technology Assessment (IATS/CNPq), R. Ramiro Barcelos, 2359, Porto Alegre, Brazil
| | - Karina Paula Medeiros Prado Martins
- grid.8430.f0000 0001 2181 4888University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil
| | - Andresa Fontoura Garbini
- grid.414914.dHospital Nossa Senhora da Conceição and Hospital Cristo Redentor, Av. Francisco Trein, 326, Porto Alegre, Brazil
| | | | - Bruno Porto Pessoa
- Hospital Júlia Kubitschek, R. Dr. Cristiano Rezende, Belo Horizonte, 2745 Brazil
| | - Carolina Cunha Matos
- grid.419130.e0000 0004 0413 0953Faculdade de Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias, 275, Belo Horizonte, Brazil
| | - Christiane Corrêa Rodrigues Cimini
- Hospital Santa Rosália, R. Dr. Onófre, 575, Teófilo Otoni, Brazil ,grid.411287.90000 0004 0643 9823Mucuri Medical School, Universidade Federal dos Vales do Jequitinhonha e Mucuri, R. Cruzeiro, 01, Teófilo Otoni, Brazil
| | - Claudete Rempel
- Hospital Bruno Born, Av. Benjamin Constant, 881, Lajeado, Brazil
| | - Daniela Ponce
- grid.410543.70000 0001 2188 478XBotucatu Medical School, Universidade Estadual Paulista “Júlio de Mesquita Filho” and Hospital das Clínicas da Faculdade de Medicina de Botucatu, Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Botucatu, Brazil
| | | | - Fernando Anschau
- grid.414914.dHospital Nossa Senhora da Conceição and Hospital Cristo Redentor, Av. Francisco Trein, 326, Porto Alegre, Brazil
| | - Gabriela Petry Crestani
- grid.414871.f0000 0004 0491 7596Hospital Mãe de Deus, R. José de Alencar, 286, Porto Alegre, Brazil
| | - Genna Maira Santos Grizende
- grid.477816.b0000 0004 4692 337XHospital Santa Casa de Misericórdia de Belo Horizonte, Av. Francisco Sales, 1111, Belo Horizonte, Brazil
| | - Gisele Alsina Nader Bastos
- grid.414856.a0000 0004 0398 2134Hospital Moinhos de Vento, R. Ramiro Barcelos, 910, Porto Alegre, Brazil
| | | | | | - Marcelo Carneiro
- Hospital Santa Cruz, R. Fernando Abott, 174, Santa Cruz do Sul, Brazil
| | - Marcia Ffner Tolfo
- Faculdade Integrada de Santa Maria, R. José do Patrocínio, 26, Santa Maria, Brazil
| | - Maria Augusta Matos Corrêa
- grid.411287.90000 0004 0643 9823Mucuri Medical School, Universidade Federal dos Vales do Jequitinhonha e Mucuri, R. Cruzeiro, 01, Teófilo Otoni, Brazil
| | - Mariani Maciel de Amorim
- grid.411513.30000 0001 2111 8057Universidade Luterana do Brasil, Av. Farroupilha, 8001, Canoas, Brazil
| | | | - Pamela Andrea Alves Durães
- grid.412520.00000 0001 2155 6671Pontifícia Universidade Católica de Minas Gerais, R. do Rosário, 1081, Betim, Brazil
| | - Patryk Marques da Silva Rosa
- grid.411452.70000 0000 9898 6728Centro Universitário de Belo Horizonte, Av. Professor Werneck, 1685, Belo Horizonte, Brazil
| | - Petrônio José de Lima Martelli
- grid.411227.30000 0001 0670 7996Centro de Ciências Médicas, Universidade Federal de Pernambuco, Hospital das Clínicas da Universidade Federal de Pernambuco, Av. Prof. Moraes Rego, 1235, Recife, Brazil
| | | | | | - Samuel Penchel Alvarenga
- grid.428481.30000 0001 1516 3599Universidade Federal de São João del-Rei, R. Sebastião Gonçalves Coelho, 400, Chanadour, Divinópolis, MG 35501-296 Brazil
| | - Eric Boersma
- grid.5645.2000000040459992XDepartment of Cardiology, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Regina Amélia Lopes Pessoa de Aguiar
- grid.8430.f0000 0001 2181 4888Department of Gynecology and Obstetrics, University Hospital. Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil
| | - Milena Soriano Marcolino
- grid.8430.f0000 0001 2181 4888Department of Internal Medicine, Medical School, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil ,Institute for Health Technology Assessment (IATS/CNPq), R. Ramiro Barcelos, 2359, Porto Alegre, Brazil ,grid.8430.f0000 0001 2181 4888University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil ,grid.8430.f0000 0001 2181 4888Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Av. Professor Alfredo Balena 190, Belo Horizonte, Brazil
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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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Caddy C, Cheong M, Lim MSC, Power R, Vogel JP, Bradfield Z, Coghlan B, Homer CSE, Wilson AN. "Tell us what's going on": Exploring the information needs of pregnant and post-partum women in Australia during the pandemic with 'Tweets', 'Threads', and women's views. PLoS One 2023; 18:e0279990. [PMID: 36638130 PMCID: PMC9838848 DOI: 10.1371/journal.pone.0279990] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 12/19/2022] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION The provision of maternity services in Australia has been significantly disrupted in response to the COVID-19 pandemic. Many changes were initiated quickly, often with rapid dissemination of information to women. The aim of this study was to better understand what information and messages were circulating regarding COVID-19 and pregnancy in Australia and potential information gaps. METHODS This study adopted a qualitative approach using social media and interviews. A data analytics tool (TIGER-C19) was used to extract data from social media platforms Reddit and Twitter from June to July 2021 (in the middle of the third COVID-19 wave in Australia). A total of 21 individual semi-structured interviews were conducted with those who were, or had been, pregnant in Australia since March 2020. Social media data were analysis via inductive content analysis and interview data were thematically analysed. RESULTS Social media provided a critical platform for sharing and seeking information, as well as highlighting attitudes of the community towards COVID-19 vaccines in pregnancy. Women interviewed described wanting further information on the risks COVID-19 posed to themselves and their babies, and greater familiarity with the health service during pregnancy, in which they would labour and give birth. Health providers were a trusted source of information. Communication strategies that allowed participants to engage in real-time interactive discussions were preferred. A real or perceived lack of information led participants to turn to informal sources, increasing the potential for exposure to misinformation. CONCLUSION It is vital that health services communicate effectively with pregnant women, early and often throughout public health crises, such as the COVID-19 pandemic. This was particularly important during periods of increased restrictions on accessing hospital services. Information and communication strategies need to be clear, consistent, timely and accessible to reduce reliance on informal and potentially inaccurate sources.
