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1.
Psychiatr Danub ; 33(2): 140-146, 2021.
Article in English | MEDLINE | ID: covidwho-2100791

ABSTRACT

INTRODUCTION: Denial of Pregnancy is a women's subjective lack of awareness of being pregnant. It can be partial (from 20 weeks but lifted before delivery) or complete (the women notice she's pregnant when labour starts). The prevalence is around 1/500 for partial denial and 1/2500 for complete denial. This article's aim is to review the literature broadly on the subject of pregnancy denial, its psychopathological hypothesis and the state of knowledge on the outcome for mothers and children. METHODS: 26 references have been selected bases on a research on pubmed database and through bibliography on the selected papers. RESULTS: Despite a lot of psychopathological hypothesis and some epidemiological studies, no objective knowledge can lead to know what kind of women will deny their pregnancy and how to prevent it. After all the studies on mother characteristics, it seems there are no "clear-cut" explanations on why a woman denies a pregnancy or what type of women could be at risk of denial. There are no official guidelines on how to manage the condition and care for the patient long term. The first elements of research on the developmental outcome for infant seem to show a delay in psychomotor skills and possible speech disorder. They have been significant advancement on the subject of children development after pregnancy denial in the last year but the psychological and developmental impact of pregnancy denial on children and mothers is still majorly unknown. With a clinical picture known for so long, to have so little objective information on how to manage it and on the possible consequences is surprising. CONCLUSION: More research needs to be conducted to objectively know the long term effects of pregnancy denial on the whole family. International consensus should be found on the definition and care management of pregnancy denial.


Subject(s)
Mothers , Child , Female , Humans , Infant , Pregnancy
2.
Psychiatr Danub ; 32(3-4): 521-526, 2020.
Article in English | MEDLINE | ID: covidwho-2100774

ABSTRACT

BACKGROUND: The Coronavirus disease 2019 (COVID-19) pandemic emerged in Wuhan, China and has spread all over the world and affected global mental health. Pregnant women may be particularly vulnerable and experience high levels of distress during an infectious disease outbreak. The aim of this study was to determine anxiety and post-traumatic stress disorder (PTSD) symptoms in pregnant women during the COVID-19 pandemic. SUBJECTS AND METHODS: This cross-sectional study surveyed a total of 283 pregnant women within the period of May 11 to May 28,2020. During their regular antenatal visit, pregnant women were invited to participate in the study. The self-created personal information form was used to assess the main characteristics of the participants. Anxiety and PTSD symptoms of the pregnant women were measured by the Spielberger State-Trait Anxiety Inventory (STAI) and Impact of Events Scale-Revised (IES-R), respectively. RESULTS: The mean age of the pregnant women was 29.20±5.55 years. Regarding gestational age, 72 (25.4%), 86 (30.4) and 125 (44.2) were in the first, second and third trimesters, respectively. The mean gestational age was 23.82±11.05 weeks. The mean STAI-S and STAI-T scores were 39.52±10.56 within the cut-off value (39-40) of the instrument and 42.74±8.33, respectively. Furthermore, the mean total IES-R score was 36.60±15.65 within the cut-off value (24) of the instrument. Multiple regression analysis revealed that pregnancy complication (p=0.01) and employment status of husband (p=0.04) were the best predictors of state anxiety. Additionally, the presence of COVID-19-related symptoms (p=0.01) and educational level (p=0.01) were found to predict PTSD symptoms. CONCLUSIONS: Pregnant women would be likely to experience high levels of anxiety and PTSD symptoms during the COVID-19 pandemic's delay phase. The results should sensitize the medical team to increased anxiety and PTDS symptoms of the pregnant women in order to prevent negative outcomes for women and their fetuses.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Adult , Anxiety/epidemiology , China , Cross-Sectional Studies , Depression , Female , Humans , Pandemics , Pregnancy , Pregnant Women , SARS-CoV-2 , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress, Psychological , Young Adult
3.
Niger J Clin Pract ; 25(10): 1745-1750, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2100047

