COVID-19 Vaccine Acceptance and Hesitancy among Pregnant Women: A Knowledge, Attitude, and Perceived Risks Survey in Lusaka, Zambia

Introduction: The coronavirus disease 2019 (COVID-19) is an infectious disease of the respiratory tract caused by SARS-CoV-2. Since its emergence, there have been increased rates of transmission and spread, morbidity and mortality which led to the development of COVID-19 vaccines to address the pandemic. This study assessed acceptance, knowledge, attitude, and perceived risks regarding COVID-19 vaccines among pregnant women attending antenatal care at two First-Level Hospitals in Lusaka, Zambia. Materials and Methods: This was a cross-sectional study that was conducted among 241 pregnant women using a questionnaire from August 2023 to October 2023 in two First-Level Hospitals in Lusaka district, Zambia. The collected data were analyzed using IBM Statistical Package for Social Sciences (SPSS) version 22.0. Statistical analysis was performed using a Chi-square test. The statistical significance was set at a 95% confidence level. Results: Of the 241 participants, 107 (42.7%) were aged between 24 and 34 years. Overall, 64.3% accepted the COVID-19 vaccines, of which 122 (50.6%) were already vaccinated. Further, 203 (84.6%) of the pregnant women had good knowledge, and 199 (82.6%) had positive attitudes towards COVID-19 vaccines. However, 58.5% thought COVID-19 vaccines were not safe and could cause infertility. Alongside this, 70.1% thought that COVID-19 vaccines were harmful during pregnancy. Having good knowledge of COVID-19 vaccines was associated with age (p = 0.049), education status (p = 0.001), and employment status (p = 0.001). Having a positive attitude towards COVID-19 vaccines was associated with education status (p = 0.001) and employment status (p = 0.001). Conclusion: This study found that most pregnant women had good knowledge, and positive attitudes, and the majority accepted the COVID-19 vaccine. Encouragingly, most of the pregnant women who accepted the COVID-19 vaccines were already vaccinated. Most pregnant women thought that COVID-19 vaccines had side effects, were not safe, and could be harmful during pregnancy. Consequently, this could have contributed to the hesitancy to receive a vaccine among some participants. The findings of this study demonstrate the need to provide pregnant women with continuous educational programs on the benefits of vaccinations for themselves and their children.

Socio-Demographic and Economic Factors Associated with Uptake of COVID-19 Vaccine among Pregnant Women at Pumwani Maternity Hospital in Nairobi County, Kenya

Introduction: Pregnant women are a highly vulnerable population for COVID-19 with increased risk of hospitalization, intensive-care unit admission, invasive ventilation support, and mortality. Objective: This study determined the socio-demographic and economic factors associated with the uptake of COVID-19 vaccine among pregnant women utilizing antenatal care services in Pumwani Maternity Hospital, Nairobi County-Kenya. Methods: The study was carried out from 15 June to 23 July 2023. Systematic sampling was used to select 302 women from whom data was collected through face-to-face interviews using a pre-tested semi-structured questionnaire. Data was analyzed using SPSS software in which bivariate and multivariate logistic regression analyses were done at a significance level of p Results: A total of 302 pregnant women participated in the study. Of these, 105 (34.8%) were aged between twenty-six (26) and thirty (30) years. The mean age of the women was 28.60 ± (SD = 5.297). The uptake of the COVID-19 vaccine was 41.1%. The common side effects reported to be associated with the vaccines were fever, headache, joint pain, vomiting and skin rash. Uptake of the COVID-19 vaccine was significantly associated with being married (AOR = 3.65, 95% CI: 0.62 - 1.80, p = 0.001), having a secondary level of education (AOR = 3.78, 95% CI: 0.99 - 2.88, p = 0.001) and being employed (COR = 2.66, 95% CI: 1.31 - 3.06, p = 0.001). Conclusion: COVID-19 vaccination uptake remains low among pregnant women in seeking ANC in Nairobi. The individual factors associated with the uptake of COVID-19 vaccine among pregnant Women at Pumwani maternity hospital in Nairobi County were being married, having secondary level of education and being employed. Integration of the COVID-19 vaccine with other routine vaccinations as per the national immunization program in Kenya and the enhancement of education regarding the safety and efficacy of the COVID-19 vaccine in pregnancy and breastfeeding and economic empowerment of women are recommended.

