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Ugeskrift For Laeger Jun 2024Group B Streptococcus (GBS) disease in neonates occurs in two forms: early-onset disease (EOD), (day 0-6), and late-onset disease (LOD), (day 7-90). This review... (Review)
Review
Group B Streptococcus (GBS) disease in neonates occurs in two forms: early-onset disease (EOD), (day 0-6), and late-onset disease (LOD), (day 7-90). This review investigates that risk-based intrapartum screening and antibiotics have reduced the incidence of EOD, but not LOD, in Denmark. No clinical or laboratory tests can rule out GBS disease at symptom onset. Thus, a high proportion of uninfected infants receive antibiotics, although this varies widely, and may be reduced by strategies of antibiotic stewardship. A future GBS vaccine for pregnant women may potentially reduce disease burden and antibiotic exposure.
Topics: Humans; Streptococcal Infections; Infant, Newborn; Streptococcus agalactiae; Anti-Bacterial Agents; Female; Pregnancy; Denmark; Pregnancy Complications, Infectious; Infant; Streptococcal Vaccines; Infectious Disease Transmission, Vertical
PubMed: 38953689
DOI: 10.61409/V01240022 -
General Physiology and Biophysics Jul 2024The work presents the connection between the infection of COVID-19 during pregnancy and non-syndromic orofacial clefts (NSOFC). Aim of the study was to compare the...
The work presents the connection between the infection of COVID-19 during pregnancy and non-syndromic orofacial clefts (NSOFC). Aim of the study was to compare the incidence of COVID-19 disease during mother´s pregnancy between a group of the children with NSOFC and a control group of the children without NSOFC. COVID-19 was confirmed by polymerase chain reaction (PCR) test. The study showed significantly higher incidence of COVID-19 disease in the group of mothers who gave birth to a child with NSOFC in comparison to the group of mothers who gave birth to a child without NSOFC. Our results indicate the possible participation of the infection of COVID-19 in the formation of NSOFCs.
Topics: Humans; Cleft Lip; Cleft Palate; COVID-19; Female; Pregnancy; Pregnancy Complications, Infectious; Incidence; Adult; Male; Infant, Newborn
PubMed: 38953573
DOI: 10.4149/gpb_2024012 -
BMJ Open Jul 2024Toxoplasmosis is a zoonotic parasitic disease caused by . It has a wide host range and is capable of vertical transmission in pregnant women, which may lead to...
BACKGROUND
Toxoplasmosis is a zoonotic parasitic disease caused by . It has a wide host range and is capable of vertical transmission in pregnant women, which may lead to undesirable pregnancy outcomes such as congenital malformations, miscarriage, premature birth and stillbirth. This study investigated the seroprevalence of infection among pregnant women attending the antenatal clinic at Namwala District Hospital in Southern Zambia.
METHODS
This was a cross-sectional study where blood was collected, and the serum was tested for IgG and IgM. A questionnaire was administered to participants on demographic characteristics and risk factors. Data were entered in Microsoft Excel and exported to STATA version 14 for analysis.
RESULTS
A total of 401 women were enrolled in the study from 3 March to 5 August 2021. The seroprevalence of IgG was 4.2% (n=17), while the seroprevalence of IgM was 0.7% (n=3). The median age was 27 (IQR: 24-30) years, and a larger proportion had primary-level education (n=223, 55.6%). The majority (81.6%) of the women were married. None of the risk factors investigated in this study were significant for infection.
CONCLUSION
There was a low seroprevalence of infection among pregnant women in the Namwala district of Southern Province, Zambia, and regular screening may not be warranted in this population. Continued research on toxoplasmosis is recommended to understand its epidemiology across Zambia.
Topics: Humans; Female; Zambia; Cross-Sectional Studies; Seroepidemiologic Studies; Adult; Pregnancy; Toxoplasmosis; Risk Factors; Toxoplasma; Young Adult; Immunoglobulin M; Antibodies, Protozoan; Pregnancy Complications, Parasitic; Immunoglobulin G; Prenatal Care
PubMed: 38950992
DOI: 10.1136/bmjopen-2024-084582 -
African Journal of Primary Health Care... Jun 2024Antenatal care remains critical for identifying and managing complications contributing to maternal and infant mortality, yet attendance among women in South Africa...
