Positive Mothers Research Articles

Factors predicting mortality in hospitalised HIV-negative children with lower-chest-wall indrawing pneumonia and implications for management.

In 2012, the World Health Organization revised treatment guidelines for childhood pneumonia with lower chest wall indrawing (LCWI) but no 'danger signs', to recommend home-based treatment. We analysed data from children hospitalized with LCWI pneumonia in the Pneumonia Etiology Research for Child Health (PERCH) study to identify sub-groups with high odds of mortality, who might continue to benefit from hospital management but may not be admitted by staff implementing the 2012 guidelines. We compare the proportion of deaths identified using the criteria in the 2012 guidelines, and the proportion of deaths identified using an alternative set of criteria from our model. PERCH enrolled a cohort of 2189 HIV-negative children aged 2-59 months who were admitted to hospital with LCWI pneumonia (without obvious cyanosis, inability to feed, vomiting, convulsions, lethargy or head nodding) between 2011-2014 in Kenya, Zambia, South Africa, Mali, The Gambia, Bangladesh, and Thailand. We analysed risk factors for mortality among these cases using predictive logistic regression. Malnutrition was defined as mid-upper-arm circumference <125mm or weight-for-age z-score <-2. Among 2189 cases, 76 (3·6%) died. Mortality was associated with oxygen saturation <92% (aOR 3·33, 1·99-5·99), HIV negative but exposed status (4·59, 1·81-11·7), moderate or severe malnutrition (6·85, 3·22-14·6) and younger age (infants compared to children 12-59 months old, OR 2·03, 95%CI 1·05-3·93). At least one of three risk factors: hypoxaemia, HIV exposure, or malnutrition identified 807 children in this population, 40% of LCWI pneumonia cases and identified 86% of the children who died in hospital (65/76). Risk factors identified using the 2012 WHO treatment guidelines identified 66% of the children who died in hospital (n = 50/76). Although it focuses on treatment failure in hospital, this study supports the proposal for better risk stratification of children with LCWI pneumonia. Those who have hypoxaemia, any malnutrition or those who were born to HIV positive mothers, experience poorer outcomes than other children with LCWI pneumonia. Consistent identification of these risk factors should be prioritised and children with at least one of these risk factors should not be managed in the community.

Cytokine IL-5 and HGF: combined prediction of non-/low immune response to hepatitis B vaccination at birth in infants born to HBsAg-positive mothers.

The immune response to hepatitis B vaccine may be influenced by numerous factors, and patients with non/low response re-exposed to hepatitis B virus remain susceptible. Thus, a better understanding of the underlying mechanisms of non/low immune response in infants born to Hepatitis B surface antigen (HBsAg)-positive mothers is essential. 100 infants born to HBsAg-positive mothers from 2015 to 2020 were enrolled in the study, further divided into the non/low response group (n=13) and the moderate strong response group (n=87) based on the quantification of hepatitis B surface antibody at 12 months of age. The differential expression of 48 immune-related cytokines in the two groups was compared and analyzed in detail. The key cytokines were further identified and clinically predictive models were developed. We found that 13 cytokines were lowly expressed and one cytokine was highly expressed in the non/low response group, compared with the moderate strong response group at birth. In addition, 9 cytokines were lowly expressed and one cytokine was highly expressed in the non/low response group at 12 months of age. Furthermore, we found that IL-5 and HGF were promising predictors for predicting the immunization response to hepatitis B vaccine in infants, and the combination of the two cytokines showed the best predictive efficiency, with an area under the curve (AUC) value of 0.844. The present study provides a theoretical basis on cytokines for developing and implementing effective immunotherapies against non/low immune response in infants born to HBsAg-positive mothers.

Parenting of siblings in Latinx families during middle childhood.

