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1.
Front Immunol ; 12: 743022, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34603330

RESUMEN

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic. The virus primarily affects the lungs where it induces respiratory distress syndrome ranging from mild to acute, however, there is a growing body of evidence supporting its negative effects on other system organs that also carry the ACE2 receptor, such as the placenta. The majority of newborns delivered from SARS-CoV-2 positive mothers test negative following delivery, suggesting that there are protective mechanisms within the placenta. There appears to be a higher incidence of pregnancy-related complications in SARS-CoV-2 positive mothers, such as miscarriage, restricted fetal growth, or still-birth. In this review, we discuss the pathobiology of COVID-19 maternal infection and the potential adverse effects associated with viral infection, and the possibility of transplacental transmission.


Asunto(s)
COVID-19/patología , Placenta/patología , Placenta/virología , Complicaciones Infecciosas del Embarazo/virología , Aborto Espontáneo/virología , Enzima Convertidora de Angiotensina 2/metabolismo , Femenino , Retardo del Crecimiento Fetal/virología , Humanos , Intercambio Materno-Fetal/fisiología , Embarazo , SARS-CoV-2/patogenicidad , Serina Endopeptidasas/metabolismo , Mortinato
2.
Diagn Pathol ; 16(1): 88, 2021 Oct 03.
Artículo en Inglés | MEDLINE | ID: mdl-34602071

RESUMEN

INTRODUCTION: COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, is a severe systemic thrombotic syndrome that emerged in 2019, with an ensuing pandemic. To evaluate the impact of this disease on placental tissue and perinatal outcome, histological, immunohistochemical and ultrastructural analyses of placental tissue were performed for five cases of pregnant women with COVID-19. CASE REPORTS: All five pregnant women in this series developed COVID-19 in late pregnancy. Two patients experienced respiratory distress, and computed tomography revealed signs of pneumonia, with bilateral involvement, multiple lobular and subsegmental areas of consolidation and ground-glass opacities. Histological studies of placental tissue revealed the presence of slight signs of maternal vascular underperfusion (MVUs) or foetal vascular underperfusion (FVUs) lesions and mild inflammatory lesions. CD15 immunoreactivity in the placental tissue was low in all cases, demonstrating that in these cases there was not severe foetal hypoxia/asphyxia risk for newborns or distal vascular immaturity. In all cases examined, ultrastructural analyses showed spherical-like coronavirus particles with an electron intermediate-density core as well as projections from the surface as spike-like structures in the syncytiotrophoblasts. At term, all of the women delivered newborns who were negative for SARS-CoV-2 by nasopharyngeal testing in their first day of life. All newborns were exclusively breastfed and were discharged on the 3rd day of life. CONCLUSIONS: In conclusion, placental patterns in pregnancy due to COVID-19 in the late stage of gestation indicate no evidence of vertical trans-placental SARS-CoV-2 transmission or a significant impact on the perinatal outcome of newborns, in both mild and more severe cases.


Asunto(s)
COVID-19/diagnóstico por imagen , Transmisión Vertical de Enfermedad Infecciosa , Pandemias , Complicaciones Infecciosas del Embarazo , SARS-CoV-2/fisiología , Adulto , COVID-19/epidemiología , COVID-19/patología , COVID-19/virología , Femenino , Humanos , Recién Nacido , Placenta/diagnóstico por imagen , Placenta/patología , Placenta/virología , Embarazo , Resultado del Embarazo , Tomografía Computarizada por Rayos X , Trofoblastos/patología , Trofoblastos/virología
3.
Rev Esc Enferm USP ; 55: e20200507, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-34479309

