scholarly journals COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases

2020 ◽  
Vol 9 (11) ◽  
pp. 3441
Author(s):  
Ramy Abou Ghayda ◽  
Han Li ◽  
Keum Hwa Lee ◽  
Hee Won Lee ◽  
Sung Hwi Hong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Mode Of Delivery ◽  
Maternal Mortality Ratio ◽  
Case Series ◽  
Neonatal Outcomes ◽  
Treatment Modalities ◽  
Adverse Pregnancy

(1) Background: Until now, several reports about pregnant women with confirmed coronavirus disease 2019 (COVID-19) have been published. However, there are no comprehensive systematic reviews collecting all case series studies on data regarding adverse pregnancy outcomes, especially association with treatment modalities. (2) Objective: We aimed to synthesize the most up-to-date and relevant available evidence on the outcomes of pregnant women with laboratory-confirmed infection with COVID-19. (3) Methods: PubMed, Scopus, MEDLINE, Google scholar, and Embase were explored for studies and papers regarding pregnant women with COVID-19, including obstetrical, perinatal, and neonatal outcomes and complications published from 1 January 2020 to 4 May 2020. Systematic review and search of the published literature was done using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). (4) Results: In total, 11 case series studies comprising 104 pregnant women with COVID-19 were included in our review. Fever (58.6%) and cough (30.7%) were the most common symptoms. Other symptoms included dyspnea (14.4%), chest discomfort (3.9%), sputum production (1.0%), sore throat (2.9%), and nasal obstruction (1.0%). Fifty-two patients (50.0%) eventually demonstrated abnormal chest CT, and of those with ground glass opacity (GGO), 23 (22.1%) were bilateral and 10 (9.6%) were unilateral. The most common treatment for COVID-19 was administration of antibiotics (25.9%) followed by antivirals (17.3%). Cesarean section was the mode of delivery for half of the women (50.0%), although no information was available for 28.8% of the cases. Regarding obstetrical and neonatal outcomes, fetal distress (13.5%), pre-labor rupture of membranes (9.6%), prematurity (8.7%), fetal death (4.8%), and abortion (2.9%) were reported. There are no positive results of neonatal infection by RT-PCR. (5) Conclusions: Although we have found that pregnancy with COVID-19 has significantly higher maternal mortality ratio compared to that of pregnancy without the disease, the evidence is too weak to state that COVID-19 results in poorer maternal outcome due to multiple factors. The number of COVID-19 pregnancy outcomes was not large enough to draw a conclusion and long-term outcomes are yet to be determined as the pandemic is still unfolding. Active and intensive follow-up is needed in order to provide robust data for future studies.

scholarly journals Assessment of HCMV-encoded microRNAs in Plasma as Potential Biomarkers in Pregnant Women with Adverse Pregnancy Outcomes

2020 ◽  
Author(s):  
Zhiying Gao ◽  
Likun Zhou ◽  
Jing Bai ◽  
Meng Ding ◽  
Deshui Liu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Expression Profiles ◽  
Plasma Concentrations ◽  
Adverse Pregnancy Outcomes ◽  
Immunoglobulin M ◽  
Validation Data ◽  
Adverse Pregnancy ◽  
Normal Controls

Abstract Background: Human cytomegalovirus (HCMV) is the most frequent cause of congenital infections and can lead to adverse pregnancy outcomes (APO). HCMV encodes multiple microRNAs (miRNAs) that have been reported to be partially related to host immune responses, cell cycle regulation, viral replication and viral latency, and can be detected in human plasma. However, the relevance of HCMV-encoded miRNAs in maternal plasma as an indicator for APO has never been evaluated.Methods: The expression profiles of 25 HCMV-encoded miRNAs were first measured in plasma samples from 20 pregnant women with APO and 28 normal controls by quantitative reverse-transcription polymerase chain reaction (RT-qPCR) technology. Next, markedly changed miRNAs were validated in another independent validation set consisting of 20 pregnant women with APO and 27 control subjects. HCMV DNA in peripheral blood leukocytes (PBLs) and anti-HCMV immunoglobulin M (IgM) and anti-HCMV immunoglobulin G (IgG) in plasma were also examined in both the training and validation sets. Diagnostic value and risk factors were compared between adverse pregnancy outcome cohorts and normal controls.Results: The analysis of training and validation data sets revealed that plasma concentrations of hcmv-miR-UL148D, hcmv-miR-US25-1-5p and hcmv-miR-US5-1 were obviously increased in pregnant women with APO compared with normal controls. Hcmv-miR-US25-1-5p presented the largest area under the receiver-operating characteristic (ROC) curve (0.735; 95% CI, 0.635–0.836), with a sensitivity of 68% and specificity of 71%. Furthermore, the plasma levels of hcmv-miR-US25-1-5p and hcmv-miR-US5-1 were obviously positively correlated with APO (P = 0.029 and 0.035, respectively). Nevertheless, neither the concentration of HCMV DNA in PBLs nor the positivity rates of anti-HCMV IgM and IgG in plasma showed statistically significant correlation with APO.Conclusion: We identified a unique signature of HCMV-encoded miRNAs in pregnant women with APO, which may be useful as a potential noninvasive biomarker for predicting and monitoring APO during HCMV infection.

