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1.
rev.cuid. (Bucaramanga.2010) ; 13(1): 1-20, 20221213.
Artículo en Español | LILACS, BDENF - Enfermería, COLNAL | ID: biblio-1369171

RESUMEN

Introducción: El SARS-CoV-2 es un Betacoronavirus, así como el SARS-CoV y el MERS-CoV, ambos asociados a abortos espontáneos, parto prematuro, morbi-mortalidad materna y alto número de ingresos a UCI en las gestantes. Además, al ser un virus nuevo, se conoce poco sobre los efectos en la gestación. Esta revisión tiene como objetivo analizar la evidencia disponible sobre el SARS-CoV-2 en la gestación. Materiales y métodos: Se realizó una búsqueda de la literatura en PubMed, ProQuest, Scopus, BVS y SciElo. Se realizó la crítica de la evidencia y la extracción de la información con dos instrumentos propuestos por el Instituto Joanna Briggs. Lo anterior bajo las directrices de PRISMA-ScR. Resultados: Se incluyeron 85 artículos que evidenciaron que la mayoría de gestantes con SARS-CoV-2 desarrollaron enfermedad leve a moderada, pero presentaron mayor riesgo de muerte y complicaciones comparado con las pacientes no embarazadas. Se documentó bajo riesgo de transmisión vertical y los resultados perinatales se asociaron a la severidad del cuadro clínico materno. La efectividad del tratamiento no fue concluyente.Discusión: Se discute la presentación clínica de la infección en las gestantes, la transmisión vertical, el tratamiento, la gravedad de la enfermedad y los desenlaces neonatales.Conclusiones: La COVID-19 en la gestación es una complicación que genera mayor morbimortalidad, por lo que es de vital importancia el desarrollo de más investigaciones que amplíen la comprensión de su comportamiento, las implicaciones fisiológicas, emocionales y el posible tratamiento. Esta revisión hace un análisis riguroso de la calidad de los estudios y aporta información valiosa de la evidencia.


Introduction: SARS-CoV-2 is a betacoronavirus as well as SARS-CoV and MERS-CoV, both associated with spontaneous miscarriage, preterm birth, maternal morbidity and mortality and a higher number of ICU admissions for pregnant women. Being a new virus, its effects on pregnancy are little known. This review aims to analyze the available evidence on SARS-CoV-2 in pregnancy. Materials and Methods: A literature review was conducted in PubMed, ProQuest, Scopus, BVS and SciElo. Evidence criticism and information extraction were conducted using two instruments from the Joanna Briggs Institute, following the PRISMA-ScR guidelines. Results: 85 articles were included evidencing that most pregnant women with SARS-COV-2 suffered mild to moderate disease and were at a higher risk of death and complications compared to non-pregnant patients. Low risk of vertical transmission was documented and adverse perinatal outcomes were associated with severe maternal clinical manifestations. The effectiveness of treatment was inconclusive. Discussion: Clinical presentation of infection in pregnant women, vertical transmission, treatment, disease severity and neonatal outcomes were discussed. Conclusions: COVID-19 during pregnancy is a complication that generates greater morbidity and mortality, for which it is vital to develop further research on the understanding of the behavior, physiological and emotional implications and possible treatment. This review makes a rigorous analysis of the quality of studies and provides valuable information from evidence.


Introdução: O SARS-CoV-2 é um betacoronavírus, assim como o SARS-CoV e o MERS-CoV, ambos associados ao aborto espontâneo, parto prematuro, morbidade e mortalidade materna e alto número de internações na UTI em mulheres grávidas. Além disso, sendo um novo vírus, pouco se sabe sobre seus efeitos na gravidez. Esta revisão tem como objetivo analisar as evidências disponíveis sobre o SARS-CoV-2 na gravidez. Materiais e métodos: Foi realizada uma pesquisa bibliográfica na PubMed, ProQuest, Scopus, BVS e SciElo. A analise crítica das provas e a extração de dados foram realizadas utilizando dois instrumentos propostos pelo Instituto Joanna Briggs sob as diretrizes do PRISMA-ScR. Resultados: 85 artigos foram incluídos, mostrando que a maioria das mulheres grávidas com SRA-CoV-2 desenvolveu doença leve a moderada, mas tinha um risco maior de morte e complicações em comparação com pacientes não grávidas. Baixo risco de transmissão vertical foi documentado e os resultados perinatais foram associados à gravidade do quadro clínico materno. A eficácia do tratamento foi inconclusiva. Discussão: Apresentação clínica da infecção em mulheres grávidas, transmissão vertical, tratamento, gravidade da doença e resultados neonatais são discutidos. Conclusões: A COVID-19 na gravidez é uma complicação que gera maior morbidade e mortalidade, portanto, mais pesquisas para expandir a compreensão de seu comportamento, implicações fisiológicas e emocionais, e o tratamento potencial são de vital importância. Esta revisão fornece uma análise rigorosa da qualidade dos estudos e informações valiosas a partir das evidências.