Parents' management of their children's sibling relationships, or sibling-focused parenting, has substantial theoretical and practical importance but is rarely studied. This study's goals were to describe dimensions of sibling-focused parenting and to examine sociocultural resources and challenges as potential correlates among Latinx mothers and fathers in 262 families with two children in middle childhood. Families were recruited from 11 public elementary schools, and caregivers (248 mother figures; 118 father figures) participated in a home visit and phone interviews at the onset of the study. Sibling-focused parenting included three dimensions: positive guidance (10 items), nonintervention (four items), and authoritarian control (five items). Parents rated positive guidance as their most frequent strategy, and comparisons of mothers and fathers from the same families revealed that mothers engaged in more sibling-focused parenting overall than fathers. Regarding correlates, mothers' familism values and mothers' and fathers' family cohesion reports were associated with more positive guidance and mothers' cohesion was negatively related to nonintervention in sibling conflicts. For mothers only, parenting stress was linked to all three dimensions of sibling-focused parenting-negatively to guidance and positively to authoritarian control and nonintervention; maternal depressive symptoms were positively linked to authoritarian control. Economic hardship was not a significant correlate of any dimension. Findings suggest that sibling-focused parenting is a key domain of parenting in need of further research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Pre-Pandemic Versus Early COVID-19 Perinatal Outcomes at a Military Hospital.

The purpose of this study was to examine the impact of the first year of COVID-19 pandemic on maternal and neonatal outcomes at a large military treatment facility in Southern California. A retrospective review of maternal and neonatal medical records was conducted between January 1, 2019, and December 31, 2020. Outcomes measured included stillbirth rate, neonatal intensive care unit admission, neonatal death, cesarean birth, and postpartum hemorrhage. A total of 4,425 records were analyzed. Rates of stillbirth between the years did not vary. The neonatal death rate decreased more than 50% in 2020 (p = .149). Cesarean births rose by 2.7% in 2020 (p = .046). Rates of postpartum hemorrhage did not vary between years. The impact of COVID-19 on maternal and neonatal outcomes at a military treatment facility in the first year of the COVID-19 pandemic provides guidance for optimizing perinatal health care. Vertical transmission of COVID-19 is low and routine testing of asymptomatic neonates of positive mothers may not be necessary. COVID-19 infections should not be an indication for cesarean birth and are not associated with neonatal deaths or NICU admission.

Mothers` Attitudes on the Influence of Social Media on Parenting Styles of Adolescent Girls in Tanga Municipality, Tanzania

This study aimed to assess the influence of mother’s attitude on social media towards parenting styles of adolescent girls. The study employed a mixed methods research approach with convergent parallel design. Questionnaires, interview, and documentary review were prominent methods used in data collection. 104 respondents were recruited to collect data which deem suitable for the study. The obtained data analysed by using free QDA Miner and SPSS for non- numerical and numerical data respectively. The findings show that mothers have either positive or negative attitude on social media use of adolescent girls. The positive mother’s attitude is influenced by such factors as screening time, learning and communication purpose. While negative mother’s attitude is influenced by factors as early sexual relationship and age of adolescent girls. Finally, the researcher recommended that adolescent should be emphasized on the positive use of social media to increase their performance in the educational carrier

Screening of Group B Streptococcal and Candida Infections in Antenatal Women Visiting a Tertiary Care Hospital and the Neonatal Outcome

Reproductive tract infections in antenatal women are frequently occurring public health concern affecting the quality of life in the infected women and further affects the neonatal outcome negatively. Vaginal infections are predominantly caused due to the disturbance in the normal vaginal microflora. Group B Streptococcus (GBS) is a major peritoneal pathogen leading to morbidity and mortality in both mother and neonates leading to complications like preterm labour, chorioamnionitis and Preterm rupture of membrane (PROM). Further, Vulvovaginal candidiasis (VVC) is a frequently encountered gynaecological disease causing morbidity in 3/4th of women at least once in their life span. It leads to infertility in non-pregnant women. It results in adverse pregnancy outcomes such as chorioamnionitis and congenital abnormalities in the neonates. The aim of this study is to screen for potential bacterial and yeast infections with focus on GBS and Candida infections and its neonatal outcome. Candida species and GBS were identified by routine culture-based tests. HiChrome agar was used for speciation of Candida species. CAMP test was performed for GBS; further identification was done using Streptococcal grouping kit. GBS was found in 15% of the antenatal women and Candida Species was found to be most common with an infection rate of 50%. Lower segment Cesarean section (LSCS) rate in GBS positive women was 60% and in Candida Non albicans positive women was found to be 65.38%. 33% of the neonates born to GBS positive mothers had respiratory distress. Infection in antenatal women negatively influenced the mode of delivery and the mean body weight of the neonates born to infected mothers were comparatively less.

