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1.
J Nepal Health Res Counc ; 19(1): 203-205, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33934161

RESUMEN

Coronavirus disease 2019 (COVID-19) pandemic will continue affecting pregnant women with possibility of vertical transmissions. However, knowledge and evidences regarding vertical transmission of COVID-19 are just emerging. This information is very crucial in the obstetrical care of COVID-19 infected women as well as in the care of newborn born to COVID-19 positive mothers. We report a case of vertical transmission in a neonate born to asymptomatic COVID-19 infected mother. Newborn was immediately shifted to isolation nursery and formula feed was started. The nasopharyngeal swab of newborn taken at 42 hours of life tested positive for SARS-CoV-2 by RT-PCR. Therefore the vertical transmission in COVID-19 is possible. Despite this, the neonatal outcome is good. Keywords: Duodenal atresia; flip flop circulation; neonates; persistent pulmonary hypertension of newborn.


Asunto(s)
/transmisión , Transmisión Vertical de Enfermedad Infecciosa , Adulto , Femenino , Humanos , Recién Nacido , Masculino , Nepal , Embarazo
2.
Medicine (Baltimore) ; 100(17): e25695, 2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-33907147

RESUMEN

RATIONALE: The chikungunya virus (CHIKV) was first isolated in a Tanzanian epidemic area between 1952 and 1953. The best description of the CHIKV transmission during pregnancy can be found in a well-documented epidemic in 2005, in the "La Reunion" island, a French territory located in the Indian Ocean, in which about one-third of the population was infected. Reports of arbovirus infections in pregnancy are increasing over time, but the spectrum of clinical findings remains an incognita among researchers, including CHIKV. PATIENT CONCERNS: In this report, it was possible to verify 2 cases exposed to CHIKV during foetal period and the possible implications of the infection on gestational structures and exposed children after the birth. DIAGNOSIS: In both cases, the mothers were positive by laboratory tests in serologic analysis for CHIKV, as ezyme-linked immunossorbent assay (ELISA), plaque reduction neutralisation testing (PRNT) and immunofluorescence (IF); but there were no positive tests in quantitative polymerase chain reaction (qPCR) for mothers or children. INTERVENTIONS: The exposed children were followed up in a paediatrics clinic in order not only to provide the medical assistance, but also to verify child development and the possible implications and neurocognitive changes caused by gestational infection. OUTCOMES: There were neurological and developmental changes in one of the children followed up on an outpatient basis. There was an improvement in the neurological situation and symptoms only 3 years and 1 month after birth. LESSONS: Based on the cases presented, we can conclude that clinical symptoms of CHIKV maternal infection may occur late in new-borns and can affect their development.


Asunto(s)
Fiebre Chikungunya , Virus Chikungunya , Complicaciones Infecciosas del Embarazo , Efectos Tardíos de la Exposición Prenatal , Trastornos Psicomotores , Tiempo , Anticuerpos Antivirales/sangre , Fiebre Chikungunya/diagnóstico , Fiebre Chikungunya/inmunología , Fiebre Chikungunya/transmisión , Virus Chikungunya/inmunología , Virus Chikungunya/aislamiento & purificación , Desarrollo Infantil , Preescolar , Continuidad de la Atención al Paciente , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Pruebas de Estado Mental y Demencia , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/inmunología , Efectos Tardíos de la Exposición Prenatal/diagnóstico , Efectos Tardíos de la Exposición Prenatal/fisiopatología , Trastornos Psicomotores/diagnóstico , Trastornos Psicomotores/etiología , Pruebas Serológicas/métodos
3.
West Afr J Med ; 38(4): 307-312, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33900708