ABSTRACT

Background: The C-reactive protein (CRP)/albumin ratio (CAR) is one of the new tools to assess the severity of inflammation. It is used to determine clinical severity and prognosis in many diseases. Aim: The present study aimed to investigate the relationship between C-reactive protein (CRP)/albumin ratio (CAR) and prognosis in pregnant patients with more severe COVID-19 infection. Retrospective study. Patients and Methods: The study was conducted in a retrospective manner by scanning the files of pregnant patients who had a positive polymerase chain reaction test result and were hospitalized in Adiyaman Training and Research Hospital. The patients were divided into two groups: patients who were admitted to the intensive care unit and patients who were not admitted. CRP/albumin ratio (CAR) levels were compared between these two groups. The cut-off value was determined in the prediction of intensive-care admission and poor prognosis. Results: 117 patient files were reviewed. 13 patients were followed up with intensive care, whereas 104 patients completed their treatment in the service. The CAR levels of the patients admitted to intensive care were significantly higher (P < 0.01). In the estimation of intensive-care admission, the CAR level was determined to be 0.970 in the area under the curve with 100% sensitivity and 86.5% specificity in the receiver operating characteristic (ROC) curve. The cut-off CAR level was calculated as 1.8. Conclusion: CAR is a valuable biomarker for predicting prognosis, as well as follow-ups of pregnant COVID-19 patients.


Subject(s)
C-Reactive Protein , COVID-19 , Humans , Pregnancy , Female , C-Reactive Protein/analysis , Retrospective Studies , Prognosis , Albumins
4.
Indian J Pathol Microbiol ; 65(4): 860-863, 2022.
Article in English | MEDLINE | ID: covidwho-2100025

ABSTRACT

Background: SARS-CoV-2 has emerged as a major pandemic of the century and little is known about the impact of maternal infection on placental histopathology. Histopathologic examination of placental tissue can contribute to significant information regarding the pathophysiology of the disease and how it affects the fetal outcome. Materials and Methods: This was a cross-sectional study conducted at the Department of Pathology, Government Doon Medical College and Hospital, Dehradun, on the placenta of 50 coronavirus disease 2019 (COVID-19)-positive pregnant females confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR) from August 2020 to October 2020. Fifty term historical placentas were taken as control. Placenta sections were fixed in formalin, processed into paraffin blocks, stained with hematoxylin and eosin (H and E) stain, and visualized for any abnormality. Results: The most prominent histological finding in the placenta of pregnant women affected by COVID-19 was chorangiosis, which is a feature of fetal vascular malperfusion seen in 28 (56%) cases. Other features included maternal vascular malperfusions (MVM) such as villous crowding and agglutination in 12 (24%) cases. Tenney-Parker change was seen in 13 (26%) patients. Intervillous fibrinoid deposition and intervillous hemorrhage were seen in 37 (74%) patients and 7 (14%) patients showed significant calcification. Other findings observed were less common. Conclusion: Infection with SARS-CoV-2 may be associated with a significant impact on fetal and maternal circulation causing features of fetal and maternal malperfusion such as chorangiosis, villous crowding, and agglutination. Indicating that the infection could cause a potential rise in the risk of adverse perinatal outcomes such as intrauterine fetal growth retardation, preterm birth, or stillbirth.


Subject(s)
COVID-19 , Placenta Diseases , Pregnancy Complications, Infectious , Premature Birth , Female , Humans , Infant, Newborn , Pregnancy , SARS-CoV-2 , Placenta/pathology , Cross-Sectional Studies , Premature Birth/pathology , Fetal Growth Retardation , Placenta Diseases/pathology
5.
Zhonghua Er Ke Za Zhi ; 60(11): 1163-1167, 2022 Nov 02.
Article in Chinese | MEDLINE | ID: covidwho-2099938