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Embarazo , Coronavirus , SARS-CoV-2 , COVID-19
2.
J Immunol ; 209(8): 1465-1473, 2022 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-36192115

RESUMEN

Widespread SARS-CoV-2 infection among pregnant individuals has led to a generation of fetuses exposed in utero, but the long-term impact of such exposure remains unknown. Although fetal infection is rare, children born to mothers with SARS-CoV-2 infection may be at increased risk for adverse neurodevelopmental and cardiometabolic outcomes. Fetal programming effects are likely to be mediated at least in part by maternal immune activation. In this review, we discuss recent evidence regarding the effects of prenatal SARS-CoV-2 infection on the maternal, placental, and fetal immune response, as well as the implications for the long-term health of offspring. Extrapolating from what is known about the impact of maternal immune activation in other contexts (e.g., obesity, HIV, influenza), we review the potential for neurodevelopmental and cardiometabolic morbidity in offspring. Based on available data suggesting potential increased neurodevelopmental risk, we highlight the importance of establishing large cohorts to monitor offspring born to SARS-CoV-2-positive mothers for neurodevelopmental and cardiometabolic sequelae.


Asunto(s)
COVID-19 , Enfermedades Cardiovasculares , Complicaciones Infecciosas del Embarazo , Niño , Femenino , Humanos , Inmunidad , Transmisión Vertical de Enfermedad Infecciosa , Placenta , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , SARS-CoV-2
3.
Pan Afr Med J ; 42: 173, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36187044

RESUMEN

Since the global pandemic of the 2019 coronavirus disease (COVID-19), few studies have reported on the relevance of bacteria co-infection on outcome of COVID-19 patients. Little is known about the clinical presentation among pregnant women, mother-to-child transmission, and fetal outcomes. This report shows a 24-year-old nulliparous woman who was 32 weeks pregnant and was admitted to the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi Ghana with symptoms of fever (40.3°C), cough and breathlessness of two weeks duration. Her nasopharyngeal sample tested positive for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and blood culture isolated Burkholderia cepacia. She was given medications but went into pre-term labour and delivered a stillborn baby. This rare case of COVID-19 and Burkholderia cepacia co-infection emphasizes the need for a thorough assessment and appropriate treatment of patients presenting with fever and respiratory symptoms in order to mitigate poor outcome.


Asunto(s)
Burkholderia cepacia , COVID-19 , Coinfección , Complicaciones Infecciosas del Embarazo , Adulto , COVID-19/complicaciones , COVID-19/diagnóstico , Coinfección/diagnóstico , Femenino , Muerte Fetal , Fiebre/etiología , Humanos , Transmisión Vertical de Enfermedad Infecciosa , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Resultado del Embarazo , SARS-CoV-2 , Adulto Joven
4.
Ceska Gynekol ; 87(4): 269-273, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36055787

RESUMEN

OBJECTIVE: We hereby present a case of intrauterine death of a fetus due to placental damage by placentitis caused by SARS-CoV-2 infection in ongoing covid-19 disease and HELLP syndrome. CASE REPORT: In this case report, we describe a patient who experienced intrauterine death of a fetus and the development of HELLP syndrome in ongoing covid-19 infection. Placentitis caused by SARS-CoV-2 infection was identified as the cause of intrauterine death of a fetus. After the end of pregnancy, a patient experienced an improvement in the symptoms of covid-19 and also a gradual improvement and adjustment of laboratory and coagulation parameters. CONCLUSION: SARS-CoV-2 infection in pregnancy can be complicated by the development of SARS-CoV-2 placenitis, which can cause intrauterine death of a fetus. Covid-19 infection can even have similar signs to HELLP syndrome and therefore careful monitoring of pregnant women with covid-19 is recommended.


