Infected Women Research Articles

The prevalence and influencing factors of COVID-19 in pregnant women post-relaxation of epidemic control measures in Hunan Province, China

ObjectiveTo investigate the epidemiological characteristics of COVID-19 in pregnant women after relaxation of epidemic control measures.MethodsThis cross-sectional study employed a multistage stratified sampling method, involving six sampling sites (districts/counties) of three cities (Zhuzhou, Chenzhou, and Huaihua) in Hunan Province, China. A questionnaire-based survey collected basic maternal information, COVID-19 infection status, and pregnancy-related information of the participants. Data were extracted and double checked for accuracy. Statistical analyses were conducted using SPSS 25.0 software.ResultsAmong the 7,761 pregnant women included in the study, 5,191 (66.9%) had a positive result of SARS-CoV-2 test or related symptoms. The majority of maternal infections were mild (90.0%), and a very small fraction were severe and critical (0.4% and 0.1 %). Headache and body aches (65.3%) were the most common symptoms. Of the 5,191 pregnant women with COVID-19, 4,150 (79.9%) had no complications during pregnancy. A total of 2,711 (52.2%) infected women had deliveries, and 449 (16.6%) newborns had infections. The impacts of COVID-19 on adverse pregnancy outcomes were limited. Logistic multivariable regression analysis showed that pregnant women with an education level of junior college and above (OR = 1.39, 95% CI: 1.18, 1.64), those with a monthly household income ≥ 3,000 yuan and above (OR = 1.18, 95% CI: 1.03, 1.34), those who lived with their family during family member infection (OR = 1.48, 95% CI: 1.32, 1.66), and those with pulmonary (OR = 1.41, 95% CI: 1.07, 1.85) or other (OR = 1.40, 95% CI: 1.19, 1.65) underlying diseases were more likely to have COVID-19. A farmer/worker occupation type (OR = 0.62, 95% CI: 0.48, 0.79) was a protective factor.ConclusionA high prevalence of COVID-19 in pregnant women following relaxation of control measures has been observed at provincial scale in China. Most cases were mild, and few effects on newborns were observed. Higher education and income, living with infected family members, and having pulmonary disease were identified as risk factors, suggesting that mobility is the most critical factor influencing infection rates. This study provides useful references for epidemic prevention and control in the future.

Pregnant Women, a Potential Reservoir for Onchocerca volvulus? A Cross Sectional Study in Maridi County, South Sudan

BackgroundOnchocerciasis, a neglected tropical disease (NTD) caused by Onchocerca volvulus, is hyperendemic in many parts of Africa, including South Sudan. Pregnant women may be a parasite reservoir as they are not included in routine ivermectin (IVM) treatments due to unassessed drug safety. In our study we determined the proportion of pregnant women infected with Onchocerca volvulus and assessed the knowledge and practices on IVM use during pregnancy.Methodology/Principal FindingsA hospital-based cross-sectional study was conducted in 2023 at Maridi hospital in Maridi County, an onchocerciasis endemic area in South Sudan. All pregnant or one-week post-partum women willing to participate were interviewed, clinically examined, tested with the Ov16 Bioline rapid diagnostic test (RDT) and skin snipped for O. volvulus detection. A total of 317 women aged between 14 and 44 years participated in the study [median age: 23 years (IQR: 19–29)]. Of 290 women who were tested, 179 (61.7%) were Ov16 RDT positive (SD Bioline). Of the 162 women skin snipped, 51 (31.5%) were positive for O. volvulus microfilarial worm following microscopic examination. The microfilaridemia (skin parasite load) ranged between one microfilaria per skin snip (1mf/ss) and 300 mf/ss with a mean value of value of 12.4 (sd: ± 49.1) mf/ss. Most pregnant women (87.8% (274/312)) knew that it was not advised to take IVM during pregnancy. Out of 309 women, 54 (17.5%) had never taken IVM, and 6.4% (16/251) inadvertently took IVM during pregnancy. Of the 16 women who took IVM during pregnancy, 50% (8/16) knew that they were pregnant. Out of 248 women with children, 9 (3.6%) had children suffering from epilepsy; two of them had two children with epilepsy. No abnormalities were reported in the children of the women who took IVM.ConclusionsOur study is the first to investigate the prevalence and level of O. volvulus infection among pregnant women in onchocerciasis-endemic areas in Africa. Our results showed a high infection rate of O. volvulus among pregnant women, which may pose a risk for adverse materno-foetal outcomes. Pregnant women in South Sudan are a reservoir for parasite transmission. A clinical trial evaluating the potential beneficial effect of treating O. volvulus infected pregnant women with IVM should be considered, as our preliminary results and the literature suggest that IVM intake might not affect the newborn.