ABSTRACT

Objective: To summarize the management and short-term outcomes of neonates delivered by mothers infected with SARS-CoV-2 Omicron variant. Methods: A retrospective study was performed on 158 neonates born to mothers infected with SARS-CoV-2 Omicron variant admitted to the isolation ward of Children's Hospital of Fudan University from March 15th, 2022 to May 30th, 2022. The postnatal infection control measures for these neonates, and their clinical characteristics and short-term outcomes were analyzed. They were divided into maternal symptomatic group and maternal asymptomatic group according to whether their mothers had SARS-CoV-2 symptoms. The clinical outcomes were compared between the 2 groups using Rank sum test and Chi-square test. Results: All neonates were under strict infection control measures at birth and after birth. Of the 158 neonates, 75 (47.5%) were male. The gestational age was (38+3±1+3) weeks and the birth weight was (3 201±463)g. Of the neonates included, ten were preterm (6.3%) and the minimum gestational age was 30+1 weeks. Six neonates (3.8%) had respiratory difficulty and 4 of them were premature and required mechanical ventilation. All 158 neonates were tested negative for SARS-COV-2 nucleic acid by daily nasal swabs for the first 7 days. A total of 156 mothers (2 cases of twin pregnancy) infected with SARS-CoV-2 Omicron variant, the time from confirmed SARS-CoV-2 infection to delivery was 7 (3, 12) days. Among them, 88 cases (56.4%) showed clinical symptoms, but none needed intensive care treatment. The peripheral white blood cell count of the neonates in maternal symptomatic group was significantly higher than that in maternal symptomatic group (23.0 (18.7, 28.0) × 109 vs. 19.6 (15.4, 36.6) × 109/L, Z=2.44, P<0.05). Conclusions: Neonates of mothers infected with SARS-CoV-2 Omicron variant during third trimester have benign short-term outcomes, without intrauterine infection through vertical transmission. Strict infection control measures at birth and after birth can effectively protect these neonates from SARS-CoV-2 infection.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Female , Humans , Infant , Infant, Newborn , Male , Pregnancy , Mothers , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/prevention & control , Retrospective Studies , SARS-CoV-2
6.
BMC Pediatr ; 22(1): 625, 2022 11 03.
Article in English | MEDLINE | ID: covidwho-2098326

ABSTRACT

BACKGROUND: Research of coronavirus disease (COVID-19) effects on newborns is ongoing. But the research of specific variant's effects is none. This study analyzed the effects of the Omicron variant on the perinatal outcomes of full-term newborns during the Omicron wave period.  METHODS: Between December 2021 and April 2022, this study was conducted on all newborns who visited a single center. We investigated due to the Omicron maternal infection maternal pregnancy complications, delivery methods, birth week, Apgar scores, neonatal resuscitation program requirement, whether respiratory support was required until 12 h after childbirth, suspicious infectious status, and mortality depending on maternal Omicron infection. RESULTS: A total of 127 neonates were enrolled, and 12 were excluded based on exclusion criteria. Sixteen neonates were born to mothers with a history of Omicron COVID-19, and 99 were born to non-infectious mothers. All infected mothers became infected in the 3rd trimester. Of the 16 mothers, seven were symptomatic, and four met the isolation criteria, according to Korean guidelines. The birth weight of newborns to mothers with a history of COVID and those without was 2.958 ± 0.272 kg and 3.064 ± 0.461 kg (p = 0.049), respectively. The 5-min Apgar score at childbirth was 9.29 ± 0.756 and 9.78 ± 0.460 for neonates born to symptomatic and asymptomatic mothers (p = 0.019), respectively. When compared with or without maternal self-isolation, neonates requiring respiratory support 12 h after birth demonstrated a significant difference (p = 0.014; OR, 10.275). Additionally, the presence or absence of transient tachypnea of the newborn showed a significant value (p = 0.010; OR 11.929). CONCLUSIONS: Owing to Omicron COVID-19, newborns were born with lower birth weight, low 5-min Apgar scores, and required respiratory support until 12 h after birth.


Subject(s)
COVID-19 , Infant, Newborn, Diseases , Pregnancy Complications, Infectious , Pregnancy Complications , Pregnancy , Female , Infant, Newborn , Humans , SARS-CoV-2 , Infectious Disease Transmission, Vertical , Resuscitation , Birth Weight
10.
Nurs Educ Perspect ; 43(6): E109-E111, 2022.
Article in English | MEDLINE | ID: covidwho-2097466

ABSTRACT

ABSTRACT: The advent of COVID-19 required educational programs to rapidly transition courses to the remote environment. A postpartum hemorrhage simulation used within a traditional prelicensure bachelor of science in nursing program was rapidly transitioned to the remote virtual format to meet required social distancing guidelines. This quasi-experimental study examined student knowledge before and after participation in a remote virtual simulation (RVS) with a postanalysis of student confidence and satisfaction. RVS can increase student knowledge and provide adequate student satisfaction. However, hands-on learning appears to result in higher student confidence and satisfaction compared to RVS.


Subject(s)
COVID-19 , Education, Nursing, Baccalaureate , Students, Nursing , Pregnancy , Female , Humans , Learning , Personal Satisfaction
12.
Georgian Med News ; (328-329): 100-107, 2022.
Article in English | MEDLINE | ID: covidwho-2092168

ABSTRACT

Currently, in relation to the effect of this pandemic on pregnancy, there are more questions than certainties about the real impact of COVID-19 on pregnant women. Studies are updated and often contradict each other. There is no evidence to suggest that pregnant women with COVID-19 have higher morbidity than affected non-pregnant women. We aimed to know whether maternal morbidities were more frequent in pregnant woman with COVID-19 compared to non-infected pregnant women. A retrospective case control study was conducted during a period of 6 months. Medical records were reviewed. A 120 files of COVID-19 infected women from Mosul city, and 95 files of non-infected pregnant women were reviewed and analyzed. We found that Infection with COVID-19 had a significant effect on pregnancy outcome, infected women were more likely to have higher incidence rates of adverse perinatal outcomes in both mothers and the newborns. Also, higher odds of complications associated with severe disease form Findings of our study came in line with previous studies in other countries, however, more medical care and support should be provided to pregnant women infected with COVID-19, particularly severe cases. Further studies with larger sample size are still needed for good understanding of the effect of virus on pregnancy outcomes.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Infant, Newborn , Female , Pregnancy , Humans , Pregnancy Trimester, Third , Case-Control Studies , Retrospective Studies , Pregnancy Outcome
13.
Rev Colomb Obstet Ginecol ; 73(2): 194-202, 2022 06 30.
Article in English, Spanish | MEDLINE | ID: covidwho-2091184

ABSTRACT

Objectives: To describe the prevalence of symptoms of depression and worry affecting pregnant women during the COVID-19 pandemic. Material and methods: Descriptive crosssectional study that included pregnant women with access to a technological device (mobile phone, computer or tablet) and Internet connection, living in Antioquia, Colombia. Women with literary and technological illiteracy were excluded. An online survey was conducted to gather information about sociodemographic and baseline clinical conditions and the main concerns caused by the pandemic. Additionally, the Edinburg Depression Scale (EPDS) was applied in order to measure the risk of depression. The Jamovi software was used for data processing and statistical analysis. Results: Overall, 345 pregnant women between 15 and 44 years of age were surveyed, with the finding of a 30.4 % prevalence of the risk of depression. Domestic violence and absence of a support network were identified in 4.9 % and 8.4 % of cases. The major sources of worry were the fear of being separated from their babies on the day of birth, the possibility of having to be alone during childbirth, and the fear of contagion due to potential effects on the fetus or the newborn. Conclusions: Depression symptoms have been frequent among pregnant women during the COVID-19 pandemic. It is important to inquire about stress factors and depression symptoms during prenatal visits, childbirth and the postpartum period. Additional local studies are needed to assess other mental health disorders that may have increased during the COVID-19 pandemic.


Objetivos: describir la prevalencia de los síntomas de depresión y las preocupaciones que afectaron a las gestantes durante la pandemia por COVID-19. Materiales y métodos: estudio transversal descriptivo, se incluyeron mujeres gestantes, con acceso a un medio tecnológico (celular, computador o tableta) y conectividad a internet, residentes en Antioquia, Colombia. Se excluyeron mujeres con analfabetismo literario y tecnológico. Se encuestaron, en línea, las condiciones sociodemográficas y clínicas basales y las principales preocupaciones generadas por la pandemia, además se aplicó la Escala de Depresión de Edimburgo (EPDS) para medir el riesgo de depresión. Se usó el software Jamovi para el procesamiento y análisis estadístico. Resultados: se encuestaron 345 mujeres gestantes de 15 a 44 años, se identificó una prevalencia de riesgo de depresión en 30,4 % de las mujeres encuestadas. Se identificó violencia intrafamiliar en el 4,9 % y ausencia de red de apoyo en el 8,4 %. Se encontraron como mayores preocupaciones temor a ser separadas del bebé el día del parto, la posibilidad de no tener acompañante durante el parto, y temor al contagio por los efectos en el bebé in útero o en el recién nacido. Conclusiones: los síntomas de depresión han sido frecuentes en las mujeres gestantes durante la pandemia del COVID-19. Es importante averiguar por factores de estrés y síntomas de depresión en el control prenatal, el parto y el postparto. Se requieren nuevos estudios locales que evalúen otros trastornos de salud mental que se hayan podido incrementar durante la pandemia por COVID-19.