Asunto(s)
COVID-19 , Síndrome HELLP , Complicaciones Infecciosas del Embarazo , COVID-19/complicaciones , Femenino , Feto , Síndrome HELLP/diagnóstico , Humanos , Transmisión Vertical de Enfermedad Infecciosa , Placenta , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , SARS-CoV-2 , Mortinato
6.
Int J Mol Sci ; 23(18)2022 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-36142219

RESUMEN

COVID-19 is a severe respiratory disease threatening pregnant women, which increases the possibility of adverse pregnancy outcomes. Several recent studies have demonstrated the ability of SARS-CoV-2 to infect the mother enterocytes, disturbing the gut microbiota diversity. The aim of this study was to characterize the entero-mammary microbiota of women in the presence of the virus during delivery. Fifty mother-neonate pairs were included in a transversal descriptive work. The presence of SARS-CoV-2 RNA was detected in nasopharyngeal, mother rectal swabs (MRS) and neonate rectal swabs (NRS) collected from the pairs, and human colostrum (HC) samples collected from mothers. The microbiota diversity was characterized by high-throughput DNA sequencing of V3-16S rRNA gene libraries prepared from HC, MRS, and NRS. Data were analyzed with QIIME2 and R. Our results indicate that several bacterial taxa are highly abundant in MRS positive for SARS-CoV-2 RNA. These bacteria mostly belong to the Firmicutes phylum; for instance, the families Bifidobacteriaceae, Oscillospiraceae, and Microbacteriaceae have been previously associated with anti-inflammatory effects, which could explain the capability of women to overcome the infection. All samples, both positive and negative for SARS-CoV-2, featured a high abundance of the Firmicutes phylum. Further data analysis showed that nearly 20% of the bacterial diversity found in HC was also identified in MRS. Spearman correlation analysis highlighted that some genera of the Proteobacteria and Actinobacteria phyla were negatively correlated with MRS and NRS (p < 0.005). This study provides new insights into the gut microbiota of pregnant women and their potential association with a better outcome during SARS-CoV-2 infection.


Asunto(s)
COVID-19 , Microbioma Gastrointestinal , Antiinflamatorios , Bacterias/genética , Femenino , Firmicutes/genética , Microbioma Gastrointestinal/genética , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Embarazo , ARN Ribosómico 16S/genética , ARN Viral , SARS-CoV-2
7.
Artículo en Inglés | MEDLINE | ID: mdl-36078626

RESUMEN

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic significantly impacted the general population's health. At times, the infection has unfavorably influenced pregnancy evolution and the result of birth. However, vertical transmission of the virus is rare and generates controversial discussions. The study aimed to highlight the clinical, laboratory, and imaging findings of pregnant women with confirmed Coronavirus Disease 2019 (COVID-19) with possible vertical transmission and identify possible factors that encourage vertical transmission. Between 1 April 2020 and 31 December 2021, 281 pregnant women diagnosed with COVID-19 gave birth in the Obstetrics and Gynecology Departments of the tertiary unit of County Emergency Clinical Hospital from Timisoara. Three newborns (1.06%) tested positive. The characteristic of these three cases was described as a short series. In two cases, the patients were asymptomatic. In one case, the patient developed a mild form of COVID-19 with a favorable evolution in all cases. We did not identify the presence of smoking history, vaccine before admission, atypical presentation, fever, or chest X-ray abnormalities. We note possible factors that encourage vertical transmission: Pregnancy-induced hypertension, thrombophilia, asymptomatic cough, an asymptomatic or mild form of the disease, a ruptured membrane, and cesarean. The laboratory results highlight the inconstant presence of some changes found in the list of potential predictors of the severity of the infection: Lymphopenia, high values of C-reactive protein, D-dimer, fibrinogen, platelets, Aspartate Aminotransferase, Lactate dehydrogenase, and ferritin. The study's conclusion of this small group suggests that there may have been an intrauterine infection in late pregnancy and described characteristics of the pregnant women. Possible risk factors that could encourage vertical transmission have been identified.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Resultado del Embarazo , Mujeres Embarazadas , SARS-CoV-2
8.
BMC Infect Dis ; 22(1): 730, 2022 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-36076173