Effects of personalized oral hygiene management on oral health status of pregnant women

BACKGROUND The Cariostat caries activity test(CAT)was used to evaluate the effectiveness of personalized oral hygiene management combining oral health education and professional mechanical tooth cleaning on the oral health status of pregnant women.AIM To investigate whether personalized oral hygiene management enhances the oral health status of pregnant women.METHODS A total of 114 pregnant women who were examined at Dalian Women’s and Children’s Medical Center were divided into four groups:High-risk experimental group(n=29;CAT score≥2;received personalized oral hygiene management training),low-risk experimental group(n=29;CAT score≤1;received oral health education),high-risk control group(n=28;CAT score≥2),and low-risk control group(n=28;CAT score≤1).No hygiene intervention was provided to control groups.CAT scores at different times were compared using independent samples t-test and least significant difference t-test.RESULTS No significant difference in baseline CAT scores was observed between the experimental and control groups,either in the high-risk or low-risk groups.CAT scores were reduced significantly after 3(1.74±0.47 vs 2.50±0.38,P<0.0001)and 6 months(0.53±0.50 vs 2.45±0.42,P<0.0001)of personalized oral hygiene management intervention but not after oral health education alone(0.43±0.39 vs 0.46±0.33,P>0.05 and 0.45±0.36 vs 0.57±0.32,P>0.05,respectively).Within groups,the decrease in CAT scores was significant(2.43±0.44 vs 1.74±0.47 vs 0.53±0.50,P<0.0001)for only the high-risk experimental group.CONCLUSION Personalized oral hygiene management is effective in improving the oral health of pregnant women and can improve pregnancy outcomes and the oral health of the general population.

Effectiveness of Prophylactic Transvaginal Cervical Cerclage in Improving Clinical Outcomes among Pregnant Women with Cervical Insufficiency: Meta-Analysis

Background: Cervical insufficiency is one of the major causes of preterm birth among pregnant women that leads to severe mortality and morbidity issues among newborns. Prophylactic cervical cerclage is a surgical procedure performed between 11 and 14 weeks of gestation upon diagnosis of cervix insufficiency among pregnant women. Aims & Objectives: In this study, we aimed to evaluate the effectiveness of prophylactic cervical cerclage in comparison to other interventions to treat cervical insufficiency among pregnant women using a meta-analysis approach. Methods: We searched the three databases (Coachrane Library, PubMed, and MEDLINE) that were used for articles related to research aims by using MeSH keywords. The timeline of research was set from January 2015 to January 2024. The methodological quality assessment of included studies was performed by the Risk of Bias in Non-randomized Studies—of Interventions (ROBINS-I). A recent meta-analysis was conducted by using Review Manager 5.4.0 software. Results: About 441 research articles were extracted from three electronic databases and only 125 articles were assessed for eligibility criteria. Finally, 8 studies were included in the analysis for a recent meta-analysis. Six out of eight included retrospective or pilot studies were graded as having a moderate risk of bias, and two studies had low risk on the basis of owning bias. About 1008 pregnant women with cervical insufficiency were analyzed in a recent meta-analysis. By pooled analysis, it was evaluated that significant difference found in prolongation of delivery weeks (Mean difference = 1.05;Cl: 0.81 to 1.29: p > 0.00001), number of deliveries > 37 weeks (OR = 0.59;Cl: 0.19 to 1.84: p > 0.006), and preterm birth (OR = 0.73;Cl: 0.42 to 1.28: p > 0.50) among pregnant women receiving prophylactic cervical cerclage as compared to other treatment strategies. Conclusion: Recent meta-analysis suggested the prophylactic cervical cerclage reduces the rates of preterm birth, abortion rates, number of deliveries > 37 weeks, and other complications as compared to the other cervical cerclage types and conservative treatments.

