Pregnancy Complications In Women Research Articles

Pregnancy outcomes for women with myasthenia gravis and their newborns: A nationwide register-based cohort study.

Few large-scale studies examine whether maternal myasthenia gravis (MG) is a risk factor for complications during pregnancy and childbirth. This study evaluated whether maternal MG is associated with an increased risk of adverse pregnancy, delivery, and neonatal outcomes. We conducted a nationwide Swedish register-based cohort study of women who gave birth to singleton infants (≥22 gestational weeks) during 1987-2019. Exposed women were diagnosed with MG before or during the index pregnancy (N = 443). Unexposed women comprised 4249 women without a diagnosis of MG, matched for age, parity, hospital, and year of childbirth. The risks of adverse pregnancy, delivery, and neonatal outcomes for women with MG were estimated using regression modeling and presented as adjusted odds ratios (aOR). There was no increased risk of pregnancy complications in women with MG. Women with MG had a spontaneous onset of labor less often than women without MG (69.8% vs. 79.5%; aOR 0.59; p < 0.001) as well as higher labor induction rates and elective cesarean section deliveries (16.0% vs. 12.3%, aOR 1.42; p = 0.02 and 12.0% vs. 8.1%, aOR 1.59; p = 0.009). Infants of women with MG were born on average 2 days earlier (p = 0.002); however, these infants did not have a higher risk of having low APGAR, being small for gestational age, or having a congenital malformation. This first nationwide study of pregnancy in women with MG in Sweden demonstrates reassuring results overall, suggesting generally safe pregnancy outcomes for women with MG and their infants.

Virulence-associated genes and antimicrobial resistance patterns in bacteria isolated from pregnant and nonpregnant women with urinary tract infections: the risk of neonatal sepsis.

Uropathogenic Escherichia coli (UPEC) is classified as the major causative agent of urinary tract infections (UTIs). UPEC virulence and antibiotic resistance can lead to complications in pregnant women and (or) newborns. Therefore, the aim of this study was to determine the etiological agents of UTIs, as well as to identify genes related to virulence factors in bacteria isolated from pregnant and nonpregnant women. A total of 4506 urine samples were collected from pregnant and nonpregnant women. Urine cultures were performed, and PCR was used to identify phylogroups and virulence-related genes. Antibiotic resistance profiles were determined. The incidence of UTIs was 6.9% (pregnant women, n=206 and nonpregnant women, n=57), and UPEC belonging to phylogroup A was the most prevalent. The presence of genes related to capsular protection, adhesins, iron acquisition, and serum protection in UPEC was associated with not being pregnant, while the presence of genes related to adhesins was associated with pregnancy. Bacteria isolated from nonpregnant women were more resistant to antibiotics; 36.5% were multidrug resistant, and 34.9% were extensively drug resistant. Finally, UTIs were associated with neonatal sepsis risk, particularly in pregnant women who underwent cesarean section while having a UTI caused by E. coli. In conclusion, UPEC isolated from nonpregnant women carried more virulence factors than those isolated from pregnant women, and maternal UTIs were associated with neonatal sepsis risk.

Early neonatal complications in pregnant women with gestational diabetes mellitus and the effects of glycemic control on neonatal infection.

Gestational diabetes mellitus (GDM) has become increasingly prevalent globally. Glycemic control in pregnant women with GDM has a critical role in neonatal complications. To analyze the early neonatal complications in GDM, and examine the effect of blood glucose control level on neonatal infection. The clinical data of 236 pregnant women with GDM and 240 healthy pregnant women and newborns during from March 2020 to December 2021 the same period were retrospectively analyzed, and the early complications in newborns in the two groups were compared. The patients were divided into the conforming glycemic control group (CGC group) and the non-conforming glycemic control group (NCGC group) based on whether glycemic control in the pregnant women with GDM conformed to standards. Baseline data, immune function, infection-related markers, and infection rates in neonates were compared between the two groups. The incidence of neonatal complications in the 236 neonates in the GDM group was significantly higher than that in the control group (P < 0.05). Pregnant women with GDM in the NCGC group (n = 178) had significantly higher fasting plasma glucose, 2 h postprandial blood glucose and glycated hemoglobin A1C levels than those in the CGC group (n = 58) (P < 0.05). There were no differences in baseline data between the two groups (P > 0.05). Additionally, the NCGC group had significantly decreased peripheral blood CD3+, CD4+, CD8+ T cell ratios, CD4/CD8 ratios and immunoglobulin G in neonates compared with the CGC group (P < 0.05), while white blood cells, serum procalcitonin and C-reactive protein levels increased significantly. The neonatal infection rate was also significantly increased in the NCGC group (P < 0.05). The risk of neonatal complications increased in pregnant women with GDM. Poor glycemic control decreased neonatal immune function, and increased the incidence of neonatal infections.

