As the coronavirus disease 2019 (COVID-19) continues to devastate health systems worldwide, there is particular concern over the health and safety of one high-risk group, pregnant women, due to their altered immune systems. Since health workers regularly rely on symptoms to inform clinical treatment, it became critical to maintain a ranked list of COVID-19 symptoms specific to pregnant women. This systematic review investigated the prevalence of common COVID-19 symptoms in pregnant women and compared the ranked list of symptoms to articles of various sizes. Articles were included if they discussed pregnant women diagnosed with COVID-19 using polymerase chain reaction testing, and women present symptoms of COVID-19 and were published between December 1, 2019, and December 1, 2021; while articles were excluded if they did not report on pregnant women with COVID-19 displaying symptoms of COVID-19. Articles were identified on OVID MedLine and Embase in January of 2022. The risk of bias and quality appraisal was assessed using a nine-item modified Scottish Intercollegiate Guidelines Network checklist for case-control studies. The search results included 78 articles that described 41,513 pregnant women with 42 unique COVID-19 symptoms. When ranked, the most common symptoms were found to be cough (10,843 cases, 16.02%), fever (7,653 cases, 11.31%), myalgia (6,505 cases, 9.61%), headache (5,264 cases, 7.78%), and dyspnea (5,184 cases, 7.66%). When compared to other articles in the literature with sample sizes of n = 23,434, n = 8,207, and n = 651, the ranking largely aligned with those in other articles with large sample sizes and did not align with the results of articles with small sample sizes. The symptom ranking may be used to inform testing for COVID-19 in the clinic. Research is rapidly evolving with the ongoing nature of the pandemic, challenging the generalizability of the results.
The coronavirus disease 2019 (COVID-19) pandemic has had profound impacts on healthcare systems worldwide, particularly regarding the care of pregnant women and their neonates. The use of the Apgar score—a discrete numerical index used to evaluate neonatal condition immediately following delivery that has been used ubiquitously as a clinical indicator of neonatal condition and widely reported in the literature for decades—has continued during the pandemic. Although health systems adopted protocols that addressed pregnant women and their neonates during the pandemic, limited research has assessed the validity of Apgar scores for determining neonatal conditions in the context of COVID-19. Therefore, this scoping review was conducted on the first 2 years of the pandemic and included mothers with reverse transcription-polymerase chain reaction confirmed COVID-19 and their resulting positive or negative neonates. In total, 1,966 articles were assessed for eligibility, yielding 246 articles describing 663 neonates. Neonates who tested negative had median Apgar scores of 9 and 9 at 1 and 5 mins, respectively, while test-positive neonates had median Apgar scores of 8 and 9 at the same time points. The proportions of test-negative neonates with Apgar scores below 7 were 29 (4%) and 11 (2%) at 1 and 5 mins, which was not statistically significant (p = 0.327, χ2 = 0.961). These proportions were even lower for positive neonates: 22 (3%) and 11 (2%) at 1 and 5 mins, respectively, which was not statistically significant (p = 1, χ2 = 0). The low proportion of Apgar scores below 7 suggests that low Apgar scores are likely to be associated with severe maternal COVID-19 symptoms during delivery rather than neonatal COVID-19. Therefore, this study indicated that Apgar scores are poor indicators of neonatal COVID-19 status.
Introduction:The most common neonatal complication of gestational DM is macrosomia. During early pregnancy, an accumulation of maternal fat depots occurs followed by increased adipose tissue lipolysis and subsequent hyperlipidemia which mainly corresponds to increased triglycerides in all circulating lipoproteins. In GDM women the enhanced insulin resistance and altered estrogen-progesterone ratio are responsible for the reported wide range of dyslipidemic conditions 1 . Association of high maternal glucose levels and fetus macrosomia have been documented. The prospective Amsterdam Born children and development cohort study, reported that high maternal TG levels in early pregnancy were associated with higher Birth weights and subsequently a higher occurrence of LGA births, whereas low TG levels were associated with accelerated postnatal growth2. Total cholesterol, HDL and lipoprotein concentrations are not significantly different between GDM patients and control subjects3. Both maternal triglycerides and nonesterified fatty acids levels but not glucose in pregnancies with well-controlled gestational diabetes mellitus has been shown to correlate positively with both neonatal weight and fat mass4. Significantly elevated triglyceride levels in cord blood of obese GDM patients with macrosomic fetus suggests that TG may be important in the pathogenesis of fetal macrosomia5. We have undertaken this study to understand the relationship of hyperlipidemia in GDM pregnancy and the relationship between triglyceride levels and fetal macrosomia. Aims and Objectives: To correlate the relationship between fasting cholesterol and Triglycerides and offspring birthweight in women screened for GDM, To correlate the relationship between fasting maternal cholesterol, Triglycerides and mode of delivery and perinatal outcome.
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