COVID19 pandemics has had profound consequences on public health and has represented a challenge for several medical specialties. Despite this was underestimated at the beginning of the outbreak, COVID19 is actually impacting on women and children health, as well. The consequences in this field are multifaceted and complex as they span from the occurrence of COVID19 in pregnant patients, to the possibility of SARS-CoV-2 mother-to-child transmission, the occurrence of neonatal COVID and pediatric sequelae. COVID19 and the related public health measures may also have important consequences on psychological well-being and organization of perinatal care as well as they raise relevant ethical issues. All these aspects were at risk to be forgotten within the many others highlighted by the pandemics but are important both for individual care and also from a political point of view and the organization of care. There is a large demand of high-quality education, information and training in this field and we answered that by organising the COVID19 in Pregnancy and Childhood Days: this book represents the hard legacy of this event with the contribution of key opinion leaders in all the aforementioned specialties. The book is answering a clear need and is directed to: 1) obstetricians, 2) neonatologists, 3) pediatricians, 3) public health specialists, 4) adult critical care physicians, 5) infectious disease specialists, 5) psychologists. Last but not least, the informations resumed in the book are going to be useful for healthcare authorities to program perinatal care and improve it. The book will also serve as textbook for post-graduate courses and academic review resuming the state-of-the art knowledge on this area. Thus, it will be cited and used by researchers in the field: this is not a secondary characteristics as it may be quite difficult to find relevant informations, in this infodemic era, using the usual channels and databases.
Author(s): Daniele De Luca, Alexandra Benachi
Publisher: Springer
Year: 2023
Language: English
Pages: 289
City: Cham
Preface
Introduction: The Importance of European Perinatology During COVID-19 Pandemics
Contents
Contributors
Part I: Obstetrics
Chapter 1: Clinical Management of COVID-19 During Pregnancy
1.1 Introduction
1.2 Initial Clinical Assessment
1.2.1 Search for Risk Factors of Unfavorable Clinical Outcome (Respiratory Distress)
1.2.2 Search for Signs of Severity and Maternal Complications
1.2.3 Search for Obstetrical Complications
1.3 Management of a Patient with COVID-19 Infection During Pregnancy with Criteria for Hospitalization
1.3.1 Maternal Care
1.3.2 Fetal Management
1.3.3 Fetal Extraction Criteria
1.4 Conclusion
References
Chapter 2: Complications of COVID-19 in Pregnant Women
2.1 Maternal Complications
2.2 Obstetrical Complications
2.2.1 Preeclampsia
2.2.2 Preterm Birth
2.2.3 Stillbirth
References
Chapter 3: Peculiarities of ARDS Induced by COVID-19 in Pregnant Patients
3.1 SARS-CoV-2 Infection and Pregnancy
3.2 Maternal and Neonatal Management of COVID-19 ARDS
3.2.1 Respiratory Support
3.2.2 Prone Position
3.3 Extracorporeal Membrane Oxygenation (ECMO)
3.4 Delivery
References
Chapter 4: Miscarriage and Fetal Death
4.1 Introduction
4.2 Definitions
4.3 Miscarriages
4.4 Fetal Death
4.5 Conclusion
Bibliography
Chapter 5: COVID-19 in Perinatology: Obstetrical Counseling to Pregnant Women During Pandemics
