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Cardona-Pérez JA, Villegas-Mota I, Helguera-Repetto AC, Acevedo-Gallegos S, Rodríguez-Bosch M, Aguinaga-Ríos M, Coronado-Zarco I, León-Juárez M, Aguilar-Ayala D, Valdespino-Vázquez MY, Moreno-Verduzco ER, Rivera MA, Valencia-Contreras C, Gómez-Sousa MDL, Solis-Paredes M, Frías-Madrid B, Velasco-Téllez C, Rodriguez-Aldama JC, Avila-Sosa V, Galván-Contreras R, Figueroa-Damian R, Cortés-Bonilla M, Estrada-Gutierrez G, Espino-y-Sosa S, Irles C. Prevalence, clinical features, and outcomes of SARS-CoV-2 infection in pregnant women with or without mild/moderate symptoms: Results from universal screening in a tertiary care center in Mexico City, Mexico. PLoS One 2021; 16:e0249584. [PMID: 33886590 PMCID: PMC8062012 DOI: 10.1371/journal.pone.0249584] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/20/2021] [Indexed: 12/23/2022] Open
Abstract
The perinatal consequences of SARS-CoV-2 infection are still largely unknown. This study aimed to describe the features and outcomes of pregnant women with or without SARS-CoV-2 infection after the universal screening was established in a large tertiary care center admitting only obstetric related conditions without severe COVID-19 in Mexico City. This retrospective case-control study integrates data between April 22 and May 25, 2020, during active community transmission in Mexico, with one of the highest COVID-19 test positivity percentages worldwide. Only pregnant women and neonates with a SARS-CoV-2 result by quantitative RT-PCR were included in this study. Among 240 pregnant women, the prevalence of COVID-19 was 29% (95% CI, 24% to 35%); 86% of the patients were asymptomatic (95% CI, 76%-92%), nine women presented mild symptoms, and one patient moderate disease. No pregnancy baseline features or risk factors associated with severity of infection, including maternal age > 35 years, Body Mass Index >30 kg/m2, and pre-existing diseases, differed between positive and negative women. The median gestational age at admission for both groups was 38 weeks. All women were discharged at home without complications, and no maternal death was reported. The proportion of preeclampsia was higher in positive women than negative women (18%, 95% CI, 10%-29% vs. 9%, 95% CI, 5%-14%, P<0.05). No differences were found for other perinatal outcomes. SARS-CoV-2 test result was positive for nine infants of positive mothers detected within 24h of birth. An increased number of infected neonates were admitted to the NICU, compared to negative neonates (44% vs. 22%, P<0.05) and had a longer length of hospitalization (2 [2-18] days vs. 2 [2-3] days, P<0.001); these are potential proxies for illness severity. This report highlights the importance of COVID-19 detection at delivery in pregnant women living in high transmission areas.
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Affiliation(s)
- J. Arturo Cardona-Pérez
- Dirección General, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Isabel Villegas-Mota
- Unidad de Enfermedades Infecciosas y Epidemiología, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - A. Cecilia Helguera-Repetto
- Departamento de Immunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Sandra Acevedo-Gallegos
- Departamento de Medicina Materno-Fetal, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Mario Rodríguez-Bosch
- Subdirección de Ginecología y Obstetricia, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Mónica Aguinaga-Ríos
- Departamento de Genética y Genómica Humana, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Irma Coronado-Zarco
- Subdirección de Neonatología, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Moisés León-Juárez
- Departamento de Immunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Diana Aguilar-Ayala
- Departamento de Immunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | | | - Elsa Romelia Moreno-Verduzco
- Subdirección de Servicios auxiliares de Diagnóstico, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - María Antonieta Rivera
- Unidad de Cuidados Intensivos del Recién Nacido, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Carolina Valencia-Contreras
- Unidad de Cuidados Inmediatos al Recién Nacido, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - María de Lourdes Gómez-Sousa
- Departamento de Posgrado e Investigación, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Mario Solis-Paredes
- Departamento de Genética y Genómica Humana, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Brenda Frías-Madrid
- Unidad de Cuidados Intensivos del Recién Nacido, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - César Velasco-Téllez
- Departamento de Salud Mental, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Juan Carlos Rodriguez-Aldama
- Unidad de Enfermedades Infecciosas y Epidemiología, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Valeria Avila-Sosa
- Departamento de Fisiología y Desarrollo Celular, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Rafael Galván-Contreras
- Unidad de Enfermedades Infecciosas y Epidemiología, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Ricardo Figueroa-Damian
- Departamento de Infectología e Inmunología, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Manuel Cortés-Bonilla
- Dirección Médica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Guadalupe Estrada-Gutierrez
- Dirección de Investigación, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Salvador Espino-y-Sosa
- Subdirección de Investigación Clínica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | - Claudine Irles
- Departamento de Fisiología y Desarrollo Celular, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
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Contreras-Lemus J, Flores-Huerta S, Cardona-Pérez JA. [Proposal for a death certificate to improve recording and reporting of perinatal mortality]. Salud Publica Mex 2001; 43:217-23. [PMID: 11452698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
OBJECTIVE To analyze perinatal births and deaths recording at the Mexican Institute of Social Security (MISS), and to evaluate the correct classification of perinatal deaths. MATERIAL AND METHODS From January to March 2000, data were collected from the 37 MISS districts on the total number of births and deaths occurring during 1999, deaths occurring before the seventh day of life, and gestational age and weight at birth. Early neonatal and infant mortality rates were analyzed including or separating newborns with < 1,000 g and < 28 weeks of gestational age. RESULTS During 1999 there were 634,892 live births--whose gestational age and birth weight are unknown- and 3,984 stillbirths > or = 28 gestation weeks. There were 4,556 newborns who died before the seventh day of extrauterine life; 1,385 of them (30.4%) weighted less than 1,000 g and had a gestational age < 28 weeks. The analysis of mortality with and without these newborns shows a decrease of two points in early neonatal and infant mortality rates. CONCLUSIONS This study shows that classification and reporting of perinatal mortality are inappropriate. A proposal is made to develop information systems that include weight and gestational age of all births. A new perinatal death certificate replacing current fetal and general death certificates would allow proper mortality classification and comparisons between countries.