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Affiliation(s)
| | - Marc Cheong
- Burnet Institute, Melbourne, VIC, Australia
- School of Computing and Information Systems, University of Melbourne, Parkville, VIC, Australia
| | | | | | - Joshua P. Vogel
- Burnet Institute, Melbourne, VIC, Australia
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Zoe Bradfield
- Burnet Institute, Melbourne, VIC, Australia
- Curtin University, Bentley, WA, Australia
- King Edward Memorial Hospital, Subiaco, WA, Australia
| | | | - Caroline S. E. Homer
- Burnet Institute, Melbourne, VIC, Australia
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Alyce N. Wilson
- Burnet Institute, Melbourne, VIC, Australia
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
- * E-mail:
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29
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Jeličić L, Janković S, Sovilj M, Bogavac I, Drobnjak A, Dimitrijević A, Subotić M. Maternal Anxiety and Its Associated Factors During the First and Second Wave of COVID-19 Pandemic in Serbia: A Cross-Sectional Study. Psychol Res Behav Manag 2022; 15:3775-3792. [PMID: 36573089 PMCID: PMC9789720 DOI: 10.2147/prbm.s391694] [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: 10/01/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Aim The COVID 19-pandemic affects people differently, while pregnant women are among the most sensitive populations. The data about maternal mental health during the COVID-19 outbreak are in some ways consistent but also country-specific. Purpose The study aims to explore the impact of the COVID-19 pandemic on pregnant women's anxiety and identify its associated factors. Patients and Methods This cross-sectional study included a sample of 358 pregnant women during the first and second waves of the pandemic in Serbia. An anonymous survey included basic demographic questions, pregnancy-related background questions, the question of self-reported COVID-19-related fear, State-Trait Anxiety Inventory (STAI), and Multidimensional Scale of Perceived Social Support (MSPSS). Results The study revealed no pregnant women with low anxiety levels measured by STAI-T and STAI-S, while the STAI-S and STAI-T scores indicated high anxiety in 32.4% and 42.7% of pregnant women, respectively. The obtained results pointed out the nonlinear dependence of state anxiety on observed associated factors and their complex interactions, including the data collecting period. Conclusion Our findings reveal that COVID-19 affects pregnant women's mental health and makes it necessary for psychological monitoring and support for pregnant women, which may be reflected in their mental health but also the development of their offspring.
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Affiliation(s)
- Ljiljana Jeličić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, Belgrade, Serbia,Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, Belgrade, Serbia,Correspondence: Ljiljana Jeličić, R&D Institute “Life Activities Advancement Institute”, Institute for experimental phonetics and speech pathology, G. Jovanova No. 35, Belgrade, 11000, Serbia, Tel +381 11 3208 519; +381 64 22 14 295, Fax +381 11 2624 168, Email ;
| | - Svetlana Janković
- Department of Acute Perinatal Pathology, Belgrade University Medical School, Belgrade, Serbia,Clinic for Gynecology and Obstetrics Narodni Front Belgrade, Belgrade, Serbia
| | - Mirjana Sovilj
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, Belgrade, Serbia
| | - Ivana Bogavac
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, Belgrade, Serbia,Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, Belgrade, Serbia
| | - Anđela Drobnjak
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, Belgrade, Serbia
| | - Aleksandra Dimitrijević
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia,Clinic of Gynecology and Obstetrics, University Clinical Centre of Kragujevac, Kragujevac, Serbia
| | - Miško Subotić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, Belgrade, Serbia
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Gupta A, Kamity R, Sharma R, Caprio M, Mally P, Verma S. Mother to Newborn Transmission of SARS-CoV-2 Infection: Evolution of Evidence in 1.5 Years of COVID-19 Pandemic. Am J Perinatol 2022; 39:1764-1778. [PMID: 35738288 DOI: 10.1055/s-0042-1749635] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Coronavirus disease 2019 (COVID-19) pandemic caused significant mortality and morbidity in people of all age groups worldwide. Given the uncertainty regarding the mode of transmission and potential effects of COVID-19 on pregnant mothers and their newborns, guidelines for taking care of maternal-newborn dyads have evolved tremendously since the pandemic began. There has been an enormous influx of published materials regarding the outcomes of mothers and newborns. Still, multiple knowledge gaps regarding comprehensive information about risk to the mothers and newborns exist, which need to be addressed. Current evidence suggests that mothers with symptomatic COVID-19 infection are at increased risk of severe illness during pregnancy, with a higher need for respiratory support and premature deliveries. Neonates born to mothers with COVID-19 are at increased risk of needing intensive care; however, most newborns do well after birth. As new mutant variants arise, we need to be cautious while proactively understanding any new evolving patterns. All leading health authorities strongly recommend COVID-19 vaccination before or during pregnancy to reduce the risk of maternal morbidities and benefit from passing antibodies to newborns prenatally and via breastmilk. Additionally, there are racial, ethnic, and socioeconomic disparities in outcomes and vaccination coverage for pregnant women. This article summarizes the rapidly evolving evidence for the last 1.5 years and aims to help health care professionals care for mothers with COVID-19 and their newborns. KEY POINTS: · COVID-19 in pregnancy can cause perinatal morbidities.. · Breastfeeding and breast milk are safe for newborns.. · COVID-19 vaccination reduces the risk for morbidities..
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Affiliation(s)
- Arpit Gupta
- Division of Neonatology, Department of Pediatrics, NYC Health, Hospitals/Metropolitan, New York City, New York
| | - Ranjith Kamity
- Division of Neonatology, Department of Pediatrics, NYU Long Island School of Medicine, New York City, New York
| | - Rishika Sharma
- Department of Pediatrics, Family Healthcare Network, Visalia, California
| | - Martha Caprio
- Division of Neonatology, Department of Pediatrics, NYU Grossman School of Medicine, New York City, New York
| | - Pradeep Mally
- Division of Neonatology, Department of Pediatrics, NYU Grossman School of Medicine, New York City, New York
| | - Sourabh Verma
- Division of Neonatology, Department of Pediatrics, NYU Grossman School of Medicine, New York City, New York
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31
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Maudhoo A, Khalil A. Viral pulmonary infection in pregnancy - Including COVID-19, SARS, influenza A, and varicella. Best Pract Res Clin Obstet Gynaecol 2022; 85:17-25. [PMID: 35977871 PMCID: PMC9270964 DOI: 10.1016/j.bpobgyn.2022.06.006] [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: 04/01/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 12/14/2022]
Abstract
The COVID-19 pandemic has been at the forefront of medicine over the last few years. Pregnant women are often exposed to infectious agents that can be harmful not only to the mother but also to the foetus. Moreover, changes during pregnancy means that pregnant women have increased vulnerability to viral infections, especially pulmonary infections. Epidemiological studies have shown a link between maternal viral infections and miscarriage, preterm birth as well as congenital defects. With potential poor outcomes for both women and their newborns, having a good understanding of the presentation and management of these viral pulmonary infections is essential. The increased risk of adverse outcomes has been highlighted during the COVID-19, SARS and H1N1 influenza pandemics.
