3.Association between different treatment timings and adverse neonatal outcomes in pregnant women with syphilis during pregnancy.
Fang HU ; Zhao Qian HUANG ; Min CAI ; Hui Fang XU ; Hong Bo JIANG ; Shuang GAO
Chinese Journal of Preventive Medicine 2023;57(11):1782-1787
Objective: To analyze the association between different treatment timings and adverse neonatal outcomes (premature birth, death, congenital syphilis) in syphilis-infected pregnant women. Methods: The National Management Information System for Prevention of HIV, Syphilis and HBV Mother-to-Child Transmission was used to collect information on the detection and treatment of syphilis-infected pregnant women and their newborns in Guangdong Province from October 2011 to December 2021. According to the gestational weeks of syphilis-infected pregnant women receiving penicillin treatment for the first time, they were divided into four groups: treatment in the first trimester, treatment in the second trimester, treatment in the third trimester, and no treatment during pregnancy. Multivariate logistic regression was used to analyze the association between different treatment timings and adverse neonatal outcomes in syphilis-infected pregnant women. Results: A total of 22 483 syphilis-infected pregnant women were included. The number of pregnant women who started treatment in the first trimester, second trimester, and third trimester and did not receive treatment during pregnancy were 4 549 (20.23%), 8 719 (38.78%), 2 235 (9.94%) and 6 980 (31.05%), respectively. Compared with pregnant women who started treatment in the first trimester, pregnant women who did not receive anti-syphilis treatment during pregnancy had increased risks of neonatal preterm birth (OR=1.42, 95%CI: 1.24-1.62), death (OR=4.27, 95%CI: 1.64-14.69) and congenital syphilis (OR=12.26, 95%CI: 6.35-27.45). At the same time, the risk of congenital syphilis in the newborns of pregnant women who started anti-syphilis treatment in the second trimester (OR=2.68, 95%CI: 1.34-6.16) and third trimester (OR=6.27, 95%CI: 2.99-14.80) also increased. Conclusion: Early initiation of anti-syphilis treatment during pregnancy in patients with syphilis can improve neonatal outcomes.
Pregnancy
;
Female
;
Infant, Newborn
;
Humans
;
Pregnant Women
;
Syphilis/diagnosis*
;
Pregnancy Complications, Infectious/drug therapy*
;
Syphilis, Congenital/drug therapy*
;
Premature Birth
;
Infectious Disease Transmission, Vertical/prevention & control*
4.Association between different treatment timings and adverse neonatal outcomes in pregnant women with syphilis during pregnancy.
Fang HU ; Zhao Qian HUANG ; Min CAI ; Hui Fang XU ; Hong Bo JIANG ; Shuang GAO
Chinese Journal of Preventive Medicine 2023;57(11):1782-1787
Objective: To analyze the association between different treatment timings and adverse neonatal outcomes (premature birth, death, congenital syphilis) in syphilis-infected pregnant women. Methods: The National Management Information System for Prevention of HIV, Syphilis and HBV Mother-to-Child Transmission was used to collect information on the detection and treatment of syphilis-infected pregnant women and their newborns in Guangdong Province from October 2011 to December 2021. According to the gestational weeks of syphilis-infected pregnant women receiving penicillin treatment for the first time, they were divided into four groups: treatment in the first trimester, treatment in the second trimester, treatment in the third trimester, and no treatment during pregnancy. Multivariate logistic regression was used to analyze the association between different treatment timings and adverse neonatal outcomes in syphilis-infected pregnant women. Results: A total of 22 483 syphilis-infected pregnant women were included. The number of pregnant women who started treatment in the first trimester, second trimester, and third trimester and did not receive treatment during pregnancy were 4 549 (20.23%), 8 719 (38.78%), 2 235 (9.94%) and 6 980 (31.05%), respectively. Compared with pregnant women who started treatment in the first trimester, pregnant women who did not receive anti-syphilis treatment during pregnancy had increased risks of neonatal preterm birth (OR=1.42, 95%CI: 1.24-1.62), death (OR=4.27, 95%CI: 1.64-14.69) and congenital syphilis (OR=12.26, 95%CI: 6.35-27.45). At the same time, the risk of congenital syphilis in the newborns of pregnant women who started anti-syphilis treatment in the second trimester (OR=2.68, 95%CI: 1.34-6.16) and third trimester (OR=6.27, 95%CI: 2.99-14.80) also increased. Conclusion: Early initiation of anti-syphilis treatment during pregnancy in patients with syphilis can improve neonatal outcomes.
Pregnancy
;
Female
;
Infant, Newborn
;
Humans
;
Pregnant Women
;
Syphilis/diagnosis*
;
Pregnancy Complications, Infectious/drug therapy*
;
Syphilis, Congenital/drug therapy*
;
Premature Birth
;
Infectious Disease Transmission, Vertical/prevention & control*
5.Coronavirus disease 2019 in pregnant and non-pregnant women: a retrospective study.
Ying ZHA ; Ge CHEN ; Xun GONG ; Yuan-Yuan WU ; Xing-Guang LIN ; Jian-Li WU ; Ya-Fei HUANG ; Yu-Qi LI ; Ying ZHANG ; Dong-Rui DENG ; Su-Hua CHEN ; Fu-Yuan QIAO ; Ling FENG ; Wan-Jiang ZENG ; Ke-Zhen LI ; Hai-Yi LIU
Chinese Medical Journal 2021;134(10):1218-1220
6.Anesthetic Considerations for the HIV-Infected Pregnant Patient.
