Non-infected Women Research Articles

Prevalence and predictors of precancerous cervical lesions among women living with HIV in Libreville, Gabon

BackgroundHIV-infected women are at an increased risk of developing precancerous cervical lesions (PCL) than non-infected women. In Gabon, no data exists on the prevalence of PCL among women living with HIV. The aim of this study was to assess the prevalence and risk factors associated with the development of PCL among HIV-positive women in Libreville, Gabon.MethodologiesThis was a retrospective study carried out within the Gynecology and Obstetrics Department of University Hospital Center of Libreville (CHUL) from January to August 2016. It included women registered at the HIV Clinic of Nkembo, and screened for PCL or cervical cancer (CC). Descriptive statistics were used to characterize sociodemographic data and the prevalence of PCL. The chi square and odd-ratio tests were used to evaluate the associations between PCL, CD4 count, antiretroviral use, age at first sexual intercourse, number of sexual partner tobacco, and contraception use.ResultsAmong the 115 HIV-positive women recruited, 33 (28.70%; SD ± 0.45) were diagnosed with PCL. 79.1% of them were on antiretroviral therapy (ART), and the mean CD4 cell count value was 411.74 cells/mm3 (SD ± 241.77). Being on ART, age, number of sexual partners, contraceptive use and smoking were not risk-factors linked with the development of PCL. CD4 cell count was the only associated risk-factors (p-value: 0.02).ConclusionThe incidence of PCL among HIV-infected is high in Libreville, Gabon, especially among those with baseline CD4 counts < 200 cells/mm3. This study recommends screening for cervical cancer for all HIV-infected women.

Sex differences in the expression of metabolic and pro-inflammatory markers in the initial post-COVID-19 phase

Abstract Cardiovascular complications are a common manifestation of post-acute COVID-19 infection. Post-COVID-19 syndrome is often associated with the female sex and exacerbated inflammation; however, the underlying molecular mechanisms of this sex difference remain poorly understood. In the present study, we aimed to investigate several metabolic, mitochondrial, autophagy, oxidative stress, and inflammatory markers in peripheral blood mononuclear cells (PBMCs) and plasma isolated from older (&amp;gt;75) male and female patients at the initial phase (1-2 weeks) after COVID-19 pneumonia. Age-matched non-infected women and men were used as a control group. We found a significantly higher plasma TNF-α in post-COVID-19 women, but not in men, compared to the control group. Similarly, a significant elevation of IL-1β and IL-18 mRNA in PBMCs from post-COVID-19 women, but not men, was observed. These effects were associated with marked activation of AMPK (defined as pAMPK/AMPK ratio), suggesting potential metabolic stress in female post-COVID-19 PBMCs. Further analysis revealed increased expression of mitochondrial genes, which may be due to AMPK activation as a compensatory reaction to metabolic stress. Analysis of autophagy or oxidative stress (serum 8-OHdG) markers did not reveal any differences between the groups investigated. We conclude that women in the initial phase of post-COVID-19 have elevated expression of inflammatory markers in plasma and in immune cells, which is associated with metabolic stress. This may contribute to the cardiovascular complications in female post-COVID-19 patients.

Serotonin, cortisol, and DHEA-S levels in anxious and depressive pregnant women living with HIV

Pregnancy in women living with human immunodeficiency virus (WLWH) represents an important challenge for maternal-fetal health. Besides, they can also present anxiety (Anx) and depression (Dep). Imbalances in serotonin (5-HT), dehydroepiandrosterone sulfate (DHEA-S), and cortisol (CORT) levels can contribute to Anx and Dep manifestations. Currently, there is not enough data about the neuroendocrine and neurochemical changes in pregnant WLWH with affective disorders. This study aimed to characterize 5-HT, DHEA-S, and CORT plasma levels in Mexican pregnant WLWH presenting Anx/Dep. Forty-two adult pregnant women were recruited during the third trimester of gestation at the National Institute of Perinatology in Mexico during 2019–2022. These patients were divided into three groups: (1) pregnant WLWH with Anx/Dep (n = 16), (2) pregnant without HIV but with Anx/Dep (n = 12), and (3) healthy pregnant women without Anx/Dep (n = 14). WLWH presented a marked reduction in 5-HT (41.33 ± 39.37 ng/dL) compared to non-infected pregnant women with Anx/Dep (220.2 ± 151.8 ng/dL) and the healthy group (370.0 ± 145.3 ng/dL). Anx/Dep infected and uninfected pregnant women showed a significant reduction in DHEA-S levels (86.58 ± 30.59 and 76.9 ± 36.7 µg/dL, respectively) compared to healthy subjects (149.7 ± 44.6 µg/dL). Anx and Dep symptoms were inversely correlated with 5-HT and DHEA-S levels. No significant differences were observed in CORT levels among the three groups (p = 0.094). Our results suggest the presence of a disbalance in 5-HT and DHEA-S levels in pregnant WLWH with affective symptoms.

