Maternal and neonatal outcomes following SARS-CoV-2 infection

Seminars in Fetal and Neonatal Medicine, Journal Year: 2023, Volume and Issue: 28(1), P. 101428 - 101428

Published: Feb. 1, 2023

Language: Английский

---

Implementation of First-trimester Screening and Prevention of Preeclampsia: a Stepped Wedge Cluster-randomized Trial in Asia

Circulation, Journal Year: 2024, Volume and Issue: 150(16), P. 1223 - 1235

Published: June 26, 2024

BACKGROUND: This trial aimed to assess the efficacy, acceptability, and safety of a first-trimester screen-and-prevent strategy for preterm preeclampsia in Asia. METHODS: Between August 1, 2019, February 28, 2022, this multicenter stepped wedge cluster randomized included maternity/diagnostic units from 10 regions The started with period where all recruiting centers provided routine antenatal care without study-related intervention. At regular 6-week intervals, one was transit nonintervention phase intervention phase. In phase, women underwent screening using Bayes theorem-based triple-test. High-risk women, adjusted risk ≥1 100, received low-dose aspirin <16 weeks until 36 weeks. RESULTS: Overall, 88.04% (42 897 48 725) agreed undergo preeclampsia. Among those identified as high-risk 82.39% (2919 3543) prophylaxis. There no significant difference incidence between non-intervention phases (adjusted odds ratio [aOR], 1.59 [95% CI, 0.91–2.77]). However, among prophylaxis significantly associated 41% reduction (aOR, 0.59 0.37–0.92]). addition, it correlated 54%, 55%, 64% delivery at <34 0.46 0.23–0.93]), spontaneous birth 0.45 0.22–0.92]), perinatal death 0.34 0.12–0.91]), respectively. between-group aspirin-related severe adverse events. CONCLUSIONS: implementation is not effectively reduces by women. highly accepted diverse group various ethnic backgrounds beyond original population developed. These findings underpin importance widespread on global scale. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03941886.

Language: Английский

---

Preeclampsia in the Context of COVID‐19: Mechanisms, Pathophysiology, and Clinical Outcomes

American Journal of Reproductive Immunology, Journal Year: 2024, Volume and Issue: 92(2)

Published: Aug. 1, 2024

The emergence of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to global COVID-19 pandemic, significantly impacting health pregnant women. Obstetric populations, already vulnerable, face increased morbidity and mortality related COVID-19, aggravated by preexisting comorbidities. Recent studies have shed light on potential correlation between preeclampsia (PE), a leading cause maternal perinatal worldwide, emphasizing significance exploring relationship these two conditions. Here, we review pathophysiological similarities that PE shares with particular focus cases in PE-like SARS-CoV-2 infection. We highlight cellular molecular mechanistic inter-connectivity conditions, for example, regulation renin-angiotensin system, tight junction barrier integrity, complement system. Finally, discuss how pandemic dynamics, including variants vaccination efforts, shaped clinical scenario influenced severity management both PE. Continued research mechanisms infection during pregnancy risk developing from previous infections is warranted delineate complexities interactions improve

Language: Английский

---

Pregnancy and COVID-19: prevention, vaccination, therapy, and beyond

TURKISH JOURNAL OF MEDICAL SCIENCES, Journal Year: 2021, Volume and Issue: 51(SI-1), P. 3312 - 3326

Published: Sept. 19, 2021

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has alarmed the world since its first emergence. As pregnancy is characterized significant changes in cardiovascular, respiratory, endocrine, and immunological systems, there are concerns on issues like course of pregnant women, safety medications, route delivery risk obstetric complications. The aim this review to summarize current literature management women during COVID-19 pandemic. Although more than 90% with recover without serious morbidity, rapid deterioration higher rates complications may be observed. vertical transmission not been clearly revealed yet. Decreasing number prenatal visits, shortening time allocated for examinations, active use telemedicine services, limiting persons healthcare settings, combining tests same visit, restricting visitors providing a safe environment facilities, strict hygiene control, personal protective equipment visits main strategies control spread according guidelines. new medication alternatives being proposed every day treatment COVID-19, our knowledge about most these drugs limited. Preliminary results promising administration SARS-CoV-2 vaccines population. Timing should decided based maternal health condition, accompanying gestational age. Cesarean performed indications. Breast feeding encouraged as long necessary precautions viral taken. In conclusion, an individualized approach provided multidisciplinary team achieve favorable outcomes.

Language: Английский

---

An internally validated prediction model for critical COVID-19 infection and intensive care unit admission in symptomatic pregnant women

American Journal of Obstetrics and Gynecology, Journal Year: 2021, Volume and Issue: 226(3), P. 403.e1 - 403.e13