What has changed over the year in the prevention of venous thromboembolic events in pregnant women and puerperas?

An issue of venous thromboembolic events (VTEs) in pregnant women and puerperas in Russia as well as throughout the world remains relevant. Specialized events with expert’s participation could not be better to promote active discussion and constructive solution of complex problems, which refer to issues of VTEs prevention. Indeed, not disputable issues can be solved, but critical look and reasoned opinion leader presentations in the field undoubtedly improve our understanding and approaches to prevention of threatening complications in pregnant women and puerperas such as VTEs. In addition, actively discussed new data for dosing of low molecular weight heparins (LMWH) in pregnant women will allow to update current clinical guidelines, which would probably improve clinical outcomes of therapy.

Effects of bipolar disorder on maternal and fetal health during pregnancy: a systematic review

BackgroundBipolar disorder (BD) is a mental disorder characterized by mood shifts from severe depression to mania. Pregnant women with BD may experience manic or depressive episodes, so they are usually concerned about the effects of BD on their pregnancy. The aim of this systematic review is to determine the effects of BD on maternal health and fetal health, weight, and development. It also addresses how BD affects the probability of incidence of pregnancy complications in women with bipolar compared with healthy controls.MethodsSeven electronic databases (Ovid MEDLINE, Embase, MIDRIS, APA PsychINFO, Scopus, Web of Science, and ScienceOpen) were searched, and 1728 eligible studies were identified. After deduplication, screening, and manual search processes, we included only 15 studies. Descriptive analysis, and calculation of the probability of incidence for each pregnancy outcome were used to analyze the results.ResultsThe findings of the included studies suggest that BD during pregnancy may affect both fetal growth and maternal health by increasing the risk of giving birth to an infant with some birth defects such as microcephaly, CNS problems, small for gestational age, and other congenital anomalies, in addition to causing some obstetric complications such as gestational hypertension, preterm labor, need for assisted delivery, hospital readmission, and others.ConclusionBipolar disorder during pregnancy negatively affects mothers and their fetuses and increases the probability of incidence of obstetrics complications.

Increased stiffness of omental arteries from late pregnant women at advanced maternal age.

Advanced maternal age (≥35 years) is a risk factor for poor pregnancy outcomes. Pregnancy requires extensive maternal vascular adaptations, and with age, our blood vessels become stiffer and change in structure (collagen and elastin). However, the effect of advanced maternal age on the structure of human resistance arteries during pregnancy is unknown. As omental resistance arteries contribute to blood pressure regulation, assessing their structure in pregnancy may inform on the causal mechanisms underlying pregnancy complications in women of advanced maternal age. Omental fat biopsies were obtained from younger (<35 years) or advanced maternal age (≥35 years) women during caesarean delivery (n = 7-9/group). Arteries (200-300 µm) were isolated and passive mechanical properties (circumferential stress and strain) assessed with pressure myography. Collagen (Masson's Trichrome) and elastin (Verhoff) were visualized histologically and % positively-stained area was assessed. Median maternal age was 32 years (range 25-34) for younger, and 38 years (range 35-42) for women of advanced maternal age. Circumferential strain was lower in arteries from advanced maternal age versus younger women but circumferential stress was not different. Omental artery collagen levels were similar, while elastin levels were lower with advanced maternal age versus younger pregnancies. The collagen:elastin ratio was greater in arteries from advanced maternal age versus younger women. In conclusion, omental arteries from women of advanced maternal age were less compliant with less elastin compared with arteries of younger controls, which may affect how vascular stressors are tolerated during pregnancy. Understanding how vascular aging affects pregnancy adaptations may contribute to better pregnancy outcomes.