Neonatal Jaundice: A Study of the Incidence in Children of Rh (D) Negative and 0 Rh (D) Positive Mothers.

Despite advances in neonatal care, neonatal jaundice remains a common problem in maternity wards. The present retrospective epidemiological study collected data on a sample of 710 newborns and compared the incidence of neonatal jaundice in infants born to Rh (D) negative and 0 Rh (D) positive mothers. The primary aim was to determine whether the higher incidence of maternal alloimmunisation in newborns was causally related to a potentially higher incidence of neonatal jaundice in newborns of 0 Rh (D) positive mothers. To the end, we investigated a possible association between the incidence of neonatal jaundice in 0 Rh (D) positive mothers and the neonatal blood group. The incidence of neonatal jaundice was not found to differ between maternal blood groups. We discuss new preventive measures that may reduce the incidence of neonatal jaundice and thereby reduce the length of hospital stay.

Uso da imuno-histoquímica e genotipagem do gene da proteína priônica para detecção de Scrapie em ovinos no estado de Santa Catarina, Brasil

ABSTRACT: Scrapie is a contagious disease of sheep and goats caused by prions (PrPSc). This study described an outbreak of Scrapie in sheep in the state of Santa Catarina, Brazil. An 1-year and 3-month-old sheep developed clinical signs characterized by motor incoordination of the pelvic limbs, pruritus and alopecia for three days. The 38 sheep from the flock that were over 1 year of age underwent biopsies of the third eyelid and rectal mucosa, in addition to anti-PrPsc immunohistochemistry (IHC). Blood containing EDTA was collected for PRNP gene genotyping from these sheep. Of the 38, 16 (42.10%) had immunostaining againstPrPSc. IHC-positive animals were euthanized and necropsied, as well as lambs from positive mothers. Different organs of the 19 necropsied animals were collected in 10% buffered formalin for histopathological examination and anti-PrPSc IHC of the obex. The histopathology of the obex of the female with neurological signs presented discrete multifocal vacuolization of the cytoplasm of neurons and neuropil. The anti-PrPSc IHC showed that two out of the 19 obex samples had cytoplasmic immunostaining in neurons. The genotypes reported were ARQ/ARQ in 47.36%, ARR/ARQ in 36.84%, ARQ/VRQ in 10.52% and ARQ/VRR in 5.28%. The genotyping helps to identify susceptible animals and select animals more resistant to the development of Scrapie. The anti-PrPSc IHC from lymphoid biopsies, and genotyping demonstrated the high number of positive sheep classified in susceptible group.

An Observational Study on Impact of COVID-19 in Pregnancy: Clinical Profiles and Foetomaternal Outcomes in Caesarean Section Cases at a Tertiary Care Centre, Gujarat, India

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, has resulted in a crippled healthcare system worldwide. In this unprecedented situation, it is important to analyse the impact on the vulnerable population of pregnant women, especially those with high-risk pregnancies and those undergoing a Caesarean section (CS). Aim: To analyse the clinical profile, foetomaternal outcomes, and co-morbidities in COVID-19-affected pregnancy cases undergoing a CS. Materials and Methods: This was a retrospective observational study conducted at the Department of Obstetrics and Gynaecology, Government Medical College, and New Civil Hospital in Surat, Gujarat, India during the first wave of the COVID-19 pandemic from April 2020 to December 2020. The study included a total of 65 cases of COVID-19-positive mothers undergoing a C-section. Demographic parameters such as age, obstetric history, details of the C-section (like gestational age at the time of the procedure, indication, and category of the C-section), associated co-morbidities, severity of COVID-19- related symptoms and treatment, neonatal parameters {such as birth weight, Appearance, Pulse, Grimace, Activity and Respiration (APGAR) score, and COVID-19 status of the baby at birth} were analysed. Additionally, a comparison of the C-section rate and complications such as the development of severe anaemia requiring blood transfusion, postoperative development of urinary tract infections, surgical site infections, and the association of hypertensive disorders of pregnancy was conducted between COVID-19-affected and unaffected pregnancies undergoing a C-section during the study period. Data on COVID-19 negative cases were obtained from the monthly labour room statistics submitted to the department. The Chi-square test and Fisher’sexact test were used to compare parameters of the COVID-19 positive and negative groups and a p-value of less than 0.05 was considered statistically significant. Results: Out of a total of 6246 deliveries conducted at the institute during the study period, the CS rate among affected and non affected women was 44.5% (65 out of 146) vs. 32.8% (2006 out of 6100) {p=0.003, Relative Risk (RR) 1.3, 95% Confidence Interval (CI) 1.12-1.62}. The mean age of women with COVID19 undergoing a CS was 25.3 years. The difference in the rate of blood transfusion requirement in COVID-19-affected cases was 9 out of 65 (13.8%) vs. 120 out of 2006 (6%) in COVID-19 negative pregnancies (RR 2.3, 95% CI: 1.2-4.3). The difference in the rate of urinary tract infections in the postoperative period was statistically significant in COVID-19-infected patients, 5 out of 65 (7.7%) vs. 58 out of 2006 (2.9%) in non infected patients (p=0.0451, RR 2.6, 95% CI 1.1-6.4). The prevalence of hypertensive disorders among COVID-19 positive and negative mothers undergoing CS was very high in the present study (16 out of 65, 24.6% vs. 160 out of 2006, 8.1%, RR 3.08, 95% CI 1.9-4.8). Neonatal parameters like low APGAR score at birth were seen in 5 cases (8%), low birth weight in 20 cases (30%), and 3 babies (4.5%) were COVID-19 positive at birth. Conclusion: Higher rates of caesarean sections, increased prevalence of hypertensive disorders of pregnancy, anaemia requiring blood transfusion, and postoperative development of urinary tract infections among COVID-19-affected mothers undergoing a caesarean section.