Effects of the COVID-19 pandemic on maternal-fetal outcomes in a nonepidemic designated hospital: a retrospective study and clinical experience summary

ObjectiveTo assess the changes in maternal-fetal outcomes in a nonepidemic designated hospital during the COVID-19 pandemic.MethodsThis retrospective cohort study was conducted between January 1, 2019, and December 31, 2021 on pregnant patients. The fixed-effects regression model was used to determine changes in birth outcomes and pregnancy-related complications between three periods with the pre-epidemic cohort as the control group. Logistic regression was applied to determine the odds ratio (OR) for binary outcomes.ResultsThere were 15,261 births during the pre-epidemic period, and this number decreased by 15% and 23% to 12,980 and 11,736 in the first and second epidemic cohorts, respectively. The mean birth weight during the pre-epidemic period was 3319 which decreased to 3309 and 3272 g in the following periods. Excluding stillbirth and preterm, all other outcomes differed significantly between the three periods. Gestational diabetes mellitus (GDM) (17–19%) and maternal hypertension (9.2–11%) appeared to increase. Compared to the pre-epidemic period, the odds of macrosomia and LGA significantly decreased in the second epidemic cohort (adjusted ORs: 0.76 and 0.8), while the odds of low birth weight (LBW) and small gestation age (SGA) increased (ORs: 1.25 and 1.16). The odds of neonatal asphyxia (OR: 1.4), and hypertension (OR: 1.29) appeared to increase in the second epidemic cohort, while GDM decreased in the first cohort (OR: 0.88) and increased in the second cohort (OR: 1.15). Vaginal delivery underwent a marginal decrease in both the first and second epidemic cohorts (ORs: 0.89 and 0.92).ConclusionThe COVID-19 pandemic may have had a substantial and long-term impact on non-infected pregnant women and newborns. Our research results provided precious research information and clinical experience summary for population health research in the future.

Inflammatory and cardiovascular markers in placenta following SARS-CoV-2 infection during pregnancy: A Swedish prospective cohort study

IntroductionMaternal SARS-CoV-2 infection can affect pregnancy outcome, but the placental response to and the effect of timing of infection is not well studied. The aim of this study was to investigate the placental levels of inflammatory and cardiovascular markers in pregnancies complicated by SARS-CoV-2 infection compared to non-infected pregnancies, and to investigate whether there was an association between time point of infection during pregnancy and placental inflammatory and cardiovascular protein levels. MethodsPlacental samples from a prospectively recruited pregnancy cohort of SARS-CoV-2-infected (n = 53) and non-infected (n = 50) women were analysed for 177 inflammatory and cardiovascular proteins, using an antibody-based proximity extension assay. In the SARS-CoV-2-infected group, half of the women were infected before 20 weeks of gestation, and five women were hospitalised for severe SARS-CoV-2 infection. Single-protein analyses were performed with linear mixed effects models, followed by Benjamini-Hochberg correction for multiple testing. Multi-protein analyses were performed using principal component analysis and machine learning algorithms. ResultsThe perinatal outcomes and the placental levels of inflammatory or cardiovascular proteins in women with SARS-CoV-2 infection were similar to those in non-infected women. There were no differences in inflammatory or cardiovascular protein levels between early and late pregnancy SARS-CoV-2 infection, nor any linear correlations between protein levels and gestational age at time of infection. DiscussionWomen with SARS-CoV-2 infection during pregnancy without clinical signs of placental insufficiency have no changes in inflammatory or cardiovascular protein patterns in placenta at time of birth regardless of the timing of the infection.

Peripartum outcomes and immune responses after SARS-CoV-2 infection in the third trimester of pregnancy