Published: Sept. 27, 2021

Pregnant women are at an increased risk of mortality and morbidity owing to COVID-19. Many studies have reported on the association COVID-19 with pregnancy-specific adverse outcomes, but prediction models utilizing large cohorts pregnant still lacking for estimating maternal other events.The main aim this study was develop a model quantify progression critical intensive care unit admission in symptomatic infection.This multicenter retrospective cohort including 8 hospitals from 4 countries (the United Kingdom, Austria, Greece, Turkey). The data extraction February 2020 until May 2021. Included were consecutive early postpartum (within 10 days birth); reverse transcriptase polymerase chain reaction confirmed SARS-CoV-2 infection. primary outcome illness requiring care. secondary outcomes included death, preeclampsia, stillbirth. between 12 candidate predictors having known severe pregnancy analyzed log-binomial mixed-effects regression as adjusted ratios. All potential evaluated 1 only baseline factors another. predictive accuracy assessed by area under receiver operating characteristic curves.Of 793 who positive symptomatic, 44 (5.5%) admitted care, whom died (1.3%). 'mini-COvid Maternal Intensive Therapy' following demographic clinical variables available disease onset: age (adjusted ratio, 1.45; 95% confidence interval, 1.07-1.95; P=.015); body mass index 1.34; 1.06-1.66; P=.010); diagnosis third trimester 3.64; 1.78-8.46; P=.001). optimism-adjusted curve 0.73. 'full-COvid 1.39; P=.015), lower respiratory symptoms 5.11; 1.81-21.4; P=.007), neutrophil lymphocyte ratio 1.62; 1.36-1.89; P<.001); serum C-reactive protein 1.30; 1.15-1.44; P<.001), 0.85. Neither showed signs poor fit. Categorization high-risk either associated shorter interval (log-rank test P<.001, both), higher death (5.2% vs 0.2%; preeclampsia (5.7% 1.0%; P<.001). A spreadsheet calculator is estimation.At presentation COVID-19, recently can be stratified into high- low-risk disease, even where resources limited. This support nature place These also highlight independent obesity should further emphasize that absence comorbidities, vaccination particularly important these women. Finally, provides useful information policy makers when prioritizing national programs quickly protect those highest fatal

Language: Английский

---

Confirmation of preeclampsia-like syndrome induced by severe COVID-19: an observational study

American Journal of Obstetrics & Gynecology MFM, Journal Year: 2022, Volume and Issue: 5(1), P. 100760 - 100760

Published: Oct. 1, 2022

Language: Английский

---

The coronavirus disease 2019 infection in pregnancy and adverse pregnancy outcomes: a systematic review and meta-analysis

Obstetrics & Gynecology Science, Journal Year: 2023, Volume and Issue: 66(4), P. 270 - 289

Published: May 17, 2023

The coronavirus disease 2019 (COVID-19) outbreak which started in December rapidly developed into a global health concern. Pregnant women are susceptible to respiratory infections and can experience adverse outcomes. This systematic review meta-analysis compared pregnancy outcomes according COVID-19 status. MEDLINE, EMBASE, Cochrane Library databases were searched for relevant articles published between 1, 2019, October 19, 2022. Main inclusion criterion was any population-based, cross-sectional, cohort, or case-control study that assessed with without laboratory-confirmed COVID-19. Sixty-nine studies including 1,606,543 pregnant (39,716 [2.4%] diagnosed COVID-19) retrieved. COVID-19-infected had higher risk of preterm birth (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.42-1.78), preeclampsia (OR, 1.41; CI, 1.30-1.53), low weight 1.52; 1.30-1.79), cesarean delivery 1.20; 1.10-1.30), stillbirth 1.71; 1.39-2.10), fetal distress 2.49; 1.54-4.03), neonatal intensive care unit admission 2.33; 1.72-3.16), perinatal mortality 1.96; 1.15-3.34), maternal 6.15; 3.74-10.10). There no significant differences total miscarriage, premature rupture membranes, postpartum hemorrhage, cholestasis, chorioamnionitis infection. demonstrates infection during lead information could aid researchers clinicians preparing another pandemic caused by newly discovered viruses. findings this may assist evidence-based counseling help manage

Language: Английский

---

Pregnancy-specific responses to COVID-19 revealed by high-throughput proteomics of human plasma

Communications Medicine, Journal Year: 2023, Volume and Issue: 3(1)

Published: April 4, 2023

Pregnant women are at greater risk of adverse outcomes, including mortality, as well obstetrical complications resulting from COVID-19. However, pregnancy-specific changes that underlie such worsened outcomes remain unclear.Plasma samples were collected pregnant and non-pregnant individuals (male female) with (n = 72 pregnant, 52 non-pregnant) without 29 41 COVID-19 patients grouped asymptomatic, mild, moderate, severe, or critically ill according to NIH classifications. Proteomic profiling 7,288 analytes corresponding 6,596 unique protein targets was performed using the SOMAmer platform.Herein, we profile plasma proteome controls show alterations display a dose-response relationship disease severity; yet, proteomic perturbations dampened during pregnancy. In both state, response induced by shows enrichment mediators implicated in cytokine storm, endothelial dysfunction, angiogenesis. Shared identified: tailored may protect conceptus heightened inflammation, while stronger repel infection. Furthermore, can accurately identify patients, even when asymptomatic mild symptoms.This study represents most comprehensive characterization patients. Our findings emphasize distinct immune modulation between states, providing insight into pathogenesis potential explanation for more severe observed women.Pregnant increased experiencing compared general population. reasons this still unclear. We measured proteins present blood these healthy individuals. found some COVID-19-associated lower levels women, which could help fetus harmful body’s natural While affected shared others distinctly only group.

Language: Английский

---

Tissue Contamination Challenges the Credibility of Machine Learning Models in Real World Digital Pathology

Modern Pathology, Journal Year: 2024, Volume and Issue: 37(3), P. 100422 - 100422

Published: Jan. 6, 2024

Language: Английский

---

Reversing physician hesitancy to recommend COVID-19 vaccination for pregnant patients

American Journal of Obstetrics and Gynecology, Journal Year: 2021, Volume and Issue: 226(6), P. 805 - 812

Published: Nov. 8, 2021

Language: Английский

---