Histopathological Changes and Clinical Outcomes in Placentas of COVID-19 Positive Mothers: A Cohort Study

Introduction: Infection by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has been shown to affect multiple organs in the human body. Research shows that Coronavirus Disease (COVID-19)-positive pregnant women experience poorer perinatal outcomes related to placental infection, including higher risks of miscarriage, preeclampsia, preterm birth, and stillbirth. Aim: To evaluate the histopathological changes in the placentas of COVID-19-positive mothers and the associated foetal outcomes. Materials and Methods: This cohort study was conducted at Kalinga Institute of Medical Sciences (KIMS) Bhubaneswar, Odisha, India, over a period of one year and eight months, from November 2020 to July 2022. It included 23 COVID-19-positive pregnant females admitted for safe confinement during the first and second COVID-19 waves. Thirty COVID-19-negative pregnant women admitted for safe delivery during the same period served as controls. Placentas were collected, processed, and stained according to standard protocols. Descriptive data were interpreted as frequencies and percentages, and associations were tested using the Chi-square test. A p-value &lt;0.05 was considered statistically significant. Results: The study included 23 cases (mean gestational age: 37 weeks and 5 days) and 30 controls (mean gestational age: 38 weeks and 6 days). The prevalence of Maternal Vascular Malperfusion (MVM) and Foetal Vascular Malperfusion (FVM) was found to be higher among cases than controls. Conclusion: Compared to controls, COVID-19-positive placentas showed a higher prevalence of both MVM and FVM. This might be attributable to the hypercoagulable state associated with COVID-19. Further research is needed to explore the potential effects of intrauterine inflammation on neonates exposed to COVID-19.

Energy Dense Feeding in Premature Infants and Its’ Associated Outcomes

COVID-19 infection in pregnant mothers is associated with higher risk of intrauterine growth retardation and premature births. Very low birth weight infants are more susceptible to neurodevelopmental and chronic respiratory problems. An infant delivered at 33 weeks via caesarean section to a COVID-19 Stage 5A positive mother, weighing 1.43kg at birth. She was kept nil by mouth with parenteral nutrition (PN) support since day five of life until referred to dietitian on day 22 of life for enteral nutrition (EN) establishment. Feeding was administered intermittently via oro-gastric Ryle’s Tube. She was kept under non-invasive ventilation (NIV) mode and had difficulty in weaning from ventilation, leading to slow feeding progress. Initially, enteral trophic feeding was administered using premature infant formula fortified with modular products. In the later stage of feeding, modular products were tapered off and the formula was concentrated. Frequency of bowel output when using fortified formula is lesser compared to when using concentrated and supplemented formula. There is no significant difference in renal profile observed in both stages of feeding. Increasing energy intake using easily digestible sources is preferable as opposed to concentrating feeds even further due to concerns about osmolality and excess administration of other solutes. Intermittent bolus feeding mode may have an effect on dependency on oxygen since intermittent feeds can decrease tidal volume, minute ventilation and dynamic compliance. Additional research is necessary to establish optimal caloric density and nutritional compositions of feedings, feeding mechanisms and its’ effect on feeding tolerance.