RESUMEN

OBJECTIVE: To review the literature on sleep changes and brain function in children with microcephaly due to Zika virus. METHOD: Systematic review conducted in the databases MEDLINE (PubMed), Scopus, Web of Science, CINAHL, EMBASE, LILACS, and SciELO and the grey databases Google Scholar and OpenGrey. RESULTS: Ten Brazilian primary studies with observational research design were included. These were published between 2017 and 2020 with 516 children with microcephaly due to Zika virus infection aged 4 months to 4 years. Out of these, 4 investigated qualitative aspects of sleep using the questionnaires Brief Infant Sleep Questionnaire or Infant Sleep Questionnaire and 6 investigated changes in brain activities during sleep using the Electroencephalogram or Video-Electroencephalogram exams. The children's quality of sleep was not compromised in most studies. Changes in brain activity during sleep were frequent, with epileptogenic activity being a common finding among the studies. CONCLUSION: The quality of sleep of children with microcephaly due to Zika virus has shown to be similar to that of children with typical development and the presented behavioral changes may be related to changes in electric brain activity.


Asunto(s)
Microcefalia , Complicaciones Infecciosas del Embarazo , Infección por el Virus Zika , Virus Zika , Brasil , Niño , Femenino , Humanos , Lactante , Embarazo , Sueño , Infección por el Virus Zika/complicaciones
4.
Rev Med Chil ; 149(3): 348-356, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34479313

RESUMEN

BACKGROUND: National rates of HIV, gonorrhoeae and syphilis have increased in Chile in recent years, but it is not known if syphilis among pregnant women (PW) is also escalating. AIM: To explore syphilis rates among PW in a southern Chilean region and to describe clinical features of mothers and offspring. PATIENTS AND METHODS: We selected PW with positive VDRL or T. pallidum micro-he-magglutination (MHA-TP) reactive tests, referred to a high-risk obstetrical pathology center between 2011 and 2019. Clinical information of mothers and their offspring was obtained from their medical records. RESULTS: Syphilis rates among PW increased from 0.4 to 7.2 per 1,000 live births in the reference center from 2013 to 2019, along with a national and regional increase in both sexes. Twenty-nine cases of PW with syphilis were identified with a median age of 28 years (interquartile range 23-32). Seventeen percent had a history of drug abuse, and 14% had previous sexually transmitted diseases. In seven cases (24%), the diagnosis occurred at delivery. Three percent of patients had a primary syphilis, 14% a secondary syphilis, 24% an early latent syphilis, and 59% a latent syphilis. All cases except one case were treated with benzathine penicillin G and the remaining with erythromycin due to allergy suspicion. Penicillin desensitization was required in two cases (7%). Treatment timing was inadequate in 10 cases (34.5%). Of 19 patients with available serological follow-up, 10 (53%) showed a significant decrease in VDRL titers (≥ 2 dilutions) and two cases had re-infection. Two patients (7%) had an abortion, two had congenital syphilis (7%), and six had premature births (21%), totaling 35% of adverse-pregnancy outcomes. CONCLUSIONS: Resurgence of syphilis among pregnant women is happening in southern Chile and is associated to adverse-pregnancy outcomes.


Asunto(s)
Complicaciones Infecciosas del Embarazo , Sífilis Congénita , Sífilis , Adulto , Chile/epidemiología , Femenino , Humanos , Masculino , Penicilina G Benzatina , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Mujeres Embarazadas , Sífilis/epidemiología , Sífilis Congénita/epidemiología
5.
Rev Esc Enferm USP ; 55: e20200271, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-34528992

RESUMEN

OBJECTIVE: To analyze, in the light of the social-ecological theory, the temporal progression of gestational syphilis and its relationship with the implementation of the rede cegonha in Ceará. METHOD: This is a retrospective documental study, based on the information system of notifiable diseases about gestational syphilis in the perspective of the social-ecological theory. The sample consisted of all notifications from the state of Ceará in the period from 2007 to 2017. Data collection was carried out in October 2019. RESULTS: A total of 229,558 cases of gestational syphilis was reported in Brazil; of these, 7,040 were from the state of Ceará (3.1%), with a growing increase in cases over the years. Regarding the distribution of syphilis cases between the period before and after the implementation of the rede cegonha, there was an association with education (p < 0.0001), clinical classification (p < 0.0001), and gestational age (p = 0.0005). CONCLUSION: Despite the implementation of public policies and improvement of the epidemiological surveillance system, there is still a long way to go to control syphilis during pregnancy.


