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BMC Pregnancy and Childbirth Jun 2024Experiencing a miscarriage can have profound psychological implications, and the added strain of the COVID-19 pandemic may have compounded these effects. This study...
BACKGROUND
Experiencing a miscarriage can have profound psychological implications, and the added strain of the COVID-19 pandemic may have compounded these effects. This study aimed to explore the psychological experiences, assess the levels of psychological distress (depression, anxiety, and post-traumatic stress disorder), and examine the relationships of personal significance of miscarriage and perceived stress with psychological distress of women in North Carolina who suffered a miscarriage of a desired pregnancy between March 30, 2020, and February 24, 2021, of the COVID-19 pandemic, at 14 to 31 months after the loss.
METHODS
We conducted a cross-sectional mixed-methods study using a convergent parallel design. A total of 71 participants from North Carolina completed the online survey and 18 completed in-depth interviews. The survey assessed demographics, mental health and reproductive history, personal significance of miscarriage, perceived stress, anxiety, depression, and PTSD. Interview questions asked about the psychological experience of the miscarriage and how the COVID-19 pandemic affected them and their experience.
RESULTS
Findings indicated moderate to severe levels of depression, anxiety, and PTSD, which persisted 14 to 31 months post-miscarriage. After conducting hierarchical binary logistic regressions, we found that perceived stress and prior trauma increased the odds of depression, perceived stress increased the odds of anxiety, and personal significance and prior trauma increased the odds of PTSD symptoms 14-31 months post-miscarriage. Notably, a subsequent successful childbirth emerged as a protective factor against depression, anxiety, and PTSD. Qualitative findings depicted emotions such as profound isolation, guilt, and grief. Women noted that additional pandemic-specific stressors exacerbated their distress. The categories identified via conventional content analysis fell under five broader thematic groups: mental health disorders, negative emotions/feelings, positive emotions/feelings, thoughts, and other experiences.
CONCLUSIONS
Miscarriage during the COVID-19 pandemic intensified and added complexity to the psychological distress experienced by affected women. The study underscores the need for comprehensive mental health screenings, specialized support for vulnerable groups, and the necessity of trauma-informed care. Providers are strongly encouraged to adopt a multifaceted, individualized approach to patient care that is cognizant of the unique stressors introduced by the pandemic.
Topics: Humans; COVID-19; Female; Abortion, Spontaneous; Adult; Cross-Sectional Studies; Pregnancy; Stress Disorders, Post-Traumatic; Depression; Stress, Psychological; Anxiety; North Carolina; Psychological Distress; SARS-CoV-2; Surveys and Questionnaires; Young Adult; Mental Health
PubMed: 38872085
DOI: 10.1186/s12884-024-06610-z -
Journal of Food Protection Jun 2024In recent years, there have been numerous recalls of frozen vegetable products due to Listeria monocytogenes contamination, which causes listeriosis. In pregnant women,...
In recent years, there have been numerous recalls of frozen vegetable products due to Listeria monocytogenes contamination, which causes listeriosis. In pregnant women, listeriosis can cause miscarriage, stillbirth, and other serious complications. Manufacturing guidelines are created with the intention that frozen vegetables will be cooked prior to consumption. However, consumers may prepare and eat frozen vegetables without prior cooking. Therefore, it is necessary to assess behaviors that could be risky for L. monocytogenes exposure. A 10-question online survey was distributed to women between the ages of 18-54 to investigate frozen vegetable consumption behaviors. The prevalence of uncooked frozen vegetable consumption, reading preparation instructions, and listeriosis knowledge was assessed. Data were analyzed using logistic and ordered logit regression. Of 1,001 complete responses, 531 (53%) indicated that they consumed frozen vegetables in the past week, and of those 35.6% (n = 189) indicated that they consumed frozen vegetables without prior heating. Women who had not heard of listeriosis and had not read preparation instructions had significantly higher odds of uncooked frozen vegetable consumption (Odds Ratio (OR): 2.30, 95% Confidence Interval (CI): 1.48, 3.55; OR: 1.85, 95% CI: 1.13, 3.01, respectively). These results will guide future research on safe food handling practices for frozen vegetable products. The findings support the need for updating public health guidelines to include frozen vegetables as foods that are risky for listeriosis in pregnancy. Additionally, these findings have implications for future research to inform food policy governing labeling regulation on frozen vegetable products to reflect current consumer behavior.