scholarly journals Pregnancy outcomes in sexually transmitted infections or human immunodeficiency viruses infected women at a tertiary care center: a retrospective study

2021 ◽  
Vol 7 (2) ◽  
pp. 229
Author(s):  
Saradha K. P. ◽  
Anitha Christy Stephen ◽  
Vikram V. Huddar
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Adverse Pregnancy Outcomes ◽  
Cd4 Count ◽  
Clinical Staging ◽  
Normal Delivery ◽  
Adverse Pregnancy

<p><strong>Background: </strong>The natural history of HIV infection in early disease is not affected by pregnancy. In later stages there may be rapid disease progression leading to adverse pregnancy outcomes. Prevalence of HIV in India is 0.3% in pregnant women. With the advent of PPTCT, there have been a decline in the adverse pregnancy outcomes but still few adversities are reported.  Aim of the study was to assess the various pregnancy outcomes in HIV positive women and the effects of antiretroviral therapy (ART).</p><p><strong>Methods: </strong>A retrospective analytical study conducted from July 2017-June 2019 on HIV infected pregnant women. Their maternal age, CD4 count at diagnosis of HIV, after postpartum, mode of delivery, birth weight and HIV status of baby were noted and analyzed.  <strong></strong></p><p><strong>Results: </strong>18 HIV infected pregnant women were included. Their mean age was 25.6 years. 12 patients were in 2<sup>nd</sup> trimester and the rest in 1<sup>st</sup> trimester. All were on triple-drug (TEL) regimen. Three were diagnosed with HIV prior to conception and were already on ART. Remaining were detected at the time of ANC visit. All cases fall under stage I WHO clinical staging. Out of the 18 pregnant, two delivered by LSCS and the rest by normal delivery. All were term deliveries, with mean birth weight of 2.82 kg. One HIV infected baby was born by LSCS. The mean CD4 count at the time of diagnosis of HIV was 389 and at postpartum was 508. Overall, there was seen to be an increase in CD4 count without any adverse effects during ART.<strong></strong></p><p><strong>Conclusions: </strong>Prompt HIV diagnosis and ART initiation during antenatal period can have good pregnancy outcome and thereby reducing transmission to children.</p>

scholarly journals Effects of Coronavirus Disease 2019 (COVID-19) on Maternal, Perinatal and Neonatal Outcomes: a Systematic Review of 266 Pregnancies

2020 ◽  
Author(s):  
Juan Juan ◽  
María M. Gil ◽  
Zhihui Rong ◽  
Yuanzhen Zhang ◽  
Huixia Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Case Reports ◽  
Case Series ◽  
Severe Pneumonia ◽  
Outcome Data ◽  
Neonatal Outcomes ◽  
Eligibility Criteria ◽  
Maternal Deaths