Asunto(s)
Complicaciones Infecciosas del Embarazo , Sífilis Congénita , Sífilis , Brasil/epidemiología , Femenino , Edad Gestacional , Humanos , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Estudios Retrospectivos , Teoría Social , Sífilis/epidemiología , Sífilis Congénita/epidemiología
6.
Clinics (Sao Paulo) ; 76: e3032, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34495081

RESUMEN

Since the outbreak of severe acute respiratory coronavirus 2 (SARS-CoV-2), the coronavirus disease 2019 has had a wide range of effects on human health. This paper summarizes the data related to the effects of the SARS-CoV-2 infection on human reproduction. Both the male and female reproductive tract express high levels of receptors and proteins needed for viral cell entry. There is presently no evidence that gametes are affected by the infection. Male fertility may be temporarily reduced due to inflammatory responses following infection. The endometrium is highly susceptible to SARS-CoV-2 cell entry; however, it remains unclear whether this could alter receptivity and embryo implantation. Menstrual cycle changes were reported in women who experienced severe infection; however, they tended to be reversible. For couples undergoing assisted reproduction treatment, the pandemic led to a significant psychological burden, with changes in lifestyle that could directly affect the success of the treatment. Human reproduction societies recommend screening all patients prior to cycle initiation and avoiding treatment of women with severe comorbidities until the pandemic is under control. Finally, for pregnant women, it is expected that the infection is more severe in women in the third trimester and in those with comorbidities. Those who are symptomatic for SARS-CoV-2 are more likely to have increased rates of prematurity and intrapartum fetal distress than those who are asymptomatic. Vertical transmission cannot be completely ruled out, but neonatal infection rates are low. Vaccination appears to be safe and is indicated for use in pregnant and lactating women because the benefits outweigh the risks.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , Femenino , Humanos , Lactancia , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Reproducción , SARS-CoV-2
7.
West Afr J Med ; 38(8): 713-718, 2021 08 30.
Artículo en Inglés | MEDLINE | ID: mdl-34499828

RESUMEN

Prevention of mother-to-child transmission (PMTCT) of HIV programme provides antiretroviral treatment to HIV-positive pregnant women to reduce the likelihood of transmission to their infants. Despite concerted efforts to scale-up PMTCT services in Nigeria, coverage and uptake of the services by Antenatal Care (ANC) attendees is below the acceptable. Private health facilities provide ANC services to large number of women, but they are sparingly involved in PMTCT capacity enhancement interventions. This study assessed the knowledge and utilization of PMTCT services among women accessing antenatal care in Private Health facilities in Abakaliki, Ebonyi State. It was a descriptive cross-sectional study in ANC clinics of the health facilities. Data was collected using interviewer administered questionnaire and analysed with Statistical Package for Social Sciences (SPSS) version 22.0 and test of association was by Chi square at P<0.05 level of significance. Results showed mean age of the respondents was 27± 4.6 years. Majority of the respondents (83.4%) had good knowledge of PMTCT but only 68.4% accessed HIV Counselling and Testing (HCT) in the index pregnancy, with fear of stigmatization given as the major reason for not doing HCT. Only 54.5% of sero-positive attendees took anti-retroviral drugs (ARVs) during pregnancy though they all used ARVs during labour/ delivery. Utilization of PMTCT services of HIV wassignificantly associated with educational status and occupation. CONCLUSION: There was good knowledge of PMTCT but utilization of the services was suboptimal. Training and mentoring of health care workers in private facilities on HIV testing programmes is important to improve uptake of PMTCT services and allay fears of stigmatization among the pregnant women.