RESUMEN

Introduction: Human Immunodeficiency Virus (HIV) infects multiple tissues of the body, including the renal parenchyma, with HIV-associated Nephropathy (HIVAN) being the most common form of the HIV-related renal disease and an important cause of End Stage Renal Disease (ESRD) in HIV infected patients. There is paucity of studies on HIVAN among children with renal diseases, most studies on HIVAN focused on prevalence among HIV patients with vertical transmission being the commonest route. We undertook this study to determine the prevalence and impact of HIVAN among our renal patients and to highlight the new route of HIV transmission observed in these group of patients in Port Harcourt, Southern Nigeria. Materials and Methods: The study was conducted among renal patients managed in the Paediatric department of the University of Port Harcourt Teaching Hospital from December 2016 to March 2019. The information on the HIVAN patients were stored and retrieved from the renal register where all cases of renal diseases were enrolled. The diagnosis of HIVAN was made based on presence of significant proteinuria (≥ 1+), with one or more of the following: abnormal microscopic examination of urinary sediments, rising serum creatinine, renal ultrasound finding of enlarged echogenic kidneys and histology finding of focal segmental glomerulosclerosis. The patient's sociodemographic data, clinical presentation, route of transmission of HIV, laboratory investigations, treatment, and clinical outcome were obtained and analysed using SPSS version 25.0. Results: There were 112 cases of renal diseases seen during the study period of which 10 (8.9%) had HIVAN. The HIVAN patients were aged between 4-17years. Four (40%) of these HIVAN cases had CKD of which 2 (20%) had ESRD. The route of transmission of HIV was vertical (mother-to-child) in 8 patients and via sexual route in two older male patients aged 17years who were homosexuals. Mortality rate among the HIVAN patients was 30%, with 2 (20%) lost to follow up. Conclusion: There is a rising prevalence of HIVAN among paediatric patients with renal diseases in our environment, with homosexuality being a new route of HIV transmission observed in the older patients.


Asunto(s)
Nefropatía Asociada a SIDA , Infecciones por VIH , Nefropatía Asociada a SIDA/epidemiología , Adolescente , Niño , Preescolar , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Humanos , Transmisión Vertical de Enfermedad Infecciosa , Masculino , Nigeria/epidemiología , Proteinuria
4.
Medicine (Baltimore) ; 100(15): e25403, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847637

RESUMEN

ABSTRACT: Brain atrophy has been observed in perinatally HIV-infected patients (PHIV) despite initiation on combined antiretroviral treatment (cART), but neuroimaging studies are limited. We aimed to evaluate cortical thickness (CT) and subcortical gray matter (GM) volumes of PHIV youths with stable immunovirological situation and with a normal daily performance.A prospective cross-sectional study was conducted. A total of 25 PHIV patients on cART and 25 HIV-negative (HIV-) controls matched by age, sex, level of education, and socioeconomic status underwent a magnetic resonance imaging scan. CAT12 toolbox was used to extract CT values from T1w images using parcellations from Desikan-Killiany atlas (DK40). To measure regional brain volumes, native segmented images were parceled in regions of interest according to the Neuromorphometrics Atlas. Neuropsychological assessment and psychopathological symptoms were documented.Fifty participants were included (60% females, median age 20 years [interquartile range, IQR 19-23], 64% Whites). No differences regarding neuropsychological tests or psychopathological symptoms were found between groups (all P > .05). All participants presented an average performance in the Fluid Intelligence (FI) test (PHIV mean: -0.12, HIV- mean: 0.24), When comparing CT, PHIV-infected patients showed thinner cortices compared with their peers in fusiform gyrus (P = .000, P = .009), lateral-orbitofrontal gyrus (P = .006, P = .0024), and right parsobitalis gyrus (P = .047). Regarding subcortical GM volumes, PHIV patients showed lower right amygdala (P = .014) and left putamen (P = .016) volumes when compared with HIV- controls. Within the PHIV group, higher CD4 count was associated with higher volumes in right putamen (B = 0.00000038, P = .045). Moreover, increased age at cART initiation and lower nadir CD4 count was associated with larger volumes in left accumbens (B = 0.0000046, P = .033; B = -0.00000008, P = .045, respectively).PHIV patients showed thinner cortices of areas in temporal, orbito-frontal and occipital lobes and lower volumes of subcortical GM volumes when compared with the HIV- control group, suggesting cortical and subcortical brain alterations in otherwise neuroasymptomatic patients. Nevertheless, larger and longitudinal studies are required to determine the impact of HIV on brain structure in PHIV patients and to further identify risk and protective factors that could be implicated.