ABSTRACTObjectiveTo perform a systematic review of available published literature on pregnancies affected by COVID-19 to evaluate the effects of COVID-19 on maternal, perinatal and neonatal outcomes.MethodsWe performed a systematic review to evaluate the effects of COVID-19 on pregnancy, perinatal and neonatal outcomes. We conducted a comprehensive literature search using PubMed, EMBASE, Cochrane library, China National Knowledge Infrastructure Database and Wan Fang Data until April 20, 2020 (studies were identified through PubMed alert after April 20, 2020). For the research strategy, combinations of the following keywords and MeSH terms were used: SARS-CoV-2, COVID-19, coronavirus disease 2019, pregnancy, gestation, maternal, mothers, vertical transmission, maternal-fetal transmission, intrauterine transmission, neonates, infant, delivery. Eligibility criteria included laboratory-confirmed and/or clinically diagnosed COVID-19, patient was pregnant on admission, availability of clinical characteristics, including maternal, perinatal or neonatal outcomes. Exclusion criteria were unpublished reports, unspecified date and location of the study or suspicion of duplicate reporting, and unreported maternal or perinatal outcomes. No language restrictions were applied.ResultsWe identified several case-reports and case-series but only 19 studies, including a total of 266 pregnant women with COVID-19, met eligibility criteria and were finally included in the review. In the combined data from seven case-series, the maternal age ranged from 20 to 41 years and the gestational age on admission ranged from 5 to 41 weeks. The most common symptoms at presentation were fever, cough, dyspnea/shortness of breath and fatigue. The rate of severe pneumonia was relatively low, with the majority of the cases requiring intensive care unit admission. Almost all cases from the case-series had positive computer tomography chest findings. There were six and 22 cases that had nucleic-acid testing in vaginal mucus and breast milk samples, respectively, which were negative for SARS-CoV-2. Only a few cases had spontaneous miscarriage or abortion. 177 cases had delivered, of which the majority by Cesarean section. The gestational age at delivery ranged from 28 to 41 weeks. Apgar scores at 1 and 5 minutes ranged from 7 to 10 and 8 to 10, respectively. A few neonates had birthweight less than 2500 grams and over one-third of cases were transferred to neonatal intensive care unit. There was one case each of neonatal asphyxia and neonatal death. There were 113 neonates that had nucleic-acid testing in throat swab, which was negative for SARS-CoV-2. From the case-reports, two maternal deaths among pregnant women with COVID-19 were reported.ConclusionsThe clinical characteristics of pregnant women with COVID-19 are similar to those of nonpregnant adults with COVID-19. Currently, there is no evidence that pregnant women with COVID-19 are more prone to develop severe pneumonia, in comparison to nonpregnant patients. The subject of vertical transmission of SARS-CoV-2 remains controversial and more data is needed to investigate this possibility. Most importantly, in order to collect meaningful pregnancy and perinatal outcome data, we urge researchers and investigators to reference previously published cases in their publications and to record such reporting when the data of a case is being entered into a registry or several registries.ContributionWhat are the novel findings of this work?Amongst a few cases from the case-series that had qRT-PCR testing in vaginal mucus and breast milks, the results were negative for SARS-CoV-2. Similarly, some of the cases from the case-series had qRT-PCR testing in amniotic fluid, cord blood, neonatal throat swab and neonatal feces, and the results were negative for SARS-CoV-2. Amongst the case-reports, there were two maternal deaths and two neonates tested positive for SARS-CoV-2 at 16 / 24 hours of life.What are the clinical implications of this work?The subject of vertical transmission of SARS-CoV-2 remains controversial and more data is needed to investigate this possibility. In order to collect meaningful pregnancy and perinatal outcome data, we urge researchers and investigators to reference previously published cases in their publications and to record such reporting when the data of a case is being entered into a registry or several registries.

scholarly journals Adverse pregnancy outcomes in women with diabetes-related microvascular disease and risks of disease progression in pregnancy: A systematic review and meta-analysis

PLoS Medicine ◽  
2021 ◽  
Vol 18 (11) ◽  
pp. e1003856
Author(s):  
Sophie Relph ◽  
Trusha Patel ◽  
Louisa Delaney ◽  
Soha Sobhy ◽  
Shakila Thangaratinam
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
Microvascular Disease ◽  
Adverse Pregnancy ◽  
In Pregnancy