5.1 Clinical Implications of COVID-19 Infection During Pregnancy
5.2 Changes to Obstetric Healthcare During the Pandemic
5.2.1 Prenatal Care
5.2.2 Intrapartum Care
5.2.3 Postnatal Care
5.3 Use of COVID-19-Specific Medication During Pregnancy
5.4 Pregnancy and Pandemics: Lessons for the Future
5.4.1 Prediction
5.4.2 Preparedness
References
Part II: Perinatal Medicine
Chapter 6: Biological Mechanisms of Transplacental SARS-COV-2 Transmission
6.1 The Maternal–Fetal Interface
6.2 SARS-COV-2 Infection: Virus Characteristics (Genomic and Taxonomy)
6.3 SARS-COV-2 and Cell Entry: Mechanism and Receptors
6.4 ACE2 and TMPRSS2: Role in the Placental Transmission
6.5 Latest News
6.6 Conclusions
References
Chapter 7: Placental Pathology During COVID-19
7.1 Introduction
7.2 Role of Placental Pathology in Emerging Infections
7.3 Placental Pathology and COVID-19
7.4 SARS-CoV-2 Placentitis
7.5 Determining Placental Infection with SARS-CoV-2
7.6 Placental Pathology and Stillbirth from COVID-19
References
Chapter 8: Perinatal Diagnostic of SARS-CoV-2 Infection
8.1 Samples Suitable for Testing
8.2 Detecting the Presence of SARS-CoV-2 Virus
8.3 Detecting the Presence of Antibodies Against SARS-CoV-2 Virus
8.4 Interpretation of Virological and Serological Diagnostic Tests in Perinatal SARS-CoV-2 Infection
References
Chapter 9: Vertical SARS-CoV-2 Transmission
9.1 Introduction
9.2 Definitions
9.3 Mechanisms of In Utero SARS-CoV-2 Transmission
9.4 Mechanisms of Intrapartum SARS-CoV-2 Transmission
9.5 Consequences of SARS-CoV-2 Vertical Transmission
References
Chapter 10: Transplacental Transfer of SARS-COV-2 Antibodies
10.1 Mechanisms of Transfer of Molecules Across the Placental Barrier
10.2 Immunoglobulin Structure and Types
10.3 Antibody Transfer from Maternal to Fetal Circulation
10.4 Transfer of SARS-CoV-2 Antibodies After Maternal Infection
10.4.1 Maternal IgG Concentration
10.4.2 Time Between Maternal Infection and Delivery
10.4.3 Gestational Age at Infection
10.4.4 Disease Severity
10.4.5 Maternal Viral Load
10.5 Transfer of SARS-CoV-2 Antibodies After Maternal Vaccination
10.5.1 Maternal IgG Titers
10.5.2 Gestational Age at Vaccination
10.5.3 Time Between Maternal Vaccination and Delivery
10.5.4 Number of Vaccine Doses
10.6 Comparison of Antibody Transfer Following Infection to Antibody Transfer Following Vaccination
References
Part III: Neonatology
Chapter 11: COVID-19 in Neonates: Mechanisms, Clinical Features, and Treatments
11.1 Introduction
11.2 Transmission of SARS-CoV-2 Infection to Newborn Infants
11.3 Diagnostic Criteria for Neonatal SARS-COV-2 Infection
11.4 Virological Tests
11.5 Clinical Manifestations of Neonatal COVID-19
11.6 Severe and Critical Forms of Neonatal COVID-19
11.7 Laboratory Findings in Neonatal COVID-19
11.8 Imaging in Neonatal COVID-19
11.9 Delayed M anifestations of Neonatal SARS-COV-2 Infection: MIS-N
11.10 Treatment
11.10.1 General Principles
11.10.2 Vital Support
11.10.3 Specific Antiviral Therapies
11.10.4 Anti-inflammatory Drugs
References
Chapter 12: Impact of COVID on Prematurity
12.1 Introduction
12.2 Evidence so Far
12.3 Other Adverse Pregnancy Outcomes
12.4 Mechanism of Prematurity Associated with COVID-19 in Pregnancy
12.5 Direct Versus Indirect Effect
12.6 Does COVID-19 Cause Preterm Birth, Preeclampsia and Stillbirth?
12.6.1 Bradford-Hill Criteria (Table 12.1)
