International Journal of Environmental Research and Public Health

Research

12 pages, 1076 KiB

Open AccessArticle

Association of D-Dimer, C-Reactive Protein, and Ferritin with COVID-19 Severity in Pregnant Women: Important Findings of a Cross-Sectional Study in Northern Brazil

by Jenephy Thalita Rosa Paixão, Carolinne de Jesus Santos e Santos, Ana Paula Figueiredo de Montalvão França, Sandra Souza Lima, Rogério Valois Laurentino, Ricardo Roberto de Souza Fonseca, Antonio Carlos Rosário Vallinoto, Aldemir Branco Oliveira-Filho and Luiz Fernando Almeida Machado

Int. J. Environ. Res. Public Health 2023, 20(14), 6415; https://doi.org/10.3390/ijerph20146415 - 20 Jul 2023

Cited by 3 | Viewed by 1815

Abstract

Background: The COVID-19 pandemic has had a great impact on pregnant women due to the broad clinical spectrum of the disease. The present study investigated the profile of three biomarkers during hospital admission of pregnant women—D-dimer, C-reactive protein (CRP), and ferritin—and their correlation [...] Read more.

Background: The COVID-19 pandemic has had a great impact on pregnant women due to the broad clinical spectrum of the disease. The present study investigated the profile of three biomarkers during hospital admission of pregnant women—D-dimer, C-reactive protein (CRP), and ferritin—and their correlation with the severity and outcome of COVID-19. Methods: The cross-sectional study included 226 pregnant women hospitalized in the city of Belém, Pará, Northern Brazil, from April 2020 to July 2021. Epidemiological and laboratory data were obtained from medical records, and all pregnant women underwent RT-PCR molecular testing for the detection of SARS-CoV-2. Results: In total, 121 (53.5%) were positive and 105 (46.5%) were negative for SARS-CoV-2 using RT-PCR. Most pregnant women (49.5%) with COVID-19 were between 26 and 34 years old, were residing in the interior of the state of Pará (51.2%), and were in the third gestational trimester (71.9%). In addition, 71.1% of them were admitted to the ward and 28.9% were admitted to the intensive care unit (ICU), with 90.9% surviving COVID-19. The concentrations of D-dimer (p = 0.0122) and ferritin (p ≤ 0.0001) were significantly higher among pregnant women with COVID-19, especially among those hospitalized in the ICU. Conclusion: Ferritin and D-dimer seem to serve as important biomarkers for the prognosis of COVID-19 in pregnant women, which was not observed for CRP. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

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12 pages, 481 KiB

Open AccessArticle

Body Esteem and Self-Efficacy of Pregnant Women with Gestational Diabetes Mellitus

by Agnieszka Bień, Agnieszka Pieczykolan, Magdalena Korżyńska-Piętas and Joanna Grzesik-Gąsior

Int. J. Environ. Res. Public Health 2023, 20(3), 2171; https://doi.org/10.3390/ijerph20032171 - 25 Jan 2023

Cited by 2 | Viewed by 2461

Abstract

The diagnosis of gestational diabetes mellitus provokes a change in a pregnant woman’s lifestyle, which may affect her well-being and precipitate a sense of loss of self-control over her own body. The perception of “body image” is not only physical appearance and physical [...] Read more.

The diagnosis of gestational diabetes mellitus provokes a change in a pregnant woman’s lifestyle, which may affect her well-being and precipitate a sense of loss of self-control over her own body. The perception of “body image” is not only physical appearance and physical attractiveness but also the emotional attitude to the body and beliefs about it. The aim of the study was to analyze the factors affecting body esteem and analyze the relationship between body esteem and self-efficacy in pregnant women with gestational diabetes mellitus. The study was conducted in the period from April 2019 to January 2021 among 287 women with gestational diabetes mellitus with the use of the following research tools: Body Esteem Scale (BES) and Generalized Self-Efficacy Scale (GSES). The explanatory variables for the sexual attractiveness variable were age (β = 0.252; p = 0.006) and education (β = 0.334; p = 0.007), for the weight concern variable were age (β = 0.161; p = 0.005), BMI (β = 0.334; p = 0.005), and education (β = 0.252; p = 0.033), for the physical condition variable, were age (β = 0.096; p = 0.004) and education (β = 0.213; p = 0.006). Positive correlations were found between self-efficacy and body esteem in the aspects of sexual attractiveness (p = 0.350), weight concern (p = 0.296), and physical condition (p = 0.286). Positive correlations were found between self-efficacy and body esteem in the aspects of sexual attractiveness (p = 0.350), weight concern (p = 0.296), and physical condition (p = 0.286). Older women who had better education and a lower BMI rated their bodies better. In women with gestational diabetes mellitus, high self-efficacy determines a better perception of their bodies in all areas: sexual attractiveness, weight concern, and physical condition. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