BackgroundSARS-CoV-2 infection in pregnant women during the third trimester resulted in overall adverse pregnancy outcomes compared to non-infected controls and a unique humoral and cellular response at delivery. In this study we aimed to assess the impact of SARS-CoV-2 infection on maternal/neonatal peripartum outcomes andimmunological profiles.MethodIn this study, we recruited 304 SARS-CoV-2 infected pregnant women and 910 SARS-CoV-2 non-infected pregnant women who were admitted for delivery. Peripartum and neonates’ outcomes response to SARS-CoV-2 infection were analyzed. Furthermore, we characterized the antibody and cytokines profile in SARS-CoV-2 infected maternal blood (MB) and cord blood (CB). We also assessed routine laboratory tests and liver function tests in MB before labor. Unpaired T test, Mann-Whitney test and Spearman test were used to analyze the data.ResultsSARS-CoV-2 infected pregnant women were significantly associated with increased risk of adverse pregnancy outcomes, including preterm labor (13.8% vs. 9.5%, p = 0.033) and meconium-stained amniotic fluid (8.9% vs. 5.5%, p = 0.039). The risk of low birth weight (< 2500 g) (10.5% vs. 6.5%, p = 0.021) and Apgar score < 8 at 1-minute (9.2% vs. 5.8%, p = 0.049) significantly increased in newborns from COVID-19 positive mothers than their counterparts. Our results showed that antibodies were increased in adverse-outcome SARS-CoV-2 infected mothers and their neonates, and abnormal proportion of immune cells were detected in SARS-CoV-2 infected mothers. While the immune response showed no difference between adverse-outcome infected pregnant women and normal-outcome infected pregnant women. Thus, SARS-CoV-2 infection during the third trimester of pregnancy induced a unique humoral and cellular response at delivery.ConclusionSARS-CoV-2 infection closer to delivery could incline to adverse pregnancy outcomes. Therefore, the utmost care is required for SARS-CoV-2 infected pregnant women and their newborns.Trial registrationThe study protocol was approved by the Institutional Review Board of the First Hospital of Jilin University with the approval code number 23K170-001, and informed consent was obtained from all enrolled patients prior to sample collection.

Maternal and Neonatal Outcomes of COVID-19 in Pregnancy in Tertiary Care Centers in Saudi Arabia: A Comparative Study

Abstract Background: The coronavirus disease 2019 (COVID-19) infection has been linked to increased risks of severe maternal outcomes globally, including intensive care unit admissions and mechanical ventilation. Studies and reports suggest that pregnant women with COVID-19 face higher risks of complications. However, there is limited data directly comparing maternal and neonatal outcomes in pregnant women with and without COVID-19. Objectives: We aimed to compare both maternal and neonatal outcomes in pregnant women with and without COVID-19 infection. Materials and Methods: This is a multicenter retrospective cohort study conducted at two Ministry of National Guard Health Affairs Hospitals in Saudi Arabia, including all pregnant women, who delivered and received follow-up care at either site between March 2020 and October 2021. COVID-19 infection was confirmed by laboratory tests in the infected patients. Descriptive statistics were conducted for the cohort baseline description, and multivariable logistic regression was conducted to assess the associated risks for maternal, and neonatal outcomes. Results: The study included 639 pregnant women with confirmed COVID-19 infection and 644 pregnant women with no COVID-19 infection. There was no statistically significant difference in the risk of stillbirth [adjusted odds ratio (aOR) = 2.88; 95% confidence interval (95% CI) = 0.89, 11.74] or miscarriage (aOR = 0.53, 95% CI = 0.24, 1.09) between COVID-19 infected and noninfected pregnant women. On the other hand, COVID-19 infection was associated with an increased risk of low birth weight (aOR = 1.53, 95% CI = 1.06, 2.20), Apgar score-1 min &lt;7 (aOR = 2.30, 95% CI 1.62, 3.29), and Apgar score-5 min &lt;7 (aOR 2.84, 95% CI 1.92, 4.27). Conclusion: This study concludes that infants born to pregnant women with COVID-19 infection were more likely to have neonatal complications compared with those born to noninfected women. Future prospective studies could include the long-term effects of maternal and neonatal COVID-19 infection.

The impact of miRNA-155 in acute and chronic toxoplasmosis in Iraqi women

Toxoplasmosis is a prevalent parasitic infection caused by Toxoplasma gondii known to induce complex immune responses, to control the infection. MicroRNAs (miRNAs) are a cluster of small noncoding RNAs that are reported to have regulatory functions in the immune response. The objective of this study is to assess the expression of miR-155 and its targets, Src homology-2 domain-containing inositol 5- phosphatase 1 (SHIP-1) and suppressor of cytokine signaling-1 (SOCS1), in non-pregnant Iraqi women seropositive for toxoplasmosis. The study included 55 non-pregnant women positive for toxoplasmosis (20 in the acute phase and 35 in the chronic phase) and 35 non-pregnant women negative for toxoplasmosis (control group). Serum samples were collected from all participants to investigate the expression of miR-155 by RT‒PCR, in addition to the levels of SOCS1 and SHIP-1 measured by ELISA. The results showed a significant increase in the expression of miR-155 in both groups of acute and chronic toxoplasmosis compared to the control group. Lower levels of SOCS1 and SHIP-1 were found in acutely infected women compared to those with chronic infection and non-infected women. These findings showed the possible critical impact of miR-155 on host immune response during T.gondii infection, proposing that miR-155 can be explored as a prospective target to support host immune response against infectious diseases, with special help in early detection and management of toxoplasmosis in high-risk immunocompromised patients. Further studies are needed to evaluate the molecular pathways by which miRNAs improve immunity against toxoplasmosis.

