Pregnant women who experienced severe symptoms of COVID-19 had a higher risk of complications during and after pregnancy, according to preliminary findings from a National Institutes of Health study.
Compared to COVID-19 patients without symptoms, those with severe symptoms were at higher risk for cesarean delivery, postpartum hemorrhage, hypertensive disorders of pregnancy and preterm birth.
The study was led by Torri Metz, M.D., of University of Utah Health, Salt Lake City, and Rebecca Clifton, Ph.D., of the Milken Institute School of Public Health at the George Washington University, Washington, D.C. An abstract of the study will be presented today at the Society for Maternal-Fetal Medicine’s(link is external) virtual annual meeting.
The findings come from the Gestational Research Assessments for COVID-19 (GRAVID) study conducted by investigators in the Maternal-Fetal Medicine Units (MFMU) Network, a group of U.S. clinical centers funded by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).
Researchers evaluated more than 1,200 pregnant women with COVID-19 who delivered at 33 U.S. hospitals between March 1 and July 30, 2020. Roughly half of the women (47%) were asymptomatic, 27% had mild symptoms, 14% had moderate symptoms, 8% had severe symptoms and 4% were critically ill. Those with more severe symptoms tended to be older, with a higher than average body mass index and underlying health issues, such as asthma, diabetes, hypertension, liver disease and seizure disorder.
Researchers attributed four maternal deaths to COVID-19. Transmission of SARS-CoV-2, the virus that causes COVID-19, from mother to child was rare, with 1% of newborns testing positive for the virus before discharge from the hospital.
Contrary to previous findings, low-dose aspirin therapy before conception and during early pregnancy may increase pregnancy chances and live births among women who have experienced one or two prior miscarriages, suggests a study by researchers at the National Institutes of Health.
Rather than looking solely at the difference in pregnancy rates between women who were given aspirin and those receiving a placebo, the study also accounted for differences in total aspirin use between women who deviated from the daily regimen and those who adhered to it.
The research team was led by Enrique Schisterman, Ph.D., of the Epidemiology Branch at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and colleagues. It appears in the Annals of Internal Medicine.
Published in 2014, the Effects of Aspirin in Gestation and Reproduction (EAGeR) trial included more than 1,000 women between 18 and 40 years old with one or two previous miscarriages. The women received either daily low-dose aspirin (81 milligrams) or a placebo while trying to conceive. If they did conceive, they would continue to receive this regimen through the 36th week of pregnancy. Although the study found no overall difference in pregnancy loss rates between the two groups, there was a higher birthrate for the subgroup of women who had experienced only one previous miscarriage before the 20th week of pregnancy.
Unlike the original analysis, the current reanalysis considered whether a participant adhered to the treatment or skipped days or discontinued it entirely for side effects such as bleeding, nausea or vomiting. Compared to the placebo group, for every 100 women, adhering to the aspirin regimen for five to seven days a week led to eight more positive pregnancy tests, six fewer pregnancy losses, and culminated in 15 more live births. Women who adhered to the therapy four days per week experienced similar results. The researchers concluded that taking low-dose aspirin at least four days per week could improve the odds for pregnancy and live birth in this group of women.
The offspring of older mothers don’t fare as well as those of younger mothers, in humans and many other species.
They aren’t as healthy, or they don’t live as long, or they have fewer offspring themselves. A longstanding puzzle is why evolution would maintain this maternal effect in so many species, since these late-born offspring are less fit to survive and reproduce.
In a new study in rotifers (microscopic invertebrates), scientists tested the evolutionary fitness of older-mother offspring in several real and simulated environments, including the relative luxury of laboratory culture, under threat of predation in the wild, or with reduced food supply.
They confirmed that this effect of older maternal age, called maternal effect senescence, does reduce evolutionary fitness of the offspring in all environments, primarily through reduced fertility during their peak reproductive period. They also suggest an evolutionary mechanism for why this may occur. The study, led by Kristin Gribble of the Marine Biological Laboratory and Christina Hernández of Woods Hole Oceanographic Institution, is published this week in Proceedings of the National Academy of Sciences.
“This study is unique in that it combines laboratory data from our prior work with mathematical modeling to address a longstanding question in the evolution of aging,” Gribble says.
“Natural selection should weed out these less-fit offspring of older mothers. So why do we see this phenomenon across so many species?”