Asunto(s)
Infecciones por VIH , Complicaciones Infecciosas del Embarazo , Adulto , Instituciones de Atención Ambulatoria , Estudios Transversales , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Humanos , Lactante , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Nigeria , Embarazo , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/prevención & control , Atención Prenatal , Instalaciones Privadas , Adulto Joven
8.
BMC Health Serv Res ; 21(1): 941, 2021 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-34503508

RESUMEN

INTRODUCTION: Despite prioritization, routine antenatal influenza vaccine coverage is < 16% in South Africa. We aimed to describe maternal influenza vaccine coverage in 27 antenatal clinics (ANCs) in Gauteng and Western Cape (WC) Provinces, where in collaboration with the Department of Health (DoH), we augmented the annual influenza vaccination programme among pregnant women. METHODS: From 2015 through 2018, 40,230 additional doses of influenza vaccine were added to the available stock and administered as part of routine antenatal care. Educational talks were given daily and data were collected on women attending ANCs. We compared characteristics of vaccinated and unvaccinated women using multivariable logistic regression. RESULTS: We screened 62,979 pregnant women during the period when Southern Hemisphere influenza vaccines were available (27,068 in Gauteng and 35,911 in WC). Vaccine coverage at the targeted clinics was 78.7% (49,355/62682), although pregnant women in WC were more likely to be vaccinated compared to those in the Gauteng (Odds ratio (OR) =3.7 p < 0.001). Women aged 25-29 and > 35 years were less likely to be vaccinated than women aged 18-24 years (OR = 0.9 p = 0.053; OR = 0.9 p < 0.001). HIV positive status was not associated with vaccination (OR = 1.0 p = 0.266). Reasons for not vaccinating included: vaccine stock-outs where ANCs depleted available stock of vaccines and/or were awaiting delivery of vaccines (54.6%, 6949/12723), refusal/indecision (25.8%, 3285), and current illness that contraindicated vaccination (19.6%, 2489). CONCLUSION: Antenatal vaccination uptake was likely improved by the increased vaccine supply and vaccine education offered during our campaign.


Asunto(s)
Vacunas contra la Influenza , Gripe Humana , Complicaciones Infecciosas del Embarazo , Femenino , Humanos , Programas de Inmunización , Gripe Humana/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Mujeres Embarazadas , Sudáfrica , Vacunación
9.
Ann Palliat Med ; 10(8): 8881-8888, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34488375

RESUMEN

BACKGROUND: Vaginitis is one of the most common gynecological diseases in women and may severely affect the quality of life in patients. However, very few studies have investigated aerobic vaginitis (AV) in pregnant women, and our study was designed to identify the pathogen profile, clinical importance, and risk factors of AV in pregnancy. METHODS: This was a retrospective cohort study enrolling 685 women who attended our hospital between July 2018 and June 2020. Based on the incidence of AV, enrolled women were divided into an AV group and healthy control group, and demographic and clinical characteristics were retrospectively collected by two independent investigators. Some pathogens of AV were tested using quantitative real-time polymerase chain reaction for higher accuracy. Pregnancy outcomes were also retrospectively collected. Univariable and multivariable logistic regression analysis was used to determine the risk factors of AV incidence and adverse pregnant outcomes. RESULTS: Enrolled women were divided into an AV group of 182 women and healthy control group of 503 women. The proportions of women with a history of cesarean delivery and history of vaginal infection differed between the groups (P=0.002 and <0.001, respectively). The mean gestational week at diagnosis of AV was 22.3±8.6 weeks, and the most common pathogen of AV was Escherichia coli (28.6%). After adjustment using multivariable logistic regression, a history of vaginal infection acted as an important risk factor of AV incidence, while a history of cesarean delivery, college education or above, and being employed could protect pregnant women from AV. In addition, the incidences of preterm birth, premature rupture of membranes, neonatal jaundice, and neonatal infection were much higher in the AV group than in the control group, showing significant difference (P<0.001, <0.001, =0.007, and =0.025). After adjustment using multivariable logistic regression, the incidence of AV and older age were important risk factors of premature rupture of membranes and neonatal infection. CONCLUSIONS: Compared with healthy pregnant women, the presence of AV may increase the incidence of adverse outcomes. More attention should be paid to pregnant women with a history of vaginal infection.