FETAL AND NEONATAL STATUS IN WOMEN WITH CEREBRO-VASCULAR DISORDERS AND RISK FACTORS FOR THEIR DEVELOPMENT

Introduction. Cerebrovascular diseases in pregnant women are one of the most important problems of modern obstetrics and perinatology due to the steady increase in maternal and neonatal morbidity. Diabetes mellitus and hypertensive disorders are two of the most common complications of pregnancy, which negatively affect both short-term and long-term outcomes for the mother, fetus and newborn.The aim of the study was to determine the state of the fetus and the newborn in pregnant women with cerebral disorders, taking into account risk factors (hypertension, diabetes mellitus).Material and methods. 92 pregnant women were examined, of which the main group (77 pregnant women) consisted of women with extragenital pathology, in particular, cerebrovascular disease - 20 (21.7%), hypertension - 23 (29.8%), diabetes mellitus - 34 (44.1%), the control group consisted of 15 pregnant women (16.3%) with physiological pregnancy and their newborns.Scientific research passed the bioethics commission, no violations were found (Protocol No. 7 of 05.04.2023).Statistical processing of the data obtained during the study was carried out using Microsoft Office Excel 2016 (Microsoft, USA) and Statistica 10.0 (StatSoft, USA). The significance of differences in the characteristics of dependent groups with signs of normal distribution was assessed by the paired Student's t-test (t-test of dependent samples).This work is a fragment of the complex research work of the Department of Obstetrics and Gynaecology №2 of Kharkiv National Medical University "Optimisation of diagnostics, treatment of diseases of the reproductive system and pregnancy complications in women with extragenital pathology", state registration number 0121U11923).Results. Cerebrovascular disease was represented by the consequences of traumatic brain injury in 8 (40%) cases, acute cerebrovascular accident (ischaemic, haemorrhagic) - in 5 (25%), epilepsy - in 5 (25%), encephalopathy in cerebral palsy - in 3 (15%), arteriovenous transformation, angiomatous cavity - in 2 (10%) cases. Among women of the hypertension group, pre-eclampsia was found in 11 (47.8%), gestational hypertension - in 8 (34.7%), and chronic hypertension - in 4 (17.4%) cases. Pre-gestational diabetes was detected in 8 (23.5%) pregnant women in the diabetic group, and gestational diabetes in 26 (76.5%).Doppler flowmetry examination of blood flow in the middle cerebral artery (MCA) revealed a significant decrease (p&lt;0.05) in the pulsatile index in pregnant patients of the main group (1.24±0.09) compared with women with a physiological course of the gestational process (1.82±0.11). There was a difference in the systolic-diastolic ratio in the SMA between women of the main and control groups (2.4±0.2 and 3.5±0.3, respectively) (p&lt;0.05).When analysing the acid-base status of newborns, it was noted that the pH values in the groups with extragenital pathology had a shift to the acidic side. These shifts were most pronounced in the group with placental dysfunction due to diabetes mellitus, where the pH averaged 7.18±0.05, against the background of increased PCO2 to 56.3±3.4 mm Hg (p&lt;0.05), indicating the presence of respiratory acidosis in fetuses. A decrease in the deficit of alkaline bases in the fruits of this group to an average of -7.1±0.69 mmol/l (p&lt;0.05) indicated the occurrence of manifestations of metabolic acidosis in them.Conclusions. Cerebrovascular disease was more common in pregnant women over 30 years of age, mostly residents of the region (80%), which may be due to high trauma, insufficient examination and treatment, housewives, due to the underlying disease, as well as with Rh-negative blood type (35%), hypertensive disorders, diabetes mellitus, placental dysfunction, and early delivery, which increases the risk of neonatal complications and perinatal morbidity. Hypertensive disorders and diabetes mellitus can be considered risk factors for the development of cerebrovascular disorders in pregnant women and perinatal complications.