To address this, Hernández and collaborators built mathematical models to calculate, for the first time, the strength of natural selection pressure on the survival and fertility of offspring populations as functions of the age of their mothers. They found this pressure, called the selection gradient, declines with maternal age “Because the selection pressure decreases as the mothers age, it may not be strong enough to remove these less-fit [offspring] from the population,” Hernandez says “Because of this, maternal effect senescence will persist and continue to evolve in the population, even though it results in decreased fitness,” Gribble adds. They don’t yet fully understand the genetic mechanisms that cause offspring quality to decrease with maternal age.
The models that the team developed can be applied to a wide range of species to evaluate the fitness consequences of maternal effect senescence. “As long as you have experimental data, as we did, on lifespan and fecundity of offspring from mothers of different ages, you can address this question in many organisms,” Gribble says.
President Dr Julius Maada Bio has used today’s press conference, also broadcast live, to express his outrage and total condemnation of the continued incidents of rape, sexual and gender-based violence in the West African nation.
President Bio
“The depravity of sexual violence is obscene, criminal, and totally objectionable. As a Government, we stand with the survivors, victims, and their loved ones and my Government will vigorously prosecute cases and bring all perpetrators to justice,” he said.
He reiterated his government’s commitment to providing support for survivors, adding that he was joining the First Lady, Fatima Maada Bio, to urge every Sierra Leoneans to help raise awareness, increase their advocacy while standing up to rid the country of what referred to as a menace.
“My Government is committed to equal protection and justice, inclusive development, and equal access to opportunity for every Sierra Leonean, especially women who constitute 51% of our population,” he assured.
“What we should do is to prevent rape, especially of little kids who know nothing about what is being done to them. If you can have the same passion that I have for the children of this country, rape will be a thing of the past. That is the challenge I throw to every citizen in this country,” he said, while taking questions on the matter.
Journalist and campaigner, Asmaa James, had raised the issue of recent incidents of sexual penetration involving minors
Journalist and campaigner, Asmaa James, had raised the issue of recent incidents of sexual penetration involving minors and made reference to earlier commitment by the President, who in February 2019 officially declared a National Emergency on Rape and Sexual Violence. She urged for more follow-up actions.
Minister of Gender and Children’s Affairs, Manti Tarawalli, said the fight against sexual and gender based violence is a collective one, adding that the more campaigners, advocacy groups and civil society call for more actions from government, the more they would continue to do more and also emphasise on the need for parents to be more responsible for the security of their children.
“This is not just for government. It is for communities and also parents. Since the Sexual Offences Act a lot has happened. We have started the male engagement strategy which was launched by His Excellency. What that does is to use men and boys advocates to go into communities to educate men and boys that sexual and gender-based violence is not acceptable,” she said.
She concluded that the ministry had also started a 24-hour free 116 hotline to report rape, taking in excess of 300 calls a day, adding that they were opening one-stop centres in all referral hospitals to provide psychosocial support, help the Family Support Unit to provide crime reports, provide forensic medical examination and treatment and were introducing DNA testing.
In Gorahun, the chiefdom headquarters of Tunkia Chiefdom, Baindu Sannoh has been a petty trader for about 10 years. She started with ‘Osusu’ (group savings) and continually invested in agriculture, growing groundnuts and other cash crops.
After every harvest she would sell some and keep some for the home. With the proceeds from sale she would travel to Kenema town to buy some basic food stuffs that were scarce in her community. She traded in soap, garri, sugar, rice, initially by cups and now by bags.
Then Baindu benefitted from a Small Business Development (SBD) initiative under the LANN+ project implemented by SEND Sierra Leone with funding from the German Federal Ministry for Economic Cooperation and Development (BMZ) through Welthungerhilfe (WHH). She added that to increase her stock.
She further joined the Village Savings and Loan Association Scheme (VSLA), a component under the LANN+ project.
Baindu has 3 children; two females and a boy (10). From her savings she is able to finance the education of her children and has built two latrines for her apartment, a family home.
Impact of Corona
During the Corona pandemic, Baindu has experienced drastic drop in sales.
“The restrictions, though good to prevent us from contracting the virus, are affecting our businesses,” she said. “There’s no more ‘Darwei’ (periodic markets); we just sell at home to neighbours and the community.”
During this period also, she (and her colleagues) are not making any savings with the VSLA because business activities has been hampered and they are not making profit.
Meanwhile, every morning she would put water in the veronica bucket donated to the community and ensured that anybody who passed by from the farm was encouraged to wash their hands.