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14 pages, 793 KiB

Open AccessArticle

Exploring the Needs and Expectations of Expectant and New Parents for an mHealth Application to Support the First 1000 Days of Life: Steps toward a Co-Design Approach

by Laura Brunelli, Sofia Bussolaro, Raffaella Dobrina, Chiara De Vita, Elena Mazzolini, Giuseppa Verardi, Maura Degrassi, Maria Piazza, Andrea Cassone, Anja Starec, Giuseppe Ricci, Sara Zanchiello and Tamara Stampalija

Int. J. Environ. Res. Public Health 2023, 20(2), 1227; https://doi.org/10.3390/ijerph20021227 - 10 Jan 2023

Cited by 3 | Viewed by 2695

Abstract

To improve maternal and child health, it is essential to adhere to health-promoting and preventive measures. However, reliable information as well as effective tools are not easy to identify in this field. Our cross-sectional study investigated the needs and expectations of expectant and [...] Read more.

To improve maternal and child health, it is essential to adhere to health-promoting and preventive measures. However, reliable information as well as effective tools are not easy to identify in this field. Our cross-sectional study investigated the needs and expectations of expectant and new mothers and fathers as potential primary users of a hypothetical application supporting the first 1000 days of life. Between May and August 2022, we recruited expectant and new parents by administering an 83-item 5-point Likert scale questionnaire related to the content, functionalities, and technical features of the hypothetical app. We stratified responses using sociodemographic characteristics and then performed ward hierarchical clustering. The 94 women and 69 men involved in our study generally agreed with the proposed content, but expressed low interest in certain app functionalities or features, including those related to the interaction mechanism and interactivity. Women were generally more demanding than men. Our findings, resulting from the engagement of end-users, may be useful for designers and technology providers to implement mHealth solutions that, in addition to conveying reliable information, are tailored to the needs and preferences of end-users in the first 1000 days of life. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

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12 pages, 752 KiB

Open AccessArticle

Status of Oxidative Stress during Low-Risk Labour: Preliminary Data

by Barbara Zych, Anna Górka, Aleksander Myszka, Dominika Błoniarz, Aleksandra Siekierzyńska and Witold Błaż

Int. J. Environ. Res. Public Health 2023, 20(1), 157; https://doi.org/10.3390/ijerph20010157 - 22 Dec 2022

Cited by 5 | Viewed by 1990

Abstract

Pregnancy and childbirth are associated with the forming of reactive oxygen species that generate oxidative stress. Oxidative stress is a factor that may adversely affect the development of the fetus and the course of labour. Monitoring the parameters of oxidative stress can be [...] Read more.

