Clinical Challenges in Maternal and Child Health during and after the COVID-19 Pandemic

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Pediatrics".

Deadline for manuscript submissions: 15 May 2024 | Viewed by 4253

Special Issue Editor


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Guest Editor
1. Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
2. Materno-Fetal and Obstetrics Research Unit, Department “Woman–Mother–Child”, University Hospital, 1011 Lausanne, Switzerland
Interests: fetal medicine; COVID-19 in pregnancy; fetal anemia; intrauterine transfusion; fetal and neonatal alloimmune thrombocytopenia

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic posed unprecedented challenges for health professionals in maternity and pediatric services. During the acute period of the pandemic, they had to cope with hospital saturation during waves of COVID-19, and initiate studies based on real-world evidence on the effectiveness of COVID-19 medicines and vaccines, which was even more difficult for special populations such as pregnant women and children. In most countries, they are considered vulnerable and have scarcely been included in randomized control trials on COVID-19 medicines and vaccines. However, even four years after the start of the pandemic, clinical challenges remain, such as health workers’ exhaustion, management of long COVID-19, and upcoming COVID-19 vaccination campaign programmes. We are looking for studies that will contribute to improving knowledge in the field of COVID-19 in perinatal and pediatric settings, in order to improve sustainable healthcare policies for pregnant women and children regarding COVID-19 and in case of new public health crises. Therefore, researchers in the field of COVID-19 in pregnancy and childhood are encouraged to submit an original article or review to this Special Issue (case reports and short reviews are not accepted).

Dr. Emeline Maisonneuve
Guest Editor

Manuscript Submission Information

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Keywords

  • COVID-19
  • COVID-19 medicines
  • COVID-19 vaccine
  • pregnancy
  • maternal-fetal transmission
  • neonatal COVID-19
  • children

Published Papers (3 papers)

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Research

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20 pages, 611 KiB  
Article
Maternal Mental Health in Pregnancy and Its Impact on Children’s Cognitive Development at 18 Months, during the COVID-19 Pandemic (CONCEPTION Study)
by Narimene Ait Belkacem, Jessica Gorgui, Vanina Tchuente, Delphine Aubin, Sarah Lippé and Anick Bérard
J. Clin. Med. 2024, 13(4), 1055; https://doi.org/10.3390/jcm13041055 - 13 Feb 2024
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Abstract
Background: The COVID-19 pandemic has significantly affected the mental health of pregnant persons. Objective: We aimed to evaluate the impact of maternal mental health and antidepressant use on children’s cognitive development. Methods: We followed a cohort of children born during the COVID-19 pandemic. [...] Read more.
Background: The COVID-19 pandemic has significantly affected the mental health of pregnant persons. Objective: We aimed to evaluate the impact of maternal mental health and antidepressant use on children’s cognitive development. Methods: We followed a cohort of children born during the COVID-19 pandemic. Maternal mental health was self-reported during pregnancy (Edinburgh Postnatal Depression Scale, General Anxiety Disorder-7, stress levels, and antidepressant use). The child’s cognitive development was measured using the third edition of the Ages & Stages Questionnaires® (ASQ-3) at 18 months. Multivariate multinomial logistic regression models were built to assess the association between in utero exposure to maternal mental health and ASQ-3 domains: communication, gross motor, fine motor, problem-solving, and personal–social. Results: Overall, 472 children were included in our analyses. After adjusting for potential confounders, a need for further assessment in communication (adjusted odds ratio (aOR) 12.2, 95% confidence interval (CI) (1.60;92.4)), and for improvement in gross motricity (aOR 6.33, 95%CI (2.06;19.4)) were associated with in utero anxiety. The need for improvement in fine motricity (aOR 4.11, 95%CI (1.00; 16.90)) was associated with antidepressant exposure. In utero depression was associated with a decrease in the need for improvement in problem solving (aOR 0.48, 95%CI (0.24; 0.98)). Conclusions: During the COVID-19 pandemic, maternal mental health appears to be associated with some aspects of children’s cognitive development. Full article
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11 pages, 460 KiB  
Article
Impact of SARS-CoV-2 Infection on Maternal and Neonatal Outcome in Correlation with Sociodemographic Aspects: A Retrospective Case-Control Study
by Radu Chicea, Andrei Dorin Neagu, Eugen Dan Chicea, Amina Simona Grindeanu, Dan Georgian Bratu, Adrian Gheorghe Boicean, Mihai Dan Roman, Sorin Radu Fleacă, Liana Maria Chicea, Dumitru Alin Teacoe, Ioana Andrada Radu and Maria Livia Ognean
J. Clin. Med. 2023, 12(19), 6322; https://doi.org/10.3390/jcm12196322 - 30 Sep 2023
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Abstract
Background: As the COVID-19 pandemic evolved, concerns grew about its impact on pregnant women. This study aimed to determine how SARS-CoV-2 affects pregnancy, birth, and newborns, in order to identify vulnerable individuals and provide proper care. Methods: This is a retrospective case-control study [...] Read more.
Background: As the COVID-19 pandemic evolved, concerns grew about its impact on pregnant women. This study aimed to determine how SARS-CoV-2 affects pregnancy, birth, and newborns, in order to identify vulnerable individuals and provide proper care. Methods: This is a retrospective case-control study of 398 pregnant women who delivered at the Emergency Clinical County Hospital in Sibiu, Romania from 1 February 2020 to 31 March 2022. Patients were initially grouped and compared based on their RT-PCR SARS-CoV-2 test results into the COVID group (cases) (N = 199) and non-COVID group (control) (N = 199). The COVID cases were further divided and compared according to the pre-Delta (N = 105) and Delta/Omicron (N = 94) SARS-CoV-2 variants. COVID cases and control groups were compared to identify correlations between sociodemographic factors, pregnancy outcomes, and SARS-CoV-2 infection. The same comparisons were performed between pre-Delta and Delta/Omicron groups. Results: There were no significant differences concerning maternal residence, while educational level and employment proportion were higher among the positively tested patients. No significant differences were found for neonatal and pregnancy complications between COVID cases and control groups. Except for a lower mean gestational age, no significant differences were found between pre-Delta and Delta/Omicron periods. The maternal mortality in the infected group was 0.5% (1 case). Conclusions: Our study showed that SARS-CoV-2 infection at birth did not significantly affect maternal and neonatal outcomes, not even considering the SARS-CoV-2 strain. Full article
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Review

