ETIDIOH - NEW

  Abstract Risk of death for both mother and fetus following Ebola virus infection is extremely high . In this study, healthy women in Rwanda aged ≥18 years were randomized to two-dose Ebola vaccination (Ad26.ZEBOV, MVA-BN-Filo) during pregnancy (group A) or postpartum (group B). Unvaccinated pregnant group B women served as control. This was a parallel, randomized, controlled, open-label, single-center trial to evaluate the safety (primary endpoint—outcomes of interest and serious adverse events (SAEs)) and immunogenicity (secondary endpoint) of the two-dose Ebola vaccination. Among 3,484 women screened, 2,013 were randomized, and 2,012 women and 1,945 infants born alive were descriptively analyzed . Adverse outcomes of interest occurred in women ( 5.2% in group A and 7.3% in group B ) and infants ( 26.0% in group A and 25.6% in group B ). The most common maternal outcome of interest was pathways to preterm birth (3.2% in group A and 3.4% in group B), and the most common infant ou...

  Abstract Objectives There have been few studies in pregnant women of medications that are used to reduce severe complications from COVID-19 infection. Currently, nirmatrelvir/ritonavir (Paxlovid) is recommended by the National Institutes for Health to treat non-hospitalized pregnant patients with mild-to-moderate COVID-19 illness. The aim of this study was to determine the transplacental passage of molnupiravir, nirmatrelvir/ritonavir and favipiravir utilizing an ex vivo placental perfusion model. Methods Human placental cotyledons were continuously perfused in a double open circuit. The study molecules and antipyrine, a marker of placental viability, were dissolved in the maternal solution. The experiment was conducted over 90 minutes, and every 5 minutes, samples of the maternal solution and fetal exchange solutions were collected for analysis. We calculated the concentrations of study molecules, fetal transfer ratios and the clearance indexes to determine placental transfer. R...

Abstract The relationship among timing and severity of COVID-19 during pregnancy , placental pathology , and adverse pregnancy outcomes is not well understood. A prospective cohort study of 497 pregnant patients with COVID-19 whose placentas underwent systematic pathologic examination was conducted. The main exposure was timing of COVID-19 during pregnancy (first/second versus third trimester). The primary outcome was composite placental pathology that included high grade maternal vascular malperfusion or greater than 25 percent perivillous fibrin deposition. There were 63 patients who had the composite placental pathology outcome. In adjusted analyses that controlled for maternal age, parity, active infection at delivery, interval from time of diagnosis to delivery and COVID-19 variant, timing of COVID-19 during pregnancy was not associated with risk of the composite placental pathology outcome . Among secondary COVID-19 related exposures that were investigated, severity of disease an...

Highlights •  A large B19V French outbreak of an unexpected magnitude occurred, with a monthly rate that has reached 21.4%. •  During this outbreak, 50% of infected pregnant women exhibited fetal complications. •  Phylogenetic analysis revealed the co-circulation of several B19V lineages of genotype 1a, the main epidemic lineage of which emerged in 2017. Abstract Background The human parvovirus B19 (B19V) infections cycle occurs in 3- to 4-year periods and is responsible for benign childhood erythema infectiosum . It is also associated with transient aplastic crisis in patients with underlying hemolytic diseases and with severe fetal sometimes fatal infection . This study investigated the epidemiological, clinical and molecular characteristics of an unusually large 2023-2024 outbreak of B19V. Methods . Laboratory-confirmed cases were retrospectively and prospectively recorded at the Clermont-Ferrand University Hospital, France , between January, 2018 and November, 2023 an...

Abstract Oropouche fever is caused by the Oropouche virus (OROV; Bunyaviridae , Orthobunyavirus), one of the most frequent arboviruses that infect humans in the Brazilian Amazon . This year, an OROV outbreak was identified in Brazil , and its vertical transmission was reported, which was associated with fetal death and microcephaly. We describe the clinical manifestations identified in three cases of congenital OROV infection with confirmed serology (OROV-IgM) in the mother-newborn binomial . One of the newborns died , and post-mortem molecular analysis using real-time RT-qPCR identified the OROV genome in several tissues . All three newborns were born in the Amazon region in Brazil , and the mothers reported fever, rash, headache, myalgia, and/or retro-orbital pain during pregnancy . The newborns presented with severe microcephaly secondary to brain damage and arthrogryposis , suggestive of an embryo/fetal disruptive process at birth . Brain and spinal images identified overlapping su...

 Source: US National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/39668388/  Abstract Human cases of avian influenza A(H5N2) and A(H5N1) viruses associated with outbreaks in birds and mammals are increasing globally, raising concerns about the possibility of a future avian influenza pandemic . We conducted a systematic review examining 30 reported cases of avian influenza in pregnant women . We found high mortality rates for mothers (90.0%, 27/30) and their babies (86.7%, 26/30) when women were infected with avian influenza virus during pregnancy. Despite being a high-risk population and having worse health outcomes across multiple pandemics , pregnant women are often excluded from vaccine trials . However, as the risk for a new pandemic increases and human vaccines against avian influenza are developed, early inclusion of pregnant women in clinical trials can inform the risk-benefit analysis for both the mother and their newborn infant. Early inclusion of pregnan...