Asunto(s)
Complicaciones Infecciosas del Embarazo , Nacimiento Prematuro , Vaginitis , Vaginosis Bacteriana , Anciano , Femenino , Humanos , Recién Nacido , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Resultado del Embarazo , Mujeres Embarazadas , Calidad de Vida , Estudios Retrospectivos , Factores de Riesgo
10.
J Pak Med Assoc ; 71(Suppl 4)(8): S11-S15, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34469423

RESUMEN

OBJECTIVE: To conduct a community-based cross-sectional survey to determine the prevalence of human immunodeficiency virus (HIV) among pregnant women in taluka Ratodero, Larkana, and two adjacent talukas: Sajawal, district Kambar Shahdadkot and Garhi Yasin, district Shikarpur. Methods: The study was conducted among pregnant women in the three talukas of rural Sindh: Ratodero, Garhi Yasin, and Sajawal, from October 16, 2020 - December 23, 2020. A total of 1,157 pregnant women were interviewed at their homes and tested using the AlereTM HIV Combo rapid finger prick test. The study captured women's sociodemographic, economic, and health characteristics, including age, education, employment, number of children, home or hospital delivery, antenatal care use, antenatal trimester, history of blood transfusion, and HIV test result. Descriptive statistics were calculated: percentages for categorical variables and mean ± standard deviation (SD) for continuous variables. RESULTS: It was found that 0.35% (4/1,157) of women were HIV-positive, of which 3 were in Ratodero, Larkana, and 1 was in Garhi Yasin, Shikarpur. The average age of women was 28.7 ± 4.0 years. Most of the women (n=1067; 92.2%) did not attend a school, and 99.0% (n=1145) had never had a formal job. The average gestational age was 7.6 (±2.2) months. More than three-quarters of the women participating in the study (n=894; 77.3%) were not registered with a formal healthcare facility for antenatal care. CONCLUSIONS: Considering several HIV sub-epidemics in Larkana in the past decade, HIV infection among pregnant women has remained low in Larkana and adjacent districts.


Asunto(s)
Infecciones por VIH , Complicaciones Infecciosas del Embarazo , Adulto , Niño , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Humanos , Lactante , Pakistán/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Mujeres Embarazadas , Atención Prenatal , Prevalencia , Adulto Joven
11.
Saudi Med J ; 42(9): 1009-1016, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34470840

RESUMEN

OBJECTIVES: To describe the effectiveness of HIV guidelines in prevention of mother-to-child transmission (PMTCT). METHODS: A retrospective review from January 2009 to December 2018 at the King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia. The main outcome measures were characteristics of HIV-exposed patients and transmission rate. RESULTS: A total of 18 HIV-positive mothers and their 26 infants were included. The mean age of mothers at delivery was 31.69 years, and 50% were under 30 years old. All mothers received lifelong ART, except one who was not diagnosed until the 27th week of gestation. Among the mothers, 83% complied with treatment regimens, and 11% had ART resistance. Human immunodeficiency virus polymerase chain reaction (PCR) was undetectable in 19 pregnancies. Seven mothers had opportunistic infections and treatment was immediately initiated. After reviewing the infants' HIV PCR tests, the transmission rates of HIV were 0% for both spontaneous vaginal delivery and cesarean section. CONCLUSION: Many challenges face the efforts to decrease vertical HIV transmission, and a particular focus on the transitions between stages of care is needed. We believe that early screening, counseling, and regular follow-up have contributed to MTCT elimination.