Frequency of malnutrition and their relationship with complications in pregnant women and their newborns

En el embarazo el requerimiento energético y de nutrientes aumentan, el déficit o el exceso puede afectar el estado nutricional de la madre y del neonato. Con el objetivo de determinar la frecuencia de malnutrición y su relación con complicaciones en mujeres embarazadas y sus recién nacidos que acuden al Hospital Distrital de Capiatá del Ministerio de Salud Pública y Bienestar Social, en el mes de febrero a agosto de 2022, se realizó un estudio observacional descriptivo de corte transverso retrospectivo que incluyó a 140 gestantes, de las cuales 64 presentaron complicaciones por malnutrición y 76 no presentaron ninguna complicación. La edad media fue de 26,9±6,6 años con un rango de edad de 15 a 40 años. Los resultados muestran que el 45.7% (n=64) de las gestantes presentaron complicaciones por malnutrición, el 51,6% presentó diabetes gestacional, anemia en el 29,7%, el 7,8% presentó anemia y diabetes gestacional, el otro 7,8% hipertensión arterial, el 1,6% manifestó hipertensión arterial y diabetes gestacional y el otro 1,6% presentó anemia, hipertensión arterial y diabetes gestacional. En relación a la evaluación nutricional al inicio y al final de la gestación en las gestantes con complicaciones hubo una leve disminución en los porcentajes de obesidad de 43,7% a 37,5% y un aumento del bajo peso de 11% a 20,3%. En cuanto al tipo de parto en las gestantes con complicaciones el 51,6% fue por cesárea (n=33), las cuales presentaron diabetes gestacional en el 54,5%, seguido de anemia en el 21,2%. Se comprobó un mayor porcentaje de sobrepeso y obesidad (29,7%) en los recién nacidos de madres con complicaciones. Se pudo evidenciar la frecuencia de malnutrición y complicaciones en casi la mitad de las gestantes, es preciso generar mayores estrategias en salud pública para prevenir la malnutrición y complicaciones en gestantes.

Myoma previa during cesarean section: a case report and review of the literature

Uterine fibroids are one of the most common pathologies in women of reproductive age, related not only to the achievement, but also to the course of pregnancy. In addition, in some cases it has a significant impact on the method of delivery and is associated with certain complications during labor and in the postpartum period. Myoma previa is a rare complication in pregnant women with uterine fibroids. We present a case of a patient with myoma previa during pregnancy. Due to the presence of a large protruding myoma in the patient, a decision was made to deliver by cesarean section. A live fetus was born and a large myoma in the lower uterine segment was found. Due to the suspicion of necrotic changes in the myoma, which would lead to complications in the postpartum period, a myomectomy was performed without complications. Subsequent histological examination revealed necrotic changes in the fibroid. The postpartum period in the woman passed without deviations.

Evaluation of Maternal and Fetal Complications in Pregnant Women with Polycystic Ovary Syndrome (PCOS) with Severe and Mild Phenotype

Evaluation of Maternal and Fetal Complications in Pregnant Women with Polycystic Ovary Syndrome (PCOS) with Severe and Mild Phenotype

Infections in Urinary Tract among Pregnant Women in Nasiriya City, Iraq

Abstract

Family support and the healthcare workforce when the patient chooses a cesarean section on maternal and neonatal outcomes