Background The rise in the global prevalence of diabetes, particularly among younger people, has led to an increase in the number of pregnant women with preexisting diabetes, many of whom have diabetes-related microvascular complications. We aimed to estimate the magnitude of the risks of adverse pregnancy outcomes or disease progression in this population. Methods and findings We undertook a systematic review and meta-analysis on maternal and perinatal complications in women with type 1 or 2 diabetic microvascular disease and the risk factors for worsening of microvascular disease in pregnancy using a prospective protocol (PROSPERO CRD42017076647). We searched major databases (January 1990 to July 2021) for relevant cohort studies. Study quality was assessed using the Newcastle–Ottawa Scale. We summarized the findings as odds ratios (ORs) with 95% confidence intervals (CIs) using random effects meta-analysis. We included 56 cohort studies involving 12,819 pregnant women with diabetes; 40 from Europe and 9 from North America. Pregnant women with diabetic nephropathy were at greater risk of preeclampsia (OR 10.76, CI 6.43 to 17.99, p < 0.001), early (<34 weeks) (OR 6.90, 95% CI 3.38 to 14.06, p < 0.001) and any preterm birth (OR 4.48, CI 3.40 to 5.92, p < 0.001), and cesarean section (OR 3.04, CI 1.24 to 7.47, p = 0.015); their babies were at increased risk of perinatal death (OR 2.26, CI 1.07 to 4.75, p = 0.032), congenital abnormality (OR 2.71, CI 1.58 to 4.66, p < 0.001), small for gestational age (OR 16.89, CI 7.07 to 40.37, p < 0.001), and admission to neonatal unit (OR 2.59, CI 1.72 to 3.90, p < 0.001) than those without nephropathy. Diabetic retinopathy was associated with any preterm birth (OR 1.67, CI 1.27 to 2.20, p < 0.001) and preeclampsia (OR 2.20, CI 1.57 to 3.10, p < 0.001) but not other complications. The risks of onset or worsening of retinopathy were increased in women who were nulliparous (OR 1.75, 95% CI 1.28 to 2.40, p < 0.001), smokers (OR 2.31, 95% CI 1.25 to 4.27, p = 0.008), with existing proliferative disease (OR 2.12, 95% CI 1.11 to 4.04, p = 0.022), and longer duration of diabetes (weighted mean difference: 4.51 years, 95% CI 2.26 to 6.76, p < 0.001) than those without the risk factors. The main limitations of this analysis are the heterogeneity of definition of retinopathy and nephropathy and the inclusion of women both with type 1 and type 2 diabetes. Conclusions In pregnant women with diabetes, presence of nephropathy and/or retinopathy appear to further increase the risks of maternal complications.

scholarly journals Impact of COVID-19 on the placental pathology of pregnant women and their infants: A systematic review protocol

2020 ◽  
Author(s):  
Irina Oltean ◽  
Dina El Demellawy
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Clinical Outcomes ◽  
Viral Infections ◽  
Case Reports ◽  
Case Series ◽  
Cell Mediated Immunity ◽  
Case Control Studies ◽  
Antibody Testing ◽  
Adverse Pregnancy

Pregnant women are susceptible to viral infections due to physiological changes such as cell-mediated immunity. No severe adverse pregnancy or neonatal outcomes have been consistently reported in COVID-19 positive pregnancy cases. There are controversies around the role of COVID-19 in pregnancy. A systematic review was conducted to examine clinical maternal and neonatal clinical outcomes. Studies were included if they reported COVID-19 infection among pregnant women and/or COVID-19 positive neonates as validated by positive antibody testing or viral testing using Polymerase Chain Reaction. Case series, case reports, case-control studies, and comparative studies were included. 837 records were identified, resulting in 525 records for level I screening. 41 were included after full-text review. Results suggest elevated rates of ICU admission, gestational diabetes, preeclampsia, C-sections, pre-term birth, and CRP in comparison to pregnant women without SARS-CoV-2. Careful monitoring of pregnancies with SARS-CoV-2 to minimize adverse clinical outcomes is recommended.

scholarly journals Treatment and pregnancy outcomes of pregnant women exposed to second-line anti-tuberculosis drugs in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Idah Mokhele ◽  
Nelly Jinga ◽  
Rebecca Berhanu ◽  
Thandi Dlamini ◽  
Lawrence Long ◽  
...  
Keyword(s):  
South Africa ◽  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Adverse Pregnancy Outcomes ◽  
Close Monitoring ◽  
Second Line ◽  
Tb Treatment ◽  
Adverse Pregnancy

