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Mol Psychiatry 2022 May 17. Epub 2022 May 17.

Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria.

Immune activation is one of the most common complications during pregnancy, predominantly evoked by viral infections. Nevertheless, how immune activation affects mother-offspring relationships postpartum remains unknown. Here, by using the polyinosinic-polycytidylic acid (Poly I:C) model of gestational infection we show that viral-like immune activation at mid-gestation persistently changes hypothalamic neurocircuit parameters in mouse dams and, consequently, is adverse to parenting behavior. Read More

BMJ Case Rep 2022 May 17;15(5). Epub 2022 May 17.

Department of Maternal Fetal Medicine, Henry Ford Health System, Detroit, Michigan, USA.

In critically ill patients with COVID-19, established therapies in the setting of respiratory failure include invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO). This case report describes a pregnant woman in her 30s who was hospitalised at 35 weeks gestation with moderate COVID-19 disease. Her condition worsened following delivery, and she required intubation, maximum ventilatory support and ECMO. Read More

Obstet Gynecol 2022 May 5;139(5):916-918. Epub 2022 Apr 5.

Department of Health Policy and Management, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania; the Muskie School of Public Service, University of Southern Maine, Portland, Maine; the Department of Health Policy, Management, and Leadership, West Virginia University School of Public Health, Morgantown, West Virginia; the Department of Maternal and Child Health, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina; the Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania; the Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky; the School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; the Center for Community Research and Service, University of Delaware, Newark, Delaware; and the Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania.

J Ayub Med Coll Abbottabad 2022 Apr-Jun;34(2):369-374

King Fahad Medical City, Riyadh, Saudi Arabia.

The COVID-19 infection has spread rampantly, attaining pandemic status within three months of its first appearance. It has been classically associated with respiratory signs and symptoms. However, unusual presentations have also been reported in multiple literatures. Read More

Vaccine 2022 May 12. Epub 2022 May 12.

Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.

Introduction: Since the establishment of the Global Alignment of Immunization Safety Assessment in pregnancy (GAIA) case definitions in 2015, there has been an urgent need for field validation of pharmacovigilance feasibility in low- and middle-income countries. In this study, we assess the availability and quality of archival medical records at ten randomly selected high-traffic maternity wards in Kinshasa province, Democratic Republic of Congo (DRC).

Methods: A retrospective cohort of mother-child pairs was established from all recorded births taking place at study sites between July 1, 2019 to February 28, 2020 through digitization of medical records. Read More

Int J Environ Res Public Health 2022 Apr 30;19(9). Epub 2022 Apr 30.

GIENF-281 Nursing Research Group, Nursing Department, Univesitat Jaume I, 12006 Castelló de la Plana, Spain.

This study analyses the obstetric-neonatal outcomes of women in labour with symptomatic and asymptomatic COVID-19. A retrospective, multicenter, observational study was carried out between 1 March 2020 and 28 February 2021 in eight public hospitals in the Valencian community (Spain). The chi-squared test compared the obstetric-neonatal outcomes and general care for symptomatic and asymptomatic women. Read More

Int J Environ Res Public Health 2022 Apr 27;19(9). Epub 2022 Apr 27.

Teratology Information Service, Pharmacovigilance Centre Lareb, 's Hertogenbosch, 5237 MH Hertogenbosch, The Netherlands.

Information on medication utilization among pregnant and postpartum women during the pandemic is lacking. We described the prevalence and patterns of self-reported medication use among pregnant and postpartum women during the third wave of the pandemic (June-August 2021). An online questionnaire was distributed in five European countries between June-August 2021. Read More

BMC Pregnancy Childbirth 2022 May 12;22(1):402. Epub 2022 May 12.

Center for Vaccine Development and Global Health, University of Maryland School of Medicine, 685 W. Baltimore St, Baltimore, MD, 21201, USA.

Background: Pregnant women were excluded from investigational trials of COVID-19 vaccines. Limited data are available to inform pregnant and postpartum women on their decisions to receive a COVID-19 vaccine.

Methods: The goal of this observational, prospective cohort study is to evaluate the immunogenicity and safety of various Emergency Use Authorization (EUA) or licensed COVID-19 vaccines administered to pregnant or lactating women and describe the transplacental antibody transfer and kinetics of antibodies in mothers and infants. Read More

Nat Commun 2022 May 10;13(1):2414. Epub 2022 May 10.

