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3.
Rev. enferm. UERJ ; 28: e36283, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1103400

RESUMO

Objetivo: analisar a influência das composições familiares na ocorrência da gravidez na adolescência. Método:estudo caso-controle, realizado com 74 gestantes adolescentes, grupo de casos, e 74 adultas jovens sem história pregressa de gravidez na adolescência, grupo controle, pareadas pela variável renda familiar. Os dados foram coletados por meio de entrevistas estruturadas realizadas no período deagosto a outubro de 2016 em Cuiabá, Mato Grosso, e em seguida analisados pelos métodos estatísticos descritivo e inferencial. Resultados: identificou-se associação entre a ocorrência do desfecho com pertencer a famílias não nucleares, não permanecer a mesma família durante a infância e adolescência, e a constituição de uma família própria no período da adolescência. Conclusão:verificou-se que adolescentes inseridas em famílias não nucleares estão mais expostas a fatores de risco para ocorrência da gravidez na adolescência, quando comparadas às jovensprovenientes de famílias com ambos os pais.


Objective: to analyze the influence of family compositions in the occurrence of pregnancy in adolescence. Method:this is a case-control study performed with 74 pregnant adolescents, group of cases, and 74 young adults without background history of pregnancy during adolescence, group control, paired by family income. Data were collected through structured interviews conducted in the period from August to October 2016 in Cuiabá, Mato Grosso, and then analyzed by descriptive and inferential statistical methods. Results:we identified an association between the occurrence of the outcome and the belonging to non-nuclear families, as well as the non-belonging to the same family during childhood and adolescence, besides the constitution of an own family in the period of adolescence. Conclusion: checked that adolescents inserted in nonnuclear families are more exposed to risk factors for the occurrence of pregnancy in adolescence when compared to young people coming from families with both parents.


Objetivo: analizar la influencia de las composiciones familiares en la ocurrencia del embarazo adolescente. Método: estudio caso-control efectuado con 74 adolescentes embarazadas, grupo de casos, y 74 jóvenes adultas sin historia anterior de embarazo en la adolescencia, grupo de control, agrupadas por sus ingresos familiares. Los datos se recopilaron mediante entrevistas estructuradas conducidas en el periodo de agosto a octubre de 2016 en Cuiabá, Mato Grosso, y posteriormente analizados por los métodos estadísticos descriptivo e inferencial. Resultados:se identificó una asociación entre la ocurrencia del desenlace y la pertenencia a las familias no nucleares, no permanencia en la misma familia durante niñez y adolescencia, y la constitución de una familia propia en el periodo de la adolescencia. Conclusion: comprobado eso que las adolescentes insertadas en familias no nucleares están más expuestas a los factores de riesgo para la ocurrencia del embarazo adolescente en comparación con las jóvenes provenientes de familias con ambos padres biológicos.


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto Jovem , Gravidez na Adolescência/psicologia , Características da Família , Fatores de Risco , Comportamento do Adolescente/psicologia , Relações Familiares/psicologia , Brasil/epidemiologia , Núcleo Familiar/psicologia , Estudos de Casos e Controles , Relações Pai-Filho , Relações Mãe-Filho
4.
Rev. bioét. derecho ; (50): 167-188, nov. 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-191352

RESUMO

La llegada de la pandemia por coronavirus SARS-CoV-2 (la enfermedad de la COVID-19) a España también ha repercutido en el acceso parental a las Unidades de Cuidados Intensivos Neonatales (UCIN). Al comienzo de la pandemia se tomaron las medidas que, fundamentadas en criterios de salud pública, se consideraron necesarias. A medida que avanzaba el conocimiento científico sobre la COVID-19, y en base a los nuevos datos obtenidos, se comenzaron a adaptar las medidas inicialmente establecidas. Sin embargo, creemos que la adaptación de alguno de estos protocolos, en concreto el del acceso parental a las UCIN, no ha sido la idónea desde el punto de vista bioético y del interés superior del menor. A lo largo de este artículo exponemos esas insuficiencias