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27 pages, 584 KiB  
Review
Evolution of National Guidelines on Medicines Used to Treat COVID-19 in Pregnancy in 2020–2022: A Scoping Review
by Emeline Maisonneuve, Odette de Bruin, Guillaume Favre, Anna Goncé, Serena Donati, Hilde Engjom, Eimir Hurley, Nouf Al-Fadel, Satu Siiskonen, Kitty Bloemenkamp, Hedvig Nordeng, Miriam Sturkenboom, David Baud and Alice Panchaud
J. Clin. Med. 2023, 12(13), 4519; https://doi.org/10.3390/jcm12134519 - 06 Jul 2023
Cited by 2 | Viewed by 1650
Abstract
The lack of inclusion of pregnant women in clinical trials evaluating the effectiveness of medicines to treat COVID-19 has made it difficult to establish evidence-based treatment guidelines for pregnant women. Our aim was to provide a review of the evolution and updates of [...] Read more.
The lack of inclusion of pregnant women in clinical trials evaluating the effectiveness of medicines to treat COVID-19 has made it difficult to establish evidence-based treatment guidelines for pregnant women. Our aim was to provide a review of the evolution and updates of the national guidelines on medicines used in pregnant women with COVID-19 published by the obstetrician and gynecologists’ societies in thirteen countries in 2020–2022. Based on the results of the RECOVERY (Randomized Evaluation of COVID-19 Therapy) trial, the national societies successively recommended against prescribing hydroxychloroquine, lopinavir–ritonavir and azithromycin. Guidelines for remdesivir differed completely between countries, from compassionate or conditional use to recommendation against. Nirmatrelvir–ritonavir was authorized in Australia and the UK only in research settings and was no longer recommended in the UK at the end of 2022. After initial reluctance to use corticosteroids, the results of the RECOVERY trial have enabled the recommendation of dexamethasone in case of severe COVID-19 since mid-2020. Some societies recommended prescribing tocilizumab to pregnant patients with hypoxia and systemic inflammation from June 2021. Anti-SARS-CoV-2 monoclonal antibodies were authorized at the end of 2021 with conditional use in some countries, and then no longer recommended in Belgium and the USA at the end of 2022. The gradual convergence of the recommendations, although delayed compared to the general population, highlights the importance of the inclusion of pregnant women in clinical trials and of international collaboration to improve the pharmacological treatment of pregnant women with COVID-19. Full article
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