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Med Glas (Zenica) ; 19(1)2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-34486362


Aim To investigate clinical presentation of COVID-19 infection in pregnancy, its course during pregnancy, effects on pregnancy outcomes for both mothers and newborns as well as the potential for vertical transmission. Methods This retrospective observational study included all identifi ed COVID-19-positive pregnant women admitted to the Cantonal Hospital in Zenica at any stage of pregnancy or labour from 30 April 2020 to April 30 2021. Maternity and newborns were followed until discharge from the hospital. Results Twenty-four pregnant women were positive for COVID-19. There were 79.2% asymptomatic cases, 12.5% had mild symptoms, while 8.3% had more severe forms of the disease. The main follow-up morbidities were high BMI 33.3%, anaemia 16.7%, thrombocytopenia 12.5%, hypertensive disorders 4.2% and diabetes 4.2%. The rate of premature births was 33.3%, while 8.3% pregnant women had premature rupture of the amniotic sac. Caesarean section was done for 75% women while 25% delivered vaginally. Previous caesarean section (54.2%) was the most common indication for operative completion of labour. Twentythree (92%) live babies were born, of which 8 (33.3%) were admitted to the neonatal intensive care unit. Two (8%) intrauterine foetal deaths were recorded that occurred before admission to our hospital. Two infants (8.7%) had a positive PCR test for COVID-19. Conclusion COVID-19 viral disease in pregnancy is usually presented as an asymptomatic or mild disease. It is associated with high rates of preterm birth, admission of newborns to the intensive care unit and intrauterine foetal death. Vertical transmission is possible but the newborns were asymptomatic.

Cytokine ; 149: 155751, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34739899


BACKGROUND: New biomarkers for diagnosis and monitoring the COVID-19 disease are the most important topics to be studied recently. We aimed to investigate the association between midkine levels and disease severity in pregnant women with COVID-19. METHODS: Totally 186 pregnant women were participated in this study. 96 of them were healthy pregnant women, 90 of them were pregnant women with COVID19. Pregnant women were evaluated according to their trimesters. Serum midkine level, biochemical profile clinical and disease severity outcomes of pregnant women were obtained. RESULTS: Our results showed that pregnant women with COVID19 have significantly increased serum midkine level compared to healthy pregnant women (1.801 ± 0.977 vs 0.815 ± 0.294 ng/dL). According to the data among each trimester, it was shown that there were significant increase in serum midkine level during all pregnancy trimesters (1st trimester Control Group: 0.714 ± 0.148, COVID-19 group 1.623 ± 0.824, p < 0.0001; 2nd trimester Control Group: 0.731 ± 0.261, COVID-19 group 2.059 ± 1.146, p < 0.0001; 3rd trimester Control Group: 1.0 ± 0.35, COVID-19 group 1.723 ± 0.907, p = 0.001). Serum midkine levels were significantly different between disease severity subgroups of pregnant women with COVID19; moderate and severe/critic groups had significantly higher serum midkine level than mild group. There was also significant correlation between serum midkine level and severity status (p:0.0001, r: 0.468). The most striking results of serum midkine levels were corelation between length of hospitalization (p: 0.01, r: 0.430) and O2 saturation (p < 0.0001, r: -0.521). ROC curve analysis showed that serum midkine level might be a tool for predicting COVID-19 in pregnant women with COVID-19 (AUC: 0.912, 95% CI: [0.871, 0.952], p < 0.0001) CONCLUSION: Our data showed that there is an obvious relation between COVID19 progression and serum midkine level for the first time which might be used for monitoring the disease process.

Case Rep Womens Health ; 33: e00368, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34786352


Background: Diagnostic and therapeutic challenges may arise in the management of gynecologic emergencies, such as ectopic pregnancy, for women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Case: A 33-year-old woman (gravida 3, para 2) with a history of SARS-CoV-2 infection 8 months prior experienced sudden onset of fever and cough. Four days later, she consulted her gynecologist because of a positive pregnancy test and was further referred because of suspected ectopic pregnancy at 11 weeks of gestation, as calculated from her last irregular menstrual period. At triage, the patient complained of dyspnea, chest pain, and cough. Real-time reverse transcription-polymerase chain reaction assay detected SARS-CoV-2, which was subsequently identified to be an L452R variant. Chest computerized tomography (CT) showed moderate COVID-19 pneumonia. Transvaginal ultrasonography and pelvic CT showed a right tubal mass without an intrauterine gestational sac, suggesting right tubal pregnancy. Systemic methotrexate (MTX) therapy was chosen for management of the tubal pregnancy because of the patient's unruptured hemodynamically stable status, along with immediate administration of remdesivir and casirivimab-imdevimab to prevent worsening of the pneumonia. After failed MTX therapy, gasless laparoendoscopic single-site right salpingectomy was performed due to concern for tubal rupture. Four days after surgery, the patient was discharged from the hospital without subsequent complications. Conclusions: Laparoscopic surgery, preceded by anti-viral therapy for COVID-19, is a feasible option for the management of hemodynamically stable tubal pregnancy in a woman with moderate COVID-19 pneumonia.