Subject(s)
COVID-19 , Pregnant Women , COVID-19/epidemiology , Colombia/epidemiology , Depression , Female , Humans , Pandemics , Pregnancy , Prevalence
14.
Med J Aust ; 217 Suppl 9: S7-S13, 2022 Nov 06.
Article in English | MEDLINE | ID: covidwho-2090766

ABSTRACT

Early treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections can prevent hospitalisation and death in patients with coronavirus disease 2019 (COVID-19) who have one or more risk factors for serious COVID-19 progression. While early treatment presents a range of logistical challenges, clinicians are nevertheless aided by a growing number of approved medications for early treatment of COVID-19. Medications include drugs that inhibit SARS-CoV-2 viral replication, anti-SARS-CoV-2 monoclonal antibody formulations that provide passive immunisation, and immunomodulatory drugs that suppress the body's inflammatory response. Several drugs with different modes of action are approved in Australia for early treatment of COVID-19, including nirmatrelvir plus ritonavir, molnupiravir, and monoclonal antibody formulations. Although these drugs are recommended, clinicians are encouraged to remain up to date on current indications, contraindications and the clinical efficacy of these drugs against SARS-CoV-2 variants currently circulating in communities. Other treatments, including hydroxychloroquine, ivermectin and dietary supplements, have been popularised but are not recommended for early treatment of COVID-19. As new drugs and new data on use of existing approved drugs become available, clinicians face a growing challenge in determining the optimal treatments from the array of options. As it stands, early treatment of COVID-19 needs to be individualised depending on age, pregnancy status, existing medications, and renal and liver disease status. Future treatments in development might have roles in patients with lower risk profiles and in reducing transmission as we learn to live with SARS-CoV-2.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Humans , Pregnancy , Female , SARS-CoV-2 , COVID-19/drug therapy , Hydroxychloroquine/therapeutic use , Antibodies, Viral , Antibodies, Monoclonal , Antiviral Agents/therapeutic use
15.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(10): 1356-1386, 2022 Oct 06.
Article in Chinese | MEDLINE | ID: covidwho-2090420