Cervical microbiota dysbiosis associated with high-risk Human Papillomavirus infection.

High-risk Human Papillomavirus (HR-HPV) genotypes, specifically HPV16 and HPV18, pose a significant risk for the development of cervical intraepithelial neoplasia and cervical cancer. In the multifaceted cervical microenvironment, consisting of immune cells and diverse microbiota, Lactobacillus emerges as a pivotal factor, wielding significant influence in both stabilizing and disrupting the microbiome of the reproductive tract. To analyze the distinction between the cervical microbiota and Lactobacillus-dominant/non-dominant status of HR-HPV and non-infected healthy women, sixty-nine cervical swab samples were analyzed, included 44 with HR-HPV infection and healthy controls. All samples were recruited from Human Papillomavirus-based cervical cancer screening program and subjected to 16s rRNA sequencing analysis. Alpha and beta diversity analyses reveal no significant differences in the cervical microbiota of HR-HPV-infected women, including 16 and 18 HPV genotypes, and those with squamous intraepithelial lesion (SIL), compared to a control group. In this study we identified significantly lower abundance of Lactobacillus mucosae in women with HR-HPV infection compared to the control group. Furthermore, changes in bacterial diversity were noted in Lactobacillus non-dominant (LND) samples compared to Lactobacillus-dominant (LD) in both HR-HPV-infected and control groups. LND samples in HR-HPV-infected women exhibited a cervical dysbiotic state, characterized by Lactobacillus deficiency. In turn, the LD HR-HPV group showed an overrepresentation of Lactobacillus helveticus. In summary, our study highlighted the distinctive roles of L. mucosae and L. helveticus in HR-HPV infections, signaling a need for further research to demonstrate potential clinical implications of cervical microbiota dysbiosis.

Trichuris trichiura infection is associated with changes in gut microbiome composition and function among women of reproductive age from Pemba, Tanzania

Large intestine-dwelling helminths affect microbiome composition. In sub-Saharan Africa, where helminth infections are endemic, the use of chemotherapeutic drugs is the primary strategy for controlling soil-transmitted helminthiases (STHs). However, the emergence of anthelmintic resistance necessitates the urgent exploration of alternative and complementary treatments to achieve the World Health Organization’s goal of eliminating STHs. One promising avenue involves the manipulation of gut microbiota in at-risk populations. This study aimed to enhance the understanding of the interplay between Trichuris trichiura and the gut microbiome. In this study, we used the Mini-FLOTAC technique for parasitological analyses and a shotgun metagenomic sequencing approach to investigate the effect of T. trichiura on the gut microbiome by comparing infected and non-infected women of reproductive age (WRA) from Pemba. Structural and functional analyses of the gut microbiome revealed that T. trichiura infection shaped the host gut microbiome in WRA. Some taxa vary according to infection status. Prevotella genus was more abundant in healthy participants, whereas species such as Weissella cibaria, Leuconostoc citreum (new emergent probiotics), and Leuconostoc lactis (starter) decreased in infected individuals, suggesting the use of potential probiotic treatments to mitigate dysbiosis induced by STHs. Furthermore, the overall number of common fungi, irrespective of species, was significantly higher in the mycobiome of Trichuris infected participants. Functional analysis revealed significant differences in metabolic pathways (p &amp;lt; 0.05), with cholesterol metabolism and pathogenic infections being more abundant in the infected samples than in the non-infected samples. In conclusion, this study sheds light on the intricate interactions between helminth infections and the gut microbiome in the WRA, particularly in STH-endemic regions. The identified associations between specific gut microbial changes and T. trichiura infection may pave the way for innovative complementary treatments to effectively combat STHs.