Asunto(s)
Infecciones por VIH , Complicaciones Infecciosas del Embarazo , Adulto , Cesárea , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Hospitales , Humanos , Lactante , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/prevención & control , Estudios Retrospectivos , Arabia Saudita
12.
Ceska Gynekol ; 86(4): 242-245, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34493048

RESUMEN

OBJECTIVE: Description of a case of newborn death after acute caesarean section in 31st week of pregnancy because of mothers syphilitic infection. RESULTS: Fifteen-years-old primigravid woman in 31st week of pregnancy was admitted to a secondary level hospital due to a high risk of preterm labor. The pregnancy was terminated with an acute caesarean section because of pathological cardiotocograph record. The newborn died after 35 min of resuscitation. Blood samples from the umbilical cord and mothers blood taken by her gynecologist were positive for syphilis. In cooperation with a dermatologist, the treatment has been provided and reported to the National Referential Laboratory. The autopsy of the newborn had found severe pneumonia, necrotic lymphadenitis and pyocele. CONCLUSION: The dia-gnosis of congenital syphilis had been determined after the death of a preterm delivered newborn. Resuscitation had no chance to success because of syphilitic damage of the lungs.


Asunto(s)
Complicaciones Infecciosas del Embarazo , Sífilis Congénita , Sífilis , Adolescente , Causas de Muerte , Cesárea , Femenino , Humanos , Recién Nacido , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Sífilis/diagnóstico , Sífilis Congénita/diagnóstico
13.
Rev Chilena Infectol ; 38(3): 401-409, 2021 Jun.
Artículo en Español | MEDLINE | ID: mdl-34479298

RESUMEN

Half of cases of hepatitis B around the world are produced from vertical transmission; and 90% of them can evolve to chronic hepatitis and their long term complications. Postpartum immunoprophylaxis (immunoglobulin and vaccine) is the most effective preventive measure. However, despite this prophylaxis, vertical transmission is possible if the mother presents a high viral load or e-antigen. This risk can be reduced only if screening during pregnancy and treatment if needed, are incorporated. In 2019, vaccination for hepatitis B in newborn was incorporated in Chile, but not yet prenatal screening, unlike developed countries. Chile has experienced a growth in immigration from Latin America and Caribbean, some countries with high endemicity included. Prenatal screening in Chile should be promptly incorporated.


Asunto(s)
Hepatitis B , Complicaciones Infecciosas del Embarazo , Antivirales/uso terapéutico , Chile , Femenino , Hepatitis B/diagnóstico , Hepatitis B/prevención & control , Antígenos de Superficie de la Hepatitis B , Vacunas contra Hepatitis B , Virus de la Hepatitis B , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/prevención & control
14.
Viruses ; 13(9)2021 09 20.
Artículo en Inglés | MEDLINE | ID: mdl-34578458

RESUMEN

The COVID-19 pandemic has hugely impacted global public health and economy. The COVID-19 has also shown potential impacts on maternal perinatal and neonatal outcomes. This systematic review aimed to summarize the evidence from existing systematic reviews about the effects of SARS-CoV-2 infections on maternal perinatal and neonatal outcomes. We searched PubMed, MEDLINE, Embase, and Web of Science in accordance with PRISMA guidelines, from 1 December 2019 to 7 July 2021, for published review studies that included case reports, primary studies, clinical practice guidelines, overviews, case-control studies, and observational studies. Systematic reviews that reported the plausibility of mother-to-child transmission of COVID-19 (also known as vertical transmission), maternal perinatal and neonatal outcomes, and review studies that addressed the effect of SARS-CoV-2 infection during pregnancy were also included. We identified 947 citations, of which 69 studies were included for further analysis. Most (>70%) of the mother-to-child infection was likely due to environmental exposure, although a significant proportion (about 20%) was attributable to potential vertical transmission of SARS-CoV-2. Further results of the review indicated that the mode of delivery of pregnant women infected with SARS-CoV-2 could not increase or decrease the risk of infection for the newborns (outcomes), thereby emphasizing the significance of breastfeeding. The issue of maternal perinatal and neonatal outcomes with SARS-CoV-2 infection continues to worsen during the ongoing COVID-19 pandemic, increasing maternal and neonatal mortality, stillbirth, ruptured ectopic pregnancies, and maternal depression. Based on this study, we observed increasing rates of cesarean delivery from mothers with SARS-CoV-2 infection. We also found that SARS-CoV-2 could be potentially transmitted vertically during the gestation period. However, more data are needed to further investigate and follow-up, especially with reports of newborns infected with SARS-CoV-2, in order to examine a possible long-term adverse effect.