Asunto(s)
Sustancia Gris/patología , Infecciones por VIH/fisiopatología , Infecciones por VIH/transmisión , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Factores de Edad , Antirretrovirales/uso terapéutico , Atrofia , Ganglios Basales/diagnóstico por imagen , Ganglios Basales/patología , Recuento de Linfocito CD4 , Estudios Transversales , Femenino , Sustancia Gris/diagnóstico por imagen , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Humanos , Imagen por Resonancia Magnética , Masculino , Estudios Prospectivos , Factores Socioeconómicos , Adulto Joven
5.
J Med Case Rep ; 15(1): 213, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33892788

RESUMEN

BACKGROUND: Vertical transmission of coronavirus disease 2019 (COVID-19) from mother to newborn infant is doubtful, and very little is known about disease severity and neonatal outcome. CASE PRESENTATION: We present a preterm Iranian infant born to a Persian mother with severe COVID-19 pneumonia. The mother underwent cesarean delivery, and amniotic fluid yielded a positive result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by real-time reverse transcription polymerase chain reaction (RT-PCR). The newborn infant showed early-onset infection with SARS-CoV-2 confirmed on pharyngeal swabs by RT-PCR assay within 24 hours after birth, suggesting vertical transmission. Unfortunately, the mother died 14 days after delivery. We describe the clinical course and outcome of the infant up to 7 months of age. CONCLUSION: COVID-19 infection in pregnant women may increase maternal morbidity, mortality and possibly vertical transmission in severe cases. However, it does not seem to progress to serious early or late neonatal complications.


Asunto(s)
/diagnóstico , Transmisión Vertical de Enfermedad Infecciosa , Complicaciones Infecciosas del Embarazo/diagnóstico , Nacimiento Prematuro , Líquido Amniótico/virología , Cesárea , Resultado Fatal , Femenino , Humanos , Recién Nacido , Recien Nacido Prematuro , Irán , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Resultado del Embarazo , Resucitación , Adulto Joven
6.
Medicina (B Aires) ; 81(2): 257-268, 2021.
Artículo en Español | MEDLINE | ID: mdl-33906145

RESUMEN

Mother-to-child transmission in Toxoplasma gondii infection occurs only when the infection is acquired for the first time during pregnancy. Diagnosis of maternal infection and the newborn is achieved by a combination of serological tests, clinical features and ultrasound images. An early diagnosis of maternal infection allows treatment that offers a reduction both in transmission rate and risk of congenital damage. The aim of this expert consensus was to review the scientific literature which would enable an update of the clinical practice guideline of prevention, diagnosis and treatment of congenital toxoplasmosis in our country.


Asunto(s)
Complicaciones Parasitarias del Embarazo , Toxoplasma , Toxoplasmosis Congénita , Toxoplasmosis , Niño , Consenso , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Anamnesis , Embarazo , Toxoplasmosis Congénita/diagnóstico , Toxoplasmosis Congénita/tratamiento farmacológico , Toxoplasmosis Congénita/prevención & control
7.
BMC Pregnancy Childbirth ; 21(1): 326, 2021 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-33902483