J Affect Disord ; 296: 577-586, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34606803


BACKGROUND: The COVID-19 pandemic gave rise to concerns about its potential impact on the mental health of pregnant and postpartum women as the general postpartum depression rates increased. METHODS: Three postpartum questionnaires (Edinburgh Postnatal Depression Scale - EPDS; Anxiety and Depression Scale - HAD; and a demographic questionnaire about isolation and information acquisition) were used to evaluate the mental health of women with and without COVID-19 and determine the factors associated with depressive symptoms (EPDS ≥ 12). RESULTS: Data from 184 participants with a mean of 56 postpartum days were analyzed. The rate of symptoms compatible with postpartum depression (PPD) was 38.8%, with a 14.3% positive response to item 10 on the EPDS (suicidal ideation - SI). Listening to the news about COVID-19 averaged 4.45 hours a day. Factors related to PPD were concerns about lack of hospital beds (OR = 2.45), absence of a partner (OR = 2.70), and anxiety symptoms (OR = 10). Factors related to SI were anxiety symptoms (OR = 1.56) and friends as a source of information (OR = 5.60). LIMITATIONS: Considering the rapidly changing epidemiological conditions of this pandemic, this study may only be the photograph of an instant. CONCLUSIONS: Higher rates of PPD in the Brazilian population are related not only to anxiety but also to an inadequate family environment, kind of information acquisition and concerns about the lack of hospital beds.

COVID-19 , Depressão Pós-Parto , Depressão , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Pandemias , Período Pós-Parto , Gravidez , Escalas de Graduação Psiquiátrica , Fatores de Risco , SARS-CoV-2
Talanta ; 237: 122916, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34736654


Herein, we show differences in blood serum of asymptomatic and symptomatic pregnant women infected with COVID-19 and correlate them with laboratory indexes, ATR FTIR and multivariate machine learning methods. We collected the sera of COVID-19 diagnosed pregnant women, in the second trimester (n = 12), third-trimester (n = 7), and second-trimester with severe symptoms (n = 7) compared to the healthy pregnant (n = 11) women, which makes a total of 37 participants. To assign the accuracy of FTIR spectra regions where peak shifts occurred, the Random Forest algorithm, traditional C5.0 single decision tree algorithm and deep neural network approach were used. We verified the correspondence between the FTIR results and the laboratory indexes such as: the count of peripheral blood cells, biochemical parameters, and coagulation indicators of pregnant women. CH2 scissoring, amide II, amide I vibrations could be used to differentiate the groups. The accuracy calculated by machine learning methods was higher than 90%. We also developed a method based on the dynamics of the absorbance spectra allowing to determine the differences between the spectra of healthy and COVID-19 patients. Laboratory indexes of biochemical parameters associated with COVID-19 validate changes in the total amount of proteins, albumin and lipase.

COVID-19 , Feminino , Humanos , Laboratórios , Aprendizado de Máquina , Gravidez , Gestantes , SARS-CoV-2 , Soro , Análise Espectral , Vibração
Clin Invest Ginecol Obstet ; 49(1): 100704, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-34230736


Background: Work-related stress, fear of becoming infected, and the lack of means to combat the COVID-19 pandemic, added to the situation of lockdown at home could lead to a strong impact on mental health.The objective was to determine the level of anxiety through the State-Trait Anxiety Inventory, STAI completed by the professionals of a delivery room who treated COVID-19-positive pregnant women. Material and methods: Descriptive cross-sectional study in an obstetric area in Barcelona from March 14th to May 24th, 2020. Study population: healthcare staff over 18 years old, without diagnosed anxiety disorders prior to the pandemic.The main parameters to study were the level of «state anxiety¼ and «trait anxiety¼ according to the STAI questionnaire.Descriptive and inferential statistics were performed. The level of statistical significance used was p<.05. Results: Seventy-seven professionals participated in this study.The mean score for «state anxiety¼ was 26.3 points (p-value = .067) and for «strait anxiety¼, 14.3 points (p-value = .091).It was observed that the professionals who had children (p-value = .048) and the professionals who stated that their family economic income had decreased (p-value = .026) showed higher average scores of «state anxiety¼. A positive association was observed between years of working experience and the level of «state anxiety¼, observing statistically significant differences, p-value = .030. Conclusions: The professionals who had suffered a reduction in their income together with those who lived with children presented higher scores of «state anxiety¼.