Asunto(s)
COVID-19/epidemiología , COVID-19/transmisión , COVID-19/virología , Transmisión Vertical de Enfermedad Infecciosa , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/virología , SARS-CoV-2/fisiología , COVID-19/diagnóstico , Cesárea , Femenino , Humanos , Embarazo , Resultado del Embarazo
15.
Viruses ; 13(9)2021 09 21.
Artículo en Inglés | MEDLINE | ID: mdl-34578466

RESUMEN

(1) This study aimed to evaluate characteristics, perinatal outcomes, and placental pathology of pregnant women with or without SARS-CoV-2 infection in the context of maternal PCR cycle threshold (CT) values. (2) This was a retrospective case-control study in a third-level health center in Mexico City with universal screening by RT-qPCR. The association of COVID-19 manifestations, preeclampsia, and preterm birth with maternal variables and CT values were assessed by logistic regression models and decision trees. (3) Accordingly, 828 and 298 women had a negative and positive test, respectively. Of those positive, only 2.6% of them presented mild to moderate symptoms. Clinical characteristics between both groups of women were similar. No associations between CT values were found for maternal features, such as pre-gestational BMI, age, and symptomatology. A significantly higher percentage of placental fibrinoid was seen with women with low CTs (<25; p < 0.01). Regarding perinatal outcomes, preeclampsia was found to be significantly associated with symptomatology but not with risk factors or CT values (p < 0.01, aOR = 14.72). Moreover, 88.9% of women diagnosed with COVID-19 at <35 gestational weeks and symptomatic developed preeclampsia. (4) The data support strong guidance for pregnancies with SARS-CoV-2 infection, in particular preeclampsia and placental pathology, which need further investigation.


Asunto(s)
COVID-19/epidemiología , COVID-19/virología , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/virología , SARS-CoV-2/fisiología , Adulto , Biopsia , COVID-19/diagnóstico , Femenino , Humanos , Inmunohistoquímica , Transmisión Vertical de Enfermedad Infecciosa , Placenta/patología , Placenta/virología , Reacción en Cadena de la Polimerasa , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Resultado del Embarazo , Estudios Retrospectivos , Adulto Joven
16.
Pediatr Clin North Am ; 68(5): 1055-1070, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34538298

RESUMEN

COVID-19 has afflicted the health of children and women across all age groups. Since the outbreak of the pandemic in December 2019, various epidemiologic, immunologic, clinical, and pharmaceutical studies have been conducted to understand its infectious characteristics, pathogenesis, and clinical profile. COVID-19 affects pregnant women more seriously than nonpregnant women, endangering the health of the newborn. Changes have been implemented to guidelines for antenatal care of pregnant women, delivery, and newborn care. We highlight the current trends of clinical care in pregnant women and newborns during the COVID-19 pandemic.