A causal model of eating behaviors among Thai pregnant women working in industrial factories

Objective:This study aimed to examine the causal model of eating behaviors among pregnant women working in industrial factories.Methods:This cross-sectional study was conducted on 210 participants,attending 4 healthcare centers,at a tertiary care hospital in Chonburi province,Thailand.Data were collected using 7 questionnaires:demographic form,eating behavior questionnaire,perceived benefits of the healthy eating questionnaire,perceived barriers to the healthy eating questionnaire,perceived self-efficacy questionnaire,social support questionnaire,and accessibility to healthy foods questionnaire.Descriptive statistics and path analysis were used for data analysis.Results:The participants had relatively high mean scores for eating behaviors.The final model fitted well with the dataχ^(2)=12.86,df=10,P=0.23;χ^(2)/df=1.29;comparative fit index(CFI)=0.98;goodness-of-fit index(GFI)=0.98;adjusted goodness-of-fit index(AGFI)=0.95;root mean square error of approximation(RMSEA)=0.04.Four factors-perceived benefits(β=0.13,P<0.05),perceived self-efficacy in healthy eating(β=0.22,P<0.001),pregnancy planning(β=0.28,P<0.001),and accessibility to healthy foods in the factory(β=0.12,P<0.05)-positively affected eating behavior,while only perceived barriers to healthy eating had a negative effect on eating behavior(β=−0.24,P<0.001).All the above factors explained 27.2%of the variance in eating behaviors.Conclusions:Nurses or healthcare providers can apply these findings to create an eating behavior modification program,focusing on pregnancy planning,behavior-specific variables,and interpersonal and situational influence,to promote the nutritional status of pregnant women working in industrial factories.

Analysis of Cardiac Functional Status and Factors Influencing Adverse Pregnancy Outcomes in Pregnant Women with Combined Heart Disease

Objective:To investigate the cardiac function of pregnant women with complicated heart disease during pregnancy and the factors influencing the adverse pregnancy outcome.Methods:A total of 162 cases of pregnant women with complicated heart disease admitted to the Beijing Anzhen Hospital from October 2021 to December 2023 were selected to compare the occurrence of adverse pregnancy outcomes in pregnant women with complicated heart disease at different levels of cardiac function and to analyze the single and multi factors leading to adverse pregnancy outcomes in pregnant women with complicated heart disease.Results:Among 162 pregnant women with combined heart disease in pregnancy,the highest percentage of heart disease type was congenital heart disease(80/49.38%),and the lowest percentage was other(9/5.56%);the overall incidence of adverse pregnancy outcomes in pregnant women with combined heart disease in pregnancy with cardiac function grades of 3–4 cardiac function(30/68.18%)was higher than that in pregnant women with combined heart disease in cardiac function grades of 1–2(40/33.90%)(P=0.000);age,marital status,hypertension,and past history of all pregnant women were not statistically significant(P>0.05);gestational age,type of heart disease,and cardiac function grading were statistically significant(P<0.05),and these factors were all independent risk factors for adverse pregnancy resolution in pregnant women with combined heart disease(P<0.05).Conclusion:The overall incidence of adverse pregnancy outcomes was higher in pregnant women with heart disease than in those with heart disease grades 1–2,and the number of pregnancies,the type of heart disease,and heart function grades were all independent risk factors for adverse pregnancy outcomes in pregnant women with heart disease.

Blood Lead Dynamics of Lead-Exposed Pregnant Women and Its Effects on Fetus Development

The dynamics of blood lead (Pb-B) and blood zinc protoporphyrin (ZPP-B) of women in early pregnancy and parturient women with lead exposure and the effects on fetus development were investigated. Pb-B of lead-exposed women was high: 0.984 μmol/L (20.38 μg/dl) and ZPP was 84.52μg/dl. Cord blood Pb-B was 0.896 μmol/L(18.56μg/dl)and cord blood ZPP was 69.24μg/dl. In the control group, Pb-B was 0.261μmol/L(5.41μg/dl), ZPP-B, 37.59 μg/dl, cord blood, Pb-B 0.34 μmol/L (7.93 μg/dl), and cord ZPP-B 49.0μg/dl. There was a significant correlation between blood lead and blood ZPP, maternal Pb-B and cord Pb-B, maternal Pb-B and cord ZPP-B. The significance of the consistency of high level Pb-B and the effects on fetus development is discussed.