Expectations
Baindu is looking forward to the second loan under the project but everything has stopped because of the Corona pandemic.
The 35 year-old hopes Coronavirus will go away and things will return to normal; get further loan and invest more in her business to make money.
For Mimi Pabai, 42, a mother of three, she can now see light at the end of the tunnel with the introduction of the EU-funded Boosting Agriculture and Food Security (BAFS) project in which selected farmers in Bo District are beneficiaries.
Mimi ( center) with members of Gualatima Women’s Cooperative
In the Faala community of the Bo District, Southern Province of Sierra Leone, where she is head of the Gualatima Women’s Cooperative, there are visible signs of the gains brought to her farming activities.
“Life was hard when I lost my husband during the January 6, 1999 rebel invasion of Freetown at the climax of the 11-year civil war of Sierra Leone. I returned to Bo to see how I could make my life meaningful since I already had the basics in gardening,” Mimi says.
In Bo, she decided to bring other women who had suffered similar fate together to form a self-help group. This initiative led to the establishment of the Gualatima formation of a women’s cooperative with the aim of embarking on gardening as a source of livelihood.
“It was not easy in the beginning since we had no access to land. After several requests, the community elders gave us a portion of land for our farming activities. This enabled us to
cultivate leafy vegetables. Subsequently, we brought other women on board.
“The increase in the number of women led to the demand for more land for expansion of our work,” Mimi says.
With time, through Mimi’s initiative, the number of women grew exponentially. Mimi was subsequently made leader of 49 women’s groups, with a strong membership of 1,955 from several communities in the Bo and Moyamba districts of Sierra Leone. “When I was appointed chairlady, this was a turnaround in my life as many women joined me and we began doing big things.” Over the past two years, our target had been to venture into cashew production, but we had no land and no cashew seedlings. When I heard about the BAFS project, I contacted Solidaridad and they happily supported us with cashew seedlings after the town chief gave us more land.
According to Mimi, Solidaridad was the first organization to change the narrative of women not owning cash crop farms. Together with her group, they were lucky to have been the first women’s group to receive and plant 107 acres of cashew seedlings under the Boosting Agriculture and Food Security (BAFS) project. The project targets smallholder farmers as the driving force of agricultural production in Sierra Leone.
“We were proud to see the Solidaridad vehicle with the seedlings in our community. It makes us proud and more committed as farmers.”
Solidaridad West Africa, through the European Union funding, focuses on cashew, coffee and cocoa. The overall objective of the BAFS project is to reduce poverty and food insecurity while improving household living conditions, as well as higher incomes.
This is achieved by a special focus on increasing the quality and quantity of production, processing, marketing and trading while implementing environmentally sound agricultural practices.
The project seeks to improve household living conditions by promoting tree crop intensification and diversification through intercropping techniques such that the women would be able to make enough money and remain self-reliant.
The project is implemented by Solidaridad (lead implementer) and the Cotton Tree Foundation as the co-implementer across 10 districts of Sierra Leone.
“Solidaridad focuses on supporting farmers, especially women and the youth to meet the food and nutritional needs of their families, as well as improving their economic wellbeing and is, therefore, happy with this partnership with the EU and the Government of Sierra Leone,” says Nicholas Jengre, Country Representative for Solidaridad.
The longer a woman with gestational, or pregnancy-related, diabetes breastfeeds her infant, the lower her risk for developing type 2 diabetes later in life, suggests an analysis by researchers at the National Institutes of Health and other institutions.
The study was conducted by Cuilin Zhang, M.D., Ph.D., of NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and colleagues. It appears in Diabetes Care.
In addition to health risks for mothers and babies, gestational diabetes increases the risk for type 2 diabetes 10 to 20 years after pregnancy. Type 2 diabetes increases the risk for heart disease, stroke and other health problems.
The researchers analyzed data from the Nurses’ Health Study II, a long-term study of risk factors for chronic diseases in women. Of more than 4,000 women in the study who had gestational diabetes, 873 developed type 2 diabetes over the course of 25 years. Compared to women with gestational diabetes who had not breastfed, those who breastfed for six to 12 months were 9% less likely to develop type 2 diabetes, those who breastfed for one to two years were 15% less likely, and those who breastfed for more than two years were 27% less likely.
The researchers suggested that clinicians may want to encourage patients with gestational diabetes to breastfeed if they are able to, to potentially reduce their type 2 diabetes risk.
The analysis was funded by NICHD with additional support from NIH’s National Institute of General Medical Sciences.
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