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.Effect of highly active anti-retroviral therapy on prevention of mother to child transmission of HIV and on infant growth and development.
Yan HE ; Yan LUO ; Yi-ling DING ; Yu-huang ZHENG ; Jing LI ; Jian HUANG ; Jie-min LI
Chinese Journal of Preventive Medicine 2011;45(10):912-915
OBJECTIVETo identify the effect of highly active anti-retroviral therapy (HAART) on prevention of mother to child transmission (PMTCT) of HIV and on infant growth and development.
METHODSA total of 16 HIV-infected women or pregnant women selected in this study received HAART before or 18 - 24 weeks after pregnancy. The treatment included taking Zidovudine (AZT) 0.3 g each time, twice a day, Lamivudine (3TC) 0.3 g each time, once a day and Nevirapine (NVP) 0.2 g each time, twice a day or Efavirenz (EFV) 0.6 g each time, once a day, as well as labor intervention and artificial feeding. The growth index for 17 infants from HIV-infected mothers (experimental group) and 16 normal infants (control group) were observed for 18 months. Neonatal hemoglobin (Hb), liver and kidney function, serum iron and calcium were detected at neonatal period and at 12(th) month, respectively.
RESULTSAll the pregnant women were in good conditions and had tolerance with HAART. The birth weight, length and Apgar score of the newborns in the experimental group were (3.5 ± 0.9) kg, (54.2 ± 3.8) cm and 7 - 10 scores respectively, however those in the control group were (3.6 ± 0.8) kg, (55.6 ± 3.6) cm and 8 - 10 scores (t(weight) = 1.01, t(length) = 6.98, P > 0.05). Weight and length of infants in experimental group were (9.36 ± 1.8) kg and (76.3 ± 2.7) cm at 12(th) month, while those in control group were (9.86 ± 2.5) kg and (76.8 ± 2.9) cm (t(weight) = 0.83, t(length) = 1.00, P > 0.05). The level of Hb in experimental group was (126.2 ± 16.7) g/L, and was (148.6 ± 20.5) g/L in control group (t = -5.89, P = 0.11). At 12(th) month, the levels of Hb and the total bilirubin (TB) were (125.9 ± 19.8) g/L and (11.7 ± 3.5) µmol/L in experimental group; and those in the control group were (130.1 ± 18.7) g/L and (13.2 ± 3.7) µmol/L (t(Hb) = -3.82, t(TB) = -2.14, P > 0.05). Serum iron and calcium were (25.4 ± 5.7) µmol/L and (26.4 ± 7.2) µmol/L at neonatal period and were (2.3 ± 0.6) mol/L and (2.8 ± 0.6) mol/L at 12(th) month in experimental group, while those were (26.2 ± 4.9) µmol/L and (28.1 ± 6.9) µmol/L at neonatal period and were (2.6 ± 0.5) mol/L and (3.1 ± 0.5) mol/L at 12(th) month in the control group (t(Fe) = 0.80 and t(Ca) = -3.00 in neonatal period, t(Fe) = -1.50 and t(Ca) = -1.00 at 12(th) month, P > 0.05). All infants of HIV-infected mothers were not infected with HIV when they were 18 months old.
CONCLUSIONHAART can prevent mother to child transmission of HIV and it was not found to influence the baby's growth and development in this study.
Adult ; Antiretroviral Therapy, Highly Active ; Child Development ; drug effects ; Female ; HIV ; HIV Infections ; prevention & control ; transmission ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; prevention & control ; Maternal Exposure ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; virology