Comparison of Clinical, Laboratory Parameters, and Outcome of COVID-19-Positive and Negative Neonates Delivered from COVID-19-Positive Mothers

Abstract Objective Severe acute respiratory syndrome coronavirus 2 is a highly contagious respiratory viral infection that affects all individuals, although neonates are considered to be the most susceptible populations; therefore, this study was conducted to evaluate the clinical outcome and association between coronavirus disease 2019 (COVID-19)-positive mothers and newborns. Methods This cross-sectional study was conducted at a dedicated COVID-19 tertiary care hospital in India over a period of 1 year. The pregnant mothers infected with COVID-19 virus were enrolled with their newborn baby up to the age of 28 days. COVID-19 test was done by using a rapid antigen kit and further confirmed by reverse-transcription polymerase chain reaction. Results Prevalence of COVID-19-positive newborns born of COVID-19-positive mothers is reported at 8.4%. Female:male ratio was found to be 1:1.2. Raised D-dimer (88.9%) and C-reactive protein (88.9%) were the most common findings in COVID-19-positive newborns followed by leucopenia (33.3%). Among the COVID-19 newborns, Apgar score less than or equal to 7 and respiratory distress were found in 55.6 and 33.3%, respectively. Out of 9 COVID-19-positive newborns, two (22.2%) were expired, and out of 98 COVID-19-negative newborns, 4(4.1%) were expired. Conclusion This study revealed that severity of maternal symptoms is related to mortality of newborns. About 22.2% COVID-19-positive newborns expired, whereas 4.1% of COVID-19-negative newborns expired so risk of mortality increased among COVID-19-positive neonates as compared with negative ones. However, this study was conducted on a small sample size and further research with larger populations is needed to validate these findings.

Protection level of anti-hepatitis B vaccine and immunoglobulin in a pediatric Cameroonian population.

Despite the availability for nearly twenty years of an effective vaccine, hepatitis B remains one of the most frequent viral diseases throughout the world. Mother-to-child transmission is one of the primary routes of transmission in children. To assess the vaccine response in children born to HBV infected mothers. HBsAg-positive consenting mothers registered in the antenatal care (ANC) service database of Centre Hospitalier Dominicain St-Martin de Porres, Yaounde were enrolled with their children. Socio-demographic characteristics were collected using a tested questionnaire. The 5 markers of hepatitis B were tested and the quantification of anti-HBsAg antibodies was done by indirect ELISA method. The data collected was analyzed using Microsoft excel and Epi-info softwares. Out of 5,996 women registered, 143 were identified as HBsAg positive (2.38% prevalence) and none was HBeAg positive. Of these 143 HBsAg positive women, 50 were enrolled in the study. Of the 50 positive mothers, 78 children were included with a mean age ± standard deviation of 2.33±2.86 years. No child was infected with HBV, but all have been exposed to the virus (HBeAb-positive). Overall 64 (82.05%) received at birth both anti-HBs immunoglobulin (HBIG) and a dose of vaccine, while 14 (17.95%) received only the birth dose of vaccine. 72 (92.31%) children received all three recommended doses of vaccine. Vaccine responders were 62.82% (above 10 IU/ml), while 37.18% of children were non-responders; representing a higher risk group if not boosted. The coverage of the anti-HBV vaccine in children in this study was 92.31%. The protection level of 62.82% is below the 95% recommended rate by WHO. The factors sustaining this suboptimal protection should be investigated.