Background: Childbirth is a series of pregnancy processes that end with the expulsion of the products of conception. The number of births with SC is increasing every year. In Indonesia, the incidence of cesarean section in 2009 has reached 29.6%. This number certainly affects the mortality and morbidity rates in subsequent deliveries.Purpose: To identify family support and the healthcare workforce when the patient chooses a cesarean section on maternal and neonatal outcomesMethod: A case study with TOLAC (Trial of Labor After Cesarean Delivery) is a planned effort to give birth vaginally by a woman who has had a previous SC delivery. Women's perceptions related to pregnancy to delivery can influence the choice of the desired delivery method.Results: Women 31 year old with G3P1011 assisted since 17-18 weeks of gestation. Had an obstetric history with 1x caesarean section in 2016 because there was no progress in labour. Early referral planning has been carried out. Termination of pregnancy by sectio caesarea is planned at 38-39 weeks of gestation. Since the beginning of the pregnancy, the mother wanted to give birth vaginally, but the mother did not get support from her husband or family. Before the intervention was carried out, the mother experienced signs of labor and the mother wanted to try vaginal delivery but was not supported by healthcare workforce and a cito SC was performed. The baby was born healthy with a good Apgar score.Conclusion: The perceptions and beliefs that pregnant women have after SC surgery need to be balanced with the support of their families and healthcare workforce so that they are successful in undergoing trials of the normal delivery method according to preference. Mentoring activities can be a method of providing education, monitoring efforts, and early detection of complications in pregnant women with former SC operations.

Uterine Fibroid Diagnosed During Pregnancy: A Case Report

Uterine fibroids arise from the smooth muscle cells of the myometrium and contain large amounts of extracellular matrix. It is not uncommon for these tumours to be diagnosed during gestation and their volumetric changes remain a matter of debate. The fibroid can be a source of obstetric complications in pregnant women and pregnancy can influence the condition of the fibroid. The objective is to evaluate the behaviour of fibroids coexisting with pregnancy according to their genetic profile in order to determine the penetrance of the COMT gene in Senegalese patients. We analysed the variability of the COMT gene in 6 pregnancy patients with fibroids by PCR-sequencing. Molecular analyses of the COMT gene show an involvement of exon 4 of the said gene in this pathology.

Neurological manifestations of COVID-19 in pregnancy: a cross-sectional study.

The occurrence of neurological manifestations and complications in pregnant women compared to non-pregnant women with COVID-19 is unclear. This cross-sectional study included women aged over 18years hospitalized with SARS-CoV-2 infection confirmed by RT-PCR from March to June 2020 in Recife, Brazil. We evaluated 360 women, including 82 pregnant patients who were significantly younger (27.5 vs. 53.6years; p < 0.01) and less frequently obese (2.4% vs. 15.1%; p < 0.01) than the non-pregnant group. All pregnancies were confirmed using ultrasound imaging. Abdominal pain was the only more frequent COVID-19 manifestation during pregnancy (23.2% vs. 6.8%; p < 0.01), but was not associated with the outcomes. Almost half the pregnant women presented neurological manifestations, including anosmia (31.7%), headache (25.6%), ageusia (17.1%), and fatigue (12.2%). However, neurological manifestations occurred similarly in pregnant and non-pregnant women. Four (4.9%) pregnant women and 64 non-pregnant women (23%) presented delirium, but the frequency with age-adjustment was similar in the non-pregnant group. Pregnant women with COVID and preeclampsia (19.5%) or eclampsia (3.7%) were older (31.8 vs. 26.5years; p < 0.01), and epileptic seizures occurred more often in association with eclampsia (18.8% vs. 1.5%; p < 0.01) regardless of previous epilepsy. There were three maternal deaths (3.7%), one dead fetus, and one miscarriage. The overall prognosis was good. There was no difference in prolonged hospital stay, the need for ICU and mechanical ventilation, or death when comparing pregnant and non-pregnant women.

Characteristics and Risks of COVID-19 in Pregnant Women &amp; Neonates: A Retrospective, Age-matched Comparison Study—Wuhan Experience in the Management of Peripartum Health