Genetic association of rs7754840 and rs7756992 polymorphisms in the CDKAL1 gene and gestational diabetes mellitus in selected Filipino pregnant women

Objective:To investigate the possible association between rs7754840 and rs7756992 polymorphisms of CDKAL1 gene and susceptibility to gestational diabetes mellitus(GDM)in a Filipino pregnant population.Methods:A total of 101 patients with GDM and 99 women without GDM were included.Two CDKAL1 gene single nucleotide polymorphisms(SNPs),namely rs7754840 and rs7756992,were genotyped by using TaqMan allelic discrimination assays.Mann-Whitney U test,median and interquartile range were used to describe physical and biochemical characteristics.The differences in the genotype and allele distribution of the target genetic variants among the two groups of participants were assessed by using Chi-square test.Conformity to Hardy-Weinberg equilibrium was tested prior to conducting further analysis.Multiple logistic regression model was used to investigate the effects of the genotype models on GDM development.Results:There was no observed correlation between the genotypes of the rs7754840 SNP and oral glucose tolerance test parameters.Consequently,there was no significant association between genetic models of the rs7754840 SNP and GDM risk(additive OR 1.43,95%CI 0.82-2.50,P=0.21;dominant OR 1.21,95%CI 0.57-2.59,P=0.62;recessive OR 1.63,95%CI 0.86-3.09,P=0.13).Conclusions:The results of this study suggest no association between CDKAL1 gene variant rs7754840 and GDM development in Filipino pregnant women.Further studies with a larger population should be performed to validate our findings.

Analysis of influencing factors and the construction of predictive models for postpartum depression in older pregnant women

BACKGROUND Changes in China's fertility policy have led to a significant increase in older pregnant women.At present,there is a lack of analysis of influencing factors and research on predictive models for postpartum depression(PPD)in older pregnant women.AIM To analysis the influencing factors and the construction of predictive models for PPD in older pregnant women.METHODS By adopting a cross-sectional survey research design,239 older pregnant women(≥35 years old)who underwent obstetric examinations and gave birth at Suzhou Ninth People's Hospital from February 2022 to July 2023 were selected as the research subjects.When postpartum women of advanced maternal age came to the hospital for follow-up 42 d after birth,the Edinburgh PPD Scale(EPDS)was used to assess the presence of PPD symptoms.The women were divided into a PPD group and a no-PPD group.Two sets of data were collected for analysis,and a prediction model was constructed.The performance of the predictive model was evaluated using receiver operating characteristic(ROC)analysis and the Hosmer-Lemeshow goodness-of-fit test.RESULTS On the 42nd day after delivery,51 of 239 older pregnant women were evaluated with the EPDS scale and found to have depressive symptoms.The incidence rate was 21.34%(51/239).There were statistically significant differences between the PPD group and the no-PPD group in terms of education level(P=0.004),family relationships(P=0.001),pregnancy complications(P=0.019),and mother–infant separation after birth(P=0.002).Multivariate logistic regression analysis showed that a high school education and below,poor family relationships,pregnancy complications,and the separation of the mother and baby after birth were influencing factors for PPD in older pregnant women(P<0.05).Based on the influencing factors,the following model equation was developed:Logit(P)=0.729×education level+0.942×family relationship+1.137×pregnancy complications+1.285×separation of the mother and infant after birth-6.671.The area under the ROC curve of this prediction model was 0.873(95%CI:0.821-0.924),the sensitivity was 0.871,and the specificity was 0.815.The deviation between the value predicted by the model and the actual value through the Hosmer-Lemeshow goodness-of-fit test was not statistically significant(χ^(2)=2.749,P=0.638),indicating that the model did not show an overfitting phenomenon.CONCLUSION The risk of PPD among older pregnant women is influenced by educational level,family relationships,pregnancy complications,and the separation of the mother and baby after birth.A prediction model based on these factors can effectively predict the risk of PPD in older pregnant women.