Esc. Anna Nery Rev. Enferm ; 26(spe): e20210179, 2022. ilus
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1292850


Objetivo: O estudo objetivou compreender as repercussões da pandemia da Covid-19 no cuidado de lactentes prematuros, na perspectiva de mães e profissionais de saúde. Método: Foram realizadas entrevistas semiestruturadas nos meses de junho e julho de 2020, por meio de ligação telefônica, com 14 mães e quatro profissionais de saúde do serviço de follow-up de uma maternidade pública da Paraíba, Brasil. Resultados: A partir da análise temática indutiva, os impactos da pandemia no cuidado ao lactente nascido prematuro, foram: sobrecarga e afastamento dos profissionais dos serviços de saúde, desativação temporária da unidade mãe canguru, descontinuidade da assistência ao prematuro, medo materno de expor a criança à Covid-19 e baixa condição socioeconômica. Foram elencadas estratégias de enfrentamento para o cuidado dos lactentes durante a pandemia, como: maior espaçamento das consultas, acompanhamento por meio telefônico e cumprimento das medidas de biossegurança. Conclusão e implicações para a prática: A pandemia exigi adaptações na assistência, tornando necessárias novas formas de cuidado a essas crianças, como exemplo, as consultas de acompanhamento remotas, a fim de garantir o seu direito à vida e saúde

Objective: The study aimed at understanding the repercussions of the Covid-19 pandemic in the care of premature infants, from the perspective of mothers and health professionals. Method: Semi-structured interviews were conducted in the months of June and July 2020, over the telephone, with 14 mothers and four health professionals from the follow-up service of a public maternity hospital in Paraíba, Brazil. Results: From the inductive thematic analysis, the impacts of the pandemic on the care of premature infants were as follows: overload and distancing of health service professionals, temporary deactivation of the Kangaroo mother unit, discontinuity of care for the premature infant, maternal fear of exposing the child to Covid-19 and low socioeconomic status. Coping strategies for the care of infants during the pandemic were listed, such as: greater spacing between consultations, phone follow-up and compliance with biosafety measures. Conclusion and implications for the practice: The pandemic required adaptations in care, which make new forms of care necessary for these children, such as remote follow-up consultations, in order to guarantee their right to life and health

Objetivo: El estudio tuvo como objetivo comprender las repercusiones de la pandemia de Covid-19 en la atención de bebés prematuros, desde la perspectiva de las madres y los profesionales de la salud. Método: Se realizaron entrevistas semiestructuradas en los meses de junio y julio de 2020, por medio de llamadas telefónicas, a 14 madres y cuatro profesionales de la salud del servicio de seguimiento de una maternidad pública en Paraíba, Brasil. Resultados: A partir del análisis temático inductivo, los efectos de la pandemia en la atención de bebés prematuros fueron los siguientes: sobrecarga y distanciamiento de profesionales de los servicios de salud, inhabilitación temporal de la unidad Madre Canguro, discontinuidad de la atención al bebé prematuro, miedo materno a exponer al niño al Covid-19 y nivel socioeconómico bajo. Se enumeraron estrategias de afrontamiento para la atención infantil durante la pandemia, tales como: mayor intervalo entre consultas, seguimiento telefónico y cumplimiento de medidas de bioseguridad. Conclusión e implicaciones para la práctica: La pandemia requirió adaptaciones en la atención, que hacen necesarias nuevas formas de atención para estos niños, como las consultas de monitoreo remoto, para garantizar su derecho a la vida y a la salud

Humanos , Feminino , Lactente , Adulto , Pessoa de Meia-Idade , Recém-Nascido Prematuro/crescimento & desenvolvimento , Pessoal de Saúde , Serviços de Saúde Materno-Infantil , COVID-19 , Cuidado do Lactente , Mães , Carga de Trabalho/psicologia , Consulta Remota , Pesquisa Qualitativa , Cobertura Vacinal , Medo , Método Canguru , Higiene das Mãos , Distanciamento Físico , COVID-19/prevenção & controle
Rev. Paul. Pediatr. (Ed. Port., Online) ; 40: e2020415, 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1250810


