The COVID-19 pandemic impacted maternal mental health differently depending on pregnancy status and trimester of gestation

Introduction: We aimed to measure the impact of the COVID-19 pandemic on maternal mental health, stratifying on pregnancy status, trimester of gestation, and pandemic period/wave.Methods: Pregnant persons and persons who delivered in Canada during the pandemic, >18 years, were recruited, and data were collected using a web-based strategy. The current analysis includes data on persons enrolled between 06/2020-08/2021. Maternal sociodemographic indicators, mental health measures (Edinburgh Perinatal Depression Scale (EPDS), Generalized Anxiety Disorders (GAD-7), stress) were self-reported. Maternal mental health in pregnant women (stratified by trimester, and pandemic period/wave at recruitment) was compared with mental health of women who had delivered; determinants of severe depression were identified with multivariate logistic regression models.Results: 2,574 persons were pregnant and 626 had already delivered at recruitment. Participants who had delivered had significantly higher mean depressive symptom scores compared to those pregnant at recruitment (9.1 (SD, 5.7) vs. 8.4 (SD, 5.3), p=0.009). Among those who were pregnant at recruitment, depressive symptoms were significantly higher in women recruited in their third trimester, and those recruited during the 2nd wave of the pandemic. Maternal anxiety (aOR 1.51; 95%CI 1.44-1.59) and stress (aOR 1.35; 95%CI 1.24-1.48) were the most significant predictors of severe maternal depression (EDPS˃13) in pregnancy. Conclusion: The COVID-19 pandemic had a significant impact on maternal depression during pregnancy and in the post-partum period. Given that gestational depression/anxiety/stress have been associated with preterm birth and childhood cognitive problems, it is essential to continue following women/children, and develop strategies to reduce COVID-19’s longer-term impact.

The Effect of China’s Two-Child Policy on the Child Sex Ratio: Evidence From Shanghai, China

Objective: The bias towards males at birth has resulted in a major imbalance in the Chinese sex ratio that is often attributed to China’s one-child policy. Relaxation of the one-child policy has the potential to reduce the imbalance in the sex ratio away from males. In this study, we assessed whether the bias towards males in the child sex ratio was reduced as a result of the two-child policy in China. Medical records data from one large municipal-level obstetrics hospital in Shanghai, East China. Design: Matching and difference-in-differences (MDID) techniques were used to investigate the effect of the two-child policy on the imbalance in the sex ratio at birth after matching for pregnancy status and socioeconomic factors. Results: Analyzing 133,358 live births suggest that the relaxation of the one-child policy had a small, but statistically significant effect in reducing the imbalance in the male to female sex ratio at birth. Conclusion: The results demonstrate that relaxation of the one-child policy reduced the imbalance in the male to female sex ratio at birth from 1.10 to 1.05 over the study period at one of the major obstetrics and gynecology hospitals in China.

Factors Affecting Hematologic and Serum Biochemical Parameters in Healthy Common Marmosets (Callithrix jacchus)

Physiologic changes during development, aging, and pregnancy may affect clinical parameters. Previously available reference values have been based on samples that may include wild and captive marmosets, with little representation of geriatricor pregnant animals. Establishing reference values under various conditions would support better recognition of pathologic conditions in marmosets. One hundred and forty-seven (70 males and 77 females) healthy marmosets from a research colony were included in this study. Exclusion criteria were abnormal physical exam findings at the time of blood sampling, chronicmedications, or clinical or pathologic evidence of disease. Reference intervals were calculated for serum chemistry andhematology. Using metadata, samples were classified based on age, sex, colony source and pregnancy status. Multiple testsindicated significant differences with varying effect sizes, indicating that developing reference intervals based on metadatacan be useful. Across all the comparisons, medium or large effect sizes were observed most frequently in blood urea nitrogen (BUN), calcium, total protein, alkaline phosphatase (ALP), weight and serum albumin. We report normative clinical pathologic data for captive common marmosets through all life stages and reproductive status. Significant differences were observed in most parameters when stratifying data based on age, sex, colony source, or pregnancy, suggesting that developing reference intervals considering this information is important for clinicians.