RESUMEN

BACKGROUND: In December 2019, in Wuhan, China, coronavirus disease 2019 (COVID-19) was emerged due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It seems that children and neonates, similar to adult and elderly individuals, are at risk of SARS-CoV-2 infection. However, adequate data are not available about neonates infected with SARS-CoV-2. METHODS: This study evaluated the presence of SARS-CoV-2 infection in neonates born to mothers or relatives with COVID-19. This cross-sectional study was performed on 25,044 consecutive Iranian participants in Tehran, Iran, from January 2020 to August 2020. Viral ribonucleic acid (RNA) was extracted from 500 µl of the oropharyngeal and nasopharyngeal specimens of the participants. The genomic RNA of SARS-CoV-2 was detected by real-time polymerase chain reaction (PCR) assay. RESULTS: Out of all participants, 98 (0.40%) cases were neonates born to mothers or relatives with SARS-CoV-2 infection. Therefore, the current study was performed on these neonates. Out of 98 studied neonates, 6 (6.1%) cases had positive PCR results for SARS-CoV-2 infection. Moreover, among 98 studied neonates' mothers, 25 (25.5%) cases had positive PCR results for SARS-CoV-2 infection. CONCLUSION: The findings of this study demonstrated that the rate of COVID-19 in neonates born to mothers or relatives with SARS-CoV-2 infection in the Iranian population is about 6.1%.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , Adulto , Anciano , COVID-19/epidemiología , Niño , Estudios Transversales , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Irán/epidemiología , Madres , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Prevalencia , ARN , SARS-CoV-2/genética
9.
Infect Dis Obstet Gynecol ; 2022: 8061112, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36046178

RESUMEN

Background: Vertical transmission of several viruses during pregnancy has been shown to cause adverse fetal outcomes. The question about the possibility of a similar outcome in association with SARS-CoV-2 has been raised in recently published articles. Indeed, the rate of transmission through the placenta to the fetus reported in women with COVID-19 has been shown to form a minority. The aim of this study was to explore the possible histopathological changes in the placenta of pregnant women with COVID-19 after delivery and those changes in the umbilical cord. Methods: A case-control study including a total of 50 full-term pregnant women with COVID-19 and 60 control pregnant females. Histopathological evaluation of placental tissues and umbilical cords were reported. Results: The main findings in the umbilical cord were increased thickness of vessels, thrombus formation, endothelins, and narrow lumen; except for the increased thickness of blood vessels, these findings were more frequently seen in women with COVID-19, in comparison with control women in a significant manner (p < 0.05). Increased thickness of blood vessels was more significantly observed in the control group compared to the COVID-19 group (p < 0.01). Findings of the placenta included avascular villi, fibrin, thrombosis, and meconium macrophage in various combinations. Except for fibrin as the sole findings, all other findings including combinations were more frequently encountered in the study group in comparison to the control group (p < 0.05). Conclusion: Pregnant women with COVID-19 have significant pathological alterations in the placenta and umbilical cord. These findings reflect the capability of SARS-CoV-2 in causing immunological reactions to the placenta, either directly or indirectly, and these pathologies may be linked to the higher rate of adverse neonatal outcomes and maternal admission to the intensive care unit.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , Estudios de Casos y Controles , Femenino , Fibrina , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Placenta/patología , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Resultado del Embarazo , Mujeres Embarazadas , SARS-CoV-2
10.
Neonatology ; 119(5): 619-628, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36088904

RESUMEN

INTRODUCTION: Our objective was to compare neonatal outcomes and resource use of neonates born to mothers with SARS-CoV-2 positivity during pregnancy with neonates born to mothers without SARS-CoV-2 positivity. METHODS: We conducted a two-country cohort study of neonates admitted between January 1, 2020, and September 15, 2021, to tertiary neonatal intensive care unit (NICU) in Canada and Sweden. Neonates from mothers who were SARS-CoV-2 positive during pregnancy were compared with three randomly selected NICU neonates of mothers who were not test-positive, matched on gestational age, sex, and birth weight (±0.25 SD). Subgroup analyses were conducted for neonates born <33 weeks' gestation and mothers who were SARS-CoV-2 positive ≤10 days prior to birth. Primary outcome was duration of respiratory support. Secondary outcomes were in-hospital mortality, neonatal morbidity, late-onset sepsis, receipt of breast milk at discharge, and length of stay. RESULTS: There were 163 exposed and 468 matched neonates in Canada, and 303 exposed and 903 matched neonates in Sweden. There was no statistically significant difference in invasive or noninvasive respiratory support durations, mortality, respiratory and other neonatal morbidities, or resource utilizations between two groups in both countries in entire cohort and in subgroup analyses. Receipt of breast milk at discharge was lower in the Canadian neonates of mothers who were SARS-CoV-2 positive ≤10 days before birth (risk ratio 0.68, 95% CI: 0.57-0.82). CONCLUSION: Maternal SARS-CoV-2 positivity was not associated with increased durations of respiratory support, morbidities, mortality, or length of hospital stay in Canada and Sweden among neonates admitted to tertiary NICU.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , COVID-19/epidemiología , Canadá/epidemiología , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Unidades de Cuidado Intensivo Neonatal , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Resultado del Embarazo , SARS-CoV-2
11.
Viruses ; 14(9)2022 08 26.
Artículo en Inglés | MEDLINE | ID: mdl-36146692