Congenital neurosyphilis in neonatal sepsis by Leclercia adecarboxylata: a case report

Introduction: Sepsis remains a leading cause of morbidity and mortality in neonates. In accordance with the development of diagnostic testing, various pathogens have been found to cause neonatal sepsis, ranging from common to even rarer pathogens. Leclercia adecarboxylata is a Gram-negative bacillus rarely found in neonatal sepsis and was previously found predominantly in environmental settings and the human gastrointestinal tract as commensal bacteria. We describe a rare case of Leclercia adecarboxylata in neonatal sepsis with congenital neurosyphilis. Case Description: We present a male neonate born from a positive syphilis serological test mother, presented with sepsis manifestation. Blood culture reveals growth of Leclercia adecarboxylata. The patient received both therapeutic regimens of antibiotics for sepsis and congenital syphilis. The cerebrospinal fluid analysis also performed revealed suggestive of congenital neurosyphilis. The patient passed away due to multiple organ failure. Conclusion: Neonatal sepsis and congenital neurosyphilis present with identical manifestations; therefore, appropriate recognition and comprehensive management should be done

Neonatal hepatitis B vaccination: Reevaluating timing and adjuvants for enhanced safety and effectiveness

AbstractOur aim is an achievement of a 100 percent vaccination rate without toxic vaccine effects. We did a comprehensive literature review on aluminum neurotoxicity and early neonatal hepatitis B vaccination. We analyzed indications for introduction of early neonatal hepatitis B vaccination and the data on experimental and clinical aluminum‐induced neurotoxicity. It is justified very early hepatitis B vaccination to be carried out in high‐risk endemic areas. In those countries there is a large number of hepatitis B positive individuals, including pregnant women, which leads to a great number of vertical, mother‐to‐child, transmissions of the virus during pregnancy. There is also a serious risk of perinatal Hepatitis B virus infections in such countries. Early neonatal hepatitis B vaccination is also carried out in low‐risk countries, where the number of hepatitis B positive pregnant women is extremely small, making the number of newborns who require the prevention of hepatitis B infection extremely small as well. It is necessary for all vaccines which contain aluminum as an adjuvant to be immediately suspended as children vaccination until they start walking and until aluminum is replaced with calcium, zinc or a nonmetallic adjuvant such as microcrystalline tyrosine or monosodium urate. Meanwhile sustained efforts should be made to create the so‐called mucosal vaccines against diphtheria, pertussis, measles, mumps and rubella. At the same time, all the children born to hepatitis B positive mothers, regardless of their place of birth must be vaccinated against hepatitis B as the benefits from vaccines by far outweigh potential harm caused by adjuvant aluminum.

Nurse-patient relationship and its implications for retention in the PMTCT of HIV programme in Ghana: an appreciative inquiry

BackgroundRelationships established between nurses and midwives, and their patients have far-reaching implications; the most significant being their impact on the health-related outcomes of patients. These relationships are especially relevant in the Prevention of Mother-to-Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) programme as women, diagnosed with HIV navigate the emotional and psychological effects of their diagnosis while carrying pregnancies. This study aimed to explore the relationships between nurses, midwives and mothers diagnosed with HIV and its impact on retention in the PMTCT Programme.MethodsAn Appreciative Inquiry approach that employed qualitative research methods was conducted among twenty-four participants made up of 12 HIV positive mothers, and eight midwives and four community health nurses engaged in the PMTCT programme. Individual generative interviews were conducted among the mothers while paired interviews were conducted among the health professionals. Thematic analysis guided by Colaizzi’s approach was conducted.ResultsThree main themes emerged each with its subthemes. Under Establishing Rapport, two sub-themes emerged; making the connection and building trusting relationships. The second theme, Journeying Together, describes how the nurse-patient relationship evolved as the participant engaged in the programme; sub-themes include developing mutual goals, impactful communication, and showing commitment and building self-worth. The third theme; Ending the professional relationship details two sub-themes; continuity of care across the cascade, and termination of care which proved unsuccessful in some relationships due to blurring professional boundaries.ConclusionsThe nurse-patient relationship in the PMTCT programme evolved as the relationship progressed along the PMTCT cascade. Strengthening of the nurse-patient relationships was underscored by building trust through the maintenance of confidentiality, setting mutual goals, shared emotional experiences and personal stories, and building clients’ self-worth. Therefore, there is a need to ensure that professional boundaries are set and maintained to reduce the occurrence of over-dependence of the clients and burnout of the nurses.