ABSTRACT Objective: To perform a systematic literature review to analyze existing data on the neurological effects of coronavirus on newborns. Data sources: We followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P), and searched the PubMed and Embase platforms for the keywords [brain damage OR pregnancy OR developmental outcomes] and [coronavirus OR SARS-CoV-2 OR SARS-CoV OR MERS-CoV] between January 1, 2000 and June 1, 2020. Data synthesis: Twenty-three reports described the course of pregnant women exposed to SARS-CoV-2, SARS-CoV, or MERS-CoV during the gestational period, eight to SARS-CoV-2, eight to SARS-CoV, and seven to MERS-CoV. No data were found on abnormalities in brain development or on a direct link between the virus and neurological abnormalities in the human embryo, fetus, or children. Spontaneous miscarriage, stillbirth, and termination of pregnancy were some complications connected with SARS/MERS-CoV infection. SARS-CoV-2 is not currently associated with complications in the gestational period. Conclusions: The literature has no data associating exposure to coronavirus during pregnancy with brain malformations and neurodevelopmental disorders. However, despite the lack of reports, monitoring the development of children exposed to SARS-CoV-2 is essential given the risk of complications in pregnant women and the potential neuroinvasive and neurotropic properties found in previous strains.

RESUMO Objetivo: Realizar uma revisão sistemática da literatura para analisar os dados existentes sobre os efeitos neurológicos do coronavírus em recém-nascidos. Fontes de dados: Esta revisão seguiu as diretrizes dos Principais Itens para Relatar Revisões Sistemáticas e Meta-Análises (Preferred Reported Items for Systematic Review - PRISMA) e dos Protocolos dos Principais Itens para Relatar Revisões Sistemáticas e Meta-Análises (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols - PRISMA-P), pesquisando as plataformas PubMed e Embase pelas palavras-chave [brain damage (dano cerebral) OU pregnancy (gravidez) OU developmental outcomes (alterações de desenvolvimento)] e [coronavirus (coronavírus) OU SARS-CoV-2 OU SARS-CoV OU MERS-CoV] entre 1º de janeiro de 2000 e 1º de junho de 2020. Síntese dos dados: Vinte e três relatos descreveram a evolução de mulheres grávidas expostas ao SARS-CoV-2, SARS-CoV ou MERS-CoV durante o período gestacional, oito ao SARS-CoV-2, oito ao SARS-CoV e sete ao MERS-CoV. Não foram encontrados dados sobre anormalidades no desenvolvimento cerebral ou sobre uma ligação direta entre o vírus e alterações neurológicas no embrião, feto ou crianças. Abortamento espontâneo, morte fetal e interrupção da gravidez foram algumas das complicações relacionadas à infecção por SARS/MERS-CoV. Até o momento, o SARS-CoV-2 não está associado a complicações no período gestacional. Conclusões: Não há dados na literatura que associem a exposição ao coronavírus durante a gravidez com malformações cerebrais e distúrbios do neurodesenvolvimento. No entanto, apesar da falta de relatos, o monitoramento do desenvolvimento de crianças expostas ao SARS-CoV-2 é essencial devido ao risco de complicações em gestantes e às potenciais propriedades neuroinvasivas e neurotrópicas encontradas em cepas anteriores.

Rev. enferm. UERJ ; 29: e56037, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1151921


Objetivo: mapear as evidências disponíveis na literatura acerca dos manejos e desfechos da infecção pelo novo coronavírus no puerpério. Método: revisão de escopo conforme o Institute Joanna Briggs, desenvolvida em quatro fontes de dados eletrônicas. A extração, análise e síntese dos dados foi realizada por quatro pesquisadores independentes. Resultados: Nove publicações foram revisadas de 188 localizadas. Seis foram os países produtores das evidências, todas obtidas e publicadas em 2020. Vinte e um casos de COVID-19 no puerpério estiveram tratados nestas publicações, sendo 15 (71,4%) relativos a evoluções graves/exacerbação da doença e seis (28,6%) diagnosticados após a alta hospitalar. Conclusão: O mapeamento aponta para a ocorrência da infecção ou seu agravamento no período pós-parto, com indicativas ao monitoramento de sinais e sintomas, exploração diagnóstica e tratamento acurado e necessidade de acompanhamento próximo das mulheres diagnosticadas com COVID-19, sintomáticas ou não, no período pós-parto.