The arrival of the SARS-CoV-2 coronavirus pandemic (COVID-19 disease) in Spain has also had an impact on parental access to Neonatal Intensive Care Units (NICU). At the beginning of the pandemic, measures were taken that, based on public health criteria, and were considered necessary. As scientific knowledge about COVID-19 advanced, and based on the new data obtained, the measures initially established began to be adapted. However, we believe that the adaptation of some of these protocols, specifically that of parental access to NICU, has not been the ideal one from the bioethical point of view and in the best interest of the minor. Throughout this article we expose these insufficiencies


L'arribada de la pandèmia per coronavirus SARS-CoV-2 (la malaltia de la COVID-19) a Espanya també ha repercutit en l'accés parental a les Unitats de Cures Intensives Neonatals (UCIN). A l'inici de la pandèmia es van prendre les mesures que, fonamentades en criteris de salut pública, es van considerar necessàries. A mesura que avançava el coneixement científic sobre la COVID-19, I en base a les noves dades obtingudes, es van començar a adaptar, les mesures inicialment establertes. No obstant això, creiem que l'adaptació d'algun d'aquests protocols, en concret el de l'accés parental a les UCIN, no ha estat la idònia des del punt de vista bioètic I de l'interès superior del menor. Al llarg d'aquest article exposem aquestes insuficiències


Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Terapia Intensiva Neonatal/ética , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Pandemias , Pais , Isolamento de Pacientes , Acompanhantes Formais em Exames Físicos/ética , Acompanhantes Formais em Exames Físicos/legislação & jurisprudência , Humanização da Assistência
5.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47926

RESUMO

A Sociedade Brasileira de Pediatria (SBP), a Sociedade Brasileira de Imunizações (SBIm) e a Federação Brasileira de Ginecologia e Obstetrícia (Febrasgo) divulgaram o documento técnico “Imunização na gestação: pré-concepção e puerpério” com o objetivo de orientar profissionais de saúde sobre a importância da vacinação durante a gestação.


Assuntos
Período Pós-Parto , Gravidez/imunologia , Imunização , Cuidado Pré-Concepcional
6.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47929

RESUMO

A coordenadora da campanha Gravidez sem Álcool da Sociedade Brasileira de Pediatria (SBP), dra. Conceição de Matos Segre, publicou artigo sobre a Síndrome Alcoólica Fetal (SAF) e os problemas por ela ocasionados. A prevalência da afecção é considerada alta em todo o mundo, sendo 9 casos por cada 1.000 nascidos vivos.


Assuntos
Complicações na Gravidez , Transtornos do Espectro Alcoólico Fetal , Alcoolismo , Gravidez
10.
J Indian Soc Pedod Prev Dent ; 38(3): 211-215, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33004717

RESUMO

Context: Delayed tooth eruption might be the primary or sole manifestation of local or systemic pathology. Aims: The aim of the study was to correlate Vitamin D level and eruption status of primary teeth. The objectives also included the assessment of the association between Vitamin D levels and socioeconomic status, infant's sun exposure, maternal sun exposure during pregnancy and religion. Settings and Design: A cross-sectional, observational study conducted on 96 infants aged 12-15 months. Materials and Methods: Ninety-six infants, aged 12-15 months were selected after obtaining parental consent. Blood samples were assessed for Vitamin D3 levels using the Vitamin D ELISA Kit. The eruption status of the teeth was recorded in all the 96 infants. The obtained data were subjected to the statistical analysis. Statistical Analysis Used: The obtained data were subjected to relevant statistical analysis such as Analysis of Variance, unpaired t-test, Kruskal-Wallis test, and Mann-Whitney U test, Chi-square Test, Tukey HSD, and Fisher's exact Test. Results: A significant correlation was found in the Vitamin D levels and the eruption timing (P < 0.001). The difference in mean Vitamin D levels among the three socio economic groups was not statistically significant (P = 0.088). A significant association was found between the infant's sun exposure and mother's sun exposure during pregnancy and religion on the Vitamin D levels (P = 0.002, P = 0.042, P = 0.002). Conclusions: Vitamin D deficiency can be considered as an etiological factor for delayed eruption. A strong association exists between the socioeconomic status, infant's sun exposure, maternal sun exposure during pregnancy, and religion with Vitamin D levels.