PubMed: 38871223
DOI: 10.1016/j.jfp.2024.100315 -
Cellular Signalling Jun 2024Recurrent miscarriage (RM) is a distressing pregnancy complication with an unknown etiology. Increasing evidence indicates the relevance of dysregulation of human...
Recurrent miscarriage (RM) is a distressing pregnancy complication with an unknown etiology. Increasing evidence indicates the relevance of dysregulation of human trophoblast stem cells (hTSCs), which may play a role in the development of RM. However, the potential molecular regulatory mechanism underlying the initiation and maintenance of hTSCs is yet to be fully elucidated. In this study, we performed data analysis and identified Forkhead box M1 (FOXM1) as a potential factor associated with RM. FOXM1 is a typical transcription factor known for its involvement in various pathophysiological processes, while the precise function of FOXM1 functions in hTSCs and RM remains incompletely understood. Utilizing RNA-seq, CUT&Tag, ChIP-qPCR, and sodium bisulfite conversion methods for methylation analysis, we elucidate the underlying regulatory mechanisms of FOXM1 in hTSCs and its implications in RM. Our findings demonstrate the relative high expression of FOXM1 in proliferating cytotrophoblasts (CTBs) compared to differentiated extravillous cytotrophoblasts (EVTs) and syncytiotrophoblasts (STBs). Besides, we provide evidence supporting a significant correlation between FOXM1 downregulation and the incidence of RM. Furthermore, we demonstrate the significant role of FOXM1 in regulating hTSCs proliferation and cell cycle through the transcriptional regulation of CDKN3, CCNB2, CCNA2, MAD2L1 and CDC25C. Notably, we observed a correlation between the downregulation of FOXM1 in RM and hypermethylation in its promoter region. Collectively, these results provide insights into the impact of FOXM1 on trophoblast regulation and offer a novel perspective on RM.
PubMed: 38871040
DOI: 10.1016/j.cellsig.2024.111259 -
Scientific Reports Jun 2024Waddlia chondrophila is a possible cause of fetal death in humans. This Chlamydia-related bacterium is an emergent pathogen that causes human miscarriages and ruminant...
Waddlia chondrophila is a possible cause of fetal death in humans. This Chlamydia-related bacterium is an emergent pathogen that causes human miscarriages and ruminant abortions, which results in financial losses. Despite the years of efforts, the underlying mechanism behind the pathogenesis of W. chondrophila is little known which hindered the development of novel treatment options. In the framework of current study, computational approaches were used to identify novel inhibitors (phytocompounds) and drug targets against W. chondrophila. At first, RNA polymerase sigma factor SigA and 3-deoxy-D-manno-octulosonic acid transferase were identified through subtractive proteomics pipeline. Afterwards, extensive docking and simulation analyses were conducted to optimize potentially novel phytocompounds by assessing their binding affinity to target proteins. A 100ns molecular dynamics simulation well complimented the compound's binding affinity and indicated strong stability of predicted compounds at the docked site. The calculation of binding free energies with MMGBSA corroborated the significant binding affinity between phytocompounds and target protein binding sites. The proposed phytocompounds may be a viable treatment option for patients infected with W. chondrophila; however, further research is required to ensure their safety.
Topics: Molecular Dynamics Simulation; Molecular Docking Simulation; Anti-Bacterial Agents; Humans; Chlamydiales; Bacterial Proteins; Binding Sites; Protein Binding; Drug Evaluation, Preclinical; Pharmacophore
PubMed: 38866811
DOI: 10.1038/s41598-024-63555-1 -
Toxicon : Official Journal of the... Aug 2024This case report investigated the outbreak of aflatoxicosis in a dairy herd in Pakistan, which resulted in 30 abortions of 40 confirmed (75%) pregnant cows in a period...