Fetal Medicine Unit, St George's Hospital, St George's University of London, London, UK.

Safety and effectiveness of COVID-19 vaccines during pregnancy is a particular concern affecting vaccination uptake by this vulnerable group. Here we evaluated evidence from 23 studies including 117,552 COVID-19 vaccinated pregnant people, almost exclusively with mRNA vaccines. We show that the effectiveness of mRNA vaccination against RT-PCR confirmed SARS-CoV-2 infection 7 days after second dose was 89·5% (95% CI 69·0-96·4%, 18,828 vaccinated pregnant people, I = 73·9%). Read More

J Virol 2022 May 10:e0023122. Epub 2022 May 10.

Duke Human Vaccine Institute, Duke Universitygrid.26009.3d Medical Center, Durham, North Carolina, USA.

Despite the worldwide availability of antiretroviral therapy (ART), approximately 150,000 pediatric HIV infections continue to occur annually. ART can dramatically reduce HIV mother-to-child transmission (MTCT), but inconsistent drug access and adherence, as well as primary maternal HIV infection during pregnancy and lactation are major barriers to eliminating vertical HIV transmission. Thus, immunologic strategies to prevent MTCT, such as an HIV vaccine, will be required to attain an HIV-free generation. Read More

Haemophilia 2022 May;28 Suppl 4:11-17

School of Pharmacy and Biomolecular Sciences, Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, Dublin 2, Ireland.

Progress in both basic and translational research into the molecular mechanisms of VWD can be seen in multiple fields.

Genetics Of Vwd: In the past several decades, knowledge of the underlying pathogenesis of von Willebrand disease (VWD) has increased tremendously, thanks in no small part to detailed genetic mapping of the von Willebrand Factor (VWF) gene and advances in genetic and bioinformatic technology. However, these advances do not always easily translate into improved management for patients with VWD and low-VWF levels. Read More

Front Immunol 2022 14;13:881321. Epub 2022 Apr 14.

First Department of Liver Disease Center, Beijing Youan Hospital, Capital Medical University, Beijing, China.

Background: The extent of the increase in postpartum alanine transaminase (ALT) varies significantly among pregnant women in the immune tolerance stage of nucleoside analogue (NA) intervention, so this study is an attempt to analyze the clinical features of patients with and without postpartum hepatitis flare and preliminarily explore the differences in their immune functions.

Methods: Pregnant women with a gestational age of 24-28 w and in the immune tolerance stage of NA intervention for hepatitis B virus (HBV) infection were included and divided into a hepatitis group (Group 1) and a nonhepatitis group (Group 2) according to the ALT level at 6-12 w after childbirth. The clinical features were analyzed, and the phenotypes, functions, and cytokines of clusters of differentiation CD8 T cells in the two groups of patients were detected using flow cytometry before and after childbirth. Read More

Psicothema 2022 May;34(2):200-208

Universidad Loyola Andalucía.

Background: The current COVID-19 pandemic is a unique stressor with potentially negative consequences for pregnant and postpartum women. We investigated the impact of the COVID-19 pandemic on perinatal depression and anxiety in Spain.

Method: This cross-sectional study was conducted from June to December 2020. Read More

Lancet 2022 05 25;399(10337):1790-1798. Epub 2022 Apr 25.

Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria.

Background: The optimal management of vulvar high-grade squamous intraepithelial lesions (vHSILs) is challenging. Surgery is the standard treatment, but recurrences are observed in half of patients. Medical treatment with imiquimod is an effective alternative, but the two modalities have not been compared in a randomised trial. Read More

Int J Public Health 2022 11;67:1604497. Epub 2022 Apr 11.

Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States.

We examined whether pre-pandemic mental health and sociodemographic characteristics increased the susceptibility of pregnant women and mothers of young children to stress in the early months of the COVID-19 pandemic. Between April and August 2020, we surveyed 1560 women participating in a sociodemographically diverse birth cohort in New York City. Women reported their perceived stress, resiliency, and financial, familial/societal, and health-related concerns. Read More

Acta Neurol Taiwan 2022 Dec;31(4):170-173

Department of Radiology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India.