Association between plasma dipeptidyl peptidase-4 levels and cognitive function in perinatal pregnant women with gestational diabetes mellitus

BACKGROUND Dipeptidyl peptidase-4(DPP4)is associated with cognitive dysfunction in patients with type 2 diabetes.AIM To assess a possible relationship between serum DPP4 and cognitive function in perinatal pregnant women with gestational diabetes mellitus(GDM).METHODS The study subjects were divided into three groups:GDM group(n=81),healthy pregnant(HP)group(n=85),and control group(n=51).The Montreal Cognitive Assessment(MoCA)was used to assess the cognitive status of each group.Venous blood samples were collected to measure blood lipids,glycated hemoglobin,and glucose levels.For each participant,a 3-mL blood sample was collected and centrifuged,and the serum was collected.Blood samples were stored at-80℃,and DPP4,interleukin-6(IL-6),and 8-iso-prostaglandin F2α(8-iso-PGF2α),and brain-derived neurotrophic factor(BDNF)were detected using ELISA.RESULTS The MoCA scores in the GDM and HP groups were significantly different from those in the control group in terms of visuospatial/executive function and attention(P<0.05);however,the scores were not significantly different between the GDM and HP groups(P>0.05).In terms of language,the GDM group had significantly different scores from those in the other two groups(P<0.05).In terms of memory,a significant difference was found between the HP and control groups(P<0.05),as well as between the GDM and HP groups.The levels of DPP4,IL-6,and 8-iso-PGF2αin the GDM group were significantly higher than those in the HP and control groups(P<0.05);however,the differences between these levels in the HP and control groups were not significant(P>0.05).The level of BDNF in the GDM group was significantly lower than that in the HP and control groups(P<0.05),although the difference in this level between the HP and control groups was not significant(P>0.05).CONCLUSION Cognitive dysfunction in perinatal pregnant women with GDM mainly manifested as memory loss,which might be associated with elevated DPP4 levels.

Accuracy of Trans-Cerebellar Diameter and Placental Thickness in Third Trimesteric Pregnant Women for Calculation of Gestational Age: A Cross Sectional Study

Background: Accurate determination of gestational age has become important for deciding the appropriate time for termination of the pregnancy as well as to monitor the fetal growth during the entire period of pregnancy. Objective: The aim of the study was to assess whether the trans-cerebellar diameter, placental thickness or combining both of them is more accurate for assessment of gestational age in the 3rd trimester of pregnancy. Patients and Methods: This is a cross sectional study conducted at outpatient Clinic and Obstetric ward, Ain Shams University Maternity Hospital, over a period of six months from March 2019 to September 2019. One hundred pregnant women were recruited according to inclusion criteria either from outpatient clinic or were admitted in obstetric ward Ain Shams Maternity Hospital to find out the most accurate fetal biometric measurement in the third trimester either trans-cerebellar diameter placental thickness or both compared to reliable LMP (last menstrual period) dates confirmed by crown rump length (CRL) in the first trimester. Results: Trans-cerebellar diameter mean ± SD was 46.0 ± 3.5 with range 38.2 - 51.7. The mean of placental thickness was 39.6 ± 7.1 with range 22.8 - 54.3. Placental thickness had highest determination (0.813) for last menstrual period followed by trans-cerebellar diameter (0.802). Combining trans-cerebellar diameter and placental thickness increased determination (0.902) for last menstrual period. Conclusion: Combined use of trans-cerebellar diameter and placental thickness in the third trimester of pregnancy is a reliable indicator for gestational age in women whose last menstrual period is unreliable or unknown, but placental thickness had higher accuracy than trans-cerebellar diameter.

Using an Alternative Method to Estimate the Status of Iodine Nutrition in Pregnant Women

Iodine is an element that is essential for the synthesis of thyroid hormones.Adequate intake of dietary iodine has been recognized as a critical factor for maintaining health.It is a well-known fact that iodine deficiency can impede the production of thyroid hormones in both the mother and fetus,which increases the risk of brain damage in the fetal stage.

