Antiviral Agents ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; virology

Antiviral Agents ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; virology

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*

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*

COVID-19 ; Female ; Humans ; Infectious Disease Transmission, Vertical ; Pregnancy ; Pregnancy Complications, Infectious/drug therapy* ; Pregnancy Outcome ; Premature Birth ; Retrospective Studies ; SARS-CoV-2

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

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

Adult ; Female ; Hepatitis B ; drug therapy ; Humans ; Lamivudine ; adverse effects ; therapeutic use ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; Reverse Transcriptase Inhibitors ; adverse effects ; therapeutic use

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

OBJECTIVETo study the prevalence and principal rules of women with syphilis during pregnancy and to develop relative methods to prevent maternal-fetal transmission.

METHODSA nested case control study on epidemiologic research was used based on review and preview methods on prevention and cure. Targeting pregnant women with syphilis diagnosed during premarital or pregnancy stages and were identified through rapid plasma reagin test (RPR) but confirmed by treponema pallidum test (TP),a total number of 339 women receiving treatment, intervention and being followed throughout the pregnant and neonatal periods.

RESULTSThe prevalence of syphilis in pregnancy was 2.33%, and the positive rate in neonatal cord blood was closely associated with the opportunity of getting maternal treatment. The lowest RPR positive rate was among these women who got pregnant after receiving the treatment. The RPR positive rate of neonatal cord blood was positively relative to the mother's RPR titer. The higher was the mother's blood RPR titer, the worse the prenatal prognosis would turn to.

CONCLUSIONMother's blood RPR titer and the opportunity of getting treatment were strongly associated with the positive rate in neonatal cord blood. Pregnancy after receiving the treatment was a powerful measure to prevent the maternal-fetal transmission of syphilis.

Case-Control Studies ; Female ; Fetal Blood ; Humans ; Infectious Disease Transmission, Vertical ; prevention & control ; Maternal-Fetal Exchange ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; Syphilis ; drug therapy ; Syphilis, Congenital ; prevention & control