ABSTRACT

Influenza is an acute respiratory infectious disease caused by the influenza virus, which seriously affects human health. The influenza virus has frequent antigenic drifts that can facilitate escape from pre-existing population immunity and lead to the rapid spread and annual seasonal epidemics. Influenza outbreaks occur in crowded settings, such as schools, kindergartens, and nursing homes. Seasonal influenza epidemics can cause 3-5 million severe cases and 290 000-650 000 respiratory disease-related deaths worldwide every year. Pregnant women, infants, adults 60 years and older, and individuals with comorbidities or underlying medical conditions are at the highest risk of severe illness and death from influenza. Given the ongoing COVID-19 pandemic, some provinces in southern China had a summer peak of influenza. SARS-CoV-2 may co-circulate with influenza and other respiratory viruses in the upcoming winter-spring influenza season. Annual influenza vaccination is an effective way to prevent influenza, reduce influenza-related severe illness and death, and reduce the harm caused by influenza-related diseases and the use of medical resources. The currently approved influenza vaccines in China include trivalent inactivated influenza vaccine (IIV3), quadrivalent inactivated influenza vaccine (IIV4), and trivalent live attenuated influenza vaccine (LAIV3). IIV3 is produced as a split virus vaccine and subunit vaccine; IIV4 is produced as a split virus vaccine; and LAIV3 is a live, attenuated virus vaccine. Except for some jurisdictions in China, the influenza vaccine is a non-immunization program vaccine-voluntarily and self-paid. China CDC has issued 'Technical Guidelines for Seasonal Influenza Vaccination in China' every year from 2018 to 2021. Over the past year, new research evidence has been published at home and abroad. To better guide the prevention and control of influenza and vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccination Technical Working Group updated and revised the 2021-2022 Technical Guidelines with the latest research progress into the 'Technical Guidelines for Seasonal Influenza Vaccination in China (2022-2023)'. The new version has updated five key areas: (1) new research evidence-especially research conducted in China-has been added, including new estimates of the burden of influenza disease, assessments of influenza vaccine effectiveness and safety, and analyses of the cost-effectiveness of influenza vaccination; (2) policies and measures for influenza prevention and control that were issued by the government over the past year; (3) influenza vaccines approved for marketing in China this year; (4) composition of trivalent and quadrivalent influenza vaccines for the 2022-2023 northern hemisphere influenza season; and (5) recommendations for influenza vaccination during the 2022-2023 influenza season. The 2022-2023 Guidelines recommend that vaccination clinics provide influenza vaccination services to all people aged 6 months and above who are willing to be vaccinated and have no contraindications to the influenza vaccine. For adults ≥ 18 years, co-administration of COVID-19 and inactivated influenza vaccines in separate arms is acceptable regarding immunogenicity and reactogenicity. For people under 18 years old, there should be at least 14 days between influenza vaccination and COVID-19 vaccination. The Guidelines express no preference for influenza vaccine type or manufacturer-any approved, age-appropriate influenza vaccines can be used. To minimize harm from influenza and limit the impact on the effort to prevent and control COVID-19 in China, the Technical Guidelines recommend priority vaccination of the following high-risk groups during the upcoming 2022-2023 influenza season: (1) healthcare workers, including clinical doctors and nurses, public health professionals, and quarantine professionals; (2) volunteers and staff who provide services and support for large events; (3) people living in nursing homes or welfare homes and staff who take care of vulnerable, at-risk individuals; (4) people who work in high population density settings, including teachers and students in kindergartens and primary and secondary schools, and prisoners and prison staff; and (5) people at high risk of influenza, including adults ≥ 60 years of age, children 6-59 months of age, individuals with comorbidities or underlying medical conditions, family members and caregivers of infants under 6 months of age, and pregnant women. Children 6 months to 8 years of age who receive inactivated influenza vaccine for the first time should receive two doses, with an inter-dose interval of 4 or more weeks. Children who previously received the influenza vaccine and anyone 9 years or older need only one dose. LAIV is recommended only for a single dose regardless of the previous influenza vaccination. Vaccination should begin as soon as influenza vaccines become available and preferably should be completed before the onset of the local influenza season. Repeated influenza vaccination during a single influenza season is not recommended. Vaccination clinics should provide immunization services throughout the epidemic season. Pregnant women can receive inactivated influenza vaccine at any stage of pregnancy. These guidelines are intended for use by staff of CDCs, healthcare workers, maternity and child care institutions and immunization clinic staff members who work on influenza control and prevention. The guidelines will be updated periodically as new evidence becomes available.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Orthomyxoviridae , Adult , Infant , Female , Pregnancy , Humans , Adolescent , Child, Preschool , Influenza, Human/prevention & control , Influenza, Human/epidemiology , Seasons , Pandemics , COVID-19 Vaccines , SARS-CoV-2 , Vaccination , China/epidemiology , Vaccines, Attenuated , Vaccines, Combined , Vaccines, Inactivated
16.
Medicina (Kaunas) ; 58(11)2022 Oct 27.
Article in English | MEDLINE | ID: covidwho-2090279

ABSTRACT

BACKGROUND AND OBJECTIVES: The postpartum maternal physical and psychological state played a fundamental role in the mother-child relationship at the beginning of the COVID-19 pandemic. The aim of the study is to analyze the influence of maternal psychological manifestations on the mother-child couple through three objectives (briefly expressed): (I) Determination of the main acute and chronic conditions of newborns/infants. (II) Verification of the hypothesis of the existence of a link between the following neonatal variables: gestational age, birth weight, number of days of hospitalization, and specific neonatal therapies (oxygen, surfactant, and blood products' transfusion). (III) Verification of the influence of postpartum maternal psychological status on the mother-child couple through three hypotheses. MATERIALS AND METHODS: This cross-sectional study was conducted in two hospitals in Timișoara, Romania, between 1 March and 1 September 2020, and included 165 mothers and their 175 newborns. Mothers answered the Edinburgh Postnatal Depression Scale, Spielberger's Inventory of State-Trait Anxiety, and the Collins and Read Revised Adult Attachment Scale. RESULTS: (I) The acute and chronic pathology of the infants in the study group was polymorphic. (II) Large correlations were identified between the following infant variables: gestational age with birth weight, and number of hospitalization days with birth weight, gestational age, and use of blood product transfusion (all p < 0.001). (III) (1) State anxiety was the only significant predictor of number of hospitalization days (p = 0.037), number of acute disorders (p = 0.028), and number of infant chronic diseases (p = 0.037). (2) Maternal depressive symptoms were the only predictor of postpartum maternal attachment (p = 0.018). (3) Depressive symptoms, state, and trait anxiety were non-significant in all models studied (all p > 0.05). CONCLUSIONS: Postpartum maternal physical and psychological state plays a fundamental role on the mother-child relationship in the new social and complex family conditions.


