COVID-19 in a cohort of pregnant women and their descendants, the MOACC-19 study.

PURPOSE: The Mother and Child COVID-19 study is a cohort recruiting pregnant women and their children in Cantabria, North of Spain, during COVID-19 pandemic in order to ascertain consequences of SARS-CoV-2 infection on pregnant women and their descendants. This article reports the cohort profile and preliminary results as recruitment is still open. PARTICIPANTS: Three subcohorts can be identified at recruitment. Subcohort 1 includes women giving birth between 23 March and 25 May 2020; they have been retrospectively recruited and could have been exposed to COVID-19 only in their third trimester of pregnancy. Subcohort 2 includes women giving birth from 26 May 2020 on; they are being prospectively recruited and could have been exposed to COVID-19 in both their second and third trimesters of pregnancy. Subcohort 3 includes women in their 12 week of pregnancy prospectively recruited from 26 May 2020 on; they could have been exposed to COVID-19 anytime in their pregnancy. All women are being tested for SARS-CoV-2 infection using both RT-PCR for RNA detection and ELISA for anti-SARS-CoV-2 antibodies. All neonates are being tested for antibodies using immunochemoluminiscency tests; if the mother is tested positive for SARS-CoV-2 RNA, a nasopharyngeal swab is also obtained from the child for RT-PCR analysis. FINDINGS TO DATE: As of 22 October, 1167 women have been recruited (266, 354 and 547 for subcohorts 1, 2 and 3, respectively). Fourteen women tested positive to SARS-CoV-2 RNA by the day of delivery. All 14 children born from these women tested negative for SARS-CoV-2 RNA. FUTURE PLANS: Children from women included in subcohort 3 are expected to be recruited by the end of 2020. Children will be followed-up for 1 year in order to ascertain the effect that COVID-19 on their development.

Results of Pregnancy Control before and during the COVID-19 Pandemic: A Comparison of Two Cohorts.

The COVID-19 pandemic placed pregnant women at high risk, but behavioural changes have also led to lower rates of preterm births in high-income countries. The main goal of this article is to study the ongoing impact of the COVID-19 pandemic on pregnancy control and outcomes; this is a joint analysis of two cohorts. The pre-pandemic cohort includes 969 pregnant women recruited in 2018. The pandemic cohort comprises 1168 pregnant women recruited in 2020. Information on demographic and socioeconomic characteristics, reproductive history, characteristics of the current pregnancy and its outcome were obtained from medical records. Birth by Caesarean section was more frequent in the pre-pandemic cohort (adjusted odds ratio (OR) = 0.71, 95% confidence interval (CI): 0.55-0.92). A birth weight lower than 2500 g and higher than 4000 g occurred more frequently in the pre-pandemic cohort (adjusted OR = 0.62, 95% CI: 0.41-0.93 for lower than 2500 g and adjusted OR = 0.30, 95% CI: 0.20-0.46 for higher than 4000 g). Exclusive breastfeeding upon hospital discharge was more frequent in the pandemic cohort than in the pre-pandemic cohort (60% vs. 54%, p = 0.005), with adjusted OR = 0.67, 95% CI: 0.52-0.86 for mixed breastfeeding and infant formula. In conclusion, we report reductions in Caesarean sections and reduced numbers of low birth weight babies during the pandemic in a hospital located in northern Spain. Further analysis will clarify if these reductions are related to changes in health-related behaviour or healthcare operation.

Implementación de la biopsia selectiva del ganglio centinela en pacientes con cáncer de mama tratadas en hospitales comarcales de la Comunidad Autónoma de Cantabria / Implementation of sentinel lymph node biopsy in patients with breast cancer treated in district hospitals in the autonomous region of Cantabria (Spain)

Objetivo. Evaluar los resultados de la biopsia selectiva del ganglio centinela (GC) en mujeres con cáncer de mama tratadas en hospitales sin servicio de Medicina Nuclear. Sujetos y métodos. El estudio incluyó 88 mujeres con cáncer de mama no avanzado tratadas en 2 hospitales comarcales entre febrero 2007 y julio 2010. El día previo a la cirugía se realizó una linfogammagrafía en el hospital especializado. Para la localización intraoperatoria del GC se utilizaron una sonda radiodetectora y una gammacámara manual. Resultados. El GC se localizó quirúrgicamente en 97,7% de pacientes. La media de ganglios linfáticos extraídos por cada procedimiento y equipo quirúrgico fue 2,1±1,4 y 2,5±1,2. En 27,2% de pacientes se practicó linfadenectomía axilar. Hubo un resultado falso negativo y un falso positivo. Conclusiones. La implementación de la biopsia selectiva del GC en hospitales comarcales proporciona los mismos resultados que los obtenidos en el hospital supervisor (AU)

Objective. To evaluate the results of sentinel lymph node (SLN) biopsy in women with breast cancer treated in hospitals without a nuclear medicine unit. Subjects and methods. Eighty-eight patients with early-stage breast cancer treated in two district hospitals between February 2007 and July 2010 were included. The day before surgery a lymphoscintigraphy was performed in the specialized hospital. Intraoperative localization of the SLN was accomplished by the combined use of a hand-held gamma probe and a manual gamma-camera. Results. Surgical localization of the SLN was successful in 97.7% of the patients. The mean number of lymph nodes excised by each procedure and each surgical team was 2.1±1.4 and 2.5±1.2. Axillary lymph node dissection was performed in 27.2% of the patients. There was one false-negative result and one false-positive result. Conclusion. The implementation of SLN biopsy in district hospitals provides similar results to those obtained in the supervising hospital (AU)