BACKGROUND
Antenatal care remains critical for identifying and managing complications contributing to maternal and infant mortality, yet attendance among women in South Africa persists as a challenge.
AIM
This study aimed to understand the challenges faced by women attending antenatal care in Soweto, Johannesburg, using the three-delay model.
SETTING
This study was conducted in Soweto, Johannesburg.
METHODS
An exploratory, descriptive and qualitative research design was used, and in-depth interviews were conducted with 10 pregnant women and four women who had recently given birth.
RESULTS
Findings indicate delays in seeking care due to factors such as pregnancy unawareness, waiting for visible signs, and fear of human immunodeficiency virus (HIV) testing. Challenges such as transportation difficulties, distance to clinics, and facility conditions further impeded the initiation of antenatal care. Late initiation often occurred to avoid long waits, inadequate facilities, language barriers and nurse mistreatment.
CONCLUSION
From this study, we learn that challenges such as unawareness of pregnancy, cultural notions of keeping pregnancy a secret, fear of HIV testing, long waiting lines, high cost of transportation fees, clinic demarcation, shortage of essential medicines, broken toilets and verbal abuse from nurses have delayed women from initiating antenatal care early in Soweto, Johannesburg.Contribution: Challenges of women with antenatal care attendance in South Africa must be addressed by implementing community-based health education interventions, institutionalising HIV psycho-social support services and improving quality of antenatal care services in public health facilities.
Topics: Humans; South Africa; Female; Pregnancy; Prenatal Care; Adult; Qualitative Research; Patient Acceptance of Health Care; HIV Infections; Health Services Accessibility; Young Adult; Health Knowledge, Attitudes, Practice; Time Factors; Interviews as Topic
PubMed: 38949438
DOI: 10.4102/phcfm.v16i1.4333 -
Curationis Jun 2024HIV-positive and pregnancy diagnosis is a traumatic, shocking, and distressing experience for women. Adoption of routine HIV counselling and testing in the antenatal...
BACKGROUND
HIV-positive and pregnancy diagnosis is a traumatic, shocking, and distressing experience for women. Adoption of routine HIV counselling and testing in the antenatal programme aimed to increase the uptake and the early diagnosis of HIV among pregnant women to prevent maternal HIV transmission to unborn babies and neonates.
OBJECTIVES
The study aimed to explore the psychological reaction of women coincidentally discovering their HIV-positive status and pregnancy while seeking medical care in primary healthcare facilities in the Tshwane district.
METHOD
Descriptive phenomenology involving a semi-structured in-depth interview was used to collect data. The sample was purposively selected. Twenty-eight women participated in the research project. Face-to-face in-depth audio recorded interviews were used to gain a full understanding of the experiences and feelings of the participants.
RESULTS
Reason for the uptake of pregnancy and HIV testing, reactions upon discovering HIV and pregnancy-positive status, emotions arising from the pregnancy and HIV-positive diagnosis, understanding HIV infection in pregnancy, and transitions to acceptance and coping with the HIV-positive diagnosis were themes that emerged from this study.
CONCLUSION
It is crucial that responsible healthcare workers consider this psychological imbalance during their offering of antenatal and postnatal care services so that the pregnant women living with HIV can accept and cope with the situation.Contribution: This study accounts to support other studies that offer intense counselling for women coincidentally discovering their positive HIV status and pregnancy. It is important to remedy the acceptance of the situation and to promote HIV prevention and family planning for women of childbearing age.
Topics: Humans; Female; Pregnancy; Adult; HIV Infections; Primary Health Care; Pregnancy Complications, Infectious; Qualitative Research; South Africa; Interviews as Topic; Infectious Disease Transmission, Vertical; Pregnant Women
PubMed: 38949424
DOI: 10.4102/curationis.v47i1.2518 -
Frontiers in Immunology 2024A maternal vaccine to protect newborns against invasive infection is a developing medical need. The vaccine should be offered during the third trimester of pregnancy... (Review)
Review
A maternal vaccine to protect newborns against invasive infection is a developing medical need. The vaccine should be offered during the third trimester of pregnancy and induce strong immune responses and placental transfer of protective antibodies. Polysaccharide vaccines against conjugated to protein carriers are in advanced stages of development. Additionally, protein-based vaccines are also in development, showing great promise as they can provide protection regardless of serotype. Furthermore, safety concerns regarding a new vaccine are the main barriers identified. Here, we present vaccines in development and identified safety, cost, and efficacy concerns, especially in high-need, low-income countries.