Impact of Dengue Fever on Pregnancy Outcomes: A Prospective Observational Study

Dengue in pregnancy has a profound negative impact on both maternal and fetal outcomes, leading to increased maternal and neonatal mortality. Objective: To evaluate the maternal and fetal outcomes in pregnant women affected by dengue fever. Methods: A prospective observational study was carried out at Niazi Welfare Foundation Teaching Hospital, Sargodha. Non probability convenient sampling technique was used to collect data from 36 pregnant women enrolled after confirming dengue infection through NS-1 and IgM/IgG tests. Maternal and fetal outcomes were monitored throughout pregnancy, labor, and the postpartum period. Data was analyzed using SPSS version 26.0 and presented in frequency and percentages. Results: Fetal complications observed in this study were, preterm delivery in 16 cases (44.4%), term delivery in 14 cases (39%), fetal growth restriction in 8 cases (22%), and intrauterine death in 6 cases (16.6%). Maternal outcomes included, postpartum hemorrhage in 6 cases (16.6%), 7 infected women (19.4%) were admitted to the ICU, and two mothers (5.5%) died. The frequency of neonatal admission to the NICU was 30.5%. Conclusions: Dengue infection in pregnancy is linked to heightened risk of maternal and perinatal morbidity and mortality. Timely clinical interventions are necessary to avoid devastating consequences.

P-162. Estimating the Seroprevalence of HTLV-1 in Pregnant Peruvian Women Based on Blood Bank Markers: a Road to Elimination of Mother-to-Child Transmission of HTLV-1

Abstract Background The prevention of mother-to-child transmission (PMTCT) of human T-cell lymphotropic virus type 1 (HTLV-1) is a top priority for HTLV-endemic countries due to its chronicity, lack of treatment and association with the aggressive adult T cell leukemia/lymphoma in comparison to other routes of infection. As of 2024, Japan, Brazil and Chile are few of the countries with national policies regarding antenatal screening. Peru, also an endemic country with around 150,000 to 450,000 HTLV-1 carriers, has limited data in pregnant women and does not have any PMTCT policy in place. By contrast, HTLV-1/2 antibody screening of blood donations has been endorsed since 1997 and national data are available. We aim to leverage these data to estimate the prevalence of HTLV-1 in pregnant women as a first step towards development and implementation of a PMTCT policy in Peru. Figure 1 Estimation of number of HTLV-1 infected pregnant women and HTLV-1 seroprevalence in pregnant women in Peru (2017) Methods This was an ecological study using public-use data from the Peruvian Bulletin on Blood Supply 2015-2020, the 2017 National Census, the 2017 Demographic and Health Survey (DHS) and the National Registry. The unit of analysis was Peru and its subregions in the year of 2017. To estimate the number of infected women of reproductive age (WRA, 15-49 years), we used census data and a calculated percentage of HTLV-1/2 reactive blood units for this group based on a weighted factor by sex and age (Figure 1, Table 1). Using the DHS percentage of WRA currently pregnant, we estimated the number of infected pregnant women. To obtain the HTLV-1 prevalence for this group, we used the number of life births adjusted for a 9-month period (0.75) as the denominator. Calculation of weighted factor for HTLV-1/2 seroprevalence by age and sex based on local blood bank data Results A total of 359,458 blood units were screened and 2,809 were reactive for HTLV-1/2 (0.78%) (Figure 2). We estimated between 68,456 to 72,978 HTLV-1 carriers who were WRA, of whom 2,463 to 2,773 were pregnant (Figure 3). This is comparable to rates in Japan and Brazil. Our estimated HTLV-1 seroprevalence in pregnant women was 0.61% for the entire country. Number and percentage of HTLV-1/2 reactive blood units in 2017 by departments of Peru Conclusion Our findings could help guide future strategies for PMTCT, such as universal antenatal screening and assessing the feasibility of formula supplementation for infants born to HTLV-1 positive mothers. Our limitations included the use of one-year data, HTLV-1/2 false-positives in blood donors and not using inverse probability weighting. Estimated number and percentage of HTLV-1 infected pregnant women in 2017 by Departments of Peru Disclosures All Authors: No reported disclosures