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Affiliation(s)
| | - Asma Khalil
- Fetal Medicine Unit, St George's Hospital, London, United Kingdom,Corresponding author. Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St. George's University Hospitals NHS Foundation Trust, Blackshaw Road, London, SW17 0QT, United Kingdom
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32
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Ghaemi M, Hantoushzadeh S, Ghanbari R, Heidary Z. Reporting 12 Cases of Maternal Mortality Due to COVID-19; the Role of Termination of Pregnancy as a Double-Edged Sword. ARCHIVES OF IRANIAN MEDICINE 2022; 25:765-766. [PMID: 37543903 PMCID: PMC10685858 DOI: 10.34172/aim.2022.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/20/2022] [Indexed: 08/08/2023]
Affiliation(s)
- Marjan Ghaemi
- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sedigheh Hantoushzadeh
- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Ghanbari
- Gene Therapy Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Heidary
- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
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33
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Zhang J, Yuan H, Xu L, Yi C, Tang W. The impact of COVID-19 on the mental health of pregnant women in Shanghai, China. Front Public Health 2022; 10:938156. [PMID: 36276386 PMCID: PMC9583156 DOI: 10.3389/fpubh.2022.938156] [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: 05/07/2022] [Accepted: 09/14/2022] [Indexed: 01/25/2023] Open
Abstract
Background COVID-19 has dramatically impacted people's health, especially mental health. This study aimed to compare the psychological status of pregnant women before and after the COVID-19 outbreak. Methods Participants were recruited (from September 29, 2019, to November 5, 2020) and screened by the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7). The study participants were categorized into three groups based on two turning-points: January 23, 2020, when China initiated a locked-down strategy, and May 11, 2020, when Shanghai started to ease the COVID-19 measures. Multivariable logistic regression was used to determine the factors associated with depression and anxiety in pregnant women. We used enter method for variable selection; only variables with P <0.10 were included in the final model. Results We recruited 478 pregnant women. After the outbreak, the depression rate (PHQ-9 ≥ 5) increased by 12.3% (from 35.4 to 47.7%), and the anxiety rate (GAD-7 ≥ 5) was stable (13.3 vs. 16.2%). The multivariable logistic regression results further confirmed that the odds of depression in pregnant women increased 81% after the outbreak (aOR = 1.81, 95%CI: 1.16-2.84). However, the median depression scale score was still statistically higher after the pandemic situation was stable (5.0 vs. 4.0) compared to the outbreak period. Conclusion The depression rate increased among pregnant women after the outbreak and was not recovered after the ease of COVID-19 measures in Shanghai. Health institutes should pay attention to the long-term influence of the pandemic.
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Affiliation(s)
- Jiali Zhang
- Fenglin Community Health Service Center, Shanghai, China
| | - Hualong Yuan
- Fenglin Community Health Service Center, Shanghai, China
| | - Liping Xu
- Fenglin Community Health Service Center, Shanghai, China
| | - Chuntao Yi
- Fenglin Community Health Service Center, Shanghai, China
| | - Weiming Tang
- Guangdong No. 2 Provincial People's Hospital, Guangzhou, China,The University of North Carolina at Chapel Hill Project-China, Guangzhou, China,*Correspondence: Weiming Tang
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Tripathy S, A P, R SK, M A, Mohapatra S. The potential impact of COVID-19 on women's reproductive and mental health: a questionnaire study. J OBSTET GYNAECOL 2022; 42:3328-3335. [PMID: 36151782 DOI: 10.1080/01443615.2022.2125292] [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: 01/06/2023]
Abstract
The pandemic has transformed the social and economic certainties of people's lives imposing stay-at-home necessities which began in mid-March 2020. This cross-sectional observational study was performed to study the impact of COVID-19 on the reproductive and mental health of women before and after the pandemic. A digital survey form of 50 questions was developed using the Google platform andshared over 4 weeks in August 2021. Paired t-test was used to compare the variables before and after the COVID-19. Of the 450 respondents, 443(98.44%) completed the questionnaire. There was a significant difference in the average duration of menstruation and the proportion of women with a cycle length of 35-45 days increased from 5 to 8% of women after the pandemic. Painful periods (28.5 to 59.5%, p = .002) and weight increased (39.2%, p < .001) after the pandemic. Stress also increased after the pandemic (p < .001). The pandemic has significantly impacted the reproductive and mental health of women. The long-term health significances of this are yet to be determined.Impact StatementWhat is already known on this subject? The pandemic has transformed the social and economic certainties of people's lives, mainly women. Women's health significantly mental health is affected by the lack of adequate domestic and emotional support which may further consequences like the risk of anxiety and depression.What do the results of this study add? Our study shows the effect of COVID-19 on women's reproductive and mental health before and after the pandemic. Inadvertent forfeits women's health and well-being and instabilities in reproductive function as raised pressure causes irregularities in the menstrual cycle.What are the implications of these findings for clinical practice and/or further research? Women have suffered from significant mental and reproductive problems during the first and second waves of the COVID-19 pandemic. But, the long-term effects of these are not unknown. Upcoming work should comprise study throughout the pandemic and the long-term impact on women's health.
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Affiliation(s)
- Saswati Tripathy
- Department of Obstetrics and Gynaecology, SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, India
| | - Preethika A
- Center for Clinical Trials and Research, SRM Medical College Hospital and Research Center, Kattankulathur, Tamil Nadu, India
| | - Sajeetha Kumari R
- Department of Obstetrics and Gynaecology, SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, India
| | - Anuradha M
- Department of Obstetrics and Gynaecology, SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, India
| | - Satyajit Mohapatra
- Department of Pharmacology, SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, India
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Khorsand F, Barati M, Bashirian S, Jenabi E, Khazaei S. Factors Affecting Prevention Behaviors Against Covid-19 Infection Among Iranian Pregnant Women: Application of Protection Motivation Theory. CURRENT HEALTH SCIENCES JOURNAL 2022; 48:386-392. [PMID: 37304803 PMCID: PMC10248494 DOI: 10.12865/chsj.48.04.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 11/02/2022] [Indexed: 06/13/2023]
Abstract
Considering the epidemic of corona disease in the world and the importance of paying attention to pregnant women as one of the most important vulnerable groups, it is felt necessary to conduct studies and properly teach them preventive behaviors. Therefore, the present study was conducted with the aim of investigating the factors influencing the prevention of covid-19, based on the Protection Motivation Theory (PMT), among pregnant women. This cross-sectional study was conducted during 2020 with the participation of 231 pregnant women who referred to the comprehensive health service centers of Langrod city, who were selected by simple random sampling. The tool of data collection was a questionnaire consisting of two sections of demographic information and PMT constructs. According to the results, 10.32% reported a history of Covid-19 infection. Carrying out protective behaviors, such as using a mask (94.4 percent), washing hands frequently with soap and water (88.8 percent), maintaining a distance of at least one and a half meters from other people (84.5 percent) in a favorable position and avoiding. The participation in the periods (71.4 percent) was relatively favorable. The result of linear regression analysis showed that perceived self-efficacy (β=0.450) and perceived response effectiveness (β=0.305) were predictors of protective motivation or intention to perform protective behaviors against Covid-19. Also, 66.7% of women were on the path of perceived risk. The PMT can be used as a framework in designing educational programs in order to perform preventive behaviors against infectious diseases such as Covid-19.