This case report investigated the outbreak of aflatoxicosis in a dairy herd in Pakistan, which resulted in 30 abortions of 40 confirmed (75%) pregnant cows in a period of 35 days and in 18.8% depression of farm average milk production for the entire herd. The analysis of the concentrate feed of the total mixed ration (TMR), using enzyme-linked immunosorbent assay (ELISA) procedures from two different local laboratories, indicated concentrations of 60 μg/kg dry matter (DM) of aflatoxin B1 (AFB1) and 100 μg/kg DM of total aflatoxins (AFs: sum of B1, B2, G1 and G2). Subsequently, a confirmatory analysis with a more sensitive and validated multi-metabolite liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was performed. This analysis detected a concentration of total AFs in the TMR of 166 μg/kg DM ± 3.5 (AFB1:134, AFB2:17.4 and AFM1:14.9 μg/kg DM). The concentrate feed (55% of the TMR DM) was confirmed as a source of contamination, presenting a concentration >29 times higher than the EU-maximum limit value (5.68 μg/kg DM). Additionally, the multi-mycotoxin analysis evidenced the co-occurrence of 81 other toxic and potentially toxic fungal metabolites in the fed TMR. After replacing the contaminated concentrate feed with feedstuffs of the same formulation but from a new charge of ingredients, the abortion episodes ceased, and milk production increased significantly. In conclusion, the data of this case report suggest that AFs may be associated with pregnancy losses in dairy cattle and milk production depression. From the public health perspective, the data also indicate the need for a more careful examination of dairy animal feed in Pakistan. Since the high concentration of AFB1 detected in feed and considering the literature-reported transfer rates (1-6%) of this toxin to AFM1 (carcinogen for humans) in milk, the milk produced during the outbreak period is expected to be contaminated with AFM1, which raises public health concerns.
Topics: Animals; Pakistan; Female; Cattle; Disease Outbreaks; Milk; Pregnancy; Animal Feed; Dairying; Aflatoxins; Cattle Diseases; Food Contamination; Abortion, Veterinary; Lactation; Tandem Mass Spectrometry; Aflatoxin Poisoning
PubMed: 38866254
DOI: 10.1016/j.toxicon.2024.107799 -
Discovery Immunology 2024The female reproductive tract accommodates and balances the unique immunological challenges of protection from sexually transmitted pathogens and tolerance of the fetus... (Review)
Review
The female reproductive tract accommodates and balances the unique immunological challenges of protection from sexually transmitted pathogens and tolerance of the fetus and placenta in pregnancy. Leukocytes in the female reproductive tract actively engage in extensive maternal adaptations that are imperative for embryo implantation, placental development, and fetal growth support. γδ T cells are abundant at many mucosal sites in the body, where they provide protection against pathogens and cancer, and have roles in tissue renewal and homeostasis. In this review, we summarize studies in humans and rodents showing that γδ T cells are prevalent in the female reproductive tract and fluctuate in response to hormone changes across the reproductive cycle. Emerging evidence points to a link between changes in their abundance and molecular repertoire in the uterus and pregnancy disorders including recurrent miscarriage and preterm birth. However, defining the precise functional role of female reproductive tract γδ T cells and understanding their physiological significance in reproduction and pregnancy have remained elusive. Here, we critically analyze whether reproductive tract γδ T cells could be active participants in reproductive events-or whether their principal function is immune defense, in which case they may compromise pregnancy success unless adequately regulated.
PubMed: 38863792
DOI: 10.1093/discim/kyae004 -
Cureus May 2024Background A descriptive analysis of patients who underwent various embryo transfer methods to address the root cause of their infertility at a tertiary infertility care...