RESUMEN

SARS-CoV-2 is a virus that belongs to the Betacoronavirus genus of the Coronaviridae family. Other coronaviruses, such as SARS-CoV and MERS-CoV, were associated with complications in pregnant women. Therefore, this study aimed to report the clinical history of five pregnant women infected with SARS-CoV-2 (four symptomatic and one asymptomatic who gave birth to a stillborn child) during the COVID-19 pandemic. They gave birth between August 2020 to January 2021, a period in which there was still no vaccination for COVID-19 in Brazil. In addition, their placental alterations were later investigated, focusing on macroscopic, histopathological, and ultrastructural aspects compared to a prepandemic sample. Three of five placentas presented SARS-CoV-2 RNA detected by RT-PCRq at least two to twenty weeks after primary pregnancy infection symptoms, and SARS-CoV-2 spike protein was detected in all placentas by immunoperoxidase assay. The macroscopic evaluation of the placentas presented congested vascular trunks, massive deposition of fibrin, areas of infarctions, and calcifications. Histopathological analysis showed fibrin deposition, inflammatory infiltrate, necrosis, and blood vessel thrombosis. Ultrastructural aspects of the infected placentas showed a similar pattern of alterations between the samples, with predominant characteristics of apoptosis and detection of virus-like particles. These findings contribute to a better understanding of the consequences of SARS-CoV-2 infection in placental tissue, vertical transmission.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , Femenino , Fibrina , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Pandemias , Placenta , Embarazo , ARN Viral , SARS-CoV-2 , Glicoproteína de la Espiga del Coronavirus
12.
Viruses ; 14(9)2022 09 14.
Artículo en Inglés | MEDLINE | ID: mdl-36146849

RESUMEN

There is accumulating evidence on the perinatal aspects of COVID-19, but available data are still insufficient. The reports on perinatal aspects of COVID-19 have been published on a small group of patients. Vertical transmission has been noted. The SARS-CoV-2 genome can be detected in umbilical cord blood and at-term placenta, and the infants demonstrate elevated SARS-CoV-2-specific IgG and IgM antibody levels. In this work, the analysis of clinical characteristics of RT-PCR SARS-CoV-2-positive pregnant women and their infants, along with the placental pathology correlation results, including villous trophoblast immunoexpression status for SARS-CoV-2 antibody, is presented. RT-PCR SARS-CoV-2 amniotic fluid testing was performed. Neonatal surveillance of infection status comprised RT-PCR testing of a nasopharyngeal swab and the measuring of levels of anti-SARS-CoV-2 in blood serum. In the initial study group were 161 pregnant women with positive test results. From that group, women who delivered during the hospital stay were selected for further analysis. Clinical data, laboratory results, placental histomorphology results, and neonatal outcomes were compared in women with immunohistochemistry (IHC)-con SARS-CoV-2-positive and IHC SARS-CoV-2-negative placentas (26 cases). A positive placental immunoprofile was noted in 8% of cases (n = 2), whereas 92% of cases were negative (n = 24). Women with placental infection proven by IHC had significantly different pathological findings from those without. One infected neonate was noted (n = 1; 4%). Infection was confirmed in perinatal autopsy, as there was the intrauterine fetal demise. The potential course of the infection with the risk of vertical transmission and implications for fetal-neonatal condition is critical for proper clinical management, which will involve comprehensive, multidisciplinary perinatal care for SARS-CoV-2-positive patients.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , COVID-19/diagnóstico , Femenino , Humanos , Inmunoglobulina G , Inmunoglobulina M , Lactante , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Placenta/patología , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , SARS-CoV-2
13.
Glob Health Action ; 15(1): 2100602, 2022 12 31.
Artículo en Inglés | MEDLINE | ID: mdl-35969024