P-1388. Repeat Trichomonas vaginalis Infections Among Pregnant Women in South Africa

Abstract Background Trichomonas vaginalis (TV) is the most common non-viral sexually transmitted infection (STI) worldwide. It has been associated with multiple adverse outcomes in pregnancy. The prevalence of repeat TV infections among pregnant women is poorly characterized, especially in resource-limited countries. This study aimed to investigate the prevalence and causes of repeat TV infections in pregnant women in South Africa. Methods Women enrolled in a randomized controlled trial investigating optimal STI screening strategies during pregnancy were included. At baseline, TV was diagnosed via the GeneXpert nucleic acid amplification test (NAAT). Demographics, sexual history, and partner characteristics were collected. If positive, women were treated with multi-dose oral metronidazole and randomized to Arm 1 or 2 (test-of-cure at 3 weeks after enrollment or re-testing at 32-34 weeks gestation). At follow-up in both arms, a repeat TV NAAT was obtained and a questionnaire was administered examining adherence to treatment, partner treatment history, and interval sexual activity. Women with confirmed treatment completion and a repeat positive TV NAAT were classified as treatment failure if no interval sexual activity, re-infection if had interval sexual exposure to baseline partners who were not treated as contacts, or new infection if exposed to a new partner. Results Baseline TV prevalence was 10% (144/1440) (Figure 1) and 10.4% (15/144) of infected women had a repeat positive test with baseline characteristics shown in Table 1. All 15 women finished their entire course of treatment and partners were notified in 93.3% of cases (Table 2). Based on our definitions, 60% of women (9/15) were classified as treatment failure in the setting of no interval sexual exposure or sexual exposure with partner who was reportedly treated (Figure 2). 26.7% (4/15) were classified as re-infection and 13.3% (2/15) were unable to be classified. There were no new infections. Conclusion More than half of repeat TV infections in this cohort of pregnant women in South Africa were determined to be due to treatment failure. Additional studies with larger sample sizes are needed to further investigate potential causes and include drug susceptibility testing on clinical TV isolates in women with repeat infections. Disclosures Jeffrey Klausner, MD MPH, Direct Diagnostics: Advisor/Consultant Christina A. Muzny, MD, MSPH, Abbott: Advisor/Consultant|Abbott: Grant/Research Support|BioMed Diagnostics: Advisor/Consultant|BioNTech: Advisor/Consultant|BioNTech: Grant/Research Support|Cepheid: Advisor/Consultant|Cepheid: Honoraria|Elsevier: Honoraria|Gilead: Grant/Research Support|Lupin Pharmaceuticals: Grant/Research Support|Merck Manuals: Board Member|Merck Manuals: Honoraria|UpToDate: Honoraria|Visby: Grant/Research Support

Preterm Birth and SARS-CoV-2: Does a Correlation Exist?

Introduction: The emergence of the SARS-CoV-2 virus and its subsequent global pandemic have raised significant concerns regarding its impact on pregnancy outcomes. This review aims to summarize the emerging data on the risk of preterm delivery in pregnant women infected with SARS-CoV-2. Materials and Methods: A systematic search was conducted from March 2020 to December 2023 using PubMed and Web of Science, following PRISMA guidelines. Studies correlating maternal COVID-19 infection with preterm birth were included. Results: Thirteen studies were analyzed, indicating a higher incidence of preterm birth in SARS-CoV-2-positive pregnant women compared to controls. The average incidence rate of preterm birth in infected patients was 18.5%, with a median of 12.75%, while non-infected women showed an average incidence of preterm birth of 10%, with a median of 8.2%. Discussion: Studies suggest an association between SARS-CoV-2 infection during pregnancy and increased risk of preterm birth and cesarean section. The severity of symptoms and underlying comorbidities further elevate this risk. Notably, infections during the third trimester pose the highest risk of preterm birth. Conclusion: Preventing SARS-CoV-2 infection during pregnancy is crucial to mitigate adverse obstetric outcomes. Close monitoring and tailored interventions for infected pregnant women, particularly those in later trimesters and with comorbidities, are imperative to reduce the risk of preterm birth and improve maternal-fetal outcomes.