Assuntos
Erupção Dentária , Deficiência de Vitamina D , Estudos Transversais , Feminino , Humanos , Lactente , Gravidez , Dente Decíduo , Vitamina D
11.
BMC Pregnancy Childbirth ; 20(1): 580, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008308

RESUMO

BACKGROUND: During the ongoing global outbreak of COVID-19, pregnant women who are susceptible to COVID-19 should be highly concerned. The issue of vertical transmission and the possibility of neonatal infection is a major concern. CASE PRESENTATION: Case 1: A 35-year-old pregnant woman with a gestational age of 37 weeks and 6 days was admitted to our hospital at the point of giving birth. Except for the abnormalities in her chest CT image, she was asymptomatic. She had an uncomplicated spontaneous vaginal delivery, and her infant was discharged home for isolation. Because of the positive result of the maternal swabs for SARS-CoV-2 obtained on the 2nd day after sampling, we transferred the mother to the designated hospital and followed up with her by telephone interviews. Luckily, it was confirmed on February 23 that the newborn did not develop any COVID-19 symptoms after observation for 14 days after birth. Case 2: Another pregnant woman, with a gestational age of 38 weeks and 2 days, was also admitted to our hospital because of spontaneous labor with cervical dilation of 5 cm. Since she had the typical manifestations of COVID-19, including cough, lymphopenia, and abnormal chest CT images, she was highly suspected of having COVID-19. Based on the experience from case 1, we helped the mother deliver a healthy baby by vaginal delivery. On the 2nd day after delivery, the maternal nasopharyngeal swab result was positive, while the infant's result was negative. CONCLUSION: There is still insufficient evidence supporting maternal-fetal vertical transmission for COVID-19-infected mothers in late pregnancy, and vaginal delivery may not increase the possibility of neonatal infection.


Assuntos
Infecções Assintomáticas , Infecções por Coronavirus/diagnóstico , Parto Obstétrico/métodos , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Betacoronavirus , Aleitamento Materno , Técnicas de Laboratório Clínico , Infecções por Coronavirus/terapia , Tosse , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Idade Gestacional , Humanos , Linfopenia , Máscaras , Oxigenoterapia , Pandemias , Isolamento de Pacientes , Equipamento de Proteção Individual , Pneumonia Viral/terapia , Reação em Cadeia da Polimerase , Gravidez , Complicações Infecciosas na Gravidez/terapia , Testes Sorológicos , Tomografia Computadorizada por Raios X
12.
Oral Health Prev Dent ; 18(1): 855-864, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33028053

RESUMO

PURPOSE: This study examines the difference in the oral microbiome during pregnancy and the postpartum period of a Chinese population, with the focus on P. gingivalis, P. intermedia and P. nigrescens and their shift during pregnancy, in order to understand the host-microbe relationship in maintaining homeostasis during pregnancy. MATERIALS AND METHODS: This cross-sectional study was carried out in a total of 117 women who underwent prenatal or regular examinations at four public hospitals, including 84 pregnant and 33 postpartum women. Women in the postpartum group were examined within 0.5-1 year after delivery, while the pregnant group was divided into early pregnancy (0-13 weeks), middle pregnancy (14-27 weeks), and late pregnancy (28-39 weeks) according to gestational age. Sociodemographic parameters were self-reported by recruited women. The study required evaluations of probing depth (PD), bleeding index (BI), clinical attachment loss (CAL), and plaque index (PlI). Unstimulated whole saliva samples were collected for the detection of P. gingivalis, P. intermedia, and P. nigrescens. Bacterial populations were evaluated using 16S rRNA-based polymerase chain reaction. RESULTS: P. nigrescens exhibited higher prevalence in the pregnant group compared to the postpartum group (45.67% vs 12.10%, p < 0.01). P. nigrescens was more frequently detected in late than in early pregnancy (57.7% vs 48.3%, p < 0.05) and middle pregnancy (57.7% vs 31.0%, p < 0.01). Initially high prevalence of P. gingivalis in early pregnancy wanes in middle and late pregnancy (69.0%, 44.8%, 38.5%). However, the prevalence of P. gingivalis in the postpartum group (81.8%) exceeds all of the pregnant groups (p < 0.01). The change in the prevalence of P. intermedia among different groups was not statistically significant. The percentages of bleeding on probing (BOP%) sites and PD ≥4 mm sites in the postpartum group were statistically significantly higher when compared with each of the pregnant groups (p < 0.01). During pregnancy, women experienced elevated PlI, BI, PD, and BOP% (p < 0.05). The proportions of subjects in the pregnant group who agreed with the statements 'Gingival bleeding is normal', 'Can't brush teeth within 1st month postpartum', 'It's unnecessary to see a dentist if not uncomfortable' were 39.3%, 28.6%, and 35.7%, respectively. CONCLUSIONS: P. nigrescens is more related than P. gingivalis to pregnancy status. The periodontal status of Chinese women progressively deteriorates during pregnancy and persists into the postpartum period, which may result from lack of dental care knowledge.