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Affiliation(s)
- Farzaneh Khorsand
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Majid Barati
- Department of Public Health, School of Health, Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Saeed Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Ensieh Jenabi
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Salman Khazaei
- Department of Epidemiology, School of Health, Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, IR Iran
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Dandachi I, Aljabr W. Prognosis of COVID-19 in the middle eastern population, knowns and unknowns. Front Microbiol 2022; 13:974205. [PMID: 36118201 PMCID: PMC9471247 DOI: 10.3389/fmicb.2022.974205] [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] [Received: 06/20/2022] [Accepted: 08/09/2022] [Indexed: 01/08/2023] Open
Abstract
Since its emergence in China in 2019, the SARS-CoV-2 virus has affected all countries worldwide. The virus is easily transmitted from one person to another via infected aerosols or contaminated surfaces. Unlike its counterparts, the prognosis of COVID-19 ranges from asymptomatic to critical disease or death. Several factors play a role in determining the severity of the disease in infected patients. Among others, is the pre-existence of an underlying medical condition such as diabetes, cancer, and others. Furthermore, although children are less prone to the severe form of the COVID-19 disease, they require attention due to the report of many atypical presentations of the infection, post-asymptomatic exposure. In the Middle East, little is known about the prognosis of the SARS-CoV-2 infection in high-risk categories, notably patients with diabetes, cancer, and pregnant women. The aim of this review is to summarize the current knowledge about this group of population in the middle eastern region as well as to highlight the gap in the literature. We have found that the majority of the papers were from the Gulf countries. Although, few studies were conducted; high-risk patients appear to have an increased risk of morbidity and mortality from COVID-19 compared to their counterparts. Higher levels of inflammatory markers, C-reactive protein, erythrocyte sedimentation rate, D-dimer, and ferritin levels were also observed. Children are often asymptomatic or present with atypical presentations. More studies should be conducted to determine the clinical biomarkers of COVID-19 in high-risk categories to help in patient risk stratification and management in the middle eastern population.
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37
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Karaçam Z, Kizilca-Çakaloz D, Güneş-Öztürk G, Çoban A. Maternal and perinatal outcomes of pregnancy associated with COVID-19: Systematic review and meta-analysis. Eur J Midwifery 2022; 6:42. [PMID: 35860720 PMCID: PMC9254264 DOI: 10.18332/ejm/149485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/08/2022] [Accepted: 04/26/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION This study explored maternal and infant outcomes in the periods of pregnancy, birth and the postpartum, in women with COVID-19. METHODS After PROSPERO registration (CRD42020191106), scanning for the studies was carried out over the period 5-15 May 2020 in the PubMed, Science Direct, EBSCO and Web of Science databases with the search string: ['COVID-19' AND ('pregnancy' OR 'pregnant' OR 'maternal outcomes' OR 'infant outcomes' OR 'fetal outcomes' OR 'birth')]. Studies reporting maternal and perinatal outcomes of pregnant women with COVID-19 were included. Data were extracted independently by two researchers and combined with meta-analysis and pooled analysis. RESULTS The 54 studies included in this analysis contained data on 517 pregnant women diagnosed with COVID-19 and 385 infants. Of the pregnant women, 18% had gone into preterm labor and 77% had given birth by caesarean. Of the newborns, 19% had low birth weight, 14% had fetal distress, and 24% were admitted into the neonatal intensive care unit. Nine maternal and eight baby mortalities were reported in the studies. CONCLUSIONS The study revealed that COVID-19 in pregnant women appeared to be negative maternal and infant outcomes, with mortalities as well.
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Affiliation(s)
- Zekiye Karaçam
- Department of Midwifery, Faculty of Health Sciences, Aydın Adnan Menderes University, Aydın, Turkey
| | - Damla Kizilca-Çakaloz
- Department of Midwifery, Faculty of Health Sciences, Aydın Adnan Menderes University, Aydın, Turkey
| | - Gizem Güneş-Öztürk
- Department of Midwifery, Faculty of Health Sciences, Aydın Adnan Menderes University, Aydın, Turkey
| | - Ayden Çoban
- Department of Midwifery, Faculty of Health Sciences, Aydın Adnan Menderes University, Aydın, Turkey
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Shree P, Mittal N, Vishwakarma S, Verma V, Pandey V, Thadani E. Maternal and Perinatal Outcomes of COVID-19-Positive Pregnant Women. Cureus 2022; 14:e26411. [PMID: 35911372 PMCID: PMC9334844 DOI: 10.7759/cureus.26411] [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: 06/28/2022] [Indexed: 11/21/2022] Open
Abstract
Background The risks of adverse maternal and perinatal outcomes are not very clear in coronavirus disease 2019 (COVID-19)-positive pregnant women. Therefore, this study aimed to determine the maternal and fetal outcomes in COVID-19-positive pregnancies. Methodology This prospective, cohort study was conducted in a tertiary care center over the period of one year. The study group comprised pregnant patients who presented with COVID-19 in the first and second waves of the pandemic. Maternal symptoms due to COVID-19 infection, comorbidities, number of admissions to the intensive care unit (ICU), and maternal mortality were noted for every patient. Perinatal outcomes were recorded in the form of intrauterine growth retardation (IUGR), mode of delivery, preterm deliveries, birth weight of newborns, neonatal intensive care unit (NICU) admissions, and neonatal mortality. Data analysis was done in the form of a variable percentage and mean ± standard deviation (SD). Results COVID-19-positive pregnant patients were mostly asymptomatic (48.07%). Term deliveries (37-40 weeks) were seen in 44 (89.8%) patients. The percentage of normal vaginal delivery was 74% and cesarean section was 24%. Out of 52 patients, two (3.8%) patients were admitted to the high dependency unit (HDU), one (1.9%) patient was admitted to the ICU, and 49 (94.3%) patients were in the isolation ward. Of the 49 live births, four (8.16%) newborns were admitted to the NICU. No neonatal death was recorded. Conclusions In this study, COVID-19-pregnant women were mostly asymptomatic. Neonates of COVID-19-infected women also mostly tested COVID-19 negative. More studies are needed with larger sample sizes to determine the effect of COVID-19 infection in pregnant women and neonates.