Background A descriptive analysis of patients who underwent various embryo transfer methods to address the root cause of their infertility at a tertiary infertility care complex in Wardha, India, is presented herein. This analysis aims to evaluate the management of infertility and assess pregnancy outcomes. Methodology We conducted a retrospective cohort study on patients who underwent various embryo transfer methods to address the cause of their infertility, specifically focusing on a variable window of implantation (WOI) at a tertiary infertility clinic over a one-year period. The medical records of 11 patients in both the variable embryo transfer (VET) and control groups were reviewed and analyzed for this article. Results The examination of medical records revealed a significant improvement in the rate of implantation (p-value = 0.04) and clinical pregnancy outcomes (p-value = 0.03) among patients who underwent VET. Comparable statistical outcomes were observed for other variables of pregnancy outcome, including miscarriage rate, multiple pregnancy rate, and biochemical pregnancy rate. Conclusion This retrospective cohort study suggests that the utilization of VET could be a viable option for women experiencing recurrent implantation failure cycles, particularly when an adequate number of embryos are available. This is owing to the challenges in clinically diagnosing a variable WOI. Further studies with a significantly larger sample population are recommended to validate the results and integrate this approach into the standard operating procedures, aiming to enhance the likelihood of pregnancy in these populations.
PubMed: 38854330
DOI: 10.7759/cureus.60020 -
BioRxiv : the Preprint Server For... Jun 2024Rift Valley fever virus (RVFV) infection causes abortions in ruminant livestock and is associated with an increased likelihood of miscarriages in women. Using sheep and...
Rift Valley fever virus (RVFV) infection causes abortions in ruminant livestock and is associated with an increased likelihood of miscarriages in women. Using sheep and human placenta explant cultures, we sought to identify tissues at the maternal-fetal interface targeted by RVFV. Sheep villi and fetal membranes were highly permissive to RVFV infection resulting in markedly higher virus titers than human cultures. Sheep cultures were most permissive to wild-type RVFV and ΔNSm infection, while live attenuated RVFV vaccines (LAVs; MP-12, ΔNSs, and ΔNSs/ΔNSm) exhibited reduced replication. The human fetal membrane restricted wild-type and LAV replication, and when infection occurred, it was prominent in the maternal-facing side. Type-I and type-III interferons were induced in human villi exposed to LAVs lacking the NSs protein. This study supports the use of sheep and human placenta explants to understand vertical transmission of RVFV in mammals and whether LAVs are attenuated at the maternal-fetal interface.
PubMed: 38854055
DOI: 10.1101/2024.05.31.596800 -
BioRxiv : the Preprint Server For... May 2024Infection with clade I Mpox virus (MPXV) results in adverse pregnancy outcomes, yet the potential for vertical transmission resulting in fetal harm with clade IIb MPXV,...
UNLABELLED
Infection with clade I Mpox virus (MPXV) results in adverse pregnancy outcomes, yet the potential for vertical transmission resulting in fetal harm with clade IIb MPXV, the clade that is currently circulating in the Western Hemisphere, remains unknown. We established a rhesus macaque model of vertical MPXV transmission with early gestation inoculation. Three pregnant rhesus macaques were inoculated intradermally with 1.5 × 10^5 plaque forming units (PFU) of clade IIb MPXV near gestational day (GD) 30 and animals were monitored for viremia and maternal and fetal well-being. Animals were euthanized to collect tissues at 5, 14, or 25 days post-inoculation (dpi). Tissues were evaluated for viral DNA (vDNA) loads, infectious virus titers, histopathology, MPXV mRNA and protein localization, as well as MPXV protein co-localization with placental cells including, Hofbauer cells, mesenchymal stromal cells, endothelial cells, and trophoblasts. vDNA was detected in maternal blood and skin lesions by 5 dpi. Lack of fetal heartbeat was observed at 14 or 25 dpi for two dams indicating fetal demise; the third dam developed significant vaginal bleeding at 5 dpi and was deemed an impending miscarriage. vDNA was detected in placental and fetal tissue in both fetal demise cases. MPXV localized to placental villi by ISH and IHC. Clade IIb MPXV infection in pregnant rhesus macaques results in vertical transmission to the fetus and adverse pregnancy outcomes, like clade I MPXV. Further studies are needed to determine whether antiviral therapy with tecovirimat will prevent vertical transmission and improve pregnancy outcomes.
ONE SENTENCE SUMMARY
Clade IIb Mpox virus infection of pregnant rhesus macaques results in vertical transmission from mother to fetus and adverse pregnancy outcomes.
PubMed: 38853987
DOI: 10.1101/2024.05.29.596240