Assuntos
Microbiota , Doenças Periodontais , Estudos Transversais , Feminino , Humanos , Doenças Periodontais/epidemiologia , Período Pós-Parto , Gravidez , RNA Ribossômico 16S
13.
Rev Assoc Med Bras (1992) ; 66(9): 1252-1257, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33027454

RESUMO

OBJECTIVE: To describe the characteristics of patients treated at a level III surgical Neonatal Intensive Care Unit outside of a maternity service and analyze possible risk factors for mortality in this population. METHODS: A retrospective cohort study evaluating patients admitted to a level III surgical Neonatal Intensive Care Unit from June/2015 to November/2017. Univariate analysis was performed by the Chi-square test and T-student test or Mann-Whitney test. Multivariate analysis by logistic regression was performed including in the model the variables with a P-value <0.2 in univariate analysis. Kaplan-Meier curve and Log-Rank test were performed using the variables that were statistically associated with death in the multivariate analysis. A significance level of a=5% and an error B=80% were adopted. RESULTS: During this period, 246 patients were admitted to this service. 58 (23.8%) patients died, with a mean time until death of 18 days. Half of the patients had a clinical diagnosis of sepsis (50.6%), blood culture was positive in 25.2%, and gram-positive bacteria (48.4%) were the main pathogens isolated. The variables that remained in the final model after multivariate analysis were diagnosis of congenital heart disease (OR = 4.5; p = 0.016), clinical diagnosis of sepsis (OR = 8.1; p = 0.000), and isolation of gram-positive bacteria in blood culture (OR = 3.9; p = 0.006). CONCLUSION: The level III surgical Neonatal Intensive Care Unit outside of a maternity service has a different profile of morbidity and mortality, and death was associated with the diagnosis of congenital heart disease, the clinical diagnosis of sepsis, and the isolation of gram-positive bacteria in the blood culture.


Assuntos
Unidades de Terapia Intensiva Neonatal , Feminino , Humanos , Recém-Nascido , Morbidade , Gravidez , Estudos Retrospectivos , Fatores de Risco , Sepse
14.
BMC Pregnancy Childbirth ; 20(1): 600, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028237

RESUMO

BACKGROUND: The aim of this national survey was to explore pregnant women's perceptions of COVID-19 and their healthcare experiences. METHODS: Through patient and public involvement, a questionnaire was developed and advertised via the BBC website, Twitter and other online media during May 2020. The findings were analysed by qualitative thematic analysis. Women who are currently pregnant, or who have delivered during the COVID-19 pandemic were invited to partake in a national online survey. RESULTS: One thousand four hundred fifty-one participants replied to the online questionnaire. Participants provided significant insight into the perceived barriers to seeking healthcare during this pandemic. These include 'not wanting to bother anyone', 'lack of wider support from allied healthcare workers' and the influence of the media. Other concerns included the use of virtual clinics antenatally and their acceptability to patients, the presence of birthing partners, and the way in which information is communicated about rapidly changing and evolving services. The influence of the media has also had a significant impact on the way women perceive hospital care in light of COVID-19 and for some, this has shaped whether they would seek help. CONCLUSIONS: This is the first ever reported study in the United Kingdom to explore pregnant women's perceptions of COVID-19 and their subsequent healthcare experiences. It has also provided insight into perceived barriers into seeking care as well as maternal concerns antenatally, intrapartum and postpartum.