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Kim SH, Kang HS. Health Promotion Behaviors of Pregnant Couples in the COVID-19 Pandemic: Actor-Partner Interdependence Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7501. [PMID: 35742750 PMCID: PMC9224502 DOI: 10.3390/ijerph19127501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/10/2022] [Accepted: 06/17/2022] [Indexed: 11/25/2022]
Abstract
Pregnancy during the pandemic may be a stressful life event. This cross-sectional study aimed to identify the actor and partner effects of the fear of COVID-19, depression, posttraumatic growth, and marital adjustment on the health promotion behaviors of pregnant couples during the COVID-19 pandemic in Korea. Data were collected from 123 pregnant couples using a structured questionnaire. The data were analyzed using the Actor-Partner Interdependence Model (APIM). The actor effects of the fear of COVID-19, depression, and posttraumatic growth on the health promotion behaviors of pregnant women and their spouses were significant. Furthermore, both actor and partner effects of husbands' marital adjustment on health promotion behaviors were significant. When carrying out nursing intervention for the health promotion of pregnant couples, programs aimed at reducing depression and improving posttraumatic growth in pregnant couples should be included. In addition, improving marital adjustment will positively affect the health promotion behaviors of pregnant couples. The findings highlight the important role of healthcare providers in assessing depressive symptoms and fear of COVID-19 in pregnant couples and providing support to promote health behaviors as part of prenatal care.
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Affiliation(s)
- Sun Hee Kim
- Department of Nursing, Chung-Ang University Hospital, Seoul 06973, Korea;
| | - Hee Sun Kang
- Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea
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Gómez-Baya D, Gómez-Gómez I, Domínguez-Salas S, Rodríguez-Domínguez C, Motrico E. The influence of lifestyles to cope with stress over mental health in pregnant and postpartum women during the COVID-19 pandemic. CURRENT PSYCHOLOGY 2022; 42:1-20. [PMID: 35729900 PMCID: PMC9200375 DOI: 10.1007/s12144-022-03287-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2022] [Indexed: 11/23/2022]
Abstract
The COVID-19 pandemic affected daily life routines and lifestyles of pregnant and postpartum women and increased their stress and risk of suffering from mental health problems. The aim of this study was to analyse which sociodemographic variables, COVID-19 exposure variables and lifestyles to cope with stress variables predicted anxiety, depression, and PTSD symptoms in pregnant and postpartum women during the COVID-19 pandemic. A cross-sectional design was performed with a sample of 3356 Spanish women participating in the Riseup-PPD-COVID-19 study. These participants completed an online survey composed of measures of anxiety (GAD-7), depression (EPDS), and PTSD related to COVID-19 (Checklist DSM-5), as well as demographics, exposure to COVID-19, and lifestyles to cope with stress. Regarding results, 47.2% showed depression and a third reported anxiety, whereas moderate scores were observed in PTSD symptoms. The most commonly used strategies to cope with stress in the COVID-19 pandemic were talking with friends and family and increasing time with social networks. Better results in mental health were associated with coping strategies such as talking with family and friends or participating in family activities, physical activity, sleeping well at night, eating healthier, and increasing personal care. Furthermore, poor results in mental health were observed in those participants who increased time with screens, ate fast food, reported substance use, and talked more frequently with health professionals. More symptoms were also observed in younger women, primiparous women, and those who reported more exposure to COVID-19. The results underline the need to strengthen the mental health of pregnant and postpartum women. Trial registration: ClinicalTrials.gov Identifier: NCT04595123.
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Affiliation(s)
- Diego Gómez-Baya
- Department of Social, Developmental and Educational Psychology, Universidad de Huelva, Huelva, Spain
| | - Irene Gómez-Gómez
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Seville Spain
| | - Sara Domínguez-Salas
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Seville Spain
| | | | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Seville Spain
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Moro Stochero H, Souza Antunes C, Najar Smeha L, Cruz da Silva S, Stein Backes MT, Stein Backes D. Percepções de gestantes e puérperas no contexto de pandemia da covid-19. AVANCES EN ENFERMERÍA 2022. [DOI: 10.15446/av.enferm.v40n1supl.100057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Objetivo: compreender as percepções e experiências de gestantes e puérperas no contexto depandemia da covid-19.
Materiais e métodos: estudo qualitativo, de caráter exploratório-descritivo, realizado com 38mulheres, gestantes e puérperas. Os dados foram coletados a partir de um formulárioeletrônico semiestruturado, entre fevereiro e abril de 2021. As participantes foram,inicialmente, convidadas por meio das mídias sociais e, a partir do retorno afirmativo, aparticipação foi oficializada, individualmente, em endereço on-line previamente informado.Os dados foram analisados pela técnica de análise de conteúdo modalidade temática.
Resultados: os dados codificados resultaram em três categorias temáticas: “Da informação àconstrução de vínculos de acolhida e respeito”; “Medo e incertezas vivenciados pelasgestantes e puérperas”; “Estratégias qualificadoras do acompanhamento materno-infantil”.
Conclusões: a pandemia provocada pelo novo coronavírus não só freou o avanço deiniciativas na área da saúde materno-infantil, como também as retrocedeu em vários aspectos,principalmente no que se refere à falta de informações com relação ao contágio do vírus, àdiminuição da frequência das consultas pré-natais, à limitação da presença do acompanhantena hora do parto, entre outros.
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Ayed M, Embaireeg A, Kartam M, More K, Alqallaf M, AlNafisi A, Alsaffar Z, Bahzad Z, Buhamad Y, Alsayegh H, Al-Fouzan W, Alkandari H. Neurodevelopmental outcomes of infants born to mothers with SARS-CoV-2 infections during pregnancy: a national prospective study in Kuwait. BMC Pediatr 2022; 22:319. [PMID: 35637442 PMCID: PMC9149327 DOI: 10.1186/s12887-022-03359-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/09/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND An increasing proportion of women are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy. Intrauterine viral infections induce an increase in the levels of proinflammatory cytokines, which inhibit the proliferation of neuronal precursor cells and stimulate oligodendrocyte cell death, leading to abnormal neurodevelopment. Whether a maternal cytokine storm can affect neonatal brain development is unclear. The objective of the present study was to assess neurodevelopmental outcomes in neonates born to mothers with SARS-CoV-2 infections during pregnancy. METHODS In this prospective cohort study, the neurodevelopmental status of infants (N = 298) born to women with SARS-CoV-2 infections during pregnancy was assessed at 10-12 months post-discharge using the Ages and Stages Questionnaire, 3rd edition (ASQ-3). The ASQ-3 scores were classified into developmental delays (cutoff scores ≤ 2 standard deviations (SDs) below the population mean) and no delays (scores > 2 SDs above the population mean). RESULTS The majority (90%) of the infants born to mothers with SARS-CoV-2 infections during pregnancy had favorable outcomes and only 10% showed developmental delays. Two of the 298 infants tested positive for SARS-CoV-2, and both had normal ASQ-3 scores. The majority of the pregnant women had SARS-CoV-2 infections during their third trimester. The risk of developmental delays among infants was higher in those whose mothers had SARS-CoV-2 infections during the first (P = 0.039) and second trimesters (P = 0.001) than in those whose mothers had SARS-CoV-2 infections during the third trimester. CONCLUSION The neurodevelopmental outcomes of infants born to mothers with SARS-CoV-2 infections seem favorable. However, more studies with larger sample sizes and longer follow-up periods are required.