Genetic Diversity and Antiretroviral Drug Resistance among Drug-Naive HIV-1 Infected Pregnant Women Attending Antenatal Clinics in Abidjan, Cote d'Ivoire

To clarify the distribution of HIV-1 subtypes and drug resistance-related mutations, we collected and analysed serum from pregnant women who are ARV drug-naive in Abidjan. The prevalence of HIV-1 subtypes and mutations associated with antiretroviral drug resistance among drug-na?ve HIV-1 infected pregnant women was investigated from plasma of 90 young pregnant primigravida. The HIV-1 pol and env genes were amplified by using primers recognizing conserved viral sequences and sequenced by employing BigDye chemistry. Positions 1 - 99 of the PR and 1 - 350 of the RT genes were analyzed for mutations based on the international AIDS society USA panel. In 39 strains which both genes were sequenced including CFR02_AG 30 (76.9%), subtype A 3 (7.7%), CFR06_cpx 2 (5.1%), CFR09_cpx 1 (2.6%), and discordant sequences suggesting the presence of a few number of recombinant involving CRF02-AG and subtype A 3 (7.7%). None of the major drug resistance mutations was detected. The frequent minor mutations associated drug resistance observed were M36I (52%/96.3%), L10I/R/V (19%/35.2%) and L63P (7%/12.9%). The M36I mutation was widespread in all subtypes. Our result demonstrated first a significant level of viral heterogeneity and then only the presence of minor resistance associated mutations. Our study emphasizes the need of HIV sentinel survey in C?te d'Ivoire and shows that pregnant women who are candidates for receiving antiretroviral drug therapies do not contain naturally occurring or preexisting drug resistance mutations. So such drug therapies are likely to be highly effective in this setting.

Antagonistic Potential against Pathogenic Microorganisms and Hydrogen Peroxide Production of Indigenous Lactobacilli Isolated from Vagina of Chinese Pregnant Women

Objective To investigate the indigenous lactobacilli from the vagina of pregnant women and to screen the isolates with antagonistic potential against pathogenic microorganisms. Methods The strains were isolated from pregnant women＇s vagina and identified using the API50CH system. The ability of the isolates to produce hydrogen peroxide was analyzed semi-quantitatively using the TMB-HRP-MRS agar. The antagonistic effects of the isolates on pathogenic microorganisms were determined with a double layer agar plate. Results One hundred and three lactobacilli strains were isolated from 60 samples of vaginal secretion from healthy pregnant women. Among them, 78 strains could produce hydrogen peroxide, in which 68%, 80%, 80%, and 88% had antagonistic effects against Candida albicans CMCC98001, Staphylococcus aureus CMCC26003, Escherichia coli CMCC44113, and Pseudomonas aeruginosa CMCC10110, respectively. Conclusion The recovery of hydrogen peroxide-producing lactobacilli decreases with the increasing pregnant age and time. The most commonly isolated species from vagina of Chinese pregnant women are Lactobacillus acidophilus and Lactobacillus crispatus. Most of L. acidophilus and L. crispatus produce a high H2O2 level.

Low-intensity anticoagulation therapy in the pregnant women with mechanical heart valves:a report with 56 cases

Objective To evaluate the method of low-intensity anticoagulation therapy in the pregnant women who had received mechanical heart valve replacemant,and the effects of warfarin on the pregnant women and their fetus. Methods This retrospective study involved 56 pregnant women (61 pregnancies) who had received mechanical heart valve replacement. Their pregnant status,delivery, and anticoagulation therapy were observed

Toxoplasmosis among pregnant women:High seroprevalence and risk factors in Kinshasa,Democratic Republic of Congo