Assuntos
Infecções por Coronavirus , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pneumonia Viral , Complicações Infecciosas na Gravidez , Gestantes/psicologia , Percepção Social , Adulto , Atitude Frente a Saúde , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Feminino , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/psicologia , Pesquisa Qualitativa , Inquéritos e Questionários , Reino Unido/epidemiologia
15.
Rev Med Liege ; 75(10): 676-681, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-33030845

RESUMO

In Wallonia, almost one fourth of cesarean sections are performed on nulliparous women with vertex nonanomalous singleton gestations who underwent induction of labor. The purpose of this study is to compare maternal and neonatal outcomes with elective induction of labor versus spontaneous onset of labor. Data for all deliveries at CHU de Liège over a two-year period were obtained. Women with vertex nonanomalous singleton gestations who delivered from 3900 to 40+6 weeks were selected. We tested the association of elective induction and operative vaginal delivery, cesarean section, post-partum hemorrhage, episiotomy and perineal lacerations, length of labor, length of stay, 1-min and 5-min APGAR inferior to 7 and admission to neonatal intensive care unit. Length of stay was significantly longer in all induced women. In nulliparous women, there was a 45 % probability of operative vaginal delivery or cesarean section delivery in those who underwent elective induction of labor. In light of these results, it seems that our policy of elective induction of labor in nulliparous women is causing unnecessary and potentially avoidable interventions.


Assuntos
Cesárea , Trabalho de Parto Induzido , Feminino , Humanos , Gravidez , Estudos Retrospectivos
16.
Pediatrics ; 146(Suppl 2): S218-S222, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33004643

RESUMO

Data from the past decade have revealed that neonatal mortality represents a growing burden of the under-5 mortality rate. To further reduce these deaths, the focus must expand to include building capacity of the workforce to provide high-quality obstetric and intrapartum care. Obstetric complications, such as hypertensive disorders and obstructed labor, are significant contributors to neonatal morbidity and mortality. A well-prepared workforce with the necessary knowledge, skills, attitudes, and motivation is required to rapidly detect and manage these complications to save both maternal and newborn lives. Traditional off-site, didactic, and lengthy training approaches have not always yielded the desired results. Helping Mothers Survive training was modeled after Helping Babies Breathe and incorporates further evidence-based methodology to deliver training on-site to the entire team of providers, who continue to practice after training with their peers. Research has revealed that significant gains in health outcomes can be reached by using this approach. In the coronavirus disease 2019 era, we must look to translate the best practices of these training programs into a flexible and sustainable model that can be delivered remotely to maintain quality services to women and their newborns.


Assuntos
Pessoal de Saúde/educação , Capacitação em Serviço/organização & administração , Assistência Perinatal/organização & administração , Fortalecimento Institucional , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Serviços de Saúde Materno-Infantil/organização & administração , Assistência Perinatal/normas , Gravidez , Complicações na Gravidez/prevenção & controle , Complicações na Gravidez/terapia
17.
Yakugaku Zasshi ; 140(10): 1199-1206, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32999198

RESUMO

Potential risks to the fetus or infant should be considered prior to medication during pregnancy and lactation. It is essential to evaluate the exposure levels of drugs and their related factors in addition to toxicological effects. Epilepsy is one of the most common neurological complications in pregnancy; some women continue to use antiepileptic drugs (AEDs) to control seizures. Benzodiazepines (BZDs) are widely prescribed for several women who experience symptoms such as anxiety and insomnia during the postpartum period. In this review, we describe the 1) transport mechanisms of AEDs across the placenta and the effects of these drugs on placental transporters, and 2) the transfer of BZDs into breast milk. Our findings indicated that carrier systems were involved in the uptake of gabapentin (GBP) and lamotrigine (LTG) in placental trophoblast cell lines. SLC7A5 was the main contributor to GBP transport in placental cells. LTG was transported by a carrier that was sensitive to chloroquine, imipramine, quinidine, and verapamil. Short-term exposure to 16 AEDs had no effect on folic acid uptake in placental cells. However, long-term exposure to valproic acid (VPA) affected the expression of folate carriers (FOLR1, SLC46A1). Furthermore, VPA administration changed the expression levels of various transporters in rat placenta, suggesting that sensitivity to VPA differed across gestational stages. Lastly, we developed a method for quantifying eight BZDs in human breast milk and plasma using LC/MS/MS, and successfully applied it to quantify alprazolam in breast milk and plasma donated by a lactating woman.