RESUMEN

BACKGROUND: The COVID-19 pandemic has interrupted the prevention of mother-to-child transmission of HIV (PMTCT) programming in South Africa. In 2020, it was estimated that there were 4 million cross-border migrants in South Africa, some of whom are women living with HIV (WLWH), who are highly mobile and located within peripheral and urban areas of Johannesburg. Little is known about the mobility typologies of these women associated with different movement patterns, the impact of the COVID-19 pandemic on mobility typologies of women utilising PMTCT services and on how changes to services might have affected adherence. OBJECTIVE: To qualitatively explore experiences of different mobility typologies of migrant women utilising PMTCT services in a high mobility context of Johannesburg and how belonging to a specific typology might have affected the health care received and their overall experiences during the COVID-19 pandemic. METHODS: Qualitative semi-structured interviews with 40 pregnant migrant WLWH were conducted from June 2020-June 2021. Participants were recruited through purposive sampling at a public hospital in Johannesburg. A thematic approach was used to analyse interviews. RESULTS: Forty interviews were conducted with 22 cross-border and 18 internal migrants. Women in cross-border migration patterns compared to interprovincial and intraregional mobility experienced barriers of documentation, language availability, mistreatment, education and counselling. Due to border closures, they were unable to receive ART interrupting adherence and relied on SMS reminders to adhere to ART during the pandemic. All 40 women struggled to understand the importance of adherence because of the lack of infrastructure to support social distancing protocols and to provide PMTCT education. CONCLUSIONS: COVID-19 amplified existing challenges for cross-border migrant women to utilise PMTCT services. Future pandemic preparedness should be addressed with differentiated service delivery including multi-month dispensing of ARVs, virtual educational care, and language-sensitive information, responsive to the needs of mobile women to alleviate the burden on the healthcare system.


Asunto(s)
COVID-19 , Infecciones por VIH , Complicaciones Infecciosas del Embarazo , Migrantes , COVID-19/prevención & control , Atención a la Salud , Femenino , Infecciones por VIH/epidemiología , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Masculino , Pandemias/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Atención Prenatal/métodos , Sudáfrica/epidemiología
15.
Nutrients ; 14(16)2022 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-36014809

RESUMEN

The recent outbreak of the novel Coronavirus (SARS-CoV-2 or CoV-2) pandemic in 2019 and the risk of CoV-2 infection during pregnancy led the scientific community to investigate the potential negative effects of Coronavirus infection on pregnancy outcomes and fetal development. In particular, as CoV-2 neurotropism has been demonstrated in adults, recent studies suggested a possible risk of fetal brain damage and fetal brain development impairment, with consequent psychiatric manifestations in offspring of mothers affected by COronaVIrus Disease (COVID) during pregnancy. Through the understanding of CoV-2's pathogenesis and the pathways responsible for cell damage, along with the available data about neurotropic virus attitudes, different strategies have been suggested to lower the risk of neurologic disease in newborns. In this regard, the role of nutrition in mitigating fetal damages related to oxidative stress and the inflammatory environment during viral infection has been investigated, and arginine, n3PUFA, vitamins B1 and B9, choline, and flavonoids were found to be promising in and out of pregnancy. The aim of this review is to provide an overview of the current knowledge on the mechanism of fetal brain damage and the impact of nutrition in reducing inflammation related to worse neurological outcomes in the context of CoV-2 infections during pregnancy.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , Adulto , Encéfalo , Suplementos Dietéticos , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Embarazo , SARS-CoV-2
16.
Artículo en Inglés | MEDLINE | ID: mdl-35954874