Objective: to map the evidence available in the literature about management and outcomes of postpartum infection by the new coronavirus. Method: scoping review conducted in four electronic sources, following Joanna Briggs Institute guidelines. Data were extracted, analyzed and summarized by four researchers independently. Results: nine of the 188 publications located were reviewed. The evidence, all obtained and published in 2020, was produced in six countries. These publications considered 21 cases of postpartum COVID-19, 15 (71.4%) of which related to severe developments / exacerbation of the disease and six (28.6%) diagnosed after hospital discharge. Conclusion: the mapping points to the occurrence of infection or worsening of the disease in the postpartum period, indicating the need for monitoring of signs and symptoms, diagnostic exploration and accurate treatment and the need for close monitoring of postpartum women diagnosed with COVID-19, whether symptomatic or not.

Objetivo: mapear las evidencias disponibles en la literatura sobre el manejo y los resultados de la infección por el nuevo coronavirus en el período posparto. Método: revisión del alcance según el Instituto Joanna Briggs, desarrollada en cuatro fuentes de datos electrónicas. La extracción, el análisis y la síntesis de los datos fueron realizados por cuatro investigadores independientes. Resultados: se revisaron nueve publicaciones de 188 encontradas. Fueron seis los países que produjeron las evidencias, obtenidas y publicadas en 2020. En estas publicaciones se trataron 21 casos de COVID-19 en el período posparto, 15 (71,4%) de los cuales estaban relacionados con evoluciones graves/exacerbación de la enfermedad y seis (28,6%) diagnosticados tras el alta hospitalaria. Conclusión: el mapeo apunta hacia la ocurrencia de la infección o su agravamiento en el posparto, con indicaciones de seguimiento de indicios y síntomas, exploración diagnóstica, tratamiento preciso y la necesidad de un seguimiento cercano a las mujeres diagnosticadas con COVID-19, sintomáticas o no, en el período posparto.

Humanos , Feminino , Gravidez , Saúde da Mulher , Período Pós-Parto , COVID-19 , COVID-19/terapia , COVID-19/epidemiologia , Revisão , Infecções por Coronavirus , Período Pós-Parto/sangue , COVID-19/diagnóstico
Rev. colomb. anestesiol ; 49(4): e202, Oct.-Dec. 2021. tab, graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1341238


Abstract Introduction Information regarding the clinical behavior and the anesthetic and perioperative management in pregnant patients with SARS-CoV-2 is starting to appear in the literature in the form of case reports or case series. However, strong evidence and recommendations are still limited. Objective To describe the clinical characteristics, the results of anesthetic and perioperative management, and complications in seroprevalent pregnant women for SARS-CoV-2 infection, delivered by cesarean section. Methodology Observational study in which 107 clinical records of pregnant women who were seroprevalent for SARS-CoV-2 infection were reviewed and analyzed between April and June, 2020. Demographic, clinical and serological data were collected, as well as data on the anesthetic technique and intraoperative and postoperative complications. Results Of the 107 pregnant women with SARS-CoV-2 infection, 99 (92.52%) were asymptomatic and 8 (7.48%) had mild symptoms. The most frequent reasons for cesarean section were cephalo-pelvic disproportion in 20 (18.68%), previous cesarean section in 20 (18.68%) and non-reassuring fetal status in 14 (13.08%). Anesthesia technique was neuraxial in all cases, with spinal used in 100 (93.5%), combined spinal-epidural in 4 (3.7%) and epidural catheter in 3 (2.8%) patients. No deaths had occurred until the third postoperative day of follow-up. Conclusions The majority of pregnant women with SARS-CoV-2 infection are asymptomatic. In this work, spinal, combined spinal-epidural and epidural neuroxial anesthesia techniques were shown to be effective and safe for these patients and their newborn babies.

Resumen Introducción La información del comportamiento clínico, manejo anestésico y perioperatorio en gestantes con SARS-CoV-2 empieza a aparecer en la literatura mediante reportes de casos o serie de casos. Aún son limitadas la evidencia contundente y las recomendaciones. Objetivo Describir las características clínicas, resultados del manejo anestésico, perioperatorio y complicaciones en gestantes seroprevalentes para infección por SARS-CoV-2, cuyo parto fue por cesárea. Metodología Estudio observacional en el cual se revisaron y analizaron 107 historias clínicas de gestantes seroprevalentes para infección por SARS-CoV-2, de abril a junio del 2020. Se recolectaron datos demográficos, clínicos, serología, técnica anestésica y complicaciones intra y postoperatorias. Resultados De las 107 gestantes con infección por SARS-CoV-2, 99 (92,52 %) fueron asintomáticas y 8 (7,48 %) presentaron síntomas leves. Los motivos más frecuentes de cesárea fueron: desproporción céfalo-pélvica 20 (18,68 %), cesárea previa 20 (18,68 %) y estado fetal no tranquilizador 14 (13,08 %). La técnica anestésica fue neuro axial en su totalidad, espinal en 100 (93,5 %), combinada espinal-epidural en 4 (3,7 %) y epidural con catéter en 3 (2,8 %) pacientes. No se registraron muertes hasta el tercer día postoperatorio de seguimiento. Conclusiones Las gestantes con infección por SARS-CoV-2 presentan -en su mayoría- infecciones asintomáticas. En este trabajo, la anestesia neuro axial: espinal, combinada espinal-epidural y epidural, se presentan como técnicas efectivas y seguras para estas pacientes y sus recién nacidos.