Purpose: To highlight the factors leading to the delayed diagnosis of basilar artery occlusion and poor outcome in the postpartum period during the prevailing Corona Virus Disease-2019 (COVID-19) pandemic.

Case Report: We here report a case of a 34-year female who presented with a headache localized to the occipital region after cesarean section under spinal anesthesia. Her headache severity increased over time, and she developed a generalized seizure episode and became unconscious. Read More

Psychiatr Danub 2022 ;34(1):148-156

Department of Psychology, Institute of Southern Punjab, Bosan Road, Multan City, Punjab, Pakistan.

Background: Past studies provide crucial evidence that pregnancy and childbirth increase the risk of emotional vulnerability and instability. Current research intends to explore the role of early maladaptive schemas and mindfulness as determinants of postpartum depression for expecting mothers during COVID-19 pandemic.

Method: The data was collected from 170 expecting mothers who conceived and gave birth during the COVID-19 pandemic. Read More

J Ayub Med Coll Abbottabad 2022 Jan-Mar;34(1):200-202

Dr Ruth Pfau Civil Hospital Karachi, Pakistan.

Background: Antiphospholipid syndrome (APS) is an acquired prothrombic state with recurring thromboembolic and obstetric complications in the presence of antiphospholipid antibodies. Isolated skin manifestation especially symmetrical peripheral gangrene (SPG) in postpartum phase is reported rarely. To highlight this unusual presentation of APS with SPG we present a case of young female who developed SPG on her third postpartum day. Read More

Front Immunol 2022 8;13:852928. Epub 2022 Apr 8.

Department of Pharmaceutical Sciences (FARM), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Jette, Belgium.

Objectives: The availability of new vaccines against COVID-19 urges for guidance about vaccination during lactation. We aimed to review the literature to get an insight into the effects of COVID-19 vaccination on lactating women.

Design: Systematic review. Read More

PLoS One 2022 22;17(4):e0267400. Epub 2022 Apr 22.

Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

A variety of oxytocin regimens are used for labor induction and augmentation. Considering the increasing rates of labor induction, it is important to assess the most optimal oxytocin regimen without compromising maternal and fetal safety. The aim of this study was to compare delivery outcomes of low-dose and high-dose oxytocin induction protocols. Read More

Pediatr Res 2022 Apr 20. Epub 2022 Apr 20.

Department of Psychology, Columbia University, New York, NY, USA.

Background: Studies have shown that infant temperament varies with maternal psychosocial factors, in utero illness, and environmental stressors. We predicted that the pandemic would shape infant temperament through maternal SARS-CoV-2 infection during pregnancy and/or maternal postnatal stress. To test this, we examined associations among infant temperament, maternal prenatal SARS-CoV-2 infection, maternal postnatal stress, and postnatal COVID-related life disruptions. Read More

AIDS Patient Care STDS 2022 Apr;36(4):145-152

Biomedical Research and Training Institute, Harare, Zimbabwe.

We conducted a 24month prospective follow-up study, at a primary health care clinic in Harare, Zimbabwe, to determine cumulative mother-to-child transmission of HIV-1 (MTCT) rate and the contributions of intrauterine (IU), intrapartum (IP), and postpartum (PP) to MTCT, as well as maternal and infant mortality rates in the era of Option B combination antiretroviral therapy (cART). Plasma for viral load (VL) quantitation was obtained from 475 mothers enrolled into the study. VL was quantified at enrolment and every 6 months thereafter up to 24 months using the Cepheid GeneXpert HIV-1 Quantitative test. Read More

Front Public Health 2022 1;10:758447. Epub 2022 Apr 1.

College of Nursing and Health Professions Drexel University, Philadelphia, PA, United States.

Background: Mother-to-infant transmission of HIV is a major problem in Sub-Saharan Africa despite free or subsidized antiretroviral treatment (ART), but is significantly reduced when mothers adhere to ART. Because potable water access is limited in low-resource countries, we investigated water access and ART adherence intention among HIV-positive pregnant women and new mothers in Zambia.

