COVID-19 and maternal and perinatal outcomes – Authors' reply

Chmielewska, Barbara; Barratt, Imogen; Townsend, Rosemary; Kalafat, Erkan; Meulen, Jan van der; Gurol‐Urganci, Ipek; O’Brien, Pat; Morris, Edward; Thangaratinam, Shakila; Doaré, Kirsty Le; Ladhani, Shamez; Dadelszen, Peter von; Magee, Laura A.; Khalil, Asma

doi:10.1016/s2214-109x(21)00293-x

Cited by 13 publications

(7 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This has been widely interpreted to mean that the Omicron variant is causing less severe disease; however, health authorities have advised caution, as data on Omicron infection have been derived largely from countries with high vaccination rates 4 . SARS-CoV-2 infection is associated with excess maternal and perinatal mortality and morbidity 5 . Some evidence suggests that the Delta variant (compared with the wild-type strain and the Alpha variant) causes more severe disease in pregnancy and a heightened risk of stillbirth 6 .…”

Section: Introductionmentioning

confidence: 99%

Maternal and perinatal outcomes of SARS‐CoV‐2 infection in unvaccinated pregnancies during Delta and Omicron waves

İlter

Prasad

Mutlu

et al. 2022

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

Objectives Currently, there is little evidence related to the effects of the Omicron variant on pregnancy outcomes, particularly in unvaccinated women. This study aims to compare pregnancy outcomes of SARS‐CoV‐2 infected, unvaccinated women during the pre‐Delta, Delta, and Omicron waves. Methods This was a retrospective cohort study at two tertiary care facilities: Sancaktepe Training and Research Hospital, Istanbul, Turkey, and St. George's University Hospitals NHS Foundation Trust, London, UK. Included were people testing RT‐PCR positive for SARS‐CoV‐2 during pregnancy, between April 01, 2020 and February 14, 2022, and divided into three epochs: (i) pre‐Delta , 1 Apr 2020 to 8 Jun 2021 in Turkey, and 1 Apr 2020 to 31 Jul 2021 in the UK; (ii) Delta , 9 Jun 2021 to 27 Dec 2021 in Turkey, and 1 Aug 2021 to 27 Dec 2021 in the UK; and (iii) Omicron , after 27 Dec 2021 in each of Turkey and the UK, according to the date of their positive RT‐PCR test. Baseline data collected included maternal age, parity, body mass index (BMI), smoking status, gestational age at diagnosis, and comorbidities. The primary outcome was the need for oxygen supplementation, classified as oxygen support via nasal cannula or breather mask, non‐invasive mechanical ventilation with continuous positive airway pressure (CPAP) or high‐flow oxygen, mechanical ventilation with intubation, or extracorporeal membrane oxygenation (ECMO). Inferences were made after balancing of confounders, using an evolutionary search algorithm. Results 1285 RT‐PCR‐proven SARS‐CoV‐2 infections of unvaccinated pregnant women were identified during the pre‐Delta (N=870), Delta (N=339), and Omicron (N=77) epochs. In the confounder‐balanced cohort, infection during the Delta wave was associated with increased need for nasal oxygen support (RR 2.53, 95% confidence interval [CI] 1.75‐3.65, P<.001), CPAP or high‐flow oxygen (RR 2.50, 95% CI 1.37‐4.56, P=.002), mechanical ventilation (RR 4.20, 95% CI 1.60‐11.0, P=.003), and ECMO (RR 11.0, 95% CI 1.43‐84.7, P=.021). The maternal mortality rate was also 3‐4 fold higher during the Delta wave compared to pre‐Delta (5.3% vs 1.5%, P=0.010). An infection during the Omicron wave was not associated with an increased need for nasal oxygen support (RR 0.62, 95% CI 0.25‐1.55, P=0.251), CPAP or high‐flow oxygen (RR 1.07, 95% CI 0.36‐3.12, P=0.906), or mechanical ventilation (RR 0.44, 95% CI 0.06‐3.45, P=0.438). The maternal mortality rate was similar during the Omicron wave and the pre‐Delta period (1.3% vs 1.3%, P=0.999). Nasal oxygen support during the Omicron wave was significantly lower compared to Delta‐wave infection (RR 0.26, 95% CI 0.11‐0.64, P=0.003). Perinatal outcomes were available for a subset of the confounder‐balanced cohort. Preterm birth below 34 weeks’ gestation was significantly increased (P<0.001) during the Delta wave compared with...

show abstract

Section: Introductionmentioning

confidence: 99%

Maternal and perinatal outcomes of SARS‐CoV‐2 infection in unvaccinated pregnancies during Delta and Omicron waves

İlter

Prasad

Mutlu

et al. 2022

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

show abstract

“…The negative effects of the pandemic on maternal and perinatal health include restrictive measures, disruption of health services, and fear of using these services, which are among the main factors that compromised the physical, psychological, and social wellbeing of participants, similar to those facing pregnancy during the height of the pandemic ( Burki, 2020 ; Roberton et al, 2020 ). Linked to this is an additional factor: the altered family and social relationships due to estrangement from loved ones and friends ( Khalil et al, 2020 ; Chmielewska et al, 2021 ). Social support is important, but most participants perceived the disenfranchisement of their grief, on the part of both family and friends, and especially by health professionals ( Lang et al, 2011 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, studies have also shown that adverse outcomes following maternal COVID-19 infection were infrequent ( Delahoy et al, 2020 ), and others have evidenced that pregnant women were more likely to be intubated and develop composite morbidity ( DeBolt et al, 2021 ; Kotlar et al, 2021 ) or die ( Zambrano et al, 2020 ). The risk of COVID-19 transmission from mother to fetus is very low ( Egloff et al, 2020 ); however, some studies point to an increase in premature births ( Blitz et al, 2020 ; Lokken et al, 2020 ; Allotey et al, 2021 ), low birth weight, cesarean sections ( Knight et al, 2020 ; Savasi et al, 2020 ), and maternal and neonatal mortality, and extrauterine pregnancies compared with the pre-pandemic period ( Khalil et al, 2020 ; Chmielewska et al, 2021 ). As infodemia had a negative effect on pregnant women ( Ennab et al, 2022 ), it is possible to hypothesize that some concerns inherent in COVID-19 could have impacted pregnant women and their partners who lost their babies.…”