Pregnancy and childbirth are associated with the forming of reactive oxygen species that generate oxidative stress. Oxidative stress is a factor that may adversely affect the development of the fetus and the course of labour. Monitoring the parameters of oxidative stress can be used to assess the risk of health issues in the course of pregnancy and the condition of the newborn. Therefore, the analysis of oxidative stress in the physiological course of labour is the basis for understanding the role of oxidative stress in the pathogenesis of miscarriages and neonatal health circumstances. The study aimed to assess oxidative stress of mother-child pairs in the venous blood and umbilical cord blood at the time of physiological labour. One hundred and sixty-eight mother-child pairs were recruited to donate the mother’s venous blood in the first stage of labour and the venous umbilical cord blood after the newborn’s birth. Total antioxidant status (TAS), the activity of superoxide dismutase (SOD) with cofactors (Zn, Cu, Mn) and the activity of glutathione peroxidase (GPx) were analysed in venous blood plasma and umbilical cord blood. TAS value (p = 0.034), GPx activity (p < 0.001) and Zn concentration (p = 0.007) were significantly lower in maternal blood plasma as compared to neonatal umbilical cord blood. However, the activity of SOD (p = 0.013) and the concentration of Cu (p < 0.001) were significantly higher in the blood of mothers than of new-borns. The concentration of Mn in the plasma of the mother’s blood and the umbilical cord blood of the newborns was similar. Our research indicates higher levels of antioxidant enzyme (GPx) and total antioxidant potential (TAS) in umbilical cord blood compared to maternal blood, which may suggest depletion of redox reserves in women’s blood during labour. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

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13 pages, 1685 KiB

Open AccessArticle

SARS-CoV-2 in Pregnancy—A Retrospective Analysis of Selected Maternal and Fetal Laboratory Parameters

by Maciej Sobkowski, Beata Pięta, Anna Sowińska, Marlena Grabowska, Katarzyna Koch-Brzozowska, Maciej Wilczak and Agnieszka Bień

Int. J. Environ. Res. Public Health 2022, 19(22), 15307; https://doi.org/10.3390/ijerph192215307 - 19 Nov 2022

Viewed by 1804

Abstract

Pregnant women and their neonates belong to the group of individuals with elevated risk for COVID-19 infection. Data on the course of the disease and how it affects the pregnancy and neonatal wellbeing remain conflicting. The aim of the study was to evaluate [...] Read more.

Pregnant women and their neonates belong to the group of individuals with elevated risk for COVID-19 infection. Data on the course of the disease and how it affects the pregnancy and neonatal wellbeing remain conflicting. The aim of the study was to evaluate the effect of SARS CoV-2 infection on the mode of delivery, neonatal condition and selected maternal and fetal laboratory parameters. This was a single-center retrospective case–control study. This dataset was generated using electronic medical records collected by medical personnel. Two groups of patients, hospitalized between April, 2020 and February, 2021, were included in the study: study group (304)—pregnant women with SARS-CoV-2 and control group (N = 329)—healthy pregnant women or parturients. Mothers with a severe course of COVID-19 had higher activated partial thromboplastin—APTT (p = 0.02), C-Reactive Protein—CRP (p = 0.00) and procalcitonin (p = 0.032) levels as compared to pregnant women with mild or moderate course of the disease. Neonates born to SARS-CoV-2-infected mothers presented with worse condition at 1 and 5 minutes of life (p = 0.000 and 0.00, respectively) and lower Arterial Blood Gas—ABG pH scores (p = 0.016). Elective cesarean section is the most common mode of delivery for SARS-CoV2-infected mothers. Emergency cesarean sections are performed at earlier gestational age as compared to vaginal delivery and elective cesarean section. Lower Apgar scores were observed in neonates born to SARS-CoV-2-infected mothers who required oxygen therapy and whose procalcitonin levels were elevated. There is a relationship between more severe course of COVID-19 and APTT, as well as CRP and procalcitonin levels. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

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14 pages, 2369 KiB

Open AccessArticle

Weight Gain during and after Pregnancy in Women with Gestational Diabetes Mellitus―A Preliminary Study

by Dorota Ćwiek, Anna Lubkowska, Małgorzata Zimny, Katarzyna Szymoniak and Olimpia Sipak-Szmigiel

Int. J. Environ. Res. Public Health 2022, 19(19), 11959; https://doi.org/10.3390/ijerph191911959 - 22 Sep 2022

Cited by 2 | Viewed by 1864

Abstract

Appropriate gestational weight gain (GWG) favors fewer complications related to pregnancy, delivery, puerperium, and the condition of the fetus and newborn baby. The aim of this study was to evaluate weight gain in women during and after pregnancy, including both women with and [...] Read more.

Appropriate gestational weight gain (GWG) favors fewer complications related to pregnancy, delivery, puerperium, and the condition of the fetus and newborn baby. The aim of this study was to evaluate weight gain in women during and after pregnancy, including both women with and without gestational diabetes mellitus (GDM). Materials and methods: The study involved 42 singleton pregnant women diagnosed with GDM between the 24th and 28th week of pregnancy. The control group consisted of 28 nondiabetic women with a singleton pregnancy. The pre-pregnancy BMI, intra-pregnancy weight gain, and postpartum body weight were assessed in the participants. Results: There were no statistically significant differences in the values of intra-pregnancy weight gain. Only diabetic women who were also overweight or obese had a significantly higher percentage of weight gain during pregnancy. The analysis of the percentage of weight gain during the entire pregnancy showed differences only in the group of women with pre-pregnancy BMI over 30. Conclusions: There were no significant differences in total pregnancy or mid-pregnancy weight gain between women with and without GDM. Most of the women had too high or too low total-pregnancy and mid-pregnancy weight gain. Therefore it is necessary to control GWG and educate pregnant women about it. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

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12 pages, 785 KiB

Open AccessArticle

Spontaneous Perineal Trauma during Non-Operative Childbirth—Retrospective Analysis of Perineal Laceration Risk Factors

by Grażyna Bączek, Ewa Rzońca, Dorota Sys, Sylwia Rychlewicz, Anna Durka, Patryk Rzońca and Agnieszka Bień

Int. J. Environ. Res. Public Health 2022, 19(13), 7653; https://doi.org/10.3390/ijerph19137653 - 23 Jun 2022

Cited by 6 | Viewed by 4139

Abstract

Childbirth-related perineal trauma (CRPT) is defined as damage to the skin, muscles of the perineum, as well as to the anal sphincter complex and anal epithelium. The aim of the study was to analyze the risk factors for spontaneous injuries to the soft [...] Read more.

Childbirth-related perineal trauma (CRPT) is defined as damage to the skin, muscles of the perineum, as well as to the anal sphincter complex and anal epithelium. The aim of the study was to analyze the risk factors for spontaneous injuries to the soft tissues of the birth canal during non-operative delivery. This was a single-center retrospective case-control study. The study included the analysis of two groups, the study group featured 7238 patients with spontaneous perineal laceration (any degree of perineal laceration) and the control group featured patients without perineal laceration with 7879 cases. The analysis of single-factor logistic regression showed that the factors related to perineal laceration during childbirth are the age of the patients giving birth (p = 0.000), the BMI before delivery (p = 0.000), the number of pregnancies (p = 0.000) and deliveries (p = 0.000), diagnosed gestational diabetes (p = 0.046), home birth (p = 0.000), vaginal birth after cesarean (VBAC) (p = 0.001), the use of oxytocin in the second stage of childbirth (p = 0.041), the duration of the second stage of childbirth (p = 0.000), body weight (p = 0.000), and the circumference of the newborn head (p = 0.000). Independent factors that increase the risk of perineal laceration during childbirth are an older age of the woman giving birth, a history of cesarean section, a higher birth weight of the newborn, and factors that reduce the risk of spontaneous perineal trauma are a higher number of deliveries and home birth. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

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15 pages, 353 KiB

Open AccessArticle

Psychometric Evaluation of the Malay Version of the Childbirth Experience Questionnaire (CEQ-My)

by Aida Kalok, Norhani Nordin, Shalisah Sharip, Rahana Abdul Rahman, Shamsul Azhar Shah, Zaleha Abdullah Mahdy and Ixora Kamisan Atan

Int. J. Environ. Res. Public Health 2022, 19(13), 7644; https://doi.org/10.3390/ijerph19137644 - 22 Jun 2022

Cited by 5 | Viewed by 1787

Abstract

Negative childbirth experience may cause adverse psychological effects in postpartum mothers. The Childbirth Experience Questionnaire (CEQ) is a multidimensional tool designed to assess women’s perceptions of labour and birth. We aim to validate the Malay version of the CEQ (CEQ-My) and evaluate its [...] Read more.

Negative childbirth experience may cause adverse psychological effects in postpartum mothers. The Childbirth Experience Questionnaire (CEQ) is a multidimensional tool designed to assess women’s perceptions of labour and birth. We aim to validate the Malay version of the CEQ (CEQ-My) and evaluate its psychometric properties. The previously published Malay-translated CEQ was reviewed by a panel of experts and underwent minor changes. The original visual analogue scoring (VAS) was changed to a numerical scale. The reliability and construct validity of CEQ-My was assessed using Cronbach’s alpha and exploratory analysis, respectively. Known-groups validation was conducted using the Mann–Whitney U test, whilst the inter-item correlations between CEQ-My and its subdomains were evaluated through Spearman’s correlation. The final analysis involved 246 women. The questionnaire was easy to understand and all women preferred numeric scoring to the VAS. Based on the principal component factor analysis, we deleted one item and rearranged the domain for four items. The twenty-one items CEQ-My demonstrated good reliability with Cronbach’s alpha of 0.77. Women who had spontaneous vaginal delivery demonstrated significantly greater CEQ-My scores than those who underwent operative delivery (p = 0.002). The domain of professional support was positively correlated to that of own capacity and participation (p-value of < 0.001 and 0.002, respectively). The CEQ-My is a valid and reliable instrument to assess Malaysian women’s childbirth experiences. The easy-to-use electronic version of CEQ-My will improve future research and ease data collection. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

13 pages, 1073 KiB

Open AccessArticle

The Mediating Role of Dispositional Optimism in the Relationship between Health Locus of Control and Self-Efficacy in Pregnant Women at Risk of Preterm Delivery

by Iwona Niewiadomska, Agnieszka Bień, Ewa Rzońca and Krzysztof Jurek

Int. J. Environ. Res. Public Health 2022, 19(10), 6075; https://doi.org/10.3390/ijerph19106075 - 17 May 2022

Cited by 8 | Viewed by 2169

Abstract

Difficult situations during pregnancy, such as threatened preterm labor, trigger negative experiences in women. The levels of stress experienced and the way individuals cope with it depend on their personal resources, such as optimism, internal health locus of control, and self-efficacy, among other [...] Read more.

Difficult situations during pregnancy, such as threatened preterm labor, trigger negative experiences in women. The levels of stress experienced and the way individuals cope with it depend on their personal resources, such as optimism, internal health locus of control, and self-efficacy, among other factors. The purpose of this paper was to determine the role of dispositional optimism in the relationship between health locus of control and self-efficacy in pregnant women with threatened preterm labor. Dispositional optimism plays the role of mediator in relationships between: (1) internal health control and self-efficacy; and (2) impact of random events on one’s health and self-efficacy. Dispositional optimism does not mediate the relationship between the perceived impact of others on one’s health and self-efficacy. For women with a high-risk pregnancy, dispositional optimism is a significant resource for coping with the problems they encounter. It changes the direction (from negative to positive) of the association between experiencing the impact of external factors (random events) on one’s health and perceived self-efficacy. It prevents the cycle of loss caused by the interpretation of random events as having an impact on one’s health, and acts as a mediator to initiate a cycle of gains that leads to greater perceived self-efficacy. Optimistic pregnant women maintain a positive outlook, even when confronted with difficult, negative experiences such as threatened preterm labor. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

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11 pages, 331 KiB

Open AccessArticle

Assessment of the Postpartum Emotional Wellbeing among Women Participating and Not Participating in Antenatal Classes

by Anna Kucab, Edyta Barnaś and Joanna Błajda

Int. J. Environ. Res. Public Health 2022, 19(8), 4476; https://doi.org/10.3390/ijerph19084476 - 8 Apr 2022

Cited by 2 | Viewed by 2307

Abstract

The perinatal period is associated with an increased risk of emotional disorders. Exposure to stress impacts the functioning of the maternal brain, also shaping the developmental processes of the child’s brain. To assess the emotional wellbeing of women participating and not participating in [...] Read more.