The Impact of COVID-19 Infection on Gonadal Hormonal Hunctions in Iraqi Wome

Background: The COVID-19 pandemic has had effects beyond the respiratory system, impacting health and quality of life. Stress-related to the pandemic has led to temporary menstrual pattern changes in around one-third of women. These changes, likely driven by stress and anxiety, can result in problematic heavy bleeding, causing anemia and negatively affecting women's well-being. This also places a substantial socioeconomic burden on individuals, families, healthcare, and society. Objectives: This study examined the impact of COVID-19 infection on the hormone levels (estradiol, prolactin, follicle-stimulating hormone, and luteinizing hormone) and heavy menstrual bleeding in Iraqi premenopausal women infected for at least four months. Patients and Methods: This case-control study was conducted from November 2021 to April 2022, involving 100 married women aged 18 to 40. Participants were divided into two groups: 50 women with heavy bleeding post-COVID-19 infection (infection duration of at least four months) and 50 non-infected women. Results: Comparing the Mean ± SD of the two groups, showed that the LH levels were statistically highly significant in women who suffered heavy bleeding post-COVID-19 infection compared to non-COVID-19 women, with a p-value of 0.000. There was no statistically significant difference in FSH levels between the two groups. The PRL levels were significantly higher for women who suffered substantial bleeding following COVID-19 infection compared to non-COVID-19 women, with a p-value of 0.003. Moreover, The E2 was significantly higher in women who suffered excessive bleeding following COVID-19 infection than non-infected women. Conclusion: This study suggests that COVID-19 may temporarily disrupt menstrual patterns, possibly due to stress and anxiety affecting the hypothalamus-pituitary-ovary axis. This disruption can manifest as elevated levels of gonad hormones (LH, PRL, and E2) and, in some cases, lead to heavy bleeding after a coronavirus infection. Received Oct. 2022 Accepted Oct. 2023 Published Jan. 2024

Factors associated with COVID-19 infection in pregnant women: Focusing on maternal anxiety.

Given the critical importance of maternal mental health for the well-being of both the mother and fetus, it is essential to thoroughly investigate the impact of COVID-19 infection on mental health. This study aims to identify the factors associated with COVID-19 infection and mental health, underscoring the necessity of effective mental health management for pregnant women. Data were analyzed from 97 pregnant women who visited Gachon University Gil hospital in South Korea. Coronavirus 2019 (COVID-19) infection status was categorized based on whether the infection occurred during pregnancy. Maternal anxiety, the dependent variable, was measured using the state anxiety scale of the Spielberger State-Trait Anxiety Inventory. Multiple logistic regression analysis was performed to examine the association between COVID-19 infection and anxiety. Among the 97 pregnant women, 50 (51.5%) experienced anxiety. Of those infected with COVID-19, 31 (64.6%) experienced anxiety. The mean anxiety score was significantly higher in pregnant women with COVID-19 infection compared to those without infection (Infected: Mean = 46.35, SD = 13.85; Non-infected: Mean = 39.59, SD = 10.58, p-value:0.008). Maternal depression, and posttraumatic stress disorder were significantly higher in pregnant women with COVID-19 infection, while fetal attachment showed no significant difference. Pregnant women infected with COVID-19 during pregnancy were more likely to experience anxiety compared to non-infected women (Adjusted OR = 9.37; 95% CI = 1.39-63.12). This study highlights that pregnant women infected with COVID-19 are more likely to experience elevated levels of anxiety, emphasizing the critical importance of addressing mental health among pregnant women. The insights from this study could provide valuable guidance for policymaking, underscoring the need for targeted interventions to manage mental health in pregnant women and mitigate the risk of adverse outcomes.

The Impact of Wearing Different Face Masks on Vigorous Physical Exercise Performance and Perceived Exertion among COVID-19 Infected vs. Uninfected Female Students.

Under certain circumstances, masks are an effective and immediate solution to reduce the spread of viral infection. However, the impact of masks on the ability to perform vigorous exercise remains an area of concern. Primarily, this impact has been explored in healthy subjects, yielding contradictory findings, and little is known of it among COVID-19-infected individuals. This study examined the effects of surgical masks, N-95 masks, and unmasked conditions on the performance and perceived exertion (RPE) of infected vs. non-infected young women during high-intensity, repeated sprint exercise (5mSRT). Following a familiarization session, eighty-three (42 COVID-19-previously infected (PIG) and 43 non-infected (NIG)), female participants (age 20.02 ± 1.05 years, BMI 21.07 ± 2.1 kg/m2) were randomly assigned to one of three mask conditions: unmasked, surgical mask, or N95 mask. All participants attended three test sessions (i.e., one session for each mask condition) at least one week apart. At the beginning of each test session, data related to participants' physical activity (PA) and sleep behaviours during the previous week were collected. In each test session, participants performed the 5mSRT, during which performance indicators (best distance (BD), total distance (TD), fatigue index (FI) and percentage decrement (PD)) were collected, along with RPE. ANOVA indicated no significant main effects of Groups and Masks, and no significant interaction for Groups × Masks for BD, FI, PD, RPE and most sleep and PA behaviours (p > 0.05). For TD, the Groups × Mask interaction was significant (p = 0.031 and ƞp2 = 0.042). Posthoc analysis revealed, in the unmasked condition, there was no difference in TD between PIG and NIG (p > 0.05). However, when wearing a surgical mask, PIG covered lower TD compared to NIG (p < 0.05). Additionally, different types of masks did not affect TD in NIG, while PIG performed the worst using the surgical mask (p < 0.05). These results suggest post-COVID-19 individuals can maintain physical fitness through regular exercise (i.e., sport science curricula) in unmasked conditions, but not when wearing a surgical mask. Furthermore, the impact of different types of face masks on physical performance seems to be minimal, particularly in uninfected populations; future research is warranted to further explore this impact in post-COVID conditions.