Assuntos
Anticonvulsivantes/metabolismo , Benzodiazepinas/metabolismo , Transporte Biológico/genética , Aleitamento Materno , Gabapentina/metabolismo , Lactação/metabolismo , Lamotrigina/metabolismo , Transportador 1 de Aminoácidos Neutros Grandes/fisiologia , Troca Materno-Fetal , Leite Humano/metabolismo , Placenta/metabolismo , Ácido Valproico/metabolismo , Anticonvulsivantes/efeitos adversos , Benzodiazepinas/efeitos adversos , Benzodiazepinas/uso terapêutico , Linhagem Celular , Epilepsia/tratamento farmacológico , Feminino , Receptor 1 de Folato/genética , Receptor 1 de Folato/metabolismo , Gabapentina/efeitos adversos , Expressão Gênica/efeitos dos fármacos , Humanos , Lamotrigina/efeitos adversos , Gravidez , Complicações na Gravidez/tratamento farmacológico , Transportador de Folato Acoplado a Próton/genética , Transportador de Folato Acoplado a Próton/metabolismo , Ácido Valproico/efeitos adversos
18.
PLoS One ; 15(10): e0239697, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33007020

RESUMO

OBJECTIVE: The objective of this study was to define the threatened perception types of pregnant women during the COVID-19 pandemic and determine the correlations between the perception types and their demographic factors, their preventive knowledge of COVID-19 and their mental status in order to provide suggestions for pregnant women during pandemic. METHODS: Latent class analysis were used to explore the optimal numbers of clusters. Multinomial logistic regression and multiple correspondence analysis were used to analyze the demographic variables of the latent categories. MANOVA was used to analyze the difference of knowledge of COVID-19 obtained among clusters and their psychological status, and chi-square test was used determine the relationship between the latent clusters and the participant's COVID-19 worry level. RESULTS: Five clusters were found: the first cluster (n = 120, 39%) was unthreatened and confident. Cluster 2(n = 84, 28%) was unthreatened but not confident. Cluster 3 (n = 49, 17%) was threatened but confident. Cluster 4 (n = 25, 9%) was threaten, not confident and knowledgeable, and Cluster 5 (n = 20, 7%) was threatened, not confident and lacking knowledge. Three demographic variables were shown an effect on the classification, they were support from work, family support and intrapartum and postpartum complications. CONCLUSION: This study can help assess the mental health risks of pregnant women during an epidemic. The results could be helpful for families, work units, communities and medical institutions to make targeted intervention decisions for pregnant women.


Assuntos
Ansiedade/psicologia , Infecções por Coronavirus/psicologia , Saúde Mental , Pneumonia Viral/psicologia , Gestantes/psicologia , Adulto , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Análise de Classes Latentes , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/psicologia , Complicações Infecciosas na Gravidez/virologia , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
19.
J Med Case Rep ; 14(1): 186, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33023635