Tubal reanastomosis results of our clinic: A tertiary center experience

Objective: In our study, it was aimed to determine the clinical results of 42 patients who underwent tubal reanastomosis for various reasons. Materials and Methods: Our study included 42 patients at fertile age who presented to our clinic for tubal reanastomosis between 2017 and 2019. Demographic information and surgery notes of the patients were accessed through the hospital files and hospital archive system. For retrospective screening, patients were contacted by phone and their pregnancy status was learned. Results: Of the patients, 47.6% (n=20) were operated on due to a wish for fertility, 53.4% (n=22) because of other reasons. The mean age of the patients was 36.2 and the mean number of children of the patients was 4.85. Laparotomy was performed in 23.8% (n=10) of the patients, and laparoscopic surgery in 76.2% (n=32). Our intrauterine pregnancy rate after tubal reanastomosis was calculated as 9.5%. Conclusion: Tubal reanastomosis can be performed by both laparoscopic and mini-laparotomy methods. We recommend performing bilateral reanastomosis if possible. We think that it would be appropriate to prioritize laparoscopic surgery because it is minimally invasive and provides high pregnancy success.

Improvement of beef cattle cow’s pregnancy rate using an effective dose of Galectin-1

Galectins are cited in the literature as multifunctional molecules that participate in several biological processes such as adhesion, proliferation and cell cycle, apoptosis, RNA processing, control of the inflammatory processes, and physiological mechanisms of reproduction. Galectin-1 has been cited as a mediator involved in preventing early embryonic death in mammals. Exogenous GAL-1 (eGAL-1) can be found, present in Tolerana®. The goal of this study was to evaluate whether eGAL-1 can improve the pregnancy rate after a complementary AI procedure. The pregnancy rate was analyzed by determining the pregnancy status by ultrasound, 25 to 35 days after Timed Artificial Insemination (TAI) of dams (n=3,469 beef cows). The effectiveness of GAL-1 was evaluated by comparing the pregnancy rate of two groups (Treatment and Control Groups) in 107 contemporaries’ groups (YG) established by the statistical model formed. Based on this, the single dose of eGAL-1 and correct administration can increase the probability of obtaining the pregnancy rate in beef cattle up to 8.68% (p < 0.0001). The recommendation to use a dose of eGAL1 during a TAI procedure was reasonable in beef cattle routine. In average, the whole procedure, using eGAL-1, spent 10 ± 5 seconds more time than the conventional procedure.

A mixed-methods study exploring women’s perceptions of terminology surrounding fertility and menstrual regulation in Côte d’Ivoire and Nigeria

Background Women use various terms when discussing the management of their fertility and menstrual irregularities and may interpret the experience of ending a possible pregnancy in nuanced ways, especially when their pregnancy status is ambiguous. Our study aims to understand the terminology used to refer to abortion-like experiences (specifically menstrual regulation and pregnancy removal), and the specific scenarios that these practices encompass among women who reported doing something to bring back a late period or ending a pregnancy in Nigeria and Côte d’Ivoire. Methods Our analysis draws upon surveys with women in Nigeria (n = 1114) and Cote d’Ivoire (n = 352). We also draw upon qualitative in-depth interviews with a subset of survey respondents in Anambra and Kaduna States in Nigeria, and Abidjan, Cote d’Ivoire (n = 30 in both countries). We examine survey and interview questions that explored women’s knowledge of terminology pertaining to ending a pregnancy or bringing back a late period. Survey data were analyzed descriptively and weighted, and interview data were analyzed using inductive thematic analysis. Results We find that the majority (71% in Nigeria and 70% in Côte d’Ivoire) of women perceive menstrual regulation to be a distinct concept from pregnancy removal, yet there is considerable variability in whether specific scenarios are interpreted as referring to menstrual regulation or pregnancy removal. Menstrual regulation is generally considered to be more ambiguous and not dependent on pregnancy confirmation in comparison to pregnancy removal, which is consistently interpreted as voluntary termination of pregnancy. Conclusions Overall, menstrual regulation and pregnancy removal are seen as distinct experiences in both settings. These findings have relevance for researchers aiming to document abortion incidence and experiences, and practitioners seeking to address women’s reproductive health needs.