Subject(s)
COVID-19 , Depression, Postpartum , Infant , Female , Adult , Infant, Newborn , Pregnancy , Humans , Cross-Sectional Studies , COVID-19/epidemiology , Birth Weight , Romania/epidemiology , Pandemics , Mother-Child Relations , Mothers/psychology , Hospitals
17.
J Korean Med Sci ; 37(41): e297, 2022 Oct 24.
Article in English | MEDLINE | ID: covidwho-2089755

ABSTRACT

BACKGROUND: This study aimed to describe the maternal, obstetrical, and neonatal outcomes in pregnant women with coronavirus disease 2019 (COVID-19) and identify the predictors associated with the severity of COVID-19. METHODS: This multicenter observational study included consecutive pregnant women admitted because of COVID-19 confirmed using reverse transcriptase-polymerase chain reaction (RT-PCR) test at 15 hospitals in the Republic of Korea between January 2020 and December 2021. RESULTS: A total of 257 women with COVID-19 and 62 newborns were included in this study. Most of the patients developed this disease during the third trimester. Nine patients (7.4%) developed pregnancy-related complications. All pregnant women received inpatient treatment, of whom 9 (3.5%) required intensive care, but none of them died. The gestational age at COVID-19 diagnosis (odds ratio [OR], 1.096, 95% confidence interval [CI], 1.04-1.15) and parity (OR, 1.703, 95% CI, 1.13-2.57) were identified as significant risk factors of severe diseases. Among women who delivered, 78.5% underwent cesarean section. Preterm birth (38.5%), premature rupture of membranes (7.7%), and miscarriage (4.6%) occurred, but there was no stillbirth or neonatal death. The RT-PCR test of newborns' amniotic fluid and umbilical cord blood samples was negative for severe acute respiratory syndrome coronavirus 2. CONCLUSION: At the time of COVID-19 diagnosis, gestational age and parity of pregnant women were the risk factors of disease severity. Vertical transmission of COVID-19 was not observed, and maternal severity did not significantly affect the neonatal prognosis.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Premature Birth , Infant, Newborn , Female , Humans , Pregnancy , COVID-19 Testing , Cesarean Section , Pregnant Women , Pregnancy Complications, Infectious/diagnosis , Pregnancy Outcome , Infectious Disease Transmission, Vertical , RNA-Directed DNA Polymerase
18.
Pediatrics ; 150(5)2022 11 01.
Article in English | MEDLINE | ID: covidwho-2089495

ABSTRACT

OBJECTIVES: To evaluate outcomes of neonates born to mothers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy, the dynamics of placental transfer of maternal antibodies, and its persistence during infancy. METHODS: Cohort study enrolling neonates born to mothers with SARS-CoV-2 infection in pregnancy. All infants were evaluated at birth. Those born to women with infection onset within 2 weeks before delivery were excluded from further analyses. Remaining infants underwent cerebral and abdominal ultrasound, fundoscopy evaluation, and were enrolled in a 12 month follow-up. Qualitative immunoglobulin G (IgG)/immunoglobulin M and quantitative IgG to S1/S2 subunits of spike protein were assessed in mother-neonate dyads within 48 hours postdelivery and during follow-up. RESULTS: Between April 2020 and April 2021, 130 of 2745 (4.7%) neonates were born to mothers with SARS-CoV-2 infection in pregnancy, with 106 of 130 infections diagnosed before 2 weeks before delivery. Rates of preterm and cesarean delivery were comparable between women with and without infection (6% vs 8%, P = .57; 22% vs 32%, P = .06). No clinical or instrumental abnormalities were detected at birth or during follow-up. There was a positive correlation between maternal and neonatal SARS-CoV-2 IgG levels (r = 0.81, P < .001). Transplacental transfer ratio was higher after second-trimester maternal infections as compared with first and third trimester (P = .03). SARS-CoV-2 IgG level progressively decreased in all infants, with 89 of 92 (97%) infants seronegative at 6 months of age. CONCLUSIONS: Clinical outcomes were favorable in all infants. Matching peak IgG level after infection and higher IgG transplacental transfer might result in the most durable neonatal passive immunity.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Infant, Newborn , Infant , Female , Pregnancy , Humans , SARS-CoV-2 , Pregnancy Complications, Infectious/diagnosis , Infectious Disease Transmission, Vertical , Cohort Studies , Placenta , Immunoglobulin M , Immunoglobulin G
19.
Trials ; 23(1): 884, 2022 Oct 21.
Article in English | MEDLINE | ID: covidwho-2089228