The perinatal period is associated with an increased risk of emotional disorders. Exposure to stress impacts the functioning of the maternal brain, also shaping the developmental processes of the child’s brain. To assess the emotional wellbeing of women participating and not participating in antenatal classes. The study involved a group of 200 women divided into two groups: the study group, participants of the antenatal classes (N = 100), and the control group, not participating in the antenatal classes (N = 100). The Edinburgh Postnatal Depression Scale (EPDS) and Mini-COPE inventory were used. EPDS was administered at two time points: on the 2nd day of puerperium and 6 weeks after the delivery, while Mini-COPE inventory was applied once during pregnancy. Severe symptoms of depression on the 2nd day after childbirth concerned 16.0% of the women (N = 15) participating in the antenatal classes and 11.0% of the controls (N = 11). Intensification of depressive symptoms 6 weeks after the delivery occurred in 19.5% of the females attending antenatal classes (N = 17) and 18.8% of the controls (N = 18). Severe symptoms of depression 6 weeks after the delivery in the group of women participating in antenatal classes were significantly related to adopting helplessness to cope with stress and a sense of being accepted by the husband/partner, family, and society. In the case of women not participating in antenatal classes, the severity of symptoms of depression 6 weeks after the delivery was slightly related to the sense of acceptance by the husband/partner, family, and society. Apart from identifying risk factors for emotional disorders in pregnancy, it is worth taking into account whether a woman participated in antenatal classes when planning the care in the perinatal period. This factor can be a potential protective factor in preventing emotional problems after childbirth. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

Review

Jump to: Research, Other

9 pages, 306 KiB

Open AccessReview

Quality of Sex Life in Intestinal Stoma Patients—A Literature Review

by Wiktoria Paszyńska, Katarzyna Zborowska, Mariola Czajkowska and Violetta Skrzypulec-Plinta

Int. J. Environ. Res. Public Health 2023, 20(3), 2660; https://doi.org/10.3390/ijerph20032660 - 1 Feb 2023

Cited by 12 | Viewed by 3324

Abstract

Introduction: Stoma surgery may reduce the quality of life, including sex life. A literature review was undertaken to explore what factors impact on the sexual health and sexuality of people with a stoma. Methodology: A review of the literature was undertaken using the [...] Read more.

Introduction: Stoma surgery may reduce the quality of life, including sex life. A literature review was undertaken to explore what factors impact on the sexual health and sexuality of people with a stoma. Methodology: A review of the literature was undertaken using the online databases Cochrane, PsychInfo, Embase and Pubmed. The search was limited to articles on colostomates and ileostomates in the English language that were peer-reviewed and written in the past 5 years. Results: Intestinal stoma surgery affects many aspects of a patient’s life, including body image, relationship with a partner and quality of sex life. The introduction of perioperative educational programmes for patients qualified for ostomy surgery and their relatives will provide the necessary support in the face of physical and mental difficulties that may be associated with the procedure. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

19 pages, 1345 KiB

Open AccessReview

Thromboprophylaxis in Pregnant Women with COVID-19: An Unsolved Issue

by Valentin Nicolae Varlas, Roxana Georgiana Borș, Mihaela Plotogea, Madalina Iordache, Claudia Mehedințu and Monica Mihaela Cîrstoiu

Int. J. Environ. Res. Public Health 2023, 20(3), 1949; https://doi.org/10.3390/ijerph20031949 - 20 Jan 2023

Cited by 3 | Viewed by 2888

Abstract

SARS-CoV-2 infection in pregnant women is of growing interest due to controversy over the use of antiplatelet and/or anticoagulant drugs during pregnancy and postpartum. Pregnant women are susceptible to develop severe forms of viral infections due to pregnancy-related immune alterations, changes in lung [...] Read more.