Humanos , Feminino , Gravidez , Cesárea , SARS-CoV-2 , Anestesia , Peru , COVID-19 , Anestesia Epidural
Front Psychol ; 12: 729302, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34721190


Efficient data collection in developmental studies is facing challenges due to the decreased birth rates in many regions, reproducibility problems in psychology research, and the COVID-19 pandemic. Here, we propose a novel platform for online developmental science research, the Baby's Online Live Database (BOLD), which extends the scope of the accessible participant pool, simplifies its management, and enables participant recruitment for longitudinal studies. Through BOLD, researchers can conduct online recruitment of participants preregistered to BOLD simply by specifying their attributes, such as gender and age, and direct the participants to dedicated webpages for each study. Moreover, BOLD handles participant recruitment and reward payment, thereby freeing researchers from the labor of participant management. BOLD also allows researchers the opportunity to access data that were collected from participants in previous research studies. This enables researchers to carry out longitudinal analyses at a relatively low cost. To make BOLD widely accessible, a consortium was formed within the Japan Society of Baby Science, where members from diverse research groups discussed the blueprint of this system. Once in full-scaled operation, BOLD is expected to serve as a platform for various types of online studies and facilitate international collaboration among developmental scientists in the near future.

J Family Reprod Health ; 15(3): 150-159, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34721606


Objective: Female sex hormones have a pro-inflammatory effect, which may help to minimize inflammation. Estrogen's immunoregulatory properties play a significant role in the bi-directional neuroendocrine-immune activity in females. As a result, sex hormones can play a role in men's high mortality rate from coronavirus-2019 (COVID-19). It is aimed to clarify the role of 17-estradiol (E2) in the battle against COVID-19. Materials and methods: Until April 2021, a study on PubMed was performed. COVID-19, 17-estradiol (E2), immunoregulatory properties, pregnancy, menopausal symptoms, hormonal therapy, ER/ expression on immune cells, and mortality were some of the concepts used in the search. Results: Regulation of pro-inflammatory immune processes against COVID-19 appears to be associated with increased immune function (pro-inflammatory), anti-inflammatory regulation, and antiviral defense. Women with a severe coronavirus infection had higher serum IgG antibody levels than men, and their IgG production was faster in the early stages of infection. 17-estradiol (E2) levels of blood will increase by 100-fold during pregnancy. COVID-19 in pregnant women had a 15-fold lower mortality rate than other women. While menopause replacement therapy (MRT) for pre/post-menopausal women and its effectiveness in reducing COVID-19 infection is debatable. Conclusion: MRT may be considered as a viable treatment option for pre/post-menopause women with coronavirus, referring to the fact that sex hormones reduce inflammatory responses and modulate ACE2 expression. The task's difficulty and achieving the desired outcome seem to be challenging.

Front Med (Lausanne) ; 8: 727101, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34722567


Purpose: There is no clear consensus on the clinical course of critical COVID-19 patients. We examined the clinical course among intubated survivors, non-survivors, and extracorporeal membrane oxygenation (ECMO) patients to reveal the standard clinical course and the difference among critical COVID-19 patients. Methods: In this systematic review and meta-analysis, we searched PubMed, Web of Science, and Scopus for original studies published until December 11, 2020, including case accumulation and clinical course reporting. Pregnant patients and children were excluded. We followed PRISMA guidelines and registered them with PROSPERO (CRD42021235534). Results: Of the 11,716 studies identified, 94 met the selection criteria, and 2,549 cases were included in this meta-analysis. The times from intubation to extubation and death were 12.07 days (95% confidence interval 9.80-14.33 days) and 10.14 days (8.18-12.10 days), respectively, and the ECMO duration was 14.72 days (10.57-18.87 days). The time from symptom onset to hospitalization (prehospitalization period) of intubated survivors, non-survivors, and ECMO patients was 6.15 (4.61-7.69 days), 6.45 (4.55-8.34 days), and 7.15 days (6.48-7.81 days), and that from symptom onset to intubation (preintubation period) was 8.58 (7.36-9.80 days), 9.14 (7.26-11.01 days), and 10.54 days (9.18-11.90 days), respectively. Sensitivity analysis showed that the time from intubation to extubation and death was longer in the US and Europe than in East Asia. Conclusion: For COVID-19, we hypothesize that prehospitalization and preintubation periods are longer in intubated non-survivors and ECMO patients than in intubated survivors. These periods may serve as a predictor of disease severity or death and support therapeutic strategy determination.