RESUMO

INTRODUCTION: A novel coronavirus named severe acute respiratory syndrome coronavirus 2, was first reported in Wuhan, China, in December 2019. The virus, known as COVID-19, is recognized as a potentially life-threatening disease by causing severe respiratory disease. Since this virus has not previously been detected in humans, there is a paucity of information regarding its effects on humans. In addition, only limited or no information exists about its impact during pregnancy. CASE PRESENTATION: In the present case study, we report the death of a neonate born to a 32-year-old mother with coronavirus disease 2019 in Ilam, Iran, with Kurdish ethnicity. We report the infection and death of a neonate in Iran with a chest X-ray (CXR) marked abnormality 2 hours after birth demonstrating coronavirus disease 2019 disease. The neonate was born by elective cesarean section, the fetal health was assessed using fetal heart rate and a non-stress test before the birth, and there was no evidence of fetal distress. All the above-mentioned facts and radiographic abnormalities suggested that coronavirus disease 2019 is involved. CONCLUSIONS: In this case study, we report the death of a neonate born to a mother with coronavirus disease 2019, 11 hours after birth. There is a paucity of data on the vertical transmission and the adverse maternal-fetal consequences of this disease, so vertical transmission from mother to child remains to be confirmed.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Cuidados Críticos/métodos , Doenças do Recém-Nascido , Pandemias , Pneumonia Viral , Complicações Infecciosas na Gravidez , Adulto , Cesárea/métodos , Deterioração Clínica , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/transmissão , Evolução Fatal , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico , Doenças do Recém-Nascido/fisiopatologia , Doenças do Recém-Nascido/terapia , Transmissão Vertical de Doença Infecciosa , Irã (Geográfico) , Triagem Neonatal/métodos , Morte Perinatal , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Pneumonia Viral/transmissão , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/fisiopatologia , Complicações Infecciosas na Gravidez/terapia , Respiração Artificial/métodos
20.
BMJ ; 371: m3502, 2020 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028606

RESUMO

OBJECTIVE: To consolidate evidence from systematic reviews and meta-analyses investigating the association between reproductive factors in women of reproductive age and their subsequent risk of cardiovascular disease. DESIGN: Umbrella review. DATA SOURCES: Medline, Embase, and Cochrane databases for systematic reviews and meta-analyses from inception until 31 August 2019. REVIEW METHODS: Two independent reviewers undertook screening, data extraction, and quality appraisal. The population was women of reproductive age. Exposures were fertility related factors and adverse pregnancy outcomes. Outcome was cardiovascular diseases in women, including ischaemic heart disease, heart failure, peripheral arterial disease, and stroke. RESULTS: 32 reviews were included, evaluating multiple risk factors over an average follow-up period of 7-10 years. All except three reviews were of moderate quality. A narrative evidence synthesis with forest plots and tabular presentations was performed. Associations for composite cardiovascular disease were: twofold for pre-eclampsia, stillbirth, and preterm birth; 1.5-1.9-fold for gestational hypertension, placental abruption, gestational diabetes, and premature ovarian insufficiency; and less than 1.5-fold for early menarche, polycystic ovary syndrome, ever parity, and early menopause. A longer length of breastfeeding was associated with a reduced risk of cardiovascular disease. The associations for ischaemic heart disease were twofold or greater for pre-eclampsia, recurrent pre-eclampsia, gestational diabetes, and preterm birth; 1.5-1.9-fold for current use of combined oral contraceptives (oestrogen and progesterone), recurrent miscarriage, premature ovarian insufficiency, and early menopause; and less than 1.5-fold for miscarriage, polycystic ovary syndrome, and menopausal symptoms. For stroke outcomes, the associations were twofold or more for current use of any oral contraceptive (combined oral contraceptives or progesterone only pill), pre-eclampsia, and recurrent pre-eclampsia; 1.5-1.9-fold for current use of combined oral contraceptives, gestational diabetes, and preterm birth; and less than 1.5-fold for polycystic ovary syndrome. The association for heart failure was fourfold for pre-eclampsia. No association was found between cardiovascular disease outcomes and current use of progesterone only contraceptives, use of non-oral hormonal contraceptive agents, or fertility treatment. CONCLUSIONS: From menarche to menopause, reproductive factors were associated with cardiovascular disease in women. In this review, presenting absolute numbers on the scale of the problem was not feasible; however, if these associations are causal, they could account for a large proportion of unexplained risk of cardiovascular disease in women, and the risk might be modifiable. Identifying reproductive risk factors at an early stage in the life of women might facilitate the initiation of strategies to modify potential risks. Policy makers should consider incorporating reproductive risk factors as part of the assessment of cardiovascular risk in clinical guidelines. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019120076.


Assuntos
Doenças Cardiovasculares/epidemiologia , Fertilidade , Complicações na Gravidez/epidemiologia , Saúde Reprodutiva/estatística & dados numéricos , Medição de Risco , Correlação de Dados , Feminino , Humanos , Metanálise como Assunto , Gravidez , Fatores de Risco , Revisões Sistemáticas como Assunto
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