Human papillomavirus, vaginal microbiota and metagenomics: the interplay between development and progression of cervical cancer.

Persistent infection with oncogenic human papillomavirus (HPV) types, such as HPV 16 or 18, is a major factor in cervical cancer development. However, only a small percentage of infected women develop cancer, indicating that other factors are involved. Emerging evidence links vaginal microbiota with HPV persistence and cancer progression. Alterations in microbial composition, function, and metabolic pathways may contribute to this process. Despite the potential of metagenomics to explore these interactions, studies on the vaginal microbiota's role in cervical cancer are limited. This review systematically examines the relationship between cervical microbiota, HPV, and cervical cancer by analyzing studies from PubMed, EBSCO, and Scopus. We highlight how microbial diversity influences HPV persistence and cancer progression, noting that healthy women typically have lower microbiota diversity and higher Lactobacillus abundance compared to HPV-infected women, who exhibit increased Gardenella, Prevotella, Sneathia, Megasphaera, Streptococcus, and Fusobacterium spp., associated with dysbiosis. We discuss how microbial diversity is associated with HPV persistence and cancer progression, noting that studies suggest healthy women typically have lower microbiota diversity and higher Lactobacillus abundance, while HPV-infected women exhibit increased Gardnerella, Prevotella, Sneathia, Megasphaera, Streptococcus, and Fusobacterium spp., indicative of dysbiosis. Potential markers such as Gardnerella and Prevotella have been identified as potential microbiome biomarkers associated with HPV infection and cervical cancer progression. The review also discusses microbiome-related gene expression changes in cervical cancer patients. However, further research is needed to validate these findings and explore additional microbiome alterations in cancer progression.

First Report of HPV Genotyping and Distribution in People Living with and Without HIV from Iran and the Middle East.

In people living with human immune deficiency (PLHIV), the rates of human papillomavirus (HPV) infection, mixed types, and high-risk (HR) strains increase, while the virus clearance is prevented. Here, we report HPV genotyping in PLHIVs from Iran and the Middle East region for the first time. HPV genotyping in referring individuals from different provinces to our laboratory was evaluated over 2023-2024. For this, the HPV types in specimens were detected through the INNO- LiPA HPV genotyping kit. Statistical analysis was conducted with a 95% confidence interval (95%CI) and P < 0.05. Accordingly, 481 subjects from various provinces participated in this study. The rate of HPV infection was 45.7%, of which 14% were HIV-infected women referred from all provinces. The most prevalent types included 6, 51, and 18, but not 16 HR types. Mixed infections in dually infected women were significantly more than in HPV-infected ones. The HPV+/HIV+ subgroup had the lowest median age. The prevalence of HPV types and mixed infection in PLHIVs was congruent with the previous reports, except for the low rate of type 16 infection, perhaps due to the healthy nature of our subjects. Only HIV+/HPV+ cases' age was similar to the previous reports, perhaps because of sample collection and study designs. Among all factors, age and gender affected the HPV type distribution notably. The current study corroborated the results of many prior reports, demonstrating the considerable impact of HIV status on HPV distribution. The authors recommend implementing a national HPV vaccination and more comprehensive reports of HPV genotyping in PLHIVs.

A study to Determine the Antibiotic Sensitivity of Microbes Causing Cervical Infections in Women in Zawia Western Libya

Purpose: Bacterial vaginosis (BV) infections in women are typically caused by living organisms, making it one of the most significant health issues related to the vagina. Bacterial vaginitis occurs when the normal bacteria in the vagina decrease in number. Aim: This study aimed to determine the prevalence of vaginal infections and the antibiotic susceptibility of different types of bacteria among women attending Al-Zawia Medical Hospital. Methods: The study was conducted at Al-Zawia Medical Hospital from January to March 2024. Vaginal smear samples were collected from women and tested for sensitivity to antibiotics. All isolated vaginal samples were cultured using standard methods in the analytical sciences laboratory. Microbial sensitivity to antibiotics was determined using the disk diffusion technique based on the Kirby-Bauer method. Results: were analyzed descriptively. Results: Between January and March 2024, 36 vaginal swabs were collected at Al-Zawia Medical Hospital, Libya. These samples were tested at the Al-Zawia Medical Analysis Laboratory for antibiotic sensitivity. Approximately 200 women aged 10 to 54 participated in the study. Overall, 18% of women had a vaginal infection, with higher rates seen in women aged 25 to 39. Streptococcus bacteria showed 100% susceptibility to ciprofloxacin, indicating its effectiveness in inhibiting the bacteria, including Staphylococcus aureus. E. coli bacteria had a lower sensitivity in this study, with an inhibition rate of 50%. Conclusion: Bacterial vaginal infections are common among women and should be monitored regularly. Women should undergo periodic examinations for vaginal infections, and antibiotic treatment should be followed accordingly.