Objective:To determine the seroprevalence of toxoplasmosis in pregnant women,as well as the proportion of acutely infected and risk factors in the Democratic Republic of Congo.Methods:Thirty maternities in Kinshasa were randomly selected and women attending antenatal consultation were invited to participate.They were interviewed with a structured questionnaire about known risk factors(age,meat consumption,contact with soil,and presence of cat)and a venous blood sample was taken.Sera were analysed for total immunoglobulins(Ig)by VIDAS Toxo Competition using Enzyme Linked Fluorescent Assay.IgM was determined by VIDIA Toxo IgM and IgG avidity by VIDAS Toxo IgG avidity.Results:A total of 781 women were included.Median age was 28 years old(IQR:8.S).And 627women(80.3%;95%CI:77.5-83.1)were found to be positive to total Ig and 17 out of 387(4.4%;95%CI:2.3-6.4)were positive to IgM.IgC avidity was low for 2(11.8%)women,intermediate for 2(11.8%)and high for 13 women(76.4%).There was no statistically significant association between Toxoplasma gondii infection and any risk factors assessed.Conclusion:In Kinshasa,toxoplasmosis endemicity is highly prevalent.One woman out of twenty five had a recent toxoplasmosis infection and 20%were not protected against primoinfection,indicating a need for measures to prevent and control toxoplasmosis during pregnancy.

Experience of Clinical Management for Pregnant Women and Newborns with Novel Coronavirus Pneumonia in Tongji Hospital,China

Based on the New Diagnosis and Treatment Scheme for Novel Coronavirus Infected Pneumonia(Trial Edition 5),combined with our current clinical treatment experience,we recently proposed a revision of the first edition of“Guidance for maternal and fctal management during pneumonia epidemics of novel coronavirus infection in the Wuhan Tongji Hospital".This article focused on the issues of greatest concern of pregnant women including severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection diagnostic criteria,inspection precautions,drug treatment options,indications and methods of termination of pregnancy,postpartum fever,breastfeeding considerations,mode of mother-to-child transmission,neonatal isolation and advice on nconatal nursing,to provide valuable experience for better management of SARS-CoV-2 infection in pregnant women and newborns.

Knowledge, attitudes and practice survey on Zika virus infection among pregnant women in Brunei Darussalam

To assess the knowledge, attitudes, and practices(KAP) on Zika virus infection among pregnant women in Brunei Darussalam by a cross-sectional survey. Methods: Between February and June 2017, we recruited 234 pregnant women from all government healthcare centres at Brunei-Muara district, using a modified systematic sampling approach. A pre-tested and self-administered questionnaire was used and data analysis was conducted using descriptive statistics and multiple logistic regression analyses. Results: The study participants were mainly Malay(87.2%) and their mean age was 28.0 years. The median knowledge score was 13, out of a possible score of 28. Most participants(92.7%) knew that Zika virus was transmitted by mosquito bites whereas some(34.6%) knew that sexual transmission was also possible. Media(radio, television or newspapers) was the preferred source of updated information on Zika virus, followed by healthcare workers(44.0%), government announcements(43.2%), and social media(38.0%). Pregnant women who were 25 years old or older [Adj. OR=3.62(95% CI: 1.57, 9.51)], not Malays [Adj. OR=3.32(95% CI: 1.35, 8.55)], and had an average monthly household income of more than BND $3 000 [Adj. OR=4.06(95% CI: 1.81, 19.44)] were more likely to score higher for knowledge on Zika virus. The median prevention practice score was 23, out of a possible score of 36. Most participants reported wearing covering clothes(98.3%) and kept their living surroundings clean(99.6%). Most participants(88.0%) agreed that Zika is an important issue in their community. Conclusion: We found a lack of knowledge on Zika virus infection among pregnant women attending government maternal and child healthcare centres in Brunei Darussalam, in particular that Zika virus can be sexually transmitted. Such information could be well disseminated at the healthcare centre level. Health literacy studies should be conducted to understand the facilitators and barriers of KAP on Zika virus infection among pregnant women.