Asunto(s)
COVID-19/diagnóstico , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/prevención & control , Resultado del Embarazo/epidemiología , Atención Prenatal/métodos , COVID-19/transmisión , Parto Obstétrico/estadística & datos numéricos , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Embarazo
17.
Clin Med (Lond) ; 21(5): e446-e450, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34507928

RESUMEN

Pregnant women with COVID-19 are less likely to be symptomatic than non-pregnant counterparts. Risk factors for severe disease include being overweight or obese, greater than 35 years old, and having pre-existing comorbidities. Those who develop severe disease have increased rates of admission to an intensive care unit, requiring invasive ventilation and pre-term birth.Pregnant and breastfeeding women with COVID-19 should be investigated as of outside pregnancy and should receive proven therapies (such as corticosteroids and tocilizumab) on a risk/benefit basis. Admitted women should receive multidisciplinary care with input from senior decision makers and early escalation where required. There are no safety concerns -surrounding the COVID-19 vaccination and fertility or pregnancy, and so it should be offered to women based on their age and clinical risk group, in line with non-pregnant women.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , Adulto , Vacunas contra la COVID-19 , Femenino , Humanos , Embarazo , Factores de Riesgo , SARS-CoV-2
18.
BMC Pediatr ; 21(1): 400, 2021 09 13.
Artículo en Inglés | MEDLINE | ID: mdl-34517872

RESUMEN

OBJECTIVE: We report here on the management and outcomes of neonates born to mothers with active perinatal SARS-CoV-2 infection. STUDY DESIGN: In this prospective study, eligible neonates were enrolled in a database to track in-hospital outcomes and followed up outpatient periodically till 2 months of age to assess for late onset symptoms of infection. RESULTS: From April 2020 to February 2021, 67 mothers with perinatal SARS-CoV-2 infection and 70 at-risk neonates were included. Two neonates (3%) tested positive for SARS-CoV-2 within 48 h of life but remained asymptomatic during hospitalization and at all follow-up periods. Three infants were reported to have a febrile illness in 2 months follow up period, none of which was attributable to SARS-CoV-2. CONCLUSION: Our data supports the emerging evidence which describes a probable low risk of vertical transmission of SARS-CoV-2. We also demonstrate a low risk of post-natal transmission or late-onset symptomatic infection with SARS-CoV-2.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , Femenino , Humanos , Recién Nacido , Madres , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Estudios Prospectivos , SARS-CoV-2
20.
Rev Bras Ginecol Obstet ; 43(8): 595-599, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34547793

RESUMEN

OBJECTIVE: To describe the hematological changes, the platelet indices in particular, in pregnant women with coronavirus disease 2019 (COVID-19) compared to healthy pregnant women. METHODS: A retrospective case-control study conducted at the Al Yarmouk Teaching Hospital, in Baghdad, Iraq, involving 100 pregnant women, 50 with positive viral DNA for COVID-19 (case group), and 50 with negative results (control group); both groups were subjected to a thorough hematological evaluation. RESULTS: Among the main hematological variables analyzed, the platelet indices, namely the mean platelet volume (MPV) and the platelet distribution width (PDW), showed statistically significant differences (MPV: 10.87 ± 66.92 fL for the case group versus 9.84 ± 1.2 fL for the control group; PDW: 14.82 ± 3.18 fL for the case group versus 13.3 ± 2.16 fL for the controls). The criterion value of the receiver operating characteristic (ROC) curve for PDW at a cutoff point of > 11.8 fL showed a weak diagnostic marker, while the MPV at a cutoff value of > 10.17 fL showed a good diagnostic marker. CONCLUSION: The MPV and PDW are significantly affected by the this viral infection, even in asymptomatic confirmed cases, and we recommend that both parameters be included in the diagnostic panel of this infection.


Asunto(s)
Plaquetas/virología , COVID-19/sangre , Complicaciones Infecciosas del Embarazo/sangre , Adulto , Enfermedades Asintomáticas , Biomarcadores/sangre , Plaquetas/fisiología , COVID-19/diagnóstico , Prueba de COVID-19 , Estudios de Casos y Controles , Femenino , Humanos , Volúmen Plaquetario Medio , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Estudios Retrospectivos
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