Heightened expression of type I interferon signaling genes in CD4+ T cells from acutely HIV-1-infected women is associated with lower viral loads.

Sex differences play a role in the pathogenesis of a number of viral diseases. In HIV-1, several studies have reported that chronically infected women have significantly lower plasma viremia than men, although the exact mechanism by which this occurs has yet to be identified. We have performed bulk RNA-seq experiments comparing gene expression between CD4+ T cells from acutely HIV-1-infected men and women in Zambia, because we observe lower viral load (VL) despite higher CD4+ T-cell activation in these women during acute/early infection. In a univariate analysis, we have identified a number of differentially expressed genes in naïve, central memory, and effector memory CD4 T cells of women with consistent elevated expression of genes linked to type 1 interferon (IFN) signaling. Moreover, after controlling for differences in VL and CD4+ T-cell count, genes within the type I IFN signaling pathway were further shown to be more highly expressed in women, whereas those genes more highly expressed in men showed no such enrichment. A subset of the genes highly expressed in women was further identified, including several involved in type I IFN signaling in response to viral infections (IRF7, DDX58, SAMHD1, OAS2, and TRIM14), that both are more highly expressed in CD4+ T cells from women and negatively correlated with VL, suggesting that they play a role in the comparative control of VL observed in women.

Understanding the vaginal microbiome among women with different genotypes of human papillomavirus infection in remote Andaman islands.

Human papillomavirus (HPV) is a viral infection, and its acquisition and persistence are significantly influenced by the vaginal microbiota. Understanding and comparing the vaginal microbiome of HPV infected women in Andaman and Nicobar Islands is crucial. The study involved collecting vaginal swabs and extracting DNA using the QIAamp DNA Minikit. The DNA was then subjected to PCR amplification to confirm HPV infection. illumina NovaSeq 6000 platform was utilized to perform sequencing utilizing 2 x 250 paired end chemistry. Taxonomic analysis was performed and Bacterial abundance plots were generated and samples were grouped based on demographic parameters, pap test diagnosis, and genotypes. To assess diversity, samples were rarefied to 49,000 sequence reads per sample, and alpha and beta diversity metrics were calculated. The study analyzed the presence of 21 assigned phyla, with Firmicutes, Actinobacteria, Bacteriodetes, and Proteobacteria emerging as the predominant taxa. At the genus level, Lactobacillus and Gardnerella dominated across all samples. Gardnerella was significantly more abundant in HPV-positive (22.40%) compared to HPV-negative samples (10.04%). Symptomatic group of HPV-positive samples had Gardnerella, and unclassified Coriobacteriaceae being dominant. In terms of bacterial diversity, the study found statistically significant association when comprising individuals aged 21 to 30 years to those aged 31 to 40 years. Most research concluded that exposure to HPV can boost bacterial diversity in vagina compared to healthy women, increasing the risk of cervical cancer development. Current study highlights the importance of vaginal microbiome associated with high and low risk HPV, various age group as well as the symptomatic and asymptomatic cases of HPV infected women in South Andaman.

Highly viable gastrointestinal Chlamydia trachomatis in women abstaining from receptive anal intercourse