Topics: Streptococcus agalactiae; Humans; Streptococcal Infections; Streptococcal Vaccines; Pregnancy; Female; Animals; Pregnancy Complications, Infectious; Vaccine Development; Infant, Newborn; Antibodies, Bacterial
PubMed: 38947337
DOI: 10.3389/fimmu.2024.1430901 -
HIV Research & Clinical Practice Dec 2024Zimbabwe antenatal HIV prevalence rate is 16.1%. HIV-positive pregnant adolescent girls and young women (AYW) are at high risk to experience perinatal mental health...
BACKGROUND
Zimbabwe antenatal HIV prevalence rate is 16.1%. HIV-positive pregnant adolescent girls and young women (AYW) are at high risk to experience perinatal mental health challenges, attributed to a combination of factors including HIV status, stigma and perinatal depression. Perinatal depression and stigma among AYW is understudied in Zimbabwe and may affect short- and long-term health of HIV positive mothers and their children, and can impact treatment adherence.
METHODS
Qualitative data was gathered from four focus group discussions with (2 urban and 2 rural) PMTCT providers ( = 17). Focus group discussions were also conducted among AYW clients ( = 20) from two clinics in Mashonaland East.
RESULTS
Qualitative analyses identified patterns related to: (1) drop out and loss to follow up, (2) retention and adherence, (3) recurring feelings of internalized stigma; and (4) acceptability of potential MH interventions. MH services are not available and AYW have limited access to adherence counseling (1-2 times at onset). Psychological support was not available at either clinic, despite both providers and clients perceiving high rates of stigma, discrimination, and challenges with disclosure. Challenges related to long waits for ART distribution and gaps in disclosure support emerged as barriers. Providers noted that AYW present as anxious (non-diagnosed), and attribute depression to those clients who are lost to follow up, stating lack of time to screen for MH related issues or actively refer them for services. Challenges related to the ability to provide strong advice and support for disclosure also emerged among providers.
CONCLUSIONS
This study can contribute to policy and practice recommendations to better integrate MH into HIV services and develop person-centered service models for HIV positive AYW. HIGHLIGHTSPerinatal adolescents and young women (AYW) living with HIV have gaps in retention and care in the current Zimbabwe PMTCT service model.Mental health stigma must be addressed to integrate mental health into HIV services.HIV providers are aware of the need to provide mental health support to reduce loss to follow-up.Mental health screening and referrals for services are not part of standard care for perinatal HIV positive AYW in Zimbabwe.Linkages between disclosure and AYW mental health was identified as a challenge by HIV providers.Context responsive interventions can support integration of mental health screening, services, and referrals.
Topics: Humans; Female; Zimbabwe; Adolescent; HIV Infections; Social Stigma; Young Adult; Focus Groups; Pregnancy; Infectious Disease Transmission, Vertical; Adult; Qualitative Research; Pregnancy Complications, Infectious; Patient Acceptance of Health Care
PubMed: 38944816
DOI: 10.1080/25787489.2024.2371174 -
Mymensingh Medical Journal : MMJ Jul 2024Objective of the study was the effect of Covid-19 infection on pregnancy and neonatal outcomes. This prospective cohort study was conducted in Combined Military Hospital... (Comparative Study)
Comparative Study
Objective of the study was the effect of Covid-19 infection on pregnancy and neonatal outcomes. This prospective cohort study was conducted in Combined Military Hospital (CMH) Bogura, Obstetrics and Gynaecology department from June 2020 to October 2020. We have collected and analyzed data of 29 pregnant ladies positive for Covid-19. Control group was Covid-19 negative pregnant patients. Nasopharyngeal swab was taken for real time polymerase chain reaction for detection of Covid-19. We observed symptoms, compared any complication in mother and fetus, mode of termination, and duration of hospital stay. Only six patients were asymptomatic (10.3%). Fifteen (25.9%) had fever, six (6) had weakness (10.3%), 5(8.6%) had sore throat, 3(5.2%) had nausea and 5(8.6%) presented with loss of smell. Among twenty-nine patients, 5(8.6%) delivered normally, 24(41.4%) were delivered through caesarean section which was significantly higher than control group (p value <0.001). No mother became critical or expired, neonatal death was also absent. Mean duration of hospital stay was 14.13±6.192 days in case and 5.18±4.99 in control which was significantly (p value <0.001) higher. Breast feeding was significantly higher in control group (p value <0.001). This study shows feto-maternal outcome of Covid-19 pregnancy is almost same as those of normal pregnancy.