Methods: Our convenience sample consisted of 150 pregnant or postpartum women receiving ART. Read More

Lancet Psychiatry 2022 05;9(5):389-401

Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; ICES, Toronto, ON, Canada; Women's College Hospital, Toronto, ON, Canada. Electronic address:

Background: Emergency department visits for a psychiatric reason in the post-partum period represent an acute need for mental health care at a crucial time, but little is known about the extent of timely outpatient follow-up after these visits or how individual and intersecting social determinants of health influence this outcome. This study aimed to examine outpatient mental health care follow-up by a physician in the 30 days after an individual attended the emergency department for a psychiatric reason in the post-partum period and understand how social determinants of health affect who receives follow-up care.

Methods: In this population-based cohort study, routinely collected health data from Ontario, Canada were accessed through ICES to identify all post-partum individuals whose sex was listed as female on their health card and who had attended an emergency department in Ontario before the COVID-19 pandemic for a psychiatric reason. Read More

PLoS Med 2022 04 15;19(4):e1003973. Epub 2022 Apr 15.

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.

Background: Observational studies suggest that vitamin D deficiency among people living with HIV is associated with a greater risk of disease progression and death. Low levels of vitamin D in pregnancy are also associated with poor fetal and infant growth. Therefore, vitamin D supplementation may improve clinical outcomes for pregnant women living with HIV and improve fetal and postnatal growth for their infants. Read More

PLoS One 2022 14;17(4):e0267042. Epub 2022 Apr 14.

Department of Health and Social Care, School of Midwifery, AP University College, Antwerp, Belgium.

Background: The COVID-19 pandemic is likely to influence psychological health of pregnant and postpartum women.

Methods: We conducted a non-concurrent cross-sectional study among 1145 women living in the Dutch-speaking part of Belgium, 541 pregnant and 604 postpartum women. We measured psychological health with the Whooley questions, Generalized Anxiety Disorder 2-item (GAD-2) and the Edinburgh Postnatal Depression Scale (EPDS) and compared the scores of pregnant and postpartum women before and during the COVID-19 pandemic. Read More

BMC Pregnancy Childbirth 2022 Apr 13;22(1):315. Epub 2022 Apr 13.

Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue City, Vietnam.

Background: Intimate partner violence (IPV) during pregnancy is significantly associated with negative outcomes for both mother and child. Current evidence indicates an association between low levels of social support and IPV, however there is less evidence from low-and-middle income countries (LMIC) than high-income countries. Globally, the COVID-19 pandemic has radically altered how women can access social support. Read More

BMC Pregnancy Childbirth 2022 Apr 13;22(1):317. Epub 2022 Apr 13.

Department of Anaesthesia, Division of Anesthesiology and Perioperative Medicine, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.

The SARS-CoV-2 pandemic is rapidly evolving and remains a major health challenge worldwide. With an increase in pregnant women with COVID-19 infection, we recognized an urgent need to set up a multidisciplinary taskforce to provide safe and holistic care for this group of women. In this review of practice in a tertiary hospital in Singapore, we discuss the key considerations in setting up an isolation maternity unit and our strategies for peripartum and postpartum care. Read More

Georgian Med News 2022 Mar(324):32-37

Azerbaijan Medical University, Department of Obstetrics and Gynecology; Scientific Research Institute of Obstetrics and Gynecology, Baku, Azerbaijan.

The aim of this study was to optimize the diagnosis of postpartum inflammatory complications. 150 puerperas who gave written informed consent to participate in clinical and laboratory studies were divided into two groups: the main group included puerperas with developed postpartum complications (n = 100), the comparison group included puerperas with a physiological course of the postpartum period (n = 50). The data of biochemical blood tests and bacteriological analysis of aspirated vaginal contents under aseptic conditions after childbirth were used as material. Read More

J Orthop Case Rep 2021 Sep;11(9):72-76

Department of Orthopaedics, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.

Introduction: Pregnancy is a physiologically hypercoagulable state and a coronavirus disease 2019 (COVID-19) infection adds to this burden by accentuating the coagulopathy. We report two cases of severe peri-partum COVID infection leading to extremity gangrene secondary to a pro-thrombotic coagulopathy.

Case One: A 37-year-old lady, day-2 postpartum, was brought with severe COVID infection & and respiratory failure. Read More