RESUMEN

BACKGROUND: Knowledge about SARS-CoV-2 infection in pregnancy and newborns is scarce. The objective of this study is to analyse clinical and epidemiological characteristics of a cohort of women infected with SARS-CoV-2 during pregnancy and their newborns exposed to SARS-CoV-2 during gestation. METHODS: Multicentric observational study of Spanish hospitals from the GESNEO-COVD cohort, participants in RECLIP (Spanish Network of Paediatric Clinical Assays). Women with confirmed SARS-CoV-2 infection by PCR and/or serology during pregnancy, diagnosed and delivering during the period 15/03/2020-31/07/2020 were included. Epidemiological, clinical, and analytical data was collected. RESULTS: A total of 105 pregnant women with a median of 34.1 years old (IQR: 28.8-37.1) and 107 newborns were included. Globally, almost 65% of pregnant women had some COVID-19 symptoms and more than 43% were treated for SARS-COV-2. Overall, 30.8% of pregnant women had pneumonia and 5 (4.8%) women were admitted to the intensive care unit needing invasive mechanical ventilation. There was a rate of 36.2% of caesarean sections, which was associated with pneumonia during pregnancy (OR: 4.203, CI 95%: 1.473-11.995) and lower gestational age at delivery (OR: 0.724, CI 95%: 0.578-0.906). The prevalence of preterm birth was 20.6% and prematurity was associated with pneumonia during gestation (OR: 6.970, CI95%: 2.340-22.750) and having a positive SARS-CoV-2 PCR at delivery (OR: 6.520, CI95%: 1.840-31.790). All nasopharyngeal PCR in newborns were negative at birth and one positivized at 15 days of life. Two newborns died, one due to causes related to prematurity and another of unexpected sudden death during early skin-to-skin contact after delivery. CONCLUSIONS: Although vertical transmission has not been reported in this cohort, the prognosis of newborns could be worsened by SARS-CoV-2 infection during pregnancy as COVID-19 pneumonia increased the risk of caesarean section deliveries and preterm births.


Asunto(s)
/epidemiología , Portador Sano/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Nacimiento Prematuro/epidemiología , Adulto , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , /fisiopatología , Cesárea/estadística & datos numéricos , Estudios de Cohortes , Comorbilidad , Tos/fisiopatología , Diabetes Gestacional/epidemiología , Disnea/fisiopatología , Femenino , Fiebre/fisiopatología , Edad Gestacional , Humanos , Hipertensión/epidemiología , Hipotiroidismo/epidemiología , Factores Inmunológicos/uso terapéutico , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Unidades de Cuidados Intensivos/estadística & datos numéricos , Pulmón/diagnóstico por imagen , Masculino , Obesidad Materna/epidemiología , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Embarazo , Complicaciones del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/fisiopatología , Complicaciones Infecciosas del Embarazo/terapia , Segundo Trimestre del Embarazo , Tercer Trimestre del Embarazo , Radiografía Torácica , Respiración Artificial , Factores de Riesgo , Índice de Severidad de la Enfermedad , España/epidemiología
8.
Pan Afr Med J ; 38: 54, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33854683

RESUMEN

Introduction: option B+ ART is a lifelong regimen of ART using a combination of 3 ARVs and adherence to this regimen can reduce risk of MTCT to 1-2% as against 15-40% without treatment. To achieve an undetectable viral load and prevent the development of drug resistance, a person on ARV drugs need to take at least 95% of prescribed doses on time. This study assessed the level of adherence to Option B+ PMTCT program and its predictors among HIV+ Pregnant women accessing antenatal care in health facilities Abuja. Methods: we enrolled 284 HIV positive pregnant women and lactating mothers in a hospital-based cross-sectional study. We sampled respondents using two-staged sampling technique. We collected data on socio-demographic characteristics, level of adherence, patients and healthcare related factors affecting adherence, knowledge of clients on HIV, ART and MTCT. Focused group discussion guide, data abstraction form and key informant interview guide were used for PMTCT focal persons. We conducted bivariate analysis and logistic regression using Epi-Info version 7 at 5% level of significance. Results: the mean age of respondents was 30.12 years (SD±4.86) with mean knowledge score of 16.7 and 75.5%% of them had good knowledge. The level of good adherence was 83.3%. Independent factors associated with non-adherence to ART included: Forgetfulness (OR 20.02; 95% CI 6.42-62.48), having side effects (OR 39.6; 95% C.I: 4.46-352.32), lack of food (OR 34.76; 95% C.I: 2.37-509.33), disclosure of HIV status (OR 2.51; 95% CI 1.22-5.15), being too busy (OR 13.96; 95% CI 3.89-49.98). Encountering challenge in ART initiation (OR 2.05; 95% CI 1.01-4.72) and level of Knowledge (OR 2.12; 95% CI 1.06-5.42). Conclusion: the level of adherence would improve study if the Public health department of Federal Ministry of Health (FMOH), Federal Capital Development Authority (FCDA) and National Agency for the Control of AIDS (NACA) sponsors public enlightenment on HIV/AIDS through the media which may help reduce stigma and encourage voluntary HIV status disclosure. Reminders should be used by patients to help them overcome forgetfulness.