Topics: Humans; Pregnancy; Female; COVID-19; Pregnancy Complications, Infectious; Adult; Prospective Studies; Pregnancy Outcome; Bangladesh; Infant, Newborn; SARS-CoV-2; Length of Stay; Cesarean Section; Young Adult
PubMed: 38944726
DOI: No ID Found -
Scientific Reports Jun 2024Methicillin-resistant Staphylococcus (MRS) has been associated with neonatal infections, with colonization of the anovaginal tract being the main source of vertical...
Methicillin-resistant Staphylococcus (MRS) has been associated with neonatal infections, with colonization of the anovaginal tract being the main source of vertical transmission. The COVID-19 pandemic has altered the frequency of antibiotic usage, potentially contributing to changes in the dynamics of bacterial agents colonizing humans. Here we determined MRS colonization rates among pregnant individuals attending a single maternity in Rio de Janeiro, Brazil before (January 2019-March 2020) and during (May 2020-March 2021) the COVID-19 pandemic. Anovaginal samples (n = 806 [521 samples before and 285 during the pandemic]) were streaked onto chromogenic media. Colonies were identified by MALDI-TOF MS. Detection of mecA gene and SCCmec typing were assessed by PCR and antimicrobial susceptibility testing was done according to CLSI guidelines. After the onset of the pandemic, MRS colonization rates increased significantly (p < 0.05) from 8.6% (45) to 54.7% (156). Overall, 215 (26.6%) MRS isolates were detected, of which S. haemolyticus was the most prevalent species (MRSH, 84.2%; 181 isolates). SCCmec type V was the most frequent among MRS (63.3%; 136), and 31.6% (68) of MRS strains had a non-typeable SCCmec, due to new combinations of ccr and mecA complexes. Among MRS strains, 41.9% (90) were resistant to at least 3 different classes of antimicrobial agents, and 60% (54) of them were S. haemolyticus harboring SCCmec V. MRS colonization rates and the emergence of multidrug-resistant variants detected in this study indicate the need for continuing surveillance of this important pathogen within maternal and child populations.
Topics: Humans; Female; Pregnancy; COVID-19; Staphylococcal Infections; Methicillin-Resistant Staphylococcus aureus; Adult; Brazil; Pregnancy Complications, Infectious; Anti-Bacterial Agents; SARS-CoV-2; Microbial Sensitivity Tests; Pandemics; Vagina
PubMed: 38942787
DOI: 10.1038/s41598-024-64422-9 -
PloS One 2024This cross-sectional study aims to describe doubts regarding the diagnosis and treatment of syphilis in pregnancy among primary care professionals in a telehealth...
This cross-sectional study aims to describe doubts regarding the diagnosis and treatment of syphilis in pregnancy among primary care professionals in a telehealth service. All teleconsultations (TCs) offered through TelessaúdeRS-UFRGS to primary health care (PHC) services in the state of Rio Grande do Sul between 2018 and 2021 involving syphilis in pregnancy were included. A total of 356 (TCs) were analyzed. The main doubts about syphilis during pregnancy raised by primary care professionals were related to the need for retreatment (35%), diagnostic definition (23%) and initial treatment (16%). In addition, 95% of TCs were suitable for diagnosing and treating syphilis based on the 2020 Brazilian Ministry of Health guideline. This study suggests that TCs can identify failures in the diagnosis and treatment of public health problems and support decision making in PHC involving syphilis in pregnancy.
Topics: Humans; Female; Pregnancy; Syphilis; Telemedicine; Primary Health Care; Cross-Sectional Studies; Adult; Pregnancy Complications, Infectious; Brazil; Health Personnel
PubMed: 38941327
DOI: 10.1371/journal.pone.0306192