Wellcome Open Res ; 6: 21, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34722933


Preterm birth is the leading cause of infant death worldwide, but the causes of preterm birth are largely unknown. During the early COVID-19 lockdowns, dramatic reductions in preterm birth were reported; however, these trends may be offset by increases in stillbirth rates. It is important to study these trends globally as the pandemic continues, and to understand the underlying cause(s). Lockdowns have dramatically impacted maternal workload, access to healthcare, hygiene practices, and air pollution - all of which could impact perinatal outcomes and might affect pregnant women differently in different regions of the world. In the international Perinatal Outcomes in the Pandemic (iPOP) Study, we will seize the unique opportunity offered by the COVID-19 pandemic to answer urgent questions about perinatal health. In the first two study phases, we will use population-based aggregate data and standardized outcome definitions to: 1) Determine rates of preterm birth, low birth weight, and stillbirth and describe changes during lockdowns; and assess if these changes are consistent globally, or differ by region and income setting, 2) Determine if the magnitude of changes in adverse perinatal outcomes during lockdown are modified by regional differences in COVID-19 infection rates, lockdown stringency, adherence to lockdown measures, air quality, or other social and economic markers, obtained from publicly available datasets. We will undertake an interrupted time series analysis covering births from January 2015 through July 2020. The iPOP Study will involve at least 121 researchers in 37 countries, including obstetricians, neonatologists, epidemiologists, public health researchers, environmental scientists, and policymakers. We will leverage the most disruptive and widespread "natural experiment" of our lifetime to make rapid discoveries about preterm birth. Whether the COVID-19 pandemic is worsening or unexpectedly improving perinatal outcomes, our research will provide critical new information to shape prenatal care strategies throughout (and well beyond) the pandemic.

Obes Facts ; : 1-8, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34724671


INTRODUCTION: Lockdown due to the COVID-19 pandemic has caused gym closures and adjustments to ongoing weight loss programs were needed in order to keep the programs running. Little is known whether adjustments affected the success of weight reduction. Weight reduction of at least 5% is related to improved fertility and better pregnancy outcomes in obese women. This study compared success of the weight loss program in infertile polycystic ovary syndrome women with obesity who attended the program before and during lockdown due to COVID-19 pandemic. Furthermore, we checked whether there were any differences in spontaneous pregnancy rates between both groups at the end of the program. METHODS: Altogether, 27 women were prospectively included to the weight loss program. Twelve women attended the 8 - week program before COVID-19 pandemic. Fifteen women began the program before the lockdown and ended it during lockdown. Due to lockdown, the program was prolonged for 4 weeks and taken online. RESULTS: On average, prior to lockdown women achieved a BMI reduction of 6.8% whereas women that attended the program during the lockdown reduced their BMI for 3.7%. This difference was not statistically significant. No significant differences were seen in other measured anthropometric and endocrine parameters between both groups. Furthermore, there were no differences in spontaneous pregnancy rates between both groups. In women who reduced their BMI for 5% or more, spontaneous pregnancy rate was 29.4%. DISCUSSION/CONCLUSIONS: Although statistical significance has not been reached in the present study, we have shown that lockdown due to COVID-19 pandemic has led to almost half lower BMI reduction despite adaptations and longer duration of the weight loss program. On average, BMI in the group of women that attended the program during lockdown was 3.7% lower after the end of the weight loss program. This means they did not reach the wanted 5% reduction which is known to improve fertility. We have also shown that weight reduction is the correct approach for treating infertile women with obesity, as almost 30% of those who reduced their body weight by 5% or more conceived spontaneously.

Obstet Gynecol ; 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34727554


Three coronavirus disease 2019 (COVID-19) vaccines have been authorized for use in the United States; specifically, the Pfizer-BioNTech, Moderna, and Johnson & Johnson-Janssen COVID-19 vaccines were granted emergency use authorization by the U.S. Food and Drug Administration in late 2020 and early 2021. Vaccination coverage and intent among adults are lowest among those aged 18-39 years and among females in particular. In females of reproductive age, enthusiasm for receiving a COVID-19 vaccine may be negatively affected by claims currently circulating widely on diverse social media platforms regarding the vaccines adversely affecting fertility and pregnancy. Yet it is important to note that these claims are anecdotal in nature and not supported by the available scientific evidence. It is also imperative that the effects of COVID-19 vaccine on reproductive health are clarified. Herein, we discuss the existing scientific data supporting COVID-19 vaccine safety and efficacy in people who are planning to conceive or who are pregnant or lactating and highlight the importance of COVID-19 vaccination in females of reproductive age.