Asunto(s)
Fármacos Anti-VIH/administración & dosificación , Infecciones por VIH/prevención & control , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Cumplimiento de la Medicación , Adolescente , Adulto , Estudios Transversales , Femenino , Infecciones por VIH/tratamiento farmacológico , Conocimientos, Actitudes y Práctica en Salud , Humanos , Lactancia , Persona de Mediana Edad , Nigeria , Embarazo , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Complicaciones Infecciosas del Embarazo/virología , Estigma Social , Revelación de la Verdad , Carga Viral , Adulto Joven
9.
Viruses ; 13(3)2021 03 10.
Artículo en Inglés | MEDLINE | ID: mdl-33801923

RESUMEN

The effects of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in women on the gestation course and the health of the fetus, particularly in the first and second trimesters, remain very poorly explored. This report describes a case in which the normal development of pregnancy was complicated immediately after the patient had experienced Coronavirus disease 2019 (COVID-19) at the 21st week of gestation. Specific conditions included critical blood flow in the fetal umbilical artery, fetal growth restriction (1st percentile), right ventricular hypertrophy, hydropericardium, echo-characteristics of hypoxic-ischemic brain injury (leukomalacia in periventricular area) and intraventricular hemorrhage at the 25th week of gestation. Premature male neonate delivered at the 26th week of gestation died after 1 day 18 h due to asystole. The results of independent polymerase chain reaction (PCR), mass spectrometry and immunohistochemistry analyses of placenta tissue, umbilical cord blood and child blood jointly indicated vertical transmission of SARS-CoV-2 from mother to the fetus, which we conclude to be the major cause for the development of maternal vascular malperfusion in the studied case.


Asunto(s)
/transmisión , Retardo del Crecimiento Fetal/virología , Complicaciones Infecciosas del Embarazo/virología , /fisiología , Adulto , /patología , Resultado Fatal , Femenino , Retardo del Crecimiento Fetal/mortalidad , Retardo del Crecimiento Fetal/patología , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/mortalidad , Complicaciones Infecciosas del Embarazo/patología , Segundo Trimestre del Embarazo , /genética
10.
Front Immunol ; 12: 661806, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33897707

RESUMEN

Breastfeeding not only provides the optimum source of nutrients for the neonate and its first strong shield against infection but also lays the foundation for somatic and psychological bonding between the mother and child. During the current COVID-19 pandemic, although the guidelines of the relevant international and national agencies recommend breastfeeding by SARS-CoV-2-infected mothers, considerable insecurity persists in daily clinical practice regarding the safety of the infants and the perceived advantages and disadvantages of discontinuation of breastfeeding. This is a systematic review of the currently available information regarding the transmissibility of SARS-CoV-2 through or while breastfeeding and the protection against infection that breast milk might provide. The accumulated body of knowledge regarding the role of breast milk in the development of the neonatal immune system and protection against infection by other respiratory viruses is discussed, with a focus on the anti-inflammatory role of the antibodies, microbes, and viruses provided to the infant in breast milk and its relevance to the case of SARS-CoV-2.