ABSTRACT

BACKGROUND: As a pragmatic randomised timing-of-birth trial, WILL adapted its trial procedures in response to the COVID-19 pandemic. These are reviewed here to inform post-pandemic trial methodology. METHODS: The trial (internal pilot) paused in March 2020, re-opened in July 2020, and is currently recruiting in 37 UK NHS consultant-led maternity units. We evaluated pandemic adaptations made to WILL processes and surveyed sites for their views of these changes (20 sites, videoconference). RESULTS: Despite 88% of sites favouring an electronic investigator site file (ISF), information technology requirements and clinical trial unit (CTU) operating procedures mandated the ongoing use of paper ISFs; site start-up delays resulted from restricted access to the CTU. Site initiation visits (SIVs) were conducted remotely; 50% of sites preferred remote SIVs and 44% felt that it was trial-dependent, while few preferred SIVs in-person as standard procedure. The Central team felt remote SIVs provided scheduling and attendance flexibility (for sites and trial staff), the option of recording discussions for missing or future staff, improved efficiency by having multiple sites attend, and time and cost savings; the negative impact on rapport-building and interaction was partially mitigated over time with more familiarity with technology and new ways-of-working. Two methods of remote consent were developed and used by 30/37 sites and for 54/156 recruits. Most (86%) sites using remote consenting felt it improved recruitment. For remote data monitoring (5 sites), advantages were primarily for the monitor (e.g. flexibility, no time constraints, reduced cost), and disadvantages primarily for the sites (e.g. document and access preparation, attendance at a follow-up meeting), but 81% of sites desired having the option of remote monitoring post-pandemic. CONCLUSIONS: COVID adaptations to WILL trial processes improved the flexibility of trial delivery, for Central and site staff, and participants. Flexibility to use these strategies should be retained post-pandemic. TRIAL REGISTRATION: ISRCTN77258279. Registered on 05 December 2018.


Subject(s)
COVID-19 , Hypertension , Labor, Obstetric , Female , Humans , Pregnancy , Pandemics/prevention & control , SARS-CoV-2
20.
BMC Pregnancy Childbirth ; 22(1): 357, 2022 Apr 23.
Article in English | MEDLINE | ID: covidwho-2089173

ABSTRACT

BACKGROUND: Pregnancy is associated with increased risk for severe COVID-19. Few studies have examined knowledge, attitudes, and practices (KAP) related to pregnancy during the pandemic. This study investigated the association between socio-demographic characteristics and KAP related to COVID-19 among pregnant women in an urban community in Thailand. METHODS: A cross-sectional online survey was distributed among pregnant women in Bangkok, Thailand from July-August 2021. Binary logistic regression was conducted to test the association between socio-demographic characteristics and KAP related to COVID-19, and a Spearman's analysis tested correlations between KAP scores. RESULTS: A total of 150 pregnancy survey responses were received. Most participants were third trimester (27-40 weeks gestation; 68.0%). Pregnancy had never been risked contracting COVID-19 (84.7%). Most expressed concerns about being infected with COVID-19 during pregnancy and following birth (94.0 and 70.0%, respectively). The results of binary logistic regression analysis found associations between knowledge and marital status (OR = 4.983, 95%CI 1.894-13.107). In addition, having a bachelor's degree or higher was associated with higher attitude scores (OR = 2.733, 95%CI 1.045-7.149), as was being aged 26-30 (OR = 2.413 95%CI 0.882-6.602) and 31-35 years of age (OR = 2.518-2.664, 95%CI 0.841-8.442). Higher practice scores were associated with having a bachelor's degree or higher (OR = 2.285 95%CI 1.110-6.146), and income ≥15,001 bath (OR = 4.747 95%CI 1.588-14.192). Correlation analysis found a weak positive correlation between knowledge and practice scores (r = 0.210, p-value = 0.01). CONCLUSION: Participants overall had high KAP scores. This study can guide public health strategies regarding pregnant women and COVID-19. We recommend that interventions to improve and attitude and practice scores. Knowledge on pregnancy and COVID-19 should focus on reducing fear and improving attitudes toward the care of patients as well as the promotion of preventive practices.


Subject(s)
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Pandemics/prevention & control , Parturition , Pregnancy , Pregnant Women , Surveys and Questionnaires , Thailand/epidemiology
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