Chlamydia trachomatis (CT) may employ persistence to evade antimicrobial clearance, possibly residing in the gastrointestinal tract. This study assessed the reliability of droplet digital PCR (ddPCR) in CT detection, its functionality in viability assessment, and predictions on CT transmission dynamics by combining viability PCR (vPCR) and clinical data from 52 infected women. The ddPCR showed 94% positive and 100% negative agreement with Abbott Alinity STI-M for endocervical samples, and 92% positive and 87% negative agreement in rectal samples. Viability was higher in endocervical samples (89.1%) than in rectal samples (69.4%). Samples from participants not engaging in anal intercourse, and with non-concordant multi-locus sequence typing between rectum and endocervix, had on average the highest viability in rectum, indicating a persistent population residing in the gastrointestinal tract. This study demonstrates the effectiveness of ddPCR in detecting CT, especially in samples with high inhibition or low bacterial load, suggesting its superiority over quantitative real-time PCR. These findings support that rectal CT infection can occur independently of anal intercourse, possibly through vaginorectal contamination or oral routes. High rectal CT viability, independent of endocervical infection, indicates potential gastrointestinal establishment. Understanding CT dynamics in various infection sites can provide insights into the epidemiology and pathogenesis of CT.

Zika Virus Infection in Asymptomatic Pregnant Women.

Background/Objectives: Zika disease is caused by the Zika virus (ZIKV) and represents a major public health problem because of the complications in newborn babies from mothers who were infected during pregnancy. It is estimated that 80% of infected pregnant women are asymptomatic, which complicates the identification of infected individuals. In this study, we aimed to detect ZIKV in asymptomatic pregnant women and the effects in the newborns were analyzed. Methods: The presence of ZIKV was evaluated through endpoint reverse transcription-polymerase chain reaction (RT-PCR) in 114 blood samples from pregnant women treated at two hospitals in the state of Veracruz, Mexico. There was a follow-up of the participants until the birth of their newborns. Results: ZIKV RNA was detected in 4.4% (n = 5) of cases. In two positive cases, two consecutive samples were obtained, and one case of persistence of ZIKV in serum after 90 days after delivery was identified. A total of 80% of the positive cases were identified after the third trimester of pregnancy and 20% after the second trimester. Although ZIKV was shown to be a risk factor for low weight and low size at birth and prematurity, after adjustment for other variables, it did not show a significant association. In contrast, preeclampsia/eclampsia was identified as a significant risk factor for low birth weight. Conclusions: The prevalence of ZIKV found in this study suggests a latent circulation of this virus and highlights the importance of epidemiological surveillance in endemic zones. The prolonged viremia that was found suggests the need for more research because of the high impact which can mean the possible dissemination of the virus to the vector.

Distribution of Human Papillomavirus (HPV) Infection in Women of Appropriate Age in Beiliu City and Recommendations for Public Health Intervention

Distribution of Human Papillomavirus (HPV) Infection in Women of Appropriate Age in Beiliu City and Recommendations for Public Health Intervention

Hepatitis B infection (HBsAg and HBeAg) status among women attending antenatal care at public healthcare facilities of South Africa, 2017.

Eight years after WHO adopted a resolution to eliminate hepatitis B by the year 2030, the disease remains a global public health concern, with vertical transmission of HBV being a major obstacle to this goal. Our study aimed to determine the HBV infection status of pregnant women in South Africa at a national level to evaluate the risk of vertical transmission and provide evidence for public health decision-making. We conducted HBsAg testing on 1,942 HIV-uninfected and 2,312 HIV-infected pregnant women from South Africa's public health sector in 2017, followed by HBeAg testing on HBsAg-positive samples. Our data were stratified by five-year age groups and province. The overall HBV prevalence was 11.24% (478/4,254), significantly higher among HIV-infected women (15.83%) compared to HIV-uninfected women (5.77%, p = 0.007). HBV prevalence was highest among women 40-44 years (14.00%) and in Limpopo Province (19.35%). Coinfection rates of HIV-HBV ranged from 14.00% to 17.00% among women 15-44 years, and provincially, rates were highest in Limpopo, North West, and Western Cape Provinces (>20%). HBeAg prevalence among HBsAg positive women was 9.48%, with higher rates among HIV infected women (11.29%) compared to HIV-uninfected women (7.34%, p = 0.7931). HBeAg prevalence was highest among women 15-19 (10.81%), 20-24 (11.88%) and 40-44 years (25.00%), and provincially, highest in North West (26.67%). Our findings highlight the significant prevalence of HBV infection among pregnant women in 2017, emphasising concerns about vertical transmission, particularly given the high prevalence of HBeAg among HBsAg-positive women. We advocate for the prompt implementation of a universal birth dose of the HBV vaccine in South Africa to augment existing vaccination schedules and mitigate the risk of vertical transmission, thereby advancing progress towards WHO elimination targets.