Abstract Background Multi-drug resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) in pregnant women is a cause for concern globally; few data have described the safety of second-line anti-TB medications during pregnancy. We aim to describe TB treatment and pregnancy outcomes among pregnant women receiving second-line anti-tuberculosis treatment for MDR/RR-TB in Johannesburg, South Africa. Methods We conducted a retrospective record review of pregnant women (≥ 18 years) who received treatment for MDR/RR-TB between 01/2010–08/2016 at three outpatient treatment sites in Johannesburg, South Africa. Demographic, treatment and pregnancy outcome data were collected from available medical records. Preterm birth (< 37 weeks), and miscarriage were categorized as adverse pregnancy outcomes. Results Out of 720 women of child-bearing age who received MDR/RR-TB treatment at the three study sites, 35 (4.4%) pregnancies were identified. Overall, 68.7% (24/35) were HIV infected, 83.3% (20/24) were on antiretroviral therapy (ART). Most women, 88.6% (31/35), were pregnant at the time of MDR/RR-TB diagnosis and four women became pregnant during treatment. Pregnancy outcomes were available for 20/35 (57.1%) women, which included 15 live births (11 occurred prior to 37 weeks), 1 neonatal death, 1 miscarriage and 3 pregnancy terminations. Overall, 13/20 (65.0%) women with known pregnancy outcomes had an adverse pregnancy outcome. Of the 28 women with known TB treatment outcomes 17 (60.7%) completed treatment successfully (4 were cured and 13 completed treatment), 3 (10.7%) died and 8 (28.6%) were lost-to-follow-up. Conclusions Pregnant women with MDR/RR-TB suffer from high rates of adverse pregnancy outcomes and about 60% achieve a successful TB treatment outcome. These vulnerable patients require close monitoring and coordinated obstetric, HIV and TB care.

scholarly journals Association of Implementation of a Comprehensive Preconception-to-Pregnancy Management Plan With Pregnancy Outcomes Among Chinese Pregnant Women With Type 1 Diabetes: The CARNATION Study

2021 ◽  
Author(s):  
Xueying Zheng ◽  
Daizhi Yang ◽  
Sihui Luo ◽  
Jinhua Yan ◽  
Xiaohui Guo ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Pregnancy Outcomes ◽  
Prospective Cohort ◽  
Retrospective Cohort ◽  
Adverse Pregnancy Outcome ◽  
Management Plan ◽  
Comprehensive Management ◽  
Adverse Pregnancy

<b>Objective </b>To investigate the effect on pregnancy outcome of integrating a comprehensive management plan for type 1 diabetic (T1D) patients into the WHO universal maternal care infrastructure. <p><b> </b></p> <p><b>Research Design and Methods </b>A comprehensive preconception-to-pregnancy management plan for women with T1D was implemented in 11 centers from eight Chinese cities during 2015–2017. Sequential eligible pregnant women (n=133 out of 137 initially enrolled) with T1D and singleton pregnancies attending these management centers formed the prospective cohort. The main outcome was severe adverse pregnancy outcome comprising maternal mortality, neonatal death, congenital malformation(s), miscarriage in the second trimester and stillbirth. We compared pregnancy outcomes in this prospective cohort with two control groups with the same inclusion and exclusion criteria: a retrospective cohort (n=153) of all eligible pregnant women with T1D attending the same management centers during 2012–2014 and a comparison cohort (n=116) of all eligible pregnant women with T1D receiving routine care during 2015–2017 in 11 different centers from seven cities. </p> <p><b> </b></p> <p><b>Results </b>The rate of severe adverse pregnancy outcome was lower in the prospective cohort (6.02%) than in either the retrospective cohort (18.30%, adjusted odds ratio[aOR]=0.31, 95% CI 0.13–0.74) or the contemporaneous comparison cohort (25.00%, aOR=0.22, 95% CI 0.09–0.52).</p> <p><b> </b></p> <p><b>Conclusion </b>The substantial improvements in the prospective cohort are evidence of a potentially clinically important effect of the comprehensive management plan on pregnancy outcomes among Chinese pregnant women with pregestational T1D. This supports the development of similar approaches in other countries.</p>

scholarly journals Impact of coronavirus disease 2019 on the clinical outcomes and placental pathology of pregnant women and their infants: A Systematic Review

2020 ◽  
Author(s):  
Irina Oltean ◽  
Jason Tran ◽  
Sarah Lawrence ◽  
Brittany Ann Ruschkowski ◽  
Na Zeng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Clinical Outcomes ◽  
Viral Infections ◽  
Case Reports ◽  
Case Series ◽  
Cell Mediated Immunity ◽  
Case Control Studies ◽  
Antibody Testing ◽  
Adverse Pregnancy

Pregnant women are susceptible to viral infections due to physiological changes such as cell-mediated immunity. No severe adverse pregnancy or neonatal outcomes have been consistently reported in COVID-19 positive pregnancy cases. There are controversies around the role of COVID-19 in pregnancy. A systematic review was conducted to examine clinical maternal and neonatal clinical outcomes. Studies were included if they reported COVID-19 infection among pregnant women and/or COVID-19 positive neonates as validated by positive antibody testing or viral testing using Polymerase Chain Reaction. Case series, case reports, case-control studies, and comparative studies were included. 837 records were identified, resulting in 525 records for level I screening. 41 were included after full-text review. Results suggest elevated rates of ICU admission, gestational diabetes, preeclampsia, C-sections, pre-term birth, and CRP in comparison to pregnant women without SARS-CoV-2. Careful monitoring of pregnancies with SARS-CoV-2 to minimize adverse clinical outcomes is recommended.