Covid-19 Induced Neonatal Immunity

December 2019 a few cases of severe pneumonia was detected in Wuhan, China The patients were exhibiting symptoms like fever, dry cough, sore throat, breathlessness, and fatigue. investigation employing next generation sequencing and phylogenetic analysis led to the identification of the causative agent of this respiratory disease, a novel coronavirus 2019 [1]. As more cases started to appear around the world, on February 11, 2020, the World Health Organization assigned a name, Corona Virus Disease 2019 or COVID-19, to the disease and declared it a pandemic on March 11, 2020. The virus was renamed from 2019-nCoV to SARS-CoV-2 by the International Committee on Taxonomy of Viruses on the basis of its genetic similarity to a previously known coronavirus, Severe Acute Respiratory Syndrome Coronavirus(SARS-CoV) [2].Coronavirus 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome SARS-CoV- 2, has resulted in more than six million deaths and has infected over 500 million people as of July 19, 2022 [3]. SARS-CoV-2 infected pregnant women are at increased risk of severe COVID- 19 than non-pregnant women and have a higher risk of adverse pregnancy outcomes like intrauterine/fetal distress and preterm birth.The most severe outcomes of COVID-19 have been documented in geriatric individuals and pregnant women with chronic diseases, including hypertension, diabetes, and cardiopulmonary problems [4]. Newborn protection from infection is primarily dependent on neonatal innate immune responses and maternally derived, transplacentally acquired antibodies. The extent to which maternal antibodies produced in response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy cross the placenta is important for understanding potential neonatal protection from coronavirus disease 2019 (COVID- 19.We investigated humoral responses to SARS-CoV-2 inmaternalandcordbloodpairedsamples in the case of natural infection during late second and third trimesters of pregnancy recruited at TSMU Department of Obstetrics and Gynecology TSMU First University Clinic. Georgia, Tbilisi. Maternal nasopharyngeal swabs were collected for SARS-CoV-2 detection by rate-PCR for confirmation of viral infection at the admission to the hospital. We measured IgG to spike (S) receptor-binding domain and nucleocapsid (N) Sixty-eight pregnant women SARS-CoV-2 positive by rRT- PCR were included in our study. Serology samples of maternal and cord blood has been collected immediately after delivery. For study design we have determined inclusion and exclusion criteria’s. General medical data of patients included in the study have been collected from medical records and Informed written consent was obtained from all the patients involved in the study. SARS-CoV-2, IgG has been detected by ELISA method.infected mothers had increased levels of virus-specific antibodies maternal IgG levels showed positive correlations with their counterparts in cord blood. PCR positive mothers showed stronger effect when infection was closer to delivery.Our results show that SARS- CoV-2 infection during the second and third trimester of pregnancy induces antibody response at delivery and causes lower level of the SARS-CoV-2-specific IgG trans placental transfer, when the infection is closer to delivery.

1397. What were the Birth Outcomes of Infants Born to Zika Positive Mothers in Developing Countries?

Abstract Background Zika Virus became an emerging health threat in the early 21st century. Epidemics in the Pacific Islands noted flu-like symptoms and complications following human ZIKV infection. However, after a severe outbreak in 2015, Latin American studies reported fetal birth defects with maternal infection but reports in other developing countries where outbreaks occurred were not fully characterized. This study aims to review current reports on birth outcomes associated with maternal ZIKV infection . Methods This narrative review evaluated birth outcomes of Zika positive pregnant women. Research articles were found using Google Scholar, PubMed, and MEDLINE. The inclusion criteria were publication between 2012 to 2022, availability as full text in English, categorization as original research, meta-analyses or case reports. Exclusion criteria were studies that were part of a book chapter or encyclopedia and studies that cited results from developed nations. The articles were studied and 20 methodologically sound studies were selected for review, and the data was classified in themes based on birth outcomes. Results 18 studies reported that infants born to some laboratory-confirmed zika-positive mothers had abnormal birth outcomes after delivery including microcephaly, stillbirth, neurological abnormalities and hearing loss. Maternal ZIKV infection is associated with an increased risk of abnormal birth outcomes in newborns in developing countries. In the countries of studies that did not report abnormal outcomes there may have been a protective factor from previous maternal Dengue Virus (DENV) infection adding protection for their infants. Conclusion Overall, there appears a difference in birth outcomes of infants born to mothers infected with ZIKV, however more research is needed on environmental factors and prior arboviral infection as additional factors contributing to these outcomes. Disclosures All Authors: No reported disclosures

Does COVID-19 Infection during Pregnancy Increase the Appearance of Congenital Gastrointestinal Malformations in Neonates?