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Affiliation(s)
- J Contreras-Lemus
- Instituto Mexicano del Seguro Social. Mier y Pesado 120, colonia del Valle, 03100 México, D.F., México.
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Velasco-Murillo V, Navarrete-Hernández E, Ojeda-Mijares RI, Pozos-Cavanzo JL, Camacho-Rodríquez MA, Cardona-Pérez JA. [Experience and knowledge about climateric and menopause in women in Mexico City]. GAC MED MEX 2000; 136:555-64. [PMID: 11131857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE To know the experiences and knowledge about climateric and menopause in a group of women covered by Instituto Mexicano del Seguro Social (IMSS). The purpose was to contribute for planning some strategies to increase seeking for medical care at these periods of life. MATERIAL AND METHODS Descriptive survey study in a randomized sample of women aged 50-59 years, currently users of medical services in family medicine system of IMSS en Mexico City, with a confidence interval of 95%. RESULTS Mean age at menopause was 47.8 years. Most frequent climateric symptoms were: hot flushes (70.9%), depression (60.2%), insomnia (53.5%) and menstrual disturbances (37.8%). 51.1% of women seeked medical care due to climateric symptoms but only 12.1% received treatment, majority hormonals (81.6%). Past users were 14.9% and they received hormones too in 87.8%. In this survey, 83.8% of women had some knowledge about main symptoms of climateric and 90.1% knew about osteoporosis but only 37.2% had some knowledge about cardiovascular risk after menopause. The prevention of osteoporosis and coronary disease was associated with calcium and exercise; only in 1% with use of hormonals. CONCLUSIONS It exists an acceptable level of information about climateric syndrome and postmenopausal osteoporosis in these women, but it is low for risk of cardiovascular disease. Probably, their information is got from the mass media communication and did not for the activities of medical institutions in health education.
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Velasco-Murillo V, Navarrete-Hernández E, Pozos-Cavanzo J, Ojeda-Mijares RT, Cárdenas-Lara C, Cardona-Pérez JA. [Indications and justification of cesarean sections at the Instituto Mexicano del Seguro Social]. GAC MED MEX 2000; 136:421-31. [PMID: 11080926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE In view of the high frequency rates of cesarean section at the Instituto Mexicano del Seguro Social (IMSS), we carried out a study to know main causes and its justification. MATERIAL AND METHOD Retrospective study in a randomized national sample of clinical records in 3,232 cesarean cases between June 1997 and June 1999. RESULTS The most frequent indications were cephalopelvic disproportion (29.6%), one previous section (20.9%), acute fetal distress (14.1%), iterative section (11.9%), and premature rupture of amniotic membranes (10.7%). In cephalopelvic disproportion cases, mean weight of newborns was 3,430 g., 70.6% of patients had irregular uterine contractility, and 21.7% received oxytocin; 78.2% had integrity of membranes and 4 cm or less in cervical dilation. In previous section and cephalopelvic disproportion the mean weight of newborns was 3,425 g; 81.7% did not have regular contractility and, 4.8 received oxytocin. In sections due to acute fetal distress, 94.9% had an Apgar in 8 or more at 5 minutes after delivery. CONCLUSION The cesarean indications at the IMSS were similar to those are informed most to date in Mexico and throughout the world, but we did not find justification most of cases in this study.
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Affiliation(s)
- V Velasco-Murillo
- División de Salud Materna, Salud Reproductiva y Materno Infantil del IMSS, Colonia del Valle.
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