Clinical characteristics and risk factors for mortality in obstetric patients with severe COVID-19 in Brazil: a surveillance database analysis

The objective of this study was to describe clinical characteristics of pregnant and postpartum women with severe COVID-19 in Brazil and to examine risk factors for mortality. The authors identified 124 maternal deaths, corresponding to a case fatality rate among COVID-19 Acute Respiratory Distress Syndrome (ARDS) cases in the obstetric population of 12.7%. At least one comorbidity was present in 48.4% of fatal cases compared to 24.9% in survival cases. Among women who died, 58.9% were admitted to ICU, 53.2% had invasive ventilation and 29.0% had no respiratory support. The multivariate logistic regression showed that the main risk factors for maternal death by COVID-19 were postpartum at onset of ARDS, obesity, diabetes, and cardiovascular disease, while white ethnicity had a protective effect. 

Mapping Inequity among COVID Cases in Sindh, Punjab and Balochistan: Assessment of Characteristics and associations among COVID-19 Cases to Inform Equitable COVID Response

The broader goal of this study is to assess any association between individual and demographic characteristics of the COVID-19 patients and the risk and severity of the diseases. This cross-sectional study will synthesize the COVID-19 surveillance data and actively collect data on additional variables. The sample would comprise of all the reported cases irrespective of age and gender of COVID-19 in Sindh, Punjab and Balochistan. 

Effect of pregnancy prolongation in early-onset preeclampsia on postpartum maternal cardiovascular, renal and metabolic function in primiparous women: an observational study

The objective of this study was to evaluate the association between deferred delivery in early-onset preeclampsia and offspring outcome and maternal cardiovascular, renal and metabolic function in the postpartum period. Findings suggest that pregnancy prolongation in early-onset preeclampsia is associated with improved offspring outcome and survival. These effects do not appear to be deleterious to short-term maternal cardiovascular and metabolic function, but are associated with a modest increase in risk of residual albuminuria.

Neonatal management and outcomes during the COVID-19 pandemic: an observation cohort study

In this study, the authors aimed to elucidate best practices regarding infection control in mother–newborn dyads, and identify potential risk factors associated with transmission. Data suggest that perinatal transmission of COVID-19 is unlikely to occur if correct hygiene precautions are undertaken, and that allowing neonates to room in with their mothers and direct breastfeeding are safe procedures when paired with effective parental education of infant protective strategies.

What has women's reproductive health decision-making capacity and other factors got to do with pregnancy termination in sub-Saharan Africa? evidence from 27 cross-sectional surveys

The authors examined the reproductive health decision-making (RHDM) capacity and pregnancy termination among women of reproductive age in sub-Saharan Africa (SSA). Findings suggest that women who are capable of taking reproductive health decisions are more likely to terminate pregnancies. Findings also suggest that age, level of education, contraceptive use and intention, place of residence, and parity are associated with pregnancy termination.

PROVIDE Training Compendium brings lifesaving mothers’ own milk to NICU infants

Rush University Medical Center has produced PROVIDE – A Training Compendium on Providing Mothers’ Own Milk in NICU Settings, to train healthcare professionals in mothers’ own milk (MOM) feeding practices in neonatal intensive care units (NICUs) worldwide. It is available on The Global Health Network’s knowledge platform LactaHub: www.lactahub.org/nicu-training

Effect of a quality improvement package for intrapartum and immediate newborn care on fresh stillbirth and neonatal mortality among preterm and low-birthweight babies in Kenya and Uganda: a cluster-ra

The authors aimed to assess the effect of a quality improvement package for intrapartum and immediate newborn care on stillbirth and preterm neonatal survival in Kenya and Uganda, where evidence-based practices are often underutilised. This unblinded cluster-randomised controlled trial was done in western Kenya and eastern Uganda at facilities that provide 24-h maternity care with at least 200 births per year. Findings suggests that fresh stillbirth and neonatal mortality among low-birthweight and preterm babies can be decreased using a package of interventions that reinforces evidence-based practices and invests in health system strengthening.

Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019

The authors developed a model that simultaneously estimated incidence of unintended pregnancy and abortion within a Bayesian framework. The findings suggest that between 1990–94 and 2015–19, the global unintended pregnancy rate has declined, whereas the proportion of unintended pregnancies ending in abortion has increased. As a result, the global average abortion rate in 2015–19 was roughly equal to the estimates for 1990–94. Our findings suggest that people in high-income countries have better access to sexual and reproductive health care than those in low-income countries. Our findings indicate that individuals seek abortion even in settings where it is restricted. These findings emphasise the importance of ensuring access to the full spectrum of sexual and reproductive health services, including contraception and abortion care, and for additional investment towards equity in health-care services.