Perinatal Outcomes at Birth in Women Infected and Non-Infected with SARS-CoV-2: A Retrospective Study

Background: Coronavirus disease 2019 (COVID-19) was declared as a pandemic and public health emergency on 11 March 2020 by the World Health Organization. Different clinical trials on the efficacy of mRNA vaccination have excluded pregnant women, leading to a lack of empirical evidence on the efficacy of the vaccine in this population. The aim of the study was to examine the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at birth and adverse perinatal outcomes in infected and non-infected women from a university hospital in Spain. Methods: The data were obtained from electronic health records from 1 March 2020 to 28 February 2022. A bivariate descriptive analysis was performed, comparing women with and without confirmed SARS-CoV-2 infection during pregnancy using the chi-square test. A multivariate logistic regression was complementarily conducted to determine whether SARS-CoV-2 infection increases the risk of adverse obstetric and perinatal outcomes. Results: A total of 2676 women were divided into two groups: non-infected with SARS-CoV-2 (n = 2624) and infected with SARS-CoV-2 (n = 52). Infected women were primarily multiparous (p &lt; 0.03) and had received an incomplete vaccination regimen (p &lt; 0.001). A greater incidence of premature rupture of membranes (p &lt; 0.04) was observed among the non-infected women. Pertaining to perinatal outcomes, there was a notable rise in NICU admissions (p &lt; 0.014), coupled with an extended duration of stay (p &lt; 0.04), for neonates born to infected mothers in comparison to their non-infected counterparts. Conclusion: Although SARS-CoV-2 infection may pose significant risks to pregnant women and their infants, adverse obstetrical/puerperal outcomes do not significantly differ between women infected and non-infected to SARS-CoV-2 in our study. NICU admissions were higher for neonates born to infected mothers. Additionally, coronavirus disease 2019 vaccination during pregnancy is not associated with severe adverse perinatal outcomes.

Colostrum Features of Active and Recovered COVID-19 Patients Revealed Using Next-Generation Proteomics Technique, SWATH-MS.

Colostrum performs nutritional, anti-inflammatory and anti-infective functions and promotes immune system formation and organ development. The new coronavirus, SARS-CoV-2, has generated concerns about viral transmission through human milk, with a lack of evidence about human milk's protective effects against the infection. This study aimed at analyzing presence of the virus and at identifying the protein expression profile of human colostrum in active and COVID-19-recovered patients. Colostrum samples were collected from women with COVID-19 (n = 3), women recently recovered from the infection (n = 4), and non-infected women (n = 5). The samples were analyzed by means of RT-qPCR to determine presence of the virus and using SWATH-MS for proteomic analysis. Proteomic results were then analyzed using bioinformatic methods. The viral tests were negative for SARS-CoV-2 in the colostrum from COVID-19 patients. The proteomic analysis identified 301 common proteins in all samples analyzed. Nineteen proteins were upregulated and 7 were downregulated in the COVID-19 group versus the control samples, whereas 18 were upregulated and 7 were downregulated when comparing the COVID-19 group to the recovered group. Eleven proteins were biomarkers of active COVID-19 infection. Ten were upregulated: ACTN1, CD36, FAM3B, GPRC5B, IGHA2, IGK, PLTP, RAC1, SDCBP and SERPINF1, and one was downregulated: PSAP. These proteins are mainly related to immunity, inflammatory response and protein transport. In conclusion, the results of this study suggest that colostrum is not a vehicle for mother-to-child SARS-CoV-2 transmission. Moreover, the colostrum's proteome of active and recuperated patients indicate that it could provide immune benefits to infants.