COVID-19 was an infection that was capable of bringing the entire world to a standstill position within a period of days to months. Despite the advancements in the medical sector, the contagion was difficult to control and costed the lives of millions of people worldwide. Many short- and long-term effects are witnessed even to date in people that contracted the disease. Pregnant females had to suffer not only the devastating effects of the virus, but also the psycho-social impact of the lockdown. The impact of COVID-19 infection during pregnancy causing decreased antenatal care or hypoxemic episodes due to severe respiratory distress and whether it could lead to the appearance of congenital gastrointestinal malformation in neonates is still unclear. The aim of our study was to analyze if COVID-19 infection during pregnancy could increase the incidence of gastric malformations in neonates born from these women. We sifted the files of all neonates admitted into our hospital between January 2022 and December 2022, and based on inclusion and exclusion criteria, we included the cases having gastrointestinal congenital malformations during the COVID-19 pandemic. We performed a single-center, retrospective, observational descriptive study. We further divided the patients based on the anatomical location of the malformation. We also took down details of the evolution of pregnancy and whether the mother had contracted a SARS-CoV-2 infection during the pregnancy. Details regarding the Apgar score, days of intensive care admission, sex, and nutrition were the key findings studied. A total of 47 neonates were found to have digestive anomalies, among which, based on the anatomical locations, the number of malformation cases found at the level of the esophagus were 15, while 16 occurred at the level of the pylorus; we found 12 cases of malformation of the duodenum, and four cases had malformation of the rectum. Out of these 47 neonates, 38.3% were females and 61.7% were males. A total of 58% were preemies, among which 9% had intra-uterine growth retardation (IUGR), and 42% were full-term newborns, among which 4% had intra-uterine growth retardation (IUGR). A total of 45% of the births were primiparous pregnancies and 55% were from multiparous females. A total of 14 mothers were found to have tested positive for COVID-19 during the course of pregnancy (p-value = 0.23); many had mild symptoms but were not tested. COVID-19 can affect the wellbeing of the pregnant female and their fetus. Larger studies can help gain extensive knowledge as to whether COVID-19 also has the potential to result in congenital gastrointestinal anomalies in children born from COVID-19 positive mothers. In our study, only a few infants born with this pathology were found to be born from COVID-19 positive mothers. Hence, it is difficult to conclude or exclude a direct correlation between the infection and the congenital malformations.

Exploring the long-term seroprevalence of SARS-CoV-2 antibodies in infants born to women with clinical or laboratory-confirmed COVID-19

IntroductionInfants are at a higher risk of severe illness with COVID-19 infection compared to older children. While COVID-19 vaccination is not recommended for young infants, they can acquire maternally-derived anti-SARS-CoV-2 antibodies passively through the placenta and breastmilk. We described the persistence of infection-induced maternal antibodies in infant circulation at 9–12 months of age. MethodologyThis was a cross-sectional study nested within the INTERCOVID multinational cohort study. For each COVID positive pregnant woman, two unmatched consecutive COVID negative pregnant women were enrolled between April and September 2020. Women with a positive PCR test, radiographic signs consistent with COVID-19, or at least 2 predefined symptoms of COVID-19 were considered as COVID positive. For this nested cross-sectional study, all COVID positive and either one of the COVID negative participants recruited from the Aga Khan University, Pakistan were approached 9–12 months after delivery, and maternal and infant sera were collected for antibody detection. ResultsAltogether, 83 mothers provided consent, of whom 32 (38.6 %) were COVID positive and 51 (61.4 %) were COVID negative during pregnancy. Anti-SARS-CoV-2 antibodies were present in 13 (41 %) infants born to COVID positive and 19 (39 %) infants born to COVID negative mothers (p = 0.87). The presence of reactive antibodies in infants at follow-up was associated with maternal antibodies at follow-up (OR:9.50, 95 % CI:2.03–44.42; p = 0.004). COVID infection occurred in 3 (6 %) infants born to COVID negative mothers while no infant born to a COVID positive mother had a history of infection (p = 0.27). ConclusionThe presence of reactive anti-SARS-CoV-2 antibodies in infants at 9–12 months of age is associated with maternal seropositivity 9–12 months after delivery rather than maternal infection during pregnancy. Further studies are required to validate these findings and assess whether passive immunity in infants is protective against COVID-19 infection.