Mobile phone application use in pregnant women: does it make a difference? Usage and perinatal outcomes in China (Preprint)

2021 ◽  
Author(s):  
Puhong Zhang ◽  
Huan Chen ◽  
Jie Shang ◽  
Jun Ge ◽  
Huichen Zhang ◽  
...  
Keyword(s):  
Child Health ◽  
Pregnant Women ◽  
Maternal And Child Health ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Perinatal Outcomes ◽  
Northern China ◽  
Mobile Phone Application ◽  
Adverse Pregnancy ◽  
And Child Health

BACKGROUND Maternal and child health (MCH) related mobile applications (apps) are becoming increasingly popular amongst pregnant women, however, few have demonstrated they lead to improvements in pregnancy outcomes. OBJECTIVE This study aimed to investigate the use of MCH apps amongst pregnant women and explore associations with pregnancy outcomes in China. METHODS A retrospective study was conducted in six maternal and child health hospitals in Northern China. Women who delivered a singleton baby greater than 28 weeks gestation in the study hospitals were sequentially recruited from postnatal wards during October 2017 to January 2018. Information was collected on self-reported MCH app use during their pregnancy, with clinical outcomes. Women were categorized as non-users of MCH apps, and users (further divided into intermittent users and continuous users). The primary outcome was a composite adverse pregnancy outcome (CAPO) comprising preterm birth, birth weight <2500 grams, birth defects, stillbirth and neonatal asphyxia. The association between app use and CAPO was explored using multivariable logistic analysis. RESULTS The 1850 participants reported using 127 different MCH apps during pregnancy. App use frequency was reported as never, 457 (24.7%); intermittent 876 (47.4%); and continuous 517 (27.9%). Amongst app users, the most common reasons for app use were for health education (100.0%), self-monitoring (54.2%) and antenatal appointment reminders (43.2%). Non-users were older, with fewer years of education, lower incomes, and higher parity (P<0.01). No association was found between “any app” use and the CAPO (6.8% in non-users compared to 6.3% in any users, OR 0.77, 95% CI: 0.48-1.25). CONCLUSIONS Women in China access a large number of different MCH apps, with social disparities in access and frequency of use. “Any app” use was not found associated with improved pregnancy outcomes, highlighting the needs for rigorous development and testing of apps before recommendation for use in clinical settings.

scholarly journals Periodontal infection and adverse pregnancy outcomes: a systematic review of epidemiological studies

2006 ◽  
Vol 22 (10) ◽  
pp. 2041-2053 ◽  
Author(s):  
Mario Vianna Vettore ◽  
Gabriela de Almeida Lamarca ◽  
Anna Thereza Thomé Leão ◽  
Filipe Brand Thomaz ◽  
Aubrey Sheiham ◽  
...  
Keyword(s):  
Systematic Review ◽  
Periodontal Disease ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Epidemiological Studies ◽  
Adverse Pregnancy Outcomes ◽  
Bibliographic Databases ◽  
Analytical Studies ◽  
Periodontal Infection ◽  
Adverse Pregnancy

The objective of this systematic review was to evaluate analytical studies on periodontal disease as a possible risk factor for adverse pregnancy outcomes. A literature search of the MEDLINE, SciELO, and LILACS bibliographic databases and CAPES thesis database was conducted up to December 2005, covering epidemiological studies of periodontal disease and adverse pregnancy outcomes. Of the 964 papers identified, 36 analytical studies met the inclusion criteria. Twenty-six epidemiological studies reported associations between periodontal disease and adverse pregnancy outcomes. There was a clear heterogeneity between studies concerning measurement of periodontal disease and selection of type of adverse pregnancy outcome. Therefore no meta-analysis was performed. Most studies did not control for confounders, thus raising serious doubts about their conclusions. The methodological limitations of most studies did not allow conclusions concerning the effects of periodontal disease on adverse pregnancy outcomes. Larger and methodologically rigorous analytical studies using reliable outcomes and exposure measures are recommended.

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