Pregnancy Outcomes in Women Infected With COVID-19: A Retrospective Cohort Study

Introduction: Studies of the impact of the novel coronavirus 2019 (COVID-19) on pregnancy outcomes have yielded conflicting results. Objective: This study examined pregnancy outcomes in COVID-19-infected and non-infected pregnant women. Materials and Methods: In this retrospective cohort study, we included all pregnant women with (n=42) and without COVID-19 infection (n=185) admitted to a training and treatment center in Babol City, Iran, from March to November 2020. We abstracted the records of all pregnancies in women with COVID-19 (exposed cohort) and women without COVID-19 (non-exposed cohort). Patient information was taken from their medical records. The chisquare test and Student t-test were used for data analysis. Modified Poisson regression and mixed linear model were used to assess the adjusted risk ratio (aRR) and adjusted mean difference (aMD) between COVID-19 infection and pregnancy outcomes. Results: A total of 227 pregnant women (42 in the exposure group, 185 in the non-exposed group) were included in the study. The mean age of mothers was 28.12±6.27 years, and also 48.5% of them had their first pregnancy. In comparison with non-infected women, women with COVID-19 faced the highest risk of cesarean section (aRR: 2.22, 95% CI, 1.35%-3.65%, P=0.002) and preterm birth (aRR: 1.22, 95% CI, 1.02%-1.48%, P=0.026). Also, pregnant women with COVID-19 had a significantly higher duration of hospital stay (aMD: 2.20, 95% CI, 1.32%-3.08%, P=0.001) compared to pregnant women without COVID-19. There was no significant difference between the two groups in terms of postpartum hemorrhage and premature rupture of membranes. Conclusion: This study suggests that COVID-19 infection is associated with an increased risk of cesarean section, preterm birth, and increased duration of hospital stay but not with other outcomes. However, the current evidence does not support its causal effects, given the methodological limitations and small sample size.

Potential role of latent toxoplasmosis in inducing thyroid disorders with relevance to autoimmune thyroid disease and interleukin-33 level during pregnancy

Background and Aim: Latent toxoplasmosis is the most frequently occurring parasitic infection worldwide, which causes hormonal and behavioral changes that seriously affect pregnant women. It has also been linked to several autoimmune diseases, including autoimmune thyroid disease (AITD). This study aimed to investigate the association between Toxoplasma gondii seropositivity and thyroid dysfunction, considering the impact of latent toxoplasmosis on the prevalence of maternal AITD and interleukin-33 (IL-33) levels in infected and non-infected pregnant women. Materials and Methods: We conducted a cross-sectional study on 400 pregnant women aged 15–50 in the 8th–36th gestational week. Toxoplasma status was confirmed by detecting anti-Toxoplasma immunoglobulin (Ig)G antibodies. Recent and past chronic toxoplasmosis status was differentiated using the Toxoplasma IgG avidity test. Free triiodothyronine (FT3), free thyroxine, and thyroid-stimulating hormone (TSH) levels were determined to evaluate thyroid disorders. Antibodies against thyroid peroxidase, thyroglobulin, and TSH receptor were assessed to distinguish patients with autoimmune thyroid disorders from those with other thyroid diseases. We divided the subjects into four groups (Toxo+ and abnormal hormone level, Toxo– and normal hormone level, Toxo+ and normal hormone level, and Toxo– and abnormal hormone level) and evaluated their IL-33 levels to investigate its role during the infection. All the tests were performed using the enzyme-linked immunosorbent assay. Results: The results showed that (205/400, 51.2%) samples were seropositive for anti-Toxoplasma IgG antibodies. Of these, (25/205, 12.2%) and (180/195, 87.8%) had recent and past chronic infections, respectively. High infection rates were reported among rural dwellers (150/400, 37.5%) and those in their 3rd trimester (110/400, 27.5%). Of the 205 seropositive patients, (131/205, 63.9%) had thyroid disorders, among which (69/205, 33.7%) and (119/205, 58.0%) had abnormal FT3 and TSH hormone levels, respectively. In contrast, out of 195 Toxoplasma seronegative samples, (99/195, 50.8%) had thyroid disorders; (48/195, 24.6%) and (90/195, 46.2%) had abnormal FT3 and TSH hormone levels, respectively. Groups with abnormal FT3 and TSH levels had significantly higher seropositive anti-toxoplasma IgG antibodies (p = 0.01). Women with seropositive anti-Toxoplasma IgG antibodies had a high hypothyroidism rate (115/205, 56.1%) compared with those with seronegative anti-Toxoplasma IgG antibodies (86/195, 44.1%). We found an association between toxoplasmosis and thyroid status (p &lt; 0.05). Out of 400 samples, 85 (85/400, 21.25%) had AITD. Further, (58/205, 28.3%) of women with seropositive anti-toxoplasma IgG antibodies had AITD compared to (27/195, 13.85%) in the seronegative ones. We found a significant association between toxoplasmosis and AITD (p &lt; 0.05). The IL-33 level was highest in the Toxo+ and abnormal hormone level group (210.86 ± 44.39 pg/mL) and lowest in the Toxo-and normal hormone level group (22.27 ± 8.41 pg/mL). Conclusion: Our results suggest that latent toxoplasmosis was significantly associated with thyroid hormone secretion, which might stimulate the immune system, leading to the development of AITD among pregnant women. Furthermore, the T. gondii seroprevalence was positively correlated with pregnant patients who were rural dwellers and in their 3rd trimester. Keywords: autoimmune thyroiditis disease, interleukin-33, pregnancy, thyroid hormones, toxoplasmosis.