COVID-19 reinfection in pregnancy: assessment of Severity and pregnancy outcomes in England.

Disease severity and pregnancy outcomes following SARS-CoV-2 reinfections in pregnancy are not well understood. We linked women aged 18 to 50 years testing positive in the community for COVID-19 between April 2021 and March 2022 to hospital, vaccine and maternal services databases. We compared hospital and intensive care unit (ICU) admission rates following infection and reinfection in pregnant and non-pregnant women, and low birthweight, prematurity and stillbirth in women infected and reinfected during pregnancy. We identified 68,842 pregnant and 3,915,069 infected non-pregnant women. Hospital admission after SARS-CoV-2 reinfection was more common in pregnancy, especially during the third trimester (aOR= 18.56; 95% CI: 9.46 - 36.42) and was similar following reinfection or primary infection in pregnancy (aOR= 0.82; 95% CI: 0.50 - 1.33). All ICU admissions (n=49) in pregnancy occurred after primary infection with delta. There was no notable difference in adverse pregnancy outcomes after primary infection or reinfection with SARS-CoV-2 during pregnancy. Pregnant women remain at higher risk of more severe disease during reinfection compared to non-pregnant women yet; hospitalisation and ICU admissions risk were low during the omicron period. The virulence of circulating variants needs to be assessed to guide maternal COVID-19 vaccination programmes against.

Prevalence of malaria and associated factors among pregnant women in East Dembia District Northwest Ethiopia

BackgroundEven though several measures have been taken to eliminate malaria, its burden remains persistently high in Sub-Saharan Africa. More than 125 million pregnant women are at risk of getting malaria per year. There is a scarcity of community based evidence on malaria prevalence among pregnant women and associated factors in Northwest Ethiopia. This study aimed to generate evidence on the prevalence and associated factors of malaria among pregnant women in East Dembia district, North West Ethiopia.MethodsA community-based cross-sectional study was conducted from March to June 2022 in East Dembia district, Northwest Ethiopia. A multi-stage sampling technique was used to select 821 pregnant women. A structured questionnaire was used for data collection. Malaria was diagnosed using rapid diagnostic testing. The data was entered using EPI info version 7 and transferred to SPSS version 20 for analysis. Descriptive statistics were presented using frequency and percentages. Bivariable and multivariable binary logistic regression models were fitted to identify factors associated with malaria infection among pregnant women. Variables having p-value < 0.2 were considered in the multivariable analysis. And a p value of < 0.05 was used as the cut-off value for statistical significance in the multivariable models. Adjusted odds ratio with its 95% confidence interval was used to measure the strength of the association.ResultsIn this study, 111 (14%, 95% Confidence Interval (CI): 10.20–19.40%) of the participants were found to have malaria. Among these, 82 (73.80%) of the parasite-positive pregnant women were infected with Plasmodium falciparum, and the remaining 23 (20.72%) and 6 (5.41%) were infected with Plasmodium vivax and mixed species respectively. In the multivariate analysis; unprotected source of water (Adjusted Odds Ratio (AOR): 14.99; 95% CI: 1.08–207.50), utilization insecticide-treated bed net (ITN) (AOR: 0.13; 95% CI: 0.03–0.49) stagnant water less than 1Killo meter (KM) distance from home (AOR: 3.52; 95% CI: 1.16–10.74), ownership bed net (AOR: 0.10; 95% CI: 0.04–0.70) were significantly associated with malaria among pregnant women.ConclusionMalaria is still a public health problem among pregnant women in East Dembia district. The present study indicated that adequate distribution of bed net, its community ownership, and eradication of stagnant water in regular basis might be helpful to prevent and control malaria. In addition, screening pregnant women for asymptomatic malaria infection and distribution of proper utilization of bed nets shall be provided.