RESUMEN

The association between maternal COVID-19 infection, placental histomorphology and perinatal outcomes is uncertain. The published studies on how placental structure is affected after SARS-CoV-2 virus in COVID-19-infected pregnant women are lacking. We investigated the effects of maternal SARS-CoV-2 infection on placental histomorphology and pregnancy outcomes. A retrospective cohort study on 47 pregnant women with confirmed SARS-CoV-2 infection, matched with non-infected controls, was conducted. Relevant clinicopathological data and primary birth outcomes were recorded. Histomorphology and SARS-CoV-2 immunohistochemistry analyses of placental tissues were performed. Only 1 of 47 cases showed SARS-CoV-2 immunoreactivity in the syncytiotrophoblasts. Histologically, decidual vasculopathy (n = 22/47, p = 0.004), maternal vascular thrombosis (n = 9/47, p = 0.015) and chronic histiocytic intervillositis (n = 10/47, p = 0.027) were significantly higher in the COVID-19-infected placentas when compared to the control group. Maternal vascular thrombosis was a significant feature in the active COVID-19 group. A significant lower gestational age (p < 0.001)) at delivery and a higher caesarean section rate (p = 0.007) were observed in the active SARS-CoV-2-infected cases, resulting in a significant lower fetal-placental weight ratio (p = 0.022) and poorer Apgar score (p < 0.001). Notably, active (p = 0.027), symptomatic (p = 0.039), severe-critical (p = 0.002) maternal COVID-19 infection and placental inflammation (p = 0.011) were associated with an increased risk of preterm delivery. Altered placental villous maturation and severe-critical maternal COVID-19 infection were associated with an elevated risk of poor Apgar scores at birth (p = 0.018) and maternal mortality (p = 0.023), respectively.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , Cesárea , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Placenta , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Resultado del Embarazo/epidemiología , Estudios Retrospectivos , SARS-CoV-2 , Índice de Severidad de la Enfermedad
17.
Placenta ; 127: 73-76, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35973367

RESUMEN

Although SARS-CoV-2 can infect human placental tissue, vertical transmission is rare. Therefore, the placenta may function as a barrier to inhibit viral transmission to the foetus, though the mechanisms remain unclear. In this study, we confirmed the presence of the SARS-CoV-2 genome in human placental tissue by in situ hybridization with antisense probes targeting the spike protein; tissue staining was much lower when using sense probes for the spike protein. To the best of our knowledge, this is the first evidence directly indicating inefficient viral replication in the SARS-CoV-2-infected placenta. Additional studies are required to reveal the detailed mechanisms.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , Femenino , Humanos , Transmisión Vertical de Enfermedad Infecciosa , Placenta/metabolismo , Embarazo , SARS-CoV-2 , Glicoproteína de la Espiga del Coronavirus
18.
J Microbiol Biotechnol ; 32(9): 1098-1102, 2022 Sep 28.
Artículo en Inglés | MEDLINE | ID: mdl-36039383

RESUMEN

The placenta is a captivating multifunctional organ of fetal origin and plays an essential role during pregnancy by intimately connecting mother and baby. This study explicates placental pathology and information about 25 placentas collected from the mothers infected with novel coronavirus (SARS-COV-2). So far, congenital transmission of SARS-CoV-2 seems to be remarkably uncommon in spite of many cases of COVID-19 during pregnancy. Out of the 25 placental tissue samples collected, none has shown gene expression of SARS-CoV-2 when confirmed by RT-PCR. At the same time, nasal and throat swab samples collected from newborns of SARS-CoV-2-positive mothers correspondingly tested negative by RT-PCR. The shielding properties of placental barriers against viral infections from mothers to newborns remains a mystery. Major histopathological findings have been recorded as choriodecidual tissue with necrosis, intramural fibrin deposition, chorionic villi with fibrosis, and calcification. Moreover, although recent findings are insufficient to prove direct placental transmission of COVID-19, the abundance of angiotensin-converting enzymes-2 (ACE-2) on the placental surface could potentially contribute to unpleasant outcomes during pregnancy as SARSCoV-2 gains access to human cells via ACE-2. Finally, the significance of these findings is vague and needs further study.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , Angiotensinas , Femenino , Fibrina , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Madres , Placenta/patología , Embarazo , SARS-CoV-2
19.
Eur J Pediatr ; 181(9): 3537-3543, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35802208