ABSTRACT Background: Coronavirus disease 2019 (COVID-19) has since spread globally causing the ongoing pandemic. However, there are few studies on the symptoms and outcomes of pregnant women with COVID-19 and their newborns. Limited data are available comparing pregnant women with and without COVID-19 pneumonia. Our study aimed to find symptoms unique in pregnancy to help the early detection of COVID-19 in pregnant women and to evaluate its impact on perinatal women and their newborns. Methods: Clinical data were reviewed and collected for 11 pregnant women with laboratory-confirmed COVID-19 (pregnant confirmed cohort) who were consecutively admitted to Zhongnan Hospital of Wuhan University and Maternal and Child Health Hospital of Hubei Province, from January 26 to February 26, 2020. They were subsequently matched by age with 11 pregnant women suspected of COVID-19 (pregnant suspected group) who had typical changes in chest computed tomography (CT) scans but were repeatedly negative for reverse-transcriptase-polymerase-chain-reaction (RT-PCR), with 11 pregnant women who were not infected (pregnant non-infected group), and with 44 non-pregnant women with confirmed COVID-19 (Non-pregnant confirmed group). Results: The significant symptoms in pregnant confirmed women were mild fever and fatigue. Both the confirmed and suspected women had a fever (45.5% vs. 72.7%, P &gt; 0.05) which were barely distinguishable. The chest CT scans of confirmed women showed unspecific manifestations, such as bilateral pleural effusions and slightly increased densities. Eight of eleven (72.7%) confirmed women did not feel anything unusual until abnormalities were found on chest CT scans on the admission screening test. All three groups had elevated white blood cell count, neutrophil count, lactate dehydrogenase, and reduced total protein. Compared to the normal group, women in the confirmed group had significantly reduced hemoglobin, lymphocyte, albumin, and increased lactate dehydrogenase (P &lt; 0.05). The infection did not increase the risk of premature delivery, premature rupture of the membrane, or comorbidities in pregnancy. The neonates of the three groups of mothers had similar symptoms, except for those of the confirmed group had increased heart rate (130–143 bpm) and mean arterial pressure (93–112 mmHg) than those born to the normal group. The infection of the mother did lead to more complications in their neonates. And there was no evidence of vertical transmission during late pregnancy. Conclusions: Pregnant women were often asymptomatic and had incidental abnormal findings on a chest CT scan on admission. Screening of CT scans in disease prevalent areas is thus of crucial importance. Even after the laboratory confirmation, the manifestation of the CT scan could be atypical, which alerted the necessity of protection for healthcare workers. COVID-19 did not increase the risk of complications in pregnant women and their neonates.

Study on the Regulation of Trophoblast Activity by Abnormally Expressed lncRNA CCDC144NL-AS1 in Patients with Gestational Diabetes Mellitus.

Gestational diabetes mellitus (GDM) is a common complication in pregnant women. The growth and differentiation of trophoblast cells determine the function of the placenta, and therefore further affect the transport of nutrients to the fetus. lncRNA Coiled-Coil Domain Containing 144 N-Terminal-Like antisense1 (CCDC144NL-AS1) was reported to be abnormally expressed in GDM, but its function and mechanism remain undefined. This study aimed to reveal the expression of CCDC144NL-AS1 in GDM and evaluate its significance in disease development. The expression of CCDC144NL-AS1 in serum and placenta tissues of GDM patients and healthy pregnant women was evaluated using PCR. The effect of CCDC144NL-AS1 on the proliferation, migration, and invasion of trophoblast cells was evaluated with CCK8 and Transwell assay. The mechanism of the interaction between CCDC144NL-AS1 and miR-143-3p was assessed by luciferase reporter assay and cell transfection. CCDC144NL-AS1 was upregulated in GDM patients, which discriminated GDM patients from healthy pregnant women with high sensitivity and specificity and was positively correlated with the insulin resistance indexes. In trophoblast cells, high glucose exposure induced increased CCDC144NL-AS1 and suppressed cell proliferation, migration, and invasion. Silencing CCDC144NL-AS1 could alleviate the inhibitory effect of high glucose, while the knockdown of miR-143-3p reversed the effect of CCDC144NL-AS1. In conclusion, upregulated CCDC144NL-AS1 served as a diagnostic biomarker of GDM and regulated the development of trophoblast cells via negatively modulating miR-143-3p.