Artigo em Inglês | MEDLINE | ID: mdl-34730039


INTRODUCTION: Limited data exist regarding the long-term pulmonary sequelae of COVID-19. Identifying features utilizing multiple imaging modalities engenders a clearer picture of the illness's long-term consequences. AREAS COVERED: This review encompasses the common pulmonary findings associated with different imaging modalities during acute and late remission stages of COVID-19 pneumonia. EXPERT OPINION: Chest x-ray, a common preliminary diagnostic imaging technique, is not optimal for extended care due to limited tissue contrast resolution, which confers suboptimal assessment of pulmonary pathology and subtle interval changes. Ultrasound may be utilized on a case-by-case basis, as a standardized POCUS ER protocol, or in certain patient populations such as pregnant patients that refuse ionizing radiation, or in those countries with limited resources. Chest CT can be utilized in varying disease stages as abnormalities are found several months post-recovery. CT's accessibility, high tissue contrast resolution, and spatial resolution make it the best available modality for long-term monitoring of COVID-19. While MRI is another choice for extended care of extrapulmonary disease due to its lack of radiation and increased soft-tissue resolution, its usefulness for pulmonary pathologies is limited because of motion artifact and decreased signal in lungs, attributable to alveolar gas. Although 18F-FDG-PET/CT is costly and has limited specificity, when utilized in conjunction with other techniques, it provides data at the molecular level and enables quantification of inflammation. Lung perfusion scintigraphy may also help elucidate COVID-19 induced thromboembolic events and manage COVID-19 survivors battling persistent dyspnea despite normal imaging and clinical exam. Correlating the long-term pulmonary findings of COVID-19 with each imaging modality is essential in elucidating the post-recovery course.

Artigo em Inglês | MEDLINE | ID: mdl-34730232


INTRODUCTION: Conflicting reports of increases and decreases in rates of preterm birth (PTB) and stillbirth in the general population during the coronavirus disease 2019 (COVID-19) pandemic have surfaced. The objective of our study was to conduct a living systematic review and meta-analyses of studies reporting pregnancy and neonatal outcomes by comparing the pandemic and pre-pandemic periods. MATERIAL AND METHODS: We searched PubMed and Embase databases, reference lists of articles published up until August 14, 2021 and included English language studies that compared outcomes between the COVID-19 pandemic time period and the pre-pandemic time periods. Risk of bias was assessed using the Newcastle-Ottawa scale. We conducted random-effects meta-analysis using the inverse variance method. RESULTS: Forty-five studies with low-to-moderate risk of bias, reporting on 1 843 665 pregnancies during the pandemic period and 23 564 552 pregnancies during the pre-pandemic period, were included. There was significant reduction in unadjusted estimates of PTB (35 studies, unadjusted odds ratio [uaOR] 0.95, 95% CI 0.92-0.98), but not in adjusted estimates (six studies, adjusted OR [aOR] 0.95, 95% CI 0.80-1.13). This reduction was noted in studies from single centers/health areas (25 studies, uaOR 0.90, 95% CI 0.86-0.96) but not in regional/national studies (10 studies, uaOR 0.99, 95% CI 0.95-1.02). There was reduction in spontaneous PTB (six studies, uaOR 0.89, 95% CI 0.81-0.96) and induced PTB (five studies, uaOR 0.89, 95% CI 0.81-0.97). There was no difference in the odds of stillbirth between the pandemic and pre-pandemic time periods (24 studies, uaOR 1.11, 95% CI 0.97-1.26 and four studies, aOR 1.06, 95% CI 0.81-1.38). There was an increase in mean birthweight during the pandemic period compared with the pre-pandemic period (six studies, mean difference 17 g, 95% CI 7-28 g). The odds of maternal mortality were increased (four studies, uaOR 1.15, 95% CI 1.05-1.26); however, only unadjusted estimates were available and the result was mostly influenced by one study from Mexico. There was significant publication bias for the outcome of PTB. CONCLUSIONS: The COVID-19 pandemic may be associated with a reduction in PTB; however, referral bias cannot be excluded. There was no statistically significant difference in stillbirth between pandemic and pre-pandemic periods.