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Affiliation(s)
- Mariam Ayed
- grid.414755.60000 0004 4903 819XNeonatal Department, Farwaniya Hospital, 81400 Kuwait City, Kuwait
| | - Alia Embaireeg
- grid.414755.60000 0004 4903 819XNeonatal Department, Farwaniya Hospital, 81400 Kuwait City, Kuwait
| | - Mais Kartam
- grid.414755.60000 0004 4903 819XPaediatric Department, Farwaniya Hospital, 81400 Kuwait City, Kuwait
| | - Kiran More
- grid.467063.00000 0004 0397 4222Division of Neonatology, Sidra Medicine, Doha, Qatar
| | - Mafaza Alqallaf
- grid.413288.40000 0004 0429 4288Paediatric Department, Adan Hospital, Hadiya, Kuwait
| | - Abdullah AlNafisi
- grid.413527.6Paediatric Department, Sabah Hospital, Kuwait City, Kuwait
| | - Zainab Alsaffar
- grid.414755.60000 0004 4903 819XPaediatric Department, Farwaniya Hospital, 81400 Kuwait City, Kuwait
| | - Zainab Bahzad
- grid.414755.60000 0004 4903 819XPaediatric Department, Farwaniya Hospital, 81400 Kuwait City, Kuwait
| | - Yasmeen Buhamad
- grid.414755.60000 0004 4903 819XPaediatric Department, Farwaniya Hospital, 81400 Kuwait City, Kuwait
| | - Haneen Alsayegh
- grid.413513.1Paediatric Department, Amiri Hospital, Kuwait City, Kuwait
| | - Wadha Al-Fouzan
- grid.411196.a0000 0001 1240 3921Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Hessa Alkandari
- grid.452356.30000 0004 0518 1285Population Health Department, Dasman Diabetes Institute, Kuwait City, Kuwait
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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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Sessa R, Anastasi E, Brandolino G, Brunelli R, Di Pietro M, Filardo S, Masciullo L, Terrin G, Viscardi MF, Porpora MG. What is the Hidden Biological Mechanism Underlying the Possible SARS-CoV-2 Vertical Transmission? A Mini Review. Front Physiol 2022; 13:875806. [PMID: 35600312 PMCID: PMC9117645 DOI: 10.3389/fphys.2022.875806] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS- CoV-2) represents an emerging infection that is spreading around the world. Among susceptible patients, pregnant women are more likely to develop serious complications and negative obstetric outcomes. Vertical transmission constitutes a debating issue which has not been completely understood. This review aims at describing the currently available evidence on SARS-CoV2 vertical transmission. We carried out a computerized literature search in the Cochrane Library, PubMed, Scopus and Web of Science, selecting the most relevant studies on vertical transmission from the outbreak onset until February 2022. The analysis of the available literature identifies the presence of SARS-CoV2 genome in different biological specimens, confirming the hypothesis that a transplacental infection can occur. In spite of the high number of infected people around the world, mother-to-child infections have been infrequently reported but it can be observed under certain biologic conditions. A deep knowledge of the underlying mechanisms of SARS-CoV2 vertical transmission is of paramount importance for planning an adequate management for the affected mothers and newborns.
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Affiliation(s)
- Rosa Sessa
- Department of Public Health and Infectious Diseases, Microbiology Section, Sapienza University of Rome, Rome, Italy
| | - Emanuela Anastasi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Gabriella Brandolino
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Rome, Italy
| | - Roberto Brunelli
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Rome, Italy
| | - Marisa Di Pietro
- Department of Public Health and Infectious Diseases, Microbiology Section, Sapienza University of Rome, Rome, Italy
| | - Simone Filardo
- Department of Public Health and Infectious Diseases, Microbiology Section, Sapienza University of Rome, Rome, Italy
| | - Luisa Masciullo
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Rome, Italy
| | - Gianluca Terrin
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Rome, Italy
| | - Maria Federica Viscardi
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Rome, Italy
| | - Maria Grazia Porpora
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Rome, Italy
- *Correspondence: Maria Grazia Porpora,
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Yuan B, Huang X, Li J, He L. Socioeconomic disadvantages and vulnerability to the pandemic among children and youth: A macro-level investigation of American counties. CHILDREN AND YOUTH SERVICES REVIEW 2022; 136:106429. [PMID: 35221406 PMCID: PMC8864086 DOI: 10.1016/j.childyouth.2022.106429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/27/2021] [Accepted: 02/19/2022] [Indexed: 06/14/2023]
Abstract
This study intends to reveal the underlying structural inequity in vulnerability to infection of the novel coronavirus disease pandemic among children and youth. Using multi-source data from New York Times novel coronavirus disease tracking project and County Health Rankings & Roadmap Program, this study shows that children and youth in socioeconomically disadvantaged status are faced with disproportionate risk of infection in this pandemic. On the county level, socioeconomic disadvantages (i.e., single parent family, low birthweight, severe housing problems) contribute to the confirmed cases and death cases of the novel coronavirus disease. Policymakers should pay more attention to this vulnerable group to implement more targeted and effective epidemic prevention and control.
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Affiliation(s)
- Bocong Yuan
- School of Tourism Management, Sun Yat-sen University, Guangzhou, China
| | - Xinting Huang
- School of Management, Xi'an Jiaotong University, Xi'an, China
| | - Jiannan Li
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China
| | - Longtao He
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China
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Simmons LA, Whipps MDM, Phipps JE, Satish NS, Swamy GK. Understanding COVID-19 vaccine uptake during pregnancy: 'Hesitance', knowledge, and evidence-based decision-making. Vaccine 2022; 40:2755-2760. [PMID: 35361501 PMCID: PMC8947956 DOI: 10.1016/j.vaccine.2022.03.044] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 03/02/2022] [Accepted: 03/18/2022] [Indexed: 11/30/2022]
Abstract
Background A key mitigation strategy to the COVID-19 pandemic has been the development and roll-out of vaccines. However, pregnant and lactating people were not included in initial vaccine trials and this population is hesitant to receive the vaccine, despite contrary recommendations from the American College of Obstetrics and Gynecology and the Centers for Disease Control and Prevention. Understanding the reasons behind this hesitancy is vital to promote vaccine uptake. Methods We surveyed pregnant people in California from December 2020 to January 2021 (n = 387) to describe cognitions and decision-making regarding COVID-19 vaccination. Using descriptive, regression-based analyses, we examined rates of planned uptake and reasoning among individuals who reported COVID-19 vaccine hesitancy. Results Overall, the pregnant Californians that we surveyed were aware of the COVID-19 vaccines. Of 387 participants, 43% reported planning to get the vaccine as soon as possible. The remaining 57% were hesitant: 27% responded that they would not receive the vaccine. Some demographic features did predict more COVID-19 vaccine hesitancy, particularly younger age (AOR = 0.95, p = 0.025) and living in a less urban context (AOR = 0.80, p = 0.041). Essential worker status also was associated with vaccine hesitancy. Having had, or intending to have, a flu vaccine was negatively associated with COVID-19 vaccine hesitancy (p < 0.001). The most commonly reported reason for COVID-19 vaccine hesitancy was “I don’t know enough about the vaccine.” Low levels of self-reported knowledge were highly predictive of hesitancy. Conclusions Terms like “vaccine hesitance” and “anti-vax” do not adequately characterize decisions regarding delaying COVID-19 vaccination. Rather, these decisions are largely based on the lack of knowledge about the impacts of vaccination on pregnancy, fetal development, and later child wellbeing. This lack of knowledge should be countered by conversations between individual healthcare providers and their pregnant patients, and better inclusion of pregnant people and children in vaccine trials.