Section: Introductionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on perinatal loss among Italian couples: A mixed-method study

Testoni

Ronconi²,

Iacona

et al. 2022

Front. Psychol.

View full text Add to dashboard Cite

BackgroundPerinatal bereavement is an event that greatly impacts the emotional, psychological, and psychosocial aspects of those who want to have a child.ObjectivesSince there are few studies on the psychological impact of the COVID-19 pandemic on couples grieving for perinatal loss, this research aimed to survey this experience.ParticipantsBetween 2020 and 2021, in Italian provinces highly affected by the COVID-19 pandemic, 21 parents participated: 16 mothers (76%; mean age 36.2; SD: 3.1) and 5 fathers (24%; mean age 40.2; SD: 3.4), among which there were 4 couples.MethodsA mixed-method design was used through self-report questionnaires and in-depth interviews. Accompanied by a sociodemographic form, the following questionnaires were administered: Prolonged Grief-13, the Parental Assessment of Paternal Affectivity (PAPA) (to fathers), the Parental Assessment of Maternal Affectivity (PAMA) (to mothers), the Dyadic Adjustment Scale short version, the Daily Spiritual Experiences Scale, and the Impact of Event Scale-Revised. The texts obtained through the in-depth interviews underwent thematic analysis.ResultsFifty per cent of participants suffered from Post-Traumatic Stress Disorders (PTSD) symptoms and 20% suffered from relational dyadic stress. Four areas of thematic prevalence emerged: psychological complexity of bereavement, the impact of the COVID-19, disenfranchisement vs. support, and spirituality and contact with the lost child. Participants interpreted their distress as related to inadequate access to healthcare services, and perceiving the pandemic restrictions to be responsible for less support and lower quality of care. Furthermore, they needed psychological help, and most of them were unable to access this service. Spirituality/religiosity did not help, while contact with the fetus and burial did.ConclusionIt is important to implement psychological services in obstetrics departments to offer adequate support, even in pandemic situations.

show abstract

“…In developed countries, 10%-15% of women suffer from postpartum depression, 1,2 and as a result of the COVID-19 pandemic, these proportions have increased. [3][4][5][6] Indeed, the latest data have shown that approximately 25%-30% of mothers have high risk of postpartum depression. 7 In recent years, moreover, postpartum depression is no longer limited to the perinatal period but can persist for long periods.…”

Section: Introductionmentioning

confidence: 99%

The Association of Maternal Depression with Short-Chain Fatty Acid-Producing Gut Microbiota and the Japanese Diet’s Influence

Matsunaga,

Takeuchi,

Watanabe

et al. 2023

Preprint

View full text Add to dashboard Cite

The prevalence of postpartum mental illness is steadily increasing, exacerbated particularly by the COVID-19 pandemic. Recent studies indicate that maternal depression is no longer confined to the perinatal period, necessitating long-term assessment, and support for maternal mental health. Identifying risk factors for mothers’ depression is thus critical and requires development of integrated mental and physical health care that encompasses not only psychological aspects but also gut microbiota, physical condition, and eating habits. Western countries have examined the association between gut microbiota and depression in clinical samples. However, studies focusing on postpartum mothers are still limited, and moreover, no large-scale studies have yet been conducted with nonclinical participants. To address this gap, we investigated gut microbiota, physical condition, and dietary habits associated with risk of depression in nonclinical Japanese mothers. We found that microbiota diversity (Shannon α) and relative abundance of butyrate-producing bacteria (e.g., Lachnospira, Faecalibacterium, Lachnoclostridium) with 16S rRNA gene-sequencing analysis were associated with high risk of depression. Furthermore, even among nonclinical mothers, high-risk mothers showed poorer sleep quality, worse physical condition, and lower consumption of staple foods, milk, cheese, yogurt, and lactobacillus beverages compared to low-risk (healthy) mothers. Evaluation of dietary habits using the Japanese Dietary Index (JDI) suggested that consumption of a Japanese-style diet is beneficial to physical and mental health, including intestinal microbiota (e.g., Agathobacter, Subdoligranulum).

show abstract

COVID-19 and maternal and perinatal outcomes – Authors' reply

Cited by 13 publications

References 4 publications

Maternal and perinatal outcomes of SARS‐CoV‐2 infection in unvaccinated pregnancies during Delta and Omicron waves

Maternal and perinatal outcomes of SARS‐CoV‐2 infection in unvaccinated pregnancies during Delta and Omicron waves

The impact of the COVID-19 pandemic on perinatal loss among Italian couples: A mixed-method study

The Association of Maternal Depression with Short-Chain Fatty Acid-Producing Gut Microbiota and the Japanese Diet’s Influence

Contact Info

Product

Resources

About