RESUMEN

COVID-19 pandemic has affected all age groups globally including pregnant women and their neonates. The aim of the study was to understand outcomes in neonates of mothers with COVID-19 during the first and second waves of COVID-19 pandemic. A retrospective analysis of 2524 neonates born to SARS-CoV-2-infected mothers was conducted during the first wave (n = 1782) and second wave (n = 742) of the COVID-19 pandemic at five study sites of the PregCovid registry in Maharashtra, India. A significant difference was noted in preterm birth, which was higher in the second wave (15.0%, 111/742) compared to the first wave (7.8%, 139/1782) (P < 0.001). The proportion of neonates requiring NICU admission was significantly higher in the second wave (19.0%, 141/742) as compared to that in the first wave (14.8%, 264/1782) (P < 0.05). On comparing regional differences, significantly higher neonatal complications were reported from Mumbai metropolitan region (P < 0.05). During the second wave of COVID-19, birth asphyxia and prematurity were 3.8- and 2.1-fold higher respectively (P < 0.001). Neonatal resuscitation at birth was significantly higher in second wave (3.4%, 25/742 vs 1.8%, 32/1782) (P < 0.05). The prevalence of SARS-CoV-2 infection in neonates was comparable (4.2% vs 4.6%) with no significant difference between the two waves. CONCLUSION: Higher incidence of adverse outcomes in neonates born to SARS-CoV-2-infected mothers in the second wave of COVID-19 as compared to the first wave. TRIAL REGISTRATION: PregCovid study is registered with the Clinical Trial Registry of India (CTRI/2020/05/025423, Registered on 28/05/2020). WHAT IS KNOWN: • The second wave of COVID-19 was more lethal to pregnant women than the first wave. Newborns are at risk of developing complications. WHAT IS NEW: • Birth asphyxia, prematurity, and neonatal resuscitation at birth were significantly higher in the second wave as compared to those in the first wave of the COVID-19 pandemic in India.


Asunto(s)
COVID-19 , Enfermedades del Recién Nacido , Complicaciones Infecciosas del Embarazo , Nacimiento Prematuro , Asfixia/epidemiología , COVID-19/epidemiología , Femenino , Humanos , India/epidemiología , Recién Nacido de Bajo Peso , Recién Nacido , Enfermedades del Recién Nacido/epidemiología , Transmisión Vertical de Enfermedad Infecciosa , Madres , Pandemias , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Nacimiento Prematuro/epidemiología , Resucitación , Estudios Retrospectivos , SARS-CoV-2
20.
Indian J Med Res ; 155(1): 189-196, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-35859443

RESUMEN

Background & objectives: Data on neonatal COVID-19 are limited to the immediate postnatal period, with a primary focus on vertical transmission in inborn infants. This study was aimed to assess the characteristics and outcome of COVID-19 in outborn neonates. Methods: All neonates admitted to the paediatric emergency from August 1 to December 31, 2020, were included in the study. SARS-CoV-2 reverse transcription- (RT)-PCR test was done on oro/nasopharyngeal specimens obtained at admission. The clinical characteristics and outcomes of SARS-CoV-2 positive and negative neonates were compared and the diagnostic accuracy of a selective testing policy was assessed. Results: A total of 1225 neonates were admitted during the study period, of whom SARS-CoV-2 RT-PCR was performed in 969. The RT-PCR test was positive in 17 (1.8%). Mean (standard deviation) gestation and birth weight of SARS-CoV-2-infected neonates were 35.5 (3.2) wk and 2274 (695) g, respectively. Most neonates (11/17) with confirmed COVID-19 reported in the first two weeks of life. Respiratory distress (14/17) was the predominant manifestation. Five (5/17, 29.4%) SARS-CoV-2 infected neonates died. Neonates with COVID-19 were at a higher risk for all-cause mortality [odds ratio (OR): 3.1; 95% confidence interval (CI): 1.1-8.9, P=0.03]; however, mortality did not differ after adjusting for lethal malformation (OR: 2.4; 95% CI: 0.7-8.7). Sensitivity, specificity, accuracy, positive and negative likelihood ratios (95% CI) of selective testing policy for SARS-CoV-2 infection at admission was 52.9 (28.5-76.1), 83.3 (80.7-85.6), 82.8 (80.3-85.1), 3.17 (1.98-5.07), and 0.56 (0.34-0.93) per cent, respectively. Interpretation & conclusions: SARS-CoV-2 positivity rate among the outborn neonates reporting to the paediatric emergency and tested for COVID-19 was observed to be low. The selective testing policy had poor diagnostic accuracy in distinguishing COVID-19 from non-COVID illness.


Asunto(s)
COVID-19 , Complicaciones Infecciosas del Embarazo , COVID-19/diagnóstico , Niño , Femenino , Hospitalización , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Embarazo , SARS-CoV-2
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