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Affiliation(s)
- Leigh Ann Simmons
- University of California, Davis, Department of Human Ecology, Perinatal Origins of Disparities Center, 1 Shields Ave, Davis, CA 95616, United States.
| | - Mackenzie D M Whipps
- University of California, Davis, Department of Human Ecology, Perinatal Origins of Disparities Center, 1 Shields Ave, Davis, CA 95616, United States
| | - Jennifer E Phipps
- University of California, Davis, Department of Human Ecology, Perinatal Origins of Disparities Center, 1 Shields Ave, Davis, CA 95616, United States
| | - Nikita S Satish
- University of California, Davis, Department of Human Ecology, Perinatal Origins of Disparities Center, 1 Shields Ave, Davis, CA 95616, United States
| | - Geeta K Swamy
- Duke University School of Medicine, Department of Obstetrics and Gynecology, 40 Duke Medicine Circle, Durham, NC 27705, United States
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Marwah S, Dabral A, Bhagwati NM, Panwar S, Malik S, Gupta N. Preeclampsia in COVID-19: A Masquerading Errant-An Exploration of Foeto-Maternal Outcome from a Tertiary Care Hospital In India. J Obstet Gynaecol India 2022; 72:204-208. [PMID: 35345529 PMCID: PMC8943796 DOI: 10.1007/s13224-021-01610-x] [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: 06/02/2021] [Accepted: 12/06/2021] [Indexed: 11/30/2022] Open
Abstract
Background COVID-19 pandemic has shown that the multisystem involvement in COVID-infected patients is beyond the usual clinical manifestations of other respiratory viral illnesses. This study aims to evaluate the upshots of COVID-19 in women with preeclampsia. Methodology This descriptive study was conducted in department of Obstetrics & Gynaecology at VMMC & Safdarjung Hospital (May–November 2020), wherein a retrospective review of the medical records of laboratory confirmed SARS CoV2-positive pregnant women (as per ICMR), with preeclampsia (as defined by ACOG guidelines), was done in the dedicated COVID labour ward. Primary outcome was incidence of preeclampsia in SARS CoV2 positive gravid females. Secondary outcomes were socio-demographic and maternal characteristics, severity of COVID-19 and foeto-maternal outcome. Results During these 7 months, 38/302 (12.58%) SARS COV2-positive women presented with pre-eclampsia, either before or at the time of admission; amongst them 47.37% were primigravida. Severe preeclampsia was chronicled in 65.71% women. Around 20% women had severe COVID-19. All women with severe COVID19 required ICU stay, 5 requiring intubation. Three of these patients succumbed to their illness. Out of the 40 babies born to these women (including 2 twin pregnancies), 36.84% were premature deliveries. Seventeen (42.50%) babies had low birth weight. Although 82.50% were live births, five (12.50%) were intrauterine demise and 2 were early neonatal deaths. Conclusion Gravid women with preeclampsia infected with SARS CoV2 have comparative more severe illness, requiring more intensive care requirement and high maternal and neonatal morbidity.
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Affiliation(s)
- Sheeba Marwah
- Department of Obstetrics & Gynecology, VMMC & Safdarjung Hospital, New Delhi, 110029 India
| | - Anjali Dabral
- Department of Obstetrics & Gynecology, VMMC & Safdarjung Hospital, New Delhi, 110029 India
| | - Neha Mohit Bhagwati
- Department of Obstetrics & Gynecology, VMMC & Safdarjung Hospital, New Delhi, 110029 India
| | - Shweta Panwar
- Department of Obstetrics & Gynecology, VMMC & Safdarjung Hospital, New Delhi, 110029 India
| | - Sunita Malik
- Department of Obstetrics & Gynecology, VMMC & Safdarjung Hospital, New Delhi, 110029 India
| | - Nitesh Gupta
- Department of Pulmonary, Critical Care & Sleep Medicine, VMMC & Safdarjung Hospital, New Delhi, 110029 India
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Marwah M, Shokr H, Demitry A, Wang K, Ahmad S, Marwah S, Wandroo F. SARS-2 COVID-19-induced immunity response, a new prognostic marker for the pregnant population correlates inversely with neonatal Apgar score. Infection 2022; 50:1121-1129. [PMID: 35247163 PMCID: PMC8897759 DOI: 10.1007/s15010-022-01773-3] [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: 10/07/2021] [Accepted: 02/02/2022] [Indexed: 12/01/2022]
Abstract
Background The COVID-19 infection has impacted pregnancy outcomes; however, few studies have assessed the association between haematological parameters and virus-related pregnancy and neonatal outcomes. We hypothesised differences in routine haematology indices in pregnant and non-pregnant COVID-19 patients as well as COVID-19-negative pregnant subjects and observed neonatal outcomes in all pregnant populations. Further, we tested if pattern identification in the COVID-19 pregnant population would facilitate prediction of neonates with a poor Apgar score. Methods We tested our hypothesis in 327 patients (111 COVID-19-positive pregnant females, 169 COVID-19-negative pregnant females and 47 COVID-19-positive non-pregnant females) in whom standard routine laboratory indices were collected on admission. Results Pregnant COVID-19-positive patients exhibited higher WBC, neutrophil, monocyte counts as well as neutrophil/lymphocyte and neutrophil/eosinophil ratio compared to non-pregnant COVID-19-positive patients (p = 0.00001, p = 0.0023, p = 0.00002, p = 0.0402, p = 0.0161, p = 0.0352, respectively). Preterm delivery was more prevalent in COVID-19-positive pregnant patients accompanied with a significantly lower birth weight (2894.37 (± 67.50) g compared with 3194.16 (± 50.61) g, p = 0.02) in COVID-19-negative pregnant patients. The COVID-19-Induced Immunity Response (CIIR) was defined as (WBC × neutrophil) / eosinophil; Apgar scores were significantly and inversely correlated with the CIIR index (r =—0.162). Interpretation Pregnancy appears to give rise to an increased immune response to COVID-19 which appears to protect the mother, however may give rise to complications during labour as well as neonatal concerns. CIIR is a simple metric that predicts neonatal distress to aid clinicians in determining the prognosis of COVID-19 and help provide early intensive intervention to reduce complications.