Yonsei Medical Journal 2004;45(1):1-6
It has been reported that women of childbearing age constitute a large percentage of the new cases of HIV/AIDS infection. Consequently, it is not uncommon to find pregnant women who are HIV positive. Because of the increased prevalence of HIV infection in pregnant women, many anesthesiologists encounter these patients in their practices. Infection with HIV in pregnancy often raises questions about the safety of regional anesthesia in these patients. This controversy first began when it was suggested that the introduction of a spinal needle in an HIV-infected parturient would spread the disease into the CNS, leading to the development of neurological sequelae of this disease. Nevertheless, recent analysis of the problem has shown HIV infection should not contraindicate regional anesthesia.
Anesthesia, Obstetrical/*methods
;
Anti-HIV Agents/*therapeutic use
;
Female
;
HIV Infections/*drug therapy
;
Human
;
Pregnancy
;
Pregnancy Complications, Infectious/*virology
7.Recent research on the epidemiology and preventive strategies of neonatal group B Streptococcus infection in the latest decade.
Meng-Yang GUO ; Wei GAO ; Lin YUAN ; Kai-Hu YAO
Chinese Journal of Contemporary Pediatrics 2023;25(5):534-540
Currently, the main strategy for preventing neonatal group B Streptococcus (GBS) infection is prenatal screening combined with intrapartum antibiotic prophylaxis, which has effectively reduced the incidence of neonatal GBS early-onset disease. However, the burden of GBS infection is still significant. The intrapartum antibiotic prophylaxis strategy has limitations such as inducing antibiotic resistance and inability to effectively prevent GBS late-onset disease. It is crucial to develop and evaluate other prevention strategies, while paying close attention to assessing penicillin allergy in pregnant women and how to prevent GBS infection in neonates with negative maternal GBS screening. In recent years, there has been some progress in GBS vaccines and related immunological research, and the use of specific vaccines is expected to significantly reduce GBS infection in neonates.
Female
;
Humans
;
Infant, Newborn
;
Pregnancy
;
Anti-Bacterial Agents/therapeutic use*
;
Antibiotic Prophylaxis
;
Infectious Disease Transmission, Vertical/prevention & control*
;
Pregnancy Complications, Infectious/epidemiology*
;
Streptococcal Infections/drug therapy*
;
Streptococcus agalactiae
9.Human immunodeficiency virus (HIV) in pregnancy: a review of the guidelines for preventing mother-to-child transmission in Malaysia.
Annals of the Academy of Medicine, Singapore 2012;41(12):587-594
Mother-to-child transmission (MTCT) of human immunodefi ciency virus (HIV) is a devastating consequence of HIV infection during pregnancy and is largely preventable. Evidence-based interventions such as universal antenatal screening, provision of antiretroviral therapy, delivery by elective caesarean section and avoidance of breastfeeding have ensured that the rates of MTCT remain low in Malaysia. This review discusses the most recent advances in the management of HIV infection in pregnancy with emphasis on antiretroviral treatment strategies and obstetric care in a middle income country.
Anti-HIV Agents
;
therapeutic use
;
Antiretroviral Therapy, Highly Active
;
Breast Feeding
;
Cesarean Section
;
Child
;
Evidence-Based Medicine
;
Female
;
HIV Infections
;
drug therapy
;
transmission
;
Humans
;
Infectious Disease Transmission, Vertical
;
prevention & control
;
Malaysia
;
Practice Guidelines as Topic
;
Pregnancy
;
Pregnancy Complications, Infectious
;
drug therapy
10.Cross-sectional study on rates and influential factors of standard medication for antiretroviral therapy in preventing mother-to-child transmission of HIV.
Yong-zhong WANG ; Yan LI ; Cheng-qin JIANG ; Min ZHENG ; Yong ZHANG ; Yu-hua XIONG ; Yu-yan YANG ; Kai-min LUO
Chinese Journal of Preventive Medicine 2009;43(4):277-281
OBJECTIVETo understand the status of standard medication of antiretroviral therapy and identify its correlationship with preventing mother-to-child transmission of HIV (PMTCT).
METHODSQualitative and quantitative methods for measuring of standard medication towards antiretroviral therapy of PMTCT were used in a cross-sectional study of 167 pregnant women who had accessed to PMTCT services and 57 physicians providing service from January 2005 to June 2007 in 5 HIV epidemic counties in Yunnan province.
RESULTSA total of 167 mothers were recruited, of which 65.87% (110/167) demonstrated for standard medication. The percentage of rational selection of antivirus-therapy regimen was 88.02% (147/167). HIV positive mothers with rational using medicine during labor covered 81.37% (131/161). 87.42% (146/167) of women demonstrated good compliance. The main correlations with the standard medication level of HIV positive pregnant women and their infants were as follows: diagnose time (OR = 2.617; 95% CI: 1.184 - 5.783), place of delivery (OR = 0.064; 95% CI: 0.007 - 0.607), minorities (OR = 0.344; 95% CI: 0.162 - 0.730), understanding of HIV women for antiretroviral therapy (OR = 6.843; 95% CI: 1.449 - 32.312), and doctors' cognition about the regimen for antiretroviral therapy was not enough; 5 key knowledge points (purpose of PMTCT, the consequence of not requiring standard medication, the effect of knowing regimens, the relationship of CD4 levels and selected regimens, the side effect of the relevant medicine) score rate was 47.72% (136/285).
CONCLUSIONThe proportions of standard medication in PMTCT antiretroviral therapy were not high. Standard medication might be associated with multiple factors from doctors, patients and society. It is necessary to make some steps to improve standard medication of antiretroviral therapy in PMTCT.
Anti-HIV Agents ; therapeutic use ; China ; Cross-Sectional Studies ; Female ; HIV Infections ; drug therapy ; prevention & control ; transmission ; Humans ; Infectious Disease Transmission, Vertical ; prevention & control ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy