Two major challenges for pregnancy: labor emergencies and SARS-CoV-2 infection - our experience in Saint John hospital, Bucharest, Romania

Introduction: Obstetric emergencies that occur during labor, often present as a major indication for prompt completion of labor by instrumental methods or emergency cesarean section. The purpose of this study was to present the clinical features of emergencies, the evolution of labor, maternal and fetal or neonatal complications at patients with SARS-COV-2 infection. Materials and methods: We performed a retrospective study that included 150 pregnant women who gave birth in Bucur Maternity, St John Hospital, Bucharest, between 2018-2020 that fulfilled the features of obstetrical emergency during labor and SARS-CoV-2 infection. The study group was divided in patients positive for SARS-CoV-2 and negative for SARS-CoV-2. Results: Following PCR testing for SARS-CoV-2 were 26.67% of patients positive and 73.33% had a negative result. Analyzing the data obtained from this group of patients, it resulted that the average hospitalization is higher in the positive group (7.05 days) versus the negative group (5.47 days). The average gestational age at birth of SARS-CoV-2 positive patients was 37.26 weeks, lower than the gestational age of neonates from uninfected mothers (38.41 weeks). The average of the APGAR scores in the COVID group is 8.41, and for the negative group is 8.90. Conclusions: The associated SARS-CoV-2 infection played a significant role in terms of the APGAR score and the early peripartum outcomes of new-borns, negatively influencing the value of the APGAR index. Gestational age was considerably lower in patients diagnosed with the infection. The SARS-CoV-2 virus infection has a significant influence in unsatisfactory neonatal outcomes compared to new-borns of healthy mothers.

Neurodevelopmental Outcomes in Preterm Infants Receiving a Multicomponent vs. a Soybean-Based Lipid Emulsion: 24 Month Follow-Up of a Randomized Controlled Trial.

BACKGROUND: Few studies in the literature have analyzed the long-term neurodevelopmental outcomes of the administration of a multicomponent versus a soybean-based lipid emulsion (LE) in preterm infants receiving parenteral nutrition (PN). A recent randomized controlled trial conducted in our unit provided evidence of better growth in head circumference during the hospital stay in those who received a multicomponent LE. METHODS: This is a 24 month follow-up study of preterm infants, previously enrolled in a randomized trial, who received a multicomponent LE (SMOFlipid®) or a standard soybean-based one (Intralipid®). We evaluated neurodevelopmental outcomes at 24 months of corrected age (CA) in the two groups. RESULTS: Ninety-three children were followed up to the age of 24 months CA. Due to the peculiar time frame of the SARS-CoV-2 pandemic, neurodevelopmental outcomes were evaluated only in 77 children: 37 in the SMOFlipid® group and 40 in the Intralipid® group. No differences in major disability rates or in Griffith's evaluation were found between the two groups. CONCLUSIONS: In our population study, the administration of a multicomponent LE containing fish oil, compared to a soybean-based LE, had no significant effects on neurodevelopmental outcomes in preterm infants at 24 months CA.

No significant changes in preterm birth, low-birth-weight, and small-for-gestational-age infants during the first year of the COVID-19 pandemic in a rural area in Japan.

AIMS: To evaluate the coronavirus disease 2019 pandemic's impact on pregnancy outcomes in a Japanese rural area. METHODS: This retrospective study focused on the periods between March 1, 2020, and February 28, 2021 (during the coronavirus disease 2019 pandemic), and January 1, 2017, and December 31, 2019. Singleton pregnancies delivered at or after 22 gestational weeks were included. Preterm delivery, low-birth-weight, and small-for-gestational-age infant rates during the pandemic were compared to those in the preceding 3 years. RESULTS: In the pandemic and control groups, 1650 and 5762 pregnant women were included, respectively. Two pregnant women with coronavirus disease 2019 were identified (0.1%). There were no significant intergroup differences in preterm delivery rates (control, 4% vs. pandemic, 3.3%; difference: -0.7% [95% confidence interval: -1.7%-0.3%], p = 0.22). The low-birth-weight rate tended to decrease; however, the difference was insignificant (7.9% vs. 6.5%; difference: -1.4% [95% confidence interval: -2.8-0%], p = 0.06). The small-for-gestational-age infant rate was significantly lower in the pandemic than in the control group (7.3% vs. 5.2%; difference: -2.1% [95% confidence interval: -3.3-0.8%], p < 0.01). However, the interrupted time series analysis showed no significant trend. CONCLUSIONS: There were no significant changes in the rates of preterm delivery, low-birth-weight infants, and small-for-gestational-age infants during the pandemic's first year compared to those in the preceding 3 years. Behavioral changes, such as "stay-at-home" measures, may not improve pregnancy outcomes in Japan.