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Affiliation(s)
- M Marwah
- Aston Medical School, Aston University, Gosta Green, Birmingham, B4 7ET, UK
| | - H Shokr
- Pharmacy Division, School of Health Sciences, University of Manchester, Oxford Street, Manchester, M13 9PL, UK
| | - A Demitry
- Department of Obstetrics, Sandwell and West, Birmingham Hospitals NHS Trust, Hallam Street, West Bromwich, B71 4HJ, UK
| | - K Wang
- Aston Medical School, Aston University, Gosta Green, Birmingham, B4 7ET, UK
| | - S Ahmad
- Aston Medical School, Aston University, Gosta Green, Birmingham, B4 7ET, UK
| | - S Marwah
- Department of Haematology, Sandwell and West, Birmingham Hospitals NHS Trust, Hallam Street, West Bromwich, B71 4HJ, UK
| | - F Wandroo
- Department of Haematology, Sandwell and West, Birmingham Hospitals NHS Trust, Hallam Street, West Bromwich, B71 4HJ, UK.
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Yang J, D'Souza R, Kharrat A, Fell DB, Snelgrove JW, Shah PS. COVID-19 pandemic and population-level pregnancy and neonatal outcomes in general population: A living systematic review and meta-analysis (Update#2: November 20, 2021). Acta Obstet Gynecol Scand 2022; 101:273-292. [PMID: 35088409 DOI: 10.1111/aogs.14318] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 12/30/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Conflicting reports of increases and decreases in rates of preterm birth (PTB) and stillbirth in the general population during the coronavirus disease 2019 (COVID-19) pandemic have surfaced. The objective of our study was to conduct a living systematic review and meta-analyses of studies reporting pregnancy and neonatal outcomes by comparing the pandemic and pre-pandemic periods. MATERIAL AND METHODS We searched the PubMed and Embase databases and reference lists of articles published up until November 20, 2021, and included English language studies that compared outcomes between the COVID-19 pandemic time period with pre-pandemic time periods. Risk of bias was assessed using the Newcastle-Ottawa scale. We conducted random-effects meta-analysis using the inverse variance method. RESULTS Fifty-two studies with low-to-moderate risk of bias, reporting on 2 372 521 pregnancies during the pandemic period and 28 518 300 pregnancies during the pre-pandemic period, were included. There was significant reduction in unadjusted estimates of PTB (43 studies, unadjusted odds ratio [uaOR] 0.95, 95% CI 0.93-0.98), but not in adjusted estimates (five studies, adjusted OR [aOR] 0.94, 95% CI 0.74-1.19). This reduction was noted in studies from single centers/health areas (29 studies, uaOR 0.90, 95% CI 0.85-0.94) but not in regional/national studies (14 studies, uaOR 0.99, 95% CI 0.99-1.01). There was reduction in spontaneous PTB (nine studies, uaOR 0.91, 95% CI 0.88-0.94) but not in induced PTB (eight studies, uaOR 0.90, 95% CI 0.79-1.01). There was no difference in the odds of stillbirth between the pandemic and pre-pandemic time periods (32 studies, uaOR 1.07, 95% CI 0.97-1.18 and three studies, aOR 1.18, 95% CI 0.86-1.63). There was an increase in mean birthweight during the pandemic period compared with the pre-pandemic period (nine studies, mean difference 21 g, 95% CI 13-30 g). The odds of maternal mortality were increased (five studies, uaOR 1.15, 95% CI 1.05-1.26); however, only unadjusted estimates were available, and the result was mostly influenced by one study from Mexico. There was significant publication bias for the outcome of PTB. CONCLUSIONS The COVID-19 pandemic may be associated with a reduction in PTB; however, referral bias cannot be excluded. There was no statistically significant difference in stillbirths between pandemic and pre-pandemic periods.
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Affiliation(s)
- Jie Yang
- Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Rohan D'Souza
- Department of Obstetrics and Gynaecology and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.,Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Ashraf Kharrat
- Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Deshayne B Fell
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - John W Snelgrove
- Department of Obstetrics and Gynaecology and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Prakesh S Shah
- Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.,Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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50
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Butler M, Cross B, Hafeez D, Lim MF, Morrin H, Rengasamy ER, Pollak T, Nicholson TR. Emerging Knowledge of the Neurobiology of COVID-19. Psychiatr Clin North Am 2022; 45:29-43. [PMID: 35219440 PMCID: PMC8580843 DOI: 10.1016/j.psc.2021.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Many patients with COVID-19 will experience acute or longer-term neuropsychiatric complications. The neurobiological mechanisms behind these are beginning to emerge; however, the neurotropic hypothesis is not strongly supported by clinical data. The inflammatory response to SARS-CoV-2 is likely to be responsible for delirium and other common acute neuropsychiatric manifestations. Vascular abnormalities such as endotheliopathies contribute to stroke and cerebral microbleeds, with their attendant neuropsychiatric sequelae. Longer-term neuropsychiatric syndromes fall into 2 broad categories: neuropsychiatric deficits occurring after severe (hospitalized) COVID-19 and "long COVID," which occurs in many patients with a milder acute COVID-19 illness.
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Affiliation(s)
- Matthew Butler
- Institute of Psychiatry, Psychology and Neuroscience, King's College, 16 De Crespigny Park, SE5 8AF London.
| | - Benjamin Cross
- East Lancashire Hospitals NHS Trust, Casterton Ave, Burnley, BB10 2PQ
| | - Danish Hafeez
- School of Medical Sciences, The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
| | - Mao Fong Lim
- Cambridge University Hospitals NHS Foundation Trust, Hills Rd, Cambridge, CB2 0QQ, UK
| | - Hamilton Morrin
- Maidstone & Tunbridge Wells NHS Trust, Tonbridge Rd, Royal Tunbridge Wells, TN2 4QJ, UK
| | - Emma Rachel Rengasamy
- Cwm Taf Morgannwg University Health Board, Ynysmeurig House, Navigation Park, Abercynon, CF45 4SN, UK
| | - Tom Pollak
- Institute of Psychiatry, Psychology and Neuroscience, King’s College, 16 De Crespigny Park, SE5 8AF London
| | - Timothy R. Nicholson
- Institute of Psychiatry, Psychology and Neuroscience, King’s College, 16 De Crespigny Park, SE5 8AF London
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