SARS-CoV-2 infection in pregnant women is of growing interest due to controversy over the use of antiplatelet and/or anticoagulant drugs during pregnancy and postpartum. Pregnant women are susceptible to develop severe forms of viral infections due to pregnancy-related immune alterations, changes in lung functions, and hypercoagulability. The association of pregnancy with SARS-CoV-2 infection can cause an increased incidence of thrombotic complications, especially in the case of patients with some genetic variants that favor inflammation and thrombosis. Compared to the general population, pregnant women may be at increased risk of thrombotic complications related to COVID-19. The lack of extensive clinical trials on thromboprophylaxis and extrapolating data from non-pregnant patients lead to major discrepancies in treating pregnant women with COVID-19. Currently, a multidisciplinary team should determine the dose and duration of prophylactic anticoagulant therapy for these patients, depending on the disease severity, the course of pregnancy, and the estimated due date. This narrative review aims to evaluate the protective effect of thromboprophylaxis in pregnant women with COVID-19. It is unknown at this time whether antiplatelet or anticoagulant therapy initiated at the beginning of pregnancy for various diseases (preeclampsia, intrauterine growth restriction, thrombophilia) offers a degree of protection. The optimal scheme for thromboprophylaxis in pregnant women with COVID-19 must be carefully established through an individualized decision concerning gestational age and the severity of the infection. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

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24 pages, 1098 KiB

Open AccessReview

Neurodevelopment in Normocephalic Children Exposed to Zika Virus in Utero with No Observable Defects at Birth: A Systematic Review with Meta-Analysis

by Elena Marbán-Castro, Laia J. Vazquez Guillamet, Percy Efrain Pantoja, Aina Casellas, Lauren Maxwell, Sarah B. Mulkey, Clara Menéndez and Azucena Bardají

Int. J. Environ. Res. Public Health 2022, 19(12), 7319; https://doi.org/10.3390/ijerph19127319 - 14 Jun 2022

Cited by 15 | Viewed by 5217

Abstract

Zika virus (ZIKV) infection during pregnancy is a cause of pregnancy loss and multiple clinical and neurological anomalies in children. This systematic review aimed to assess the effect of ZIKV exposure in utero on the long-term neurodevelopment of normocephalic children born to women [...] Read more.

Zika virus (ZIKV) infection during pregnancy is a cause of pregnancy loss and multiple clinical and neurological anomalies in children. This systematic review aimed to assess the effect of ZIKV exposure in utero on the long-term neurodevelopment of normocephalic children born to women with ZIKV infection in pregnancy. This review was conducted according to the PRISMA guidelines for systematic reviews and meta-analyses. We performed a random effects meta-analysis to estimate the cross-study prevalence of neurodevelopmental delays in children using the Bayley Scales for Infant and Toddler Development (BSID-III). The risk of bias was assessed using Cochrane’s Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Full-text reviews were performed for 566 articles, and data were extracted from 22 articles corresponding to 20 studies. Nine articles including data from 476 children found 6.5% (95% CI: 4.1–9.3) of infants and children to have any type of non-language cognitive delay; 29.7% (95% CI: 21.7–38.2) to have language delay; and 11.5% (95% CI: 4.8–20.1) to have any type of motor delay. The pooled estimates had a high level of heterogeneity; thus, results should be interpreted with caution. Larger prospective studies that include a non-exposed control group are needed to confirm whether ZIKV exposure in utero is associated with adverse child neurodevelopmental outcomes. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

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Other

Jump to: Research, Review

9 pages, 1009 KiB

Open AccessBrief Report

Tuberculosis and Sexual and Reproductive Health of Women in Four African Countries

by Rayan Korri, Abhishek Bakuli, Olumuyiwa A. Owolabi, Julieth Lalashowi, Cândido Azize, Mohammed Rassool, Farzana Sathar, Andrea Rachow and Olena Ivanova

Int. J. Environ. Res. Public Health 2022, 19(22), 15103; https://doi.org/10.3390/ijerph192215103 - 16 Nov 2022

Cited by 2 | Viewed by 1991

Abstract

Tuberculosis (TB) is a major reason of maternal mortality in low-income countries, and it increases the probability of adverse sexual and reproductive health (SRH) outcomes, including ectopic pregnancy and perinatal mortality. The data presented here is from the TB Sequel observational cohort conducted [...] Read more.