Role of perceived family support in psychological distress for pregnant women during the COVID-19 pandemic

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has caused major public panic in China.Pregnant women may be more vulnerable to stress,which may cause them to have psychological problems.AIM To explore the effects of perceived family support on psychological distress in pregnant women during the COVID-19 pandemic.METHODS A total of 2232 subjects were recruited from three cities in China.Through the online surveys,information on demographic data and health status during pregnancy were collected.Insomnia severity index,generalized anxiety disorder 7-item scale,patient health questionnaire-9,somatization subscale of the symptom check list 90 scale,and posttraumatic stress disorder checklist were used to assess the psychological distress.RESULTS A total of 1015(45.4%)women reported having at least one psychological distress.The women who reported having inadequate family support were more likely to suffer from multiple psychological distress(≥2 psychological distress)than women who received adequate family support.Among the women who reported less family support,41.8%reported depression,31.1%reported anxiety,8.2%reported insomnia,13.3%reported somatization and 8.9%reported posttraumatic stress disorder(PTSD),which were significantly higher than those who received strong family support.Perceived family support level was negatively correlated with depressive symptoms(r=-0.118,P<0.001),anxiety symptoms(r=-0.111,P<0.001),and PTSD symptoms(r=-0.155,P<0.001).CONCLUSION Family support plays an important part on pregnant women’s mental health during the COVID-19 pandemic.Better family support can help improve the mental health of pregnant women.

Baseline Iron Status and Indices of Oxidative Stress in a Cohort of Pregnant Women in Kinshasa, DR Congo

Objective: To determine baseline iron and oxidative status in a cohort of pregnant women before iron supplementation in our setting. Background: Screening of iron deficiency before supplementation during pregnancy has been scarce. Therefore, following routine iron supplementation confounding results might be found in outcomes of groups of patients considered. Taking in account that body/serum iron status is reportedly linked to maternal oxidative status, we aimed to associate assessment of baseline iron and oxidative status of women in need of oral supplementation during pregnancy. Methods: This is a cross-sectional study concerning 74 women attending antenatal care at the University Clinics of Kinshasa from September 2017 throughout June 2018, with a singleton pregnancy not exceeding 19 weeks, regardless of age and parity. Variables of the study included sociodemographic and anthropometric ones along with parameters of iron status (hemoglobin, hematocrit, ferritin, serum iron, transferrin and iron saturation capacity). Oxidative status was assessed using superoxide dismutase (SOD) and uric acid as antioxidants, while oxidant agents were oxidized LDL and blood glucose (beside serum iron and ferritin). According to local standards anemia was defined as hemoglobin 10 g/L and pathologic serum ferritin as 15 ng/ml. For statistical calculations we used t-test, chi-square test and Pearson’s correlation test, the significance being stated at p ≤ 0.05. Results: At recruitment (15.9 ± 1.7 9 week gestational age) mean hemoglobin value of the overall study group was 10.3 ± 1.5 g/dl. Anemia was diagnosed to 39 women that represented 52.2% of the study group, most of anemic women belonging to low socioeconomic sub-group (69.2% vs 29%;P < 0.001). The majority was para 2, with average weight of 70.2 ± 14.5 Kg (P not significant between sub-groups) and BMI of 26 ± 5.2 Kg/m2 (P < 0.01). The proportion of obeses was 18.9%. The proportion of intestinal parasitosis was significantly higher among anemic women (61.5% vs 34.3%;P < 0.02) that had lower alimentary iron intake (22.8 ± 4.9 gr/day vs 31.4 ± 9.5 gr;P < 0.001). Of markers of iron status serum ferritin and iron were lower in anemic women (7.5 ± 3.9 ng/ml vs 35.7 ± 17.1 ng/ml;P < 0.001 and 52.7 ± 38.9 μg/dl vs 96.2 ± 41.8 μg/dl, respectively. Both sub-groups were similar in serum transferrin. As of markers of oxidative stress anemic women had significantly higher superoxide dismutases (SOD) (1056.4 ± 762.1 UI/L vs 682.6 ± 543.9 UI/L (P < 0.02) and oxidizedd anti LDL Ac (439.6 ± 209.5 UI/L vs 192.8 ± 136.3 UI/L (P < 0.001). Serum iron, ferritin, SOD and oxidized LDL were more likely to assess iron and oxidative status in our setting. Conclusion: The rate of anemic mothers found in our study (52.2%) has been quite constant in our setting for years, meaning endemicity. Serum iron and ferritin were significantly lower in anemic women, which is supportive of routine iron supplementation during pregnancy. Significantly higher level of SOD and oxidized LDL in anemic women suggests that maternal anemia may count into oxidative stress likely to be found in these women.