EPH166 The Effect of COVID-19 on Maternal and Neonatal Outcomes in a Large Tertiary Health System in Saudi Arabia

There is a scarcity of data comparing the rates of maternal and neonatal outcomes in pregnant women with and without COVID-19 infection. Our aim was to assess the effect of COVID-19 on maternal outcomes (stillbirths and miscarriage) and neonatal outcomes (low birth weight <2500 gm Apgar-1 minute score < 7, and Apgar-5 minute score < 7). This is a multicenter retrospective cohort study that included pregnant women who were followed and delivered at three National Guard health System hospitals between March 2020 and October 2021. A laboratory test confirmed the diagnosis of COVID-19 during pregnancy. Multivariable Logistic regression was conducted to assess the risks of maternal and neonatal outcomes. The study included 644 pregnant women with a confirmed COVID-19 infection and 654 pregnant women with no COVID-19 infection. There was no statistically significant difference in the risk of stillbirth (adjusted odds ratio, aOR1.93, 95% CI 0.55, 8.12) or miscarriage (aOR 0.52, 95% CI 0.23, 1.10) between COVID-19 infected pregnant women and non-infected pregnant women. COVID-19 infection, on the other hand, was associated with increased odds of low birth weight (aOR 1.5, 95%CI 1.06, 2.14), Apgar score-1 minute <7 (aOR 2.14, 95%CI 1.53, 3.03), and Apgar score-5 Minutes <7 (aOR 2.8, 95%CI 1.91, 4.17). Infants born to pregnant women with COVID-19 infection were more likely to have low birth weight and low Apgar scores than those born to uninfected mothers.

Evaluation of Vitamin D Serum Levels in Pregnant Women with COVID-19 Compared with the Control Group in Pregnant Women: A Case-Control Study.

The findings of studies on serum 25-hydroxy-vitamin D [25(OH) D] levels in pregnant women with or without coronavirus disease 2019 (COVID-19) were found to be controversial and inadequate. The present study was thus carried out at to fill the gap felt in this regard. In this case-control study, 63 pregnant women with singleton pregnancy who were infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and 62 pregnant women who were matched for gestational age and not infected by COVID-19 were examined. Based on clinical symptoms, the patients with COVID-19 were divided into three groups: mild, moderate, and severe. ELISA method was adopted to measure [25(OH) D] level. The [25(OH) D] means of 23.4 ± 9.2ng/ml and 31.2 ± 0.15ng/ml were noted in the case and control groups, respectively (p < 0.001). The [25(OH) D] level of lower than 30ng/ml was observed in 43.5% of the control group (n = 27) and 71.4% of the case group (n = 45; p = 0.002). Multivariate linear regression analysis to match age, gestational age, [25(OH) D] supplement use, and number of pregnancies showed that [25(OH) D] mean in the case group is 8.2 units lower, compared to the control group (p < 0.001). The [25(OH) D] level in pregnant women with COVID-19 is lower, compared to non-infected pregnant women. However, there is no significant relationship between [25(OH) D] level and disease severity. A sufficient level of [25(OH) D] may protect pregnant women against COVID-19.

GLOBAL SYSTEMATIC REVIEW AND META-ANALYSIS OF FOETAL AND MATERNAL OUTCOMES IN PREGNANT WOMEN INFECTED WITH COVID-19

This study aimed to systematically review the effects of COVID-19 infection on pregnant women and their neonatal outcomes in eight countries: UK, USA, China, France, India, Russia, Italy, and Iran. Data from various registries worldwide were analyzed, focusing on preterm births, maternal and neonatal mortality rates, and mode of delivery. The results showed that all countries experienced a significant increase in preterm birth rates among COVID-19-infected pregnant women compared to non-infected pregnant women. No significant difference was observed in maternal mortality rates across the countries, but India had the highest neonatal mortality rate. The rate of vertical transmission from infected mothers in the third trimester to their infants was estimated at 3.2%. In conclusion, COVID-19 has the most significant impact on the increase of preterm birth rates, with India experiencing the highest neonatal mortality rate compared to the other country.