Tuberculosis (TB) is a major reason of maternal mortality in low-income countries, and it increases the probability of adverse sexual and reproductive health (SRH) outcomes, including ectopic pregnancy and perinatal mortality. The data presented here is from the TB Sequel observational cohort conducted in four African countries. For this sub-study, we selected only female participants, who were diagnosed with drug susceptible TB and followed-up until the end of anti-TB treatment. The data collection included questionnaires, clinical examination and laboratory tests at TB diagnosis, day 14, month 2, 4 and 6. A total of 486 women, with 88.3% being 18–49 years old, were included in the analysis. Around 54.7% were HIV positive. Most of the participants (416/486; 85.6%) in our cohort were considered cured at month 6. Only 40.4% of non-pregnant women of reproductive age used contraception at TB diagnosis. A total of 31 out of 486 women experienced pregnancy during TB treatment. Pregnancy outcomes varied between live birth (16/31; 51.6%), induced abortion (6/31; 19.4%), miscarriage (4/31; 12.9%) and stillbirth (3/31; 9.6%). Integration and linking of SRH services with TB programmes are vital to increase contraception use and protect women from obstetric risks associated with pregnancy during TB treatment. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

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9 pages, 842 KiB

Open AccessProtocol

Study Protocol of an App-Based Prevention Program for Perinatal Depression

by Xiangmin Tan, Yuqing He, Nan Hua, James Wiley and Mei Sun

Int. J. Environ. Res. Public Health 2022, 19(18), 11634; https://doi.org/10.3390/ijerph191811634 - 15 Sep 2022

Viewed by 2435

Abstract

The prevalence of perinatal depression (PND) in China is continuously rising, and the suicide rate among pregnant women is remarkably high. Preventing the occurrence of PND based on the management of primary health care is of great significance. Improving adherence to intervention programs [...] Read more.

The prevalence of perinatal depression (PND) in China is continuously rising, and the suicide rate among pregnant women is remarkably high. Preventing the occurrence of PND based on the management of primary health care is of great significance. Improving adherence to intervention programs is a key concern for PND prevention. Thus, a new intervention strategy based on mobile health could bring a new perspective to prevent the occurrence of PND and reduce the sample dropout rate. A single-blind, cluster randomized controlled trial will be performed to evaluate the effectiveness of a personalized, dynamic, and stratified intervention strategy based on an app. Four health centers will be randomly selected and randomly assigned to an intervention group (two centers) and a control group (two centers). Participants (n = 426) will be enrolled from the four selected health centers, with 213 in each group. The intervention group will receive the interventions personalized by the feature-matching algorithm of the user profile and be reassigned to the low-risk group (Edinburgh Postnatal Depression Scale [EPDS] < 9) or moderate/high-risk group (9 ≤ EPDS < 13 and EPDS ≥ 13, but not meeting the criteria for PND) for intervention based on each EPDS score until 6 months after delivery. The control group will receive the same intervention components of the app but without the dynamic, personalized, and stratified function. Depression status, negative emotion symptoms, parental competence, and sample dropout rate will be measured at different weeks of pregnancy (12–16 [baseline], 24, 37) and at 42 days, 3 months, and 6 months after delivery. Follow-up evaluation (t₆: 12 months after delivery) will also be conducted. If the intervention is effective, it will provide a personalized, time-friendly, and dynamic intervention for preventing PND. This phenomenon can effectively reduce the sample dropout rate and provide an empirical basis for promoting maternal mental health. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

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Open AccessCase Report

Clinical, Laboratory, and Imaging Findings of Pregnant Women with Possible Vertical Transmission of SARS-CoV-2—Case Series

by Marius Craina, Daniela Iacob, Mirabela Dima, Sandor Bernad, Carmen Silaghi, Andreea Moza, Manuela Pantea, Adrian Gluhovschi and Elena Bernad

Int. J. Environ. Res. Public Health 2022, 19(17), 10916; https://doi.org/10.3390/ijerph191710916 - 1 Sep 2022

Cited by 4 | Viewed by 1867

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue Research on Maternal and Reproductive Health)

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