Impact of the COVID-19 pandemic on perinatal care and outcomes: A retrospective study in a tertiary hospital in Northern Ghana.

BACKGROUND: Perinatal mortality remains a global challenge. This challenge may be worsened by the negative effects of the COVID-19 pandemic on maternal and child health. OBJECTIVES: Examine the impact of the COVID-19 pandemic on perinatal care and outcomes in the Tamale Teaching Hospital in northern Ghana. METHODS: A hospital-based retrospective study was conducted in the Tamale Teaching Hospital. We compared antenatal care attendance, total deliveries, cesarean sections, and perinatal mortality before the COVID-19 pandemic (March 1, 2019 to February 28, 2020) and during the COVID-19 pandemic (March 1, 2020 to February 28, 2021). Interrupted time series analyses was performed to evaluate the impact of the COVID-19 pandemic on perinatal care and outcomes at TTH. RESULTS: A total number of 35,350 antenatal visits and 16,786 deliveries were registered at TTH from March 2019 to February 2021. Antenatal care, early neonatal death, and emergency cesarean section showed a rapid decline after the onset of the pandemic, with a progressive recovery over the following months. The total number of deliveries and fresh stillbirths showed a step change with a marked decrease during the pandemic, while the macerated stillbirths showed a pulse change, a temporary marked decrease with a quick recovery over time. CONCLUSION: The COVID-19 pandemic had a negative impact on perinatal care and outcomes in our facility. Pregnancy monitoring through antenatal care should be encouraged and continued even as countries tackle the pandemic.

Income Level but Not Nutrition Knowledge Is Associated with Dietary Diversity of Rural Pregnant Women from Northern Ghana.

Essential nutrients are necessary for reducing the risk of maternal mortality, prenatal mortality, and low-birthweight infants. Dietary diversity can play an important role in supplying essential nutrients to both the mother and the foetus. We evaluated nutrition knowledge, attitudes, and dietary diversity of pregnant women. In addition, we investigated the sociodemographic determinants of dietary diversity among pregnant women from a rural district in Ghana. Participants were pregnant women receiving antenatal care from a rural district hospital in Ghana. Dietary diversity was measured using a 24-hour dietary recall questionnaire. Multiple linear regression was used to determine the sociodemographic characteristics of dietary diversity. About 85% of the pregnant women knew that they should eat more in comparison to nonpregnant women, and only 16.9% knew the importance of folic acid supplementation during pregnancy. Mean (SD) dietary diversity score of the participants was 5.27 (1.35), 85.4% did not consume any fruits, and 82.3% did not take milk and milk products. Almost all participants took at least one food item in the starchy staples and green leafy vegetables food groups. Moreover, 53% consumed vitamin A-rich fruits, vegetables, and tubers; 7.7% organ meats; and 30.8% eggs. Those who earned a monthly income of ≥GHC 500 or US$ 87 (B = 1.82; 0.90-2.73; p < 0.001) significantly had higher dietary diversity scores compared to those who earned less. Dietary diversity of the pregnant women was suboptimal. The consumption of vitamin A- and iron-rich foods was inadequate. Income was an important determinant of the dietary diversity of pregnant women from Northern rural Ghana.

Upregulation of sulfatase-1 decreases metastatic potential of SKOV3 human ovarian cancer cells in vitro and in vivo.

AIM: Sulfatase-1 (SULF-1) is one of the genes associated with the inhibition of several signaling pathways by desulfating HSPG in cancer cells. The aim of this study is to investigate the effect of SULF-1 upregulation on SKOV3 ovarian cancer cell line and its influence on cell proliferation, migration, invasion in vitro, and lymph node metastasis in 615 inbred mice in vivo. MATERIALS AND METHODS: In in vitro study, we upregulated SULF-1 in SKOV3 cells using SULF-1 expression plasmid. Quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR) and western blotting were used to measure SULF-1 expression levels after stable upregulation. CCK-8, flow cytometry, Boyden Transwell-chamber, and scratch-wound healing assay were performed to explore the effect of SULF-1 on the proliferation, migration, and invasion. In in vivo study, immunohistochemistry and eosin stain (H and E) were used to evaluate the expression level of SULF-1 gene and to measure the lymph node metastatic rate of mice inoculated with SULF-1-SKOV3-expressed plasmid, SKOV3, and Nc-SKOV3 cells. RESULTS: qRT-PCR and western blot assay confirmed that SULF-1 was upregulated both in mRNA and protein levels. Following SULF-1 stable upregulation, the cell proliferation, migration, and invasion were significantly reduced in the SULF-1 upregulated cells (SULF-1-SKOV3) compared with the nontransfected (SKOV3) and the nonspecific sequence transfected cells (Nc-SKOV3). IHC results showed that SULF-1 was highly expressed after stably upregulation in SKOV3 cells, and H and E stain confirmed that the mice inoculated with SULF-1-SKOV3 cells decreased lymph node metastatic rate compared to the two control groups. CONCLUSIONS: Our findings showed that overexpression of SULF-1 in SKOV3 results in a decrease in ovarian cancer cell proliferation, migration, and invasion in vitro and decreased lymph node metastasis in vivo. This finding could have a potential therapeutic window in the management of ovarian cancer.