Prevalence and determinants of induced abortion among reproductive-aged women in Aykel town North West, Ethiopia: A community-based cross-sectional study

Objective: This study aimed to assess the prevalence and determinants of induced abortion among women of the reproductive age group in Aykel town North West, Ethiopia. Method: Community based cross-sectional study was employed in Aykel town North West Ethiopia, from August to September 2018. A systematic random sampling technique was used to recruit a total of 422 reproductive-aged women during the study period. Binary logistic regression model fitted to identify factors associated with induced abortion. Adjusted odds ratio with 95%CI used to explore the strength of association between outcome and independent variables. Result: The prevalence of induced abortion was 14.5% with 95% CI (11.2 to 18.17). Age group of 15-24 years [AOR=3.10, 95%CI (1.116-8.543)], pregnancy status unwanted [AOR=3.1; 95%CI (1.292-7.322], not ever used contraceptive [AOR = 3.96; 95%CI (1.612-9.709)], parity [AOR= 0.37, 95%CI (0.164-0.823)], knowing induce abortion complication [AOR=2.24, 95%CI (1.104-4.551],partner primary educational level [AOR = 3.68, 95%CI (1.082-12.528)] were determinants of induced abortion among reproductive age women. Conclusions: This study revealed that the magnitude of induced abortion was high. Younger age, pregnancy status unwanted, had not ever used contraceptive, knowing induced abortion complication, and partner education level was positively associated with induced abortion. In contrast, parity negatively associated with induced abortion. Therefore, induce abortion intervention like contraception provisions need to focus young age group.

COVID-19 Severity among Women of Reproductive Age with Symptomatic Laboratory-Confirmed SARS-CoV-2 by Pregnancy Status – United States, Jan 1, 2020 – Sep 30, 2021

Importance: Pregnant people are at increased risk for severe COVID-19 compared with nonpregnant people. Limited information is available on the severity of COVID-19 attributable to the Delta variant, the predominant variant in the United States as of late June 2021, among pregnant persons.Objective: To assess risk for severe COVID-19 by pregnancy status and time period relative to Delta variant predominance. Design: Using a cross-sectional design, we describe characteristics of symptomatic women of reproductive age (WRA) with COVID-19 and calculate adjusted risk ratios for severe disease comparing pregnant with nonpregnant WRA during the pre-Delta period (January 1, 2020 – June 26, 2021) and the Delta period (June 27, 2021 – September 30, 2021). Additionally, we calculate adjusted risk ratios for severe disease comparing the Delta period with the pre-Delta period for pregnant and nonpregnant WRA.Setting: Reports of COVID-19 in the United States occurring from January 1, 2020 ─ September 30, 2021, submitted to the CDC.Participants: Pregnant and nonpregnant women aged 15-44 years.Exposure(s): Laboratory-confirmed, symptomatic SARS-CoV-2 infection.Main Outcome(s): Severe disease: (intensive care unit [ICU] admission, receipt of invasive ventilation or extracorporeal membrane oxygenation [ECMO], and death).Results: Among 1,856,428 cases of symptomatic COVID-19 in WRA, the risk for severe disease was increased among pregnant compared with nonpregnant WRA during the pre-Delta and Delta periods. Compared with the pre-Delta period, the risk of ICU admission during the Delta period was 66% higher (adjusted risk ratio [aRR] 1.66, 95% CI: 1.34-2.06) for pregnant WRA and 23% higher (aRR 1.23, 95% CI: 1.12-1.35) for nonpregnant WRA. The risk of invasive ventilation or ECMO was higher for pregnant and nonpregnant WRA in the Delta period. During the Delta period, the risk of death was 3.40 (95% CI: 2.36-4.91) times the risk in the pre-Delta period among pregnant WRA and 1.96 (95% CI: 1.75-2.18) among nonpregnant WRA. Conclusions and Relevance: The overall risk for severe COVID-19 among WRA remains low; however, symptomatic pregnant WRA remain at increased risk for severe outcomes compared with symptomatic nonpregnant WRA during Delta variant predominance. Compared with the pre-Delta period, pregnant and nonpregnant WRA are at increased risk for severe COVID-19 in the Delta period.