The incidence and risk factors of fetuses with mirror-image dextrocardia with solitus inversus

Abstract Objective: This research seeks to ascertain the prevalence and determinants of mirror-image dextrocardia in fetuses Study design: With December 2022 as the reference point, we compiled colleted data on pregnant women who carried fetuses with mirror-image dextrocardia in Xi’an, Shaanxi Province: September–October 2022, November 2022, and December 2022–January 2023. An online questionnaire was distributed to 209 pregnant across China who had contracted COVID-19. The case group comprised women whose final menstrual cycle occurred in November 2022 and who had a fetus with mirror-image dextrocardia. Women with a November 2022 final menstrual period and a fetus without this condition made up the control group. To identify the risk factors associated with fetal mirror-image dextrocardia, both univariate and multivariate logistic regression analyses were employed. Results: A significant difference was noted in the gestational age at COVID-19 infection women with a September to October 2022 and December 2022 to January 2023 final menstrual period who did not bear a fetus with mirror-image dextrocardia, and those with a November 2022 final menstrual period whose fetus exhibited this condition. The univariate and multivariate analyses conducted on pregnant women with a final menstrual period in November 2022 who had contracted COVID-19 revealed significant differences in the presence and duration of fever between those bearing fetuses with mirror-image dextrocardia and those without (P = 0.000). Conclusion: The findings suggest two critical factors to the increased prevalence of fetal mirror-image dextrocardia: 1) the infection timing which occurs between the 4th and 6th week of pregnancy and 2) the presence of fever and its prolonged duration.

Assessing the Impact of COVID-19 on Pregnancy and Maternal Outcomes: A Slovak National Study

Background: The COVID-19 pandemic highlighted the global challenge of inadequate data on SARS-CoV-2’s effects on pregnant women and their infants. In response, Slovakia, along with other countries, launched a nationwide study to assess the incidence, characteristics, and outcomes of SARS-CoV-2 infection during pregnancy. Methods: We conducted a national observational descriptive study of SARS-CoV-2 positive cases among pregnant women from the pandemic’s onset to its conclusion. In collaboration with the Public Health Office of the Slovak Republic, we identified 1184 pregnant women who tested positive for SARS-CoV-2 and contacted them for participation. Results: Among the 240 participating SARS-CoV-2-positive pregnant women, 13 required hospitalizations, with an increased need for intensive care and respiratory support. However, the absolute risk of poor outcomes remained low. Higher maternal age and infection during the third trimester emerged as key risk factors for hospitalization. A symptomatic course was dominant, with fatigue (70%), headache (58%), and fever (56%) as the leading symptoms. While maternal and neonatal outcomes were generally favourable, a slight increase in caesarean sections and preterm births suggests an indirect impact on maternity care. Vaccination during pregnancy correlated with reduced symptoms and no hospitalizations. Elevated CRP levels were common among infected women, while ultrasound findings remained normal. Conclusions: This study offers a multi-dimensional view of pregnancy during the pandemic, capturing both the mother’s personal concerns and the objective insights from prenatal and labour care settings. The findings suggest that most pregnant women with SARS-CoV-2 experience mild to moderate illness, offering reassurance to clinicians about generally favourable maternal and neonatal outcomes while underscoring the need for vigilance in rare severe cases.

Discordance of 3rd and 4th generation QuantiFERON-TB Gold assays by pregnancy stages in India

BackgroundPregnancy and HIV affect CD4+ T lymphocytes and impact performance of QuantiFERON-TB Gold (QFT). We compared the results of QFT with QuantiFERON-TB Gold Plus (QFT-Plus), which also measures CD8+ responses to TB antigens, during pregnancy and postpartum. MethodsWe screened 516 pregnant women for TB infection (TBI) with IGRA. From 165 IGRA + pregnant women, QFT vs QFT-Plus results were compared at delivery and postpartum. Longitudinal changes in QFT-Plus were assessed in 74 pregnant women who received QFT-Plus testing at pregnancy, delivery, and postpartum. ResultsThrough cross-sectional analysis of the IGRA + cohort, QFT-Plus showed higher positivity than QFT (80 % vs 65 %, p = 0.04) at delivery but no difference postpartum. Among 35 women with HIV, QFT-Plus returned more positive results than QFT at delivery and postpartum (76 % vs 47 %, p = 0.08; 90 % vs 80 %, p = 0.54), though not statistically significant. Longitudinally, QFT-Plus positivity by TB1 or TB2 was highest antepartum vs. delivery and postpartum (74 % vs. 58 % vs. 62 %; p = 0.09) and performed better than TB1 alone (100 % vs 90 %, p = 0.04) in women without HIV but not in women with HIV. ConclusionsPerformance of QFT-Plus was consistent across pregnancy, including at delivery when QFT positivity is lower. QFT-Plus may enhance antenatal TBI detection among pregnant women.