Pentingnya Pemeriksaan Hemoglobin Pada Ibu Hamil

Pregnancy is a physiological condition that is naturally experienced by women who are productive and fertile. During pregnancy, a mother must routinely perform Ante Natal Care (ANC) at least 4 times during pregnancy. The purpose of a mother doing ANC is to maintain the health of the mother and fetus and to prevent complications during pregnancy. One of the causes of complications in pregnant women is anemia due to iron deficiency which is a case that is often found in pregnant women. One indicator of anemia is to look at the picture of hemoglobin levels in pregnant women. One of the causes of anemia is due to iron deficiency which results from insufficient nutrition for pregnant women. The aim of this activity is to screen pregnant women suffering from anemia at RB Sinta and provide education to pregnant women regarding the importance of ANC during pregnancy. Method: This activity is carried out by checking Hb levels in pregnant women and providing counseling

Effects of HBsAg carriers on pregnancy complications in pregnant women: a retrospective cohort study.

Hepatitis B virus (HBV) infection is a major health threat worldwide, especially in developing countries. We aimed to investigate the impact of hepatitis B carrier on pregnancy complications in pregnant women, in China. This retrospective cohort study was conducted by using data from the EHR system of Longhua District People's Hospital in Shenzhen, China, from January 2018 to June 2022. Binary logistic regression was used to evaluate the relationship between HBsAg carrier status and pregnancy complications and pregnancy outcomes. The study included 2095 HBsAg carriers (exposed group) and 23,019 normal pregnant women (unexposed group). Pregnant women in the exposed group were older than the pregnant women in the unexposed group (29 (27,32) vs. 29 (26,32), p < 0.001). In addition, the incidence of some adverse pregnancy complications in the exposure group was lower than that in the unexposed group, including hypothyroidism of pregnancy (adjusted odds ratio [aOR], 0.779; 95% confidence interval [CI], 0.617-0.984; p = 0.036), hyperthyroidism of pregnancy (aOR, 0.388; 95% CI, 0.159-0.984; p = 0.038), pregnancy induced hypertension (aOR, 0.699; 95% CI, 0.551-0.887; p = 0.003), antepartum hemorrhage (aOR, 0.294; 95% CI, 0.093-0.929; p = 0.037). However, compared with the unexposed group, the exposed group had a higher risk of lower birth weight (aOR, 1.12; 95% CI, 1.02-1.23; p = 0.018) and intrahepatic cholestasis of pregnancy (aOR, 2.888, 95% CI, 2.207-3.780; p < 0.001). The prevalence rate of HBsAg carriers in pregnant women in Longhua District of Shenzhen was 8.34%. Compared with normal pregnant women, HBsAg carriers have a higher risk of ICP, a lower risk of gestational hypothyroidism and PIH, and a lower birth weight of their infants.

Pregnancy-related aortic complications in women with bicuspid aortic valve

ObjectivesTo describe the aortic-related risks associated with pregnancy in women with bicuspid aortic valve (BAV) and to evaluate changes in aortic diameter in pregnancy.MethodsProspective observational study of patients with BAV...

Adverse outcomes and maternal complications in pregnant women with severe-critical COVID-19: atertiary center experience.

This study aimed to present perinatal outcomes, clinical challenges, and basic ICU management in pregnant women with severe-critical COVID-19 at our tertiary referral center. In this prospective cohort study, patients were divided into two groups, whether they survived or not. Clinical characteristics, obstetric and neonatal outcomes, initial laboratory test results and radiologic imaging findings, arterial blood gas parameters at ICU admission, and ICU complications and interventions were compared between groups. 157 of the patients survived, and 34 of the patients died. Asthma was the leading health problem among the non-survivors. Fifty-eight patients were intubated, and 24 of them were weaned off and discharged healthfully. Of the10 patients who underwent ECMO, only 1 survived (p<0.001). Preterm labor was the most common pregnancy complication. Maternal deterioration was the most common indication for a cesarean section. Higher neutrophil-to-lymphocyte-ratio (NLR) values, the need for prone positioning, and the occurrence of an ICU complication were important parameters that influenced maternal mortality (p<0.05). Overweight pregnant women and pregnant women with comorbidities, especially asthma, may have a higher risk of mortality related to COVID-19. A worsening maternal health condition can lead to increased rates of cesarean delivery and iatrogenic prematurity.