Cost-effectiveness analysis of Baby-Friendly Hospital Initiative in promotion of breast-feeding and reduction of late neonatal infant mortality in Brazil

The objective of this study was to analyse the cost-effectiveness of Baby-Friendly Hospital Initiative (BFHI) in promoting breast-feeding during the first hour of life (BFFHL) and reducing late neonatal mortality. Cost-effectiveness analysis showed that BFHI was highly cost-effective in raising BFFHL by 32·0 % at lower cost in comparison with non-BFHI. In addition, BFHI was cost-effective in reducing late neonatal mortality rate by 13·0 % from all causes and by 13·1 % of infant mortality rate from infections.

Characteristics of Women of Reproductive Age With Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-June 7, 2020

The objective of the study was to assess the prevalence and severity of COVID-19 among pregnant U.S. women and determine whether signs and symptoms differ among pregnant and nonpregnant women. Findings suggest that among women of reproductive age with COVID-19, pregnant women are more likely to be hospitalized and at increased risk for ICU admission and receipt of mechanical ventilation compared with nonpregnant women, but their risk for death is similar. To reduce occurrence of severe illness from COVID-19, pregnant women should be counseled about the potential risk for severe illness from COVID-19, and measures to prevent infection with SARS-CoV-2 should be emphasized for pregnant women and their families

Pregnancy and Postpartum Outcomes in a Universally Tested Population for SARS-CoV-2 in New York City: A Prospective Cohort Study

This prospective cohort study aimed to describe differences in outcomes between pregnant women with and without COVID-19. Among pregnant women with COVID-19 at delivery, the study observed increased cesarean delivery rates and increased frequency of maternal complications in the postpartum period. Additionally, intraplacental thrombi may have maternal and fetal implications for COVID-19 infections remote from delivery.

Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19)

The objective of this study was to investigate the clinical evolution of coronavirus disease 2019 (COVID-19) in hospitalized pregnant women and potential factors associated with severe maternal outcomes. In the study cohort, one in five women hospitalized with COVID-19 infection delivered urgently for respiratory compromise or were admitted to the ICU. None, however, died. Increased pregestational BMI and abnormal heart and respiratory rates on admission were associated with severe disease.

A telehealth lifestyle intervention to reduce excess gestational weight gain in pregnant women with overweight or obesity (GLOW): a randomised, parallel-group, controlled trial

In this trial, the authors investigated whether a primarily telehealth lifestyle intervention reduced excess gestational weight gain (GWG) among women with overweight or obesity. Evidence-based programme showed that health-care delivery systems could further adapt to meet the needs of their clinical settings to prevent excess GWG and improve healthy behaviours and markers of insulin resistance among women with overweight or obesity by using telehealth lifestyle interventions.

Perinatal Depressive and Anxiety Symptoms of Pregnant Women Along With COVID-19 Outbreak in China

The aim of the present study is to examine the impact of COVID-19 outbreak on the prevalence of depressive and anxiety symptoms and the corresponding risk factors among pregnant women across China. Findings suggest that major life-threatening public health events such as the COVID-19 outbreak may increase the risk for mental illness among pregnant women including thoughts of self-harm. Strategies targeting maternal stress and isolation such as effective risk communication and the provision of psychological first aid may be particularly useful to prevent negative outcomes for women and their fetuses.

DNDi short film about new treatment for sleeping sickness awarded Grand Prix at inaugural WHO film festival

Survey launched to establish what research funders should prioritise for COVID-19

COVID19 During Pregnancy: A Systematic Review of Reported Cases

The objective of thsi study was to conduct a systematic review of the outcomes reported for pregnant patients with COVID 19. Fidnings suggest that although vertical transmission of SARS-Cov2 has been excluded thus far and the outcome for mothers and fetuses has been generally good, the high rate of preterm cesarean delivery is a reason for concern. These interventions were typically elective, and it is reasonable to question whether they were warranted or not. COVID-19 associated with respiratory insufficiency in late pregnancies certainly creates a complex clinical scenario.

Coronavirus Disease 2019 (COVID-19) in Pregnant Women: A Report Based on 116 Cases

The objective of the study was to evaluate the clinical characteristics and outcomes in pregnancy and the vertical transmission potential of SARS-CoV-2 infection. Findings suggest that ARS-CoV-2 infection during pregnancy is not associated with an increased risk of spontaneous abortion and spontaneous preterm birth. There is no evidence of vertical transmission of SARS-CoV-2 infection when the infection manifests during the third-trimester of pregnancy.

Perinatal Aspects on the covid-19 Pandemic: A Practical Resource for Perinatal-Neonatal Specialists

The objective of this study was to summarize available evidence and provide perinatologists/neonatologists with tools for managing their patients. As the pandemic continues, more data will be available that could lead to changes in current knowledge and recommendations.

Coronavirus Disease 2019 Among Pregnant Chinese Women: Case Series Data on the Safety of Vaginal Birth and Breastfeeding

The objective of this study was to assess whether vaginal secretions and breast milk of COVID-19 patients contain SARS-CoV-2 virus. In this case series of 13 pregnant women with COVID-19, we observed negative viral test results in vaginal secretion specimens, suggesting that a vaginal delivery may be a safe delivery option. However, additional research is urgently needed to examine breast milk and the potential risk for viral contamination.