Asunto(s)
Anticuerpos Antivirales/inmunología , Lactancia Materna , Transmisión Vertical de Enfermedad Infecciosa , Leche Humana/inmunología , Complicaciones Infecciosas del Embarazo/inmunología , /inmunología , /patología , Femenino , Humanos , Recién Nacido , Embarazo , Complicaciones Infecciosas del Embarazo/patología
11.
Artículo en Inglés | MEDLINE | ID: mdl-33923642

RESUMEN

The new coronavirus emergency spread to Italy when little was known about the infection's impact on mothers and newborns. This study aims to describe the extent to which clinical practice has protected childbirth physiology and preserved the mother-child bond during the first wave of the pandemic in Italy. A national population-based prospective cohort study was performed enrolling women with confirmed SARS-CoV-2 infection admitted for childbirth to any Italian hospital from 25 February to 31 July 2020. All cases were prospectively notified, and information on peripartum care (mother-newborn separation, skin-to-skin contact, breastfeeding, and rooming-in) and maternal and perinatal outcomes were collected in a structured form and entered in a web-based secure system. The paper describes a cohort of 525 SARS-CoV-2 positive women who gave birth. At hospital admission, 44.8% of the cohort was asymptomatic. At delivery, 51.9% of the mothers had a birth support person in the delivery room; the average caesarean section rate of 33.7% remained stable compared to the national figure. On average, 39.0% of mothers were separated from their newborns at birth, 26.6% practised skin-to-skin, 72.1% roomed in with their babies, and 79.6% of the infants received their mother's milk. The infants separated and not separated from their SARS-CoV-2 positive mothers both had good outcomes. At the beginning of the pandemic, childbirth raised awareness and concern due to limited available evidence and led to "better safe than sorry" care choices. An improvement of the peripartum care indicators was observed over time.


Asunto(s)
Complicaciones Infecciosas del Embarazo , Cesárea , Niño , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Italia/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Estudios Prospectivos
13.
Artículo en Inglés | MEDLINE | ID: mdl-33802696

RESUMEN

There is growing literature about the SARS-CoV-2 pathogenetic effects exerted during pregnancy and whether vertical transmission or premature birth is possible. It is not well known whether changes in the immune system of pregnant women may lead to a marked susceptibility to infectious processes and the risk of adverse maternal and neonatal complications such as preterm birth, spontaneous abortion, hospitalization in an intensive care unit, transmission to the fetus or newborns, and fetal mortality are poorly understood. Along with this ongoing debate, it is not well defined whether, during pregnancy, the role of host susceptibility in producing a specific inflammatory response to SARS-CoV-2 may represent distinctive markers of risk of vertical transmission. Furthermore, SARS-CoV-2 impact on the vaginal microbiome has not yet been described, despite mounting evidence on its possible effect on the gastrointestinal microbiome and its influence on infectious diseases and preterm labor. This report describes the impact of SARS-CoV-2 on a twin pregnancy diagnosed with infection at the third trimester of gestation including tissue infections, inflammatory response, antibody production, cytokine concentration, and vaginal microbiome composition. We identified a pattern of cytokines including IL1-Ra, IL-9 G-CSF, IL-12, and IL-8 differently expressed, already associated with previously infected patients. We detected a similar concentration of almost all the cytokines tested in both twins, suggesting that the SARS-CoV-2-induced cytokine storm is not substantially impaired during the placental passage. The analysis of the vaginal microbiome did not show relevant signs of dysbiosis, similar to other healthy pregnant women and twin healthy pregnancies. The aim of this report was to analyze the immunological response against SARS-CoV-2 infection and virus tissue tropism in a twin pregnancy.


Asunto(s)
Complicaciones Infecciosas del Embarazo , Nacimiento Prematuro , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Embarazo , Resultado del Embarazo , Embarazo Gemelar
15.
Pediatr Infect Dis J ; 40(5): 473-478, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33847297

RESUMEN

Limited data are available about the outcomes of coronavirus disease 2019 (COVID-19) during pregnancy and risk of vertical transmission in exposed neonates. We reviewed studies published February 1, 2020, through August 15, 2020, on outcomes in pregnant women with COVID-19 and neonates with perinatal exposure. Among pregnant women with COVID-19, 181 (11%) required intensive care unit admission and 123 (8%) required mechanical ventilation. There were 22 maternal deaths. Most infections occurred in the third trimester. Among women who delivered, 28% had a preterm birth, and 57% had a Caesarean section. Sixty-one (4%) of 1222 neonates with reported testing had at least 1 positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test. The most common symptom among neonates was respiratory distress (n = 126; 21%). There were 14 neonatal deaths, one of which occurred in a neonate with positive testing. Further study of COVID-19 in pregnant women and neonates, including standardized reporting of outcomes, testing and treatment protocols, is essential to optimize maternal and neonatal care.


Asunto(s)
/diagnóstico , Transmisión Vertical de Enfermedad Infecciosa , Complicaciones Infecciosas del Embarazo/virología , /fisiología , /virología , Cesárea , Femenino , Hospitalización , Humanos , Recién Nacido , Embarazo , Resultado del Embarazo , Mujeres Embarazadas , Nacimiento Prematuro
16.
Cad Saude Publica ; 37(3): e00069820, 2021.
Artículo en Portugués | MEDLINE | ID: mdl-33852661

RESUMEN

Vertical HIV transmission is still an important global public health problem. This study aimed to verify vertical HIV transmission in Rio Branco, Acre, Brazil, and to assess the possibility of its elimination. A cross-sectional study was conducted of HIV in pregnant women and a longitudinal study on the incidence of vertical HIV transmission in pregnant women living in the municipality (county) of Rio Branco in 2007-2015. The cohorts of pregnant women consisted of women who had liveborn children, stillbirths, or abortions. The data were obtained from the Brazilian Information System for Notificable Diseases (SINAN), Brazilian Information System on Live Births (SINASC), Brazilian Mortality Information System (SIM), and Brazilian Hospital Information Systems (SIH). Databases. Probabilistic database linkage was performed with the OpenRecLink software. The authors calculated the HIV prevalence rate in pregnant women, the vertical transmission rate, and the principal associated factors. HIV prevalence in pregnant women showed an upward trend, and the mean prevalence was 0.18%. Variables statistically associated with the occurrence of HIV in pregnant women were maternal age ≥ 20 years (p = 0.007), lower schooling (p = 0.054), and unmarried conjugal status/without partner (p = 0.001). Vertical HIV transmission was 6.9%. Use of antiretroviral therapy (ART) during prenatal care, even among pregnant women that already knew they were HIV-positive, was less than 90%. The elective cesarean rate was less than 60%, and the use of ART during delivery and by the newborn in the first 24 hours showed variations, depending on the period in which the maternal diagnosis was made. Although the strategies for the elimination of vertical HIV transmission are well established, this study's results point to important flaws in the cascade of care for HIV-infected pregnant women in Rio Branco.


Asunto(s)
Infecciones por VIH , Complicaciones Infecciosas del Embarazo , Adulto , Brasil/epidemiología , Niño , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Estudios Longitudinales , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Adulto Joven
17.
Rev Bras Ginecol Obstet ; 43(3): 207-215, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33860504

RESUMEN

OBJECTIVE: The evaluation of the available evidence on vertical transmission by severe acute respiratory syndrome coronavirus 2 (SARS-CoV)-2. DATA SOURCES: An electronic search was performed on June 13, 2020 on the Embase, PubMed and Scopus databases using the following search terms: (Coronavirus OR COVID-19 OR COVID19 OR SARS-CoV-2 OR SARS-CoV2 OR SARSCoV2) AND (vertical OR pregnancy OR fetal). SELECTION OF STUDIES: The electronic search resulted in a total of 2,073 records. Titles and abstracts were reviewed by two authors (WPM, IDESB), who checked for duplicates using the pre-established criteria for screening (studies published in English without limitation regarding the date or the status of the publication). DATA COLLECTION: Data extraction was performed in a standardized way, and the final eligibility was assessed by reading the full text of the articles. We retrieved data regarding the delivery of the potential cases of vertical transmission, as well as the main findings and conclusions of systematic reviews. DATA SYNTHESIS: The 2,073 records were reviewed; 1,000 duplicates and 896 clearly not eligible records were excluded. We evaluated the full text of 177 records, and identified only 9 suspected cases of possible vertical transmission. The only case with sufficient evidence of vertical transmission was reported in France. CONCLUSION: The risk of vertical transmission by SARS-CoV-2 is probably very low. Despite several thousands of affected pregnant women, we have identified only one case that has fulfilled sufficient criteria to be confirmed as a case of vertical transmission. Well-designed observational studies evaluating large samples are still necessary to determine the risk of vertical transmission depending on the gestational age at infection.


Asunto(s)
/transmisión , Transmisión Vertical de Enfermedad Infecciosa , Complicaciones Infecciosas del Embarazo , Femenino , Humanos , Recién Nacido , Embarazo , Riesgo
18.
Curr Med Sci ; 41(2): 306-311, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33877546

RESUMEN

This retrospective study aimed to investigate the clinical characteristics and neonatal outcomes of pregnant women with SARS-COV-2 in Wuhan Children's Hospital and further suggested a possible management strategy for infected pregnant women under epidemic situation. In this study, 8 pregnant women with SARS-COV-2 who were admitted into Wuhan Children's Hospital, China from February 1, 2020 to March 30, 2020 and the clinical features, laboratory data, maternal and neonatal outcomes were analyzed. The mean age of the women at the time of admission was 30.6 years. The mean gestational age of the women was 37 weeks+4 days, and one woman presented with dichorionic diamniotic (DCDA) twin pregnancy. Except for one woman who was febrile, others had no typical clinical symptoms. For all pregnant women, the count of white blood cells and lymphocytes appeared normal, but 6 had a lower percentage of lymphocytes. C-reactive protein (CRP) levels were normal for all the women. One neonate was tested positive for the coronavirus IgG and IgM antibodies. The clinical symptoms of the pregnant women with SARS-COV-2 were mild, and the laboratory data showed similar characteristics to those of non-infected pregnant women. Since one neonate was tested positive for coronavirus, there is a possibility of vertical transmission of SARS-CoV-2. Prompt and efficient screening, triage, and isolation of pregnant women are effective management strategies to reduce nosocomial infection during the SARS-COV-2 epidemic.


Asunto(s)
/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , /patogenicidad , Adulto , /fisiopatología , China/epidemiología , Femenino , Humanos , Inmunoglobulina M/sangre , Lactante , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Complicaciones Infecciosas del Embarazo/fisiopatología , Complicaciones Infecciosas del Embarazo/virología , Mujeres Embarazadas , Estudios Retrospectivos
19.
Artículo en Inglés | MEDLINE | ID: mdl-33803114

RESUMEN

Despite the goal of eliminating new human immunodeficiency virus (HIV) infections in children, mother-to-child transmission is still common in resource-poor countries. The aims of this study were to assess the occurrence of mother-to-child transmission of HIV (MTCT) by age 18 months, risk factors for transmission, and the implementation of the national prevention of MTCT (PMTCT) program in a rural hospital in Tanzania. Data were collated from various medical registers and records. We included 172 children and 167 HIV-infected mothers. Among 88 children (51%) with adequate information, 9 (10.2%) were infected. Increased risk of MTCT was associated with late testing of the child (>2 months) [OR = 9.5 (95% CI: 1.8-49.4)], absence of antiretroviral therapy during pregnancy [OR = 9.7 (95% CI: 2.1-46.1)], and maternal CD4 cell count <200 cells/mm3 [OR = 15.3 (95% CI: 2.1-111)]. We were unable to determine the occurrence of MTCT transmission in 84 children (49%). The results from this study highlight that there is an urgent need for enhanced efforts to improve follow-up of HIV-exposed children, to improve documentation in registries and records, and to facilitate ease of linkage between these.


Asunto(s)
Infecciones por VIH , Complicaciones Infecciosas del Embarazo , Adolescente , Niño , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Hospitales Rurales , Humanos , Lactante , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Estudios Retrospectivos , Tanzanía/epidemiología
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