12.6.1.1 Strength
12.6.1.2 Consistency
12.6.1.3 Specificity
12.6.1.4 Temporality
12.6.1.5 Biological Gradient
12.7 Plausibility
12.8 Coherence
12.9 Experimental Evidence
12.10 Analogous Evidence
12.11 Reversibility
12.12 Clinical Implications
12.13 The Case for COVID Vaccination in Pregnancy
12.14 Lessons Learned from the COVID-19 Pandemic
References
Chapter 13: Management of Neonatal Care During COVID19 Pandemics
13.1 Introduction
13.2 Mothers with Perinatal COVID-19 Infection and Neonatal Outcome
13.3 Neonatal Infection
13.4 Neonatal Care
References
Part IV: Public Health
Chapter 14: Research Networks and Accelerated Research Pathways for Perinatal Health
14.1 Introduction
14.2 Selected Perinatal COVID-19 Research Partnerships
14.2.1 Site-Level Collaboration
14.2.2 National Surveillance
14.2.3 Population-Based Reporting
14.2.4 International Network
14.2.5 Summary of the Characteristics of the Selected Studies
14.3 Successful Planning for Pandemic Research that Is not Specific to Pregnancy
14.3.1 The UK
14.3.1.1 Challenges
14.3.1.2 UK Summary
14.3.2 The European Union (EU)
14.3.3 Interventional Studies
14.4 Discussion
14.4.1 Ways of Working
14.4.2 Ways Forward
14.4.3 Global Initiatives
14.5 Conclusions
References
Chapter 15: Impact of COVID-19 Lockdowns on Maternal and Perinatal Health
15.1 Introduction
15.1.1 Spread of the Pandemic and Initial Policy Responses
15.1.2 Drop in Preterm Births Following Lockdowns
15.1.3 Chapter Overview
15.2 Impact of Lockdown Measures on Perinatal Outcomes
15.2.1 Impact of Lockdown on Preterm Birth
15.2.2 Impact of Lockdown on Other Perinatal Outcomes
15.3 Impact of Lockdown Measures on Maternal Outcomes
15.3.1 Impact of Lockdown on Hypertensive Disorders of Pregnancy
15.3.2 Impact of Lockdown on Other Maternal Outcomes
15.3.3 Impact of Lockdown on Start and Mode of Delivery
15.4 Impact of Lockdown on Postnatal Care and Breastfeeding
15.5 Inequalities in Impact of Lockdown on Maternal and Perinatal Health
15.6 Methodological Considerations
15.6.1 Methodological Considerations: Original Studies
15.6.2 Methodological Considerations: Meta-Analyses
15.7 Exploring the Underlying Mechanisms
15.7.1 Changes in Healthcare Seeking and Delivery
15.7.2 Maternal Stress and Working Conditions
15.7.3 Maternal Infections
15.7.4 Air Pollution
15.7.5 Other Mechanisms
15.8 Future Research Needs and Implications
15.9 Conclusion
References
Chapter 16: Prevention of Future Pandemics and Impact on Perinatology
16.1 Background
16.2 Prevention and Communication
16.2.1 Facebook and Fake News
16.2.2 Twitter and Fake News About Pregnancy and the COVID-19 Vaccination
16.2.3 YouTube and Fake News About Pregnancy and the COVID-19 Vaccination Abortion
16.2.4 Instagram and Fake News
16.2.5 Newspapers, Journals, and Magazines
16.3 European Institutional Websites Dealing with COVID-19 Vaccine During Pregnancy
16.4 Conclusions and Recommendations
References
Part V: Psychology and Ethics
Chapter 17: Perinatal Psychological and Psychiatric Impact of the SARS-CoV-2 Pandemic Health Crisis
17.1 Introduction
17.2 Mental Health of Pregnant Versus Non-pregnant Women during the SARS-CoV-2 Pandemic
17.3 Mental Health of Pregnant Women During the Pandemic Versus Before the Pandemic
17.4 Impact of the Pandemic on Pregnant Women with Pre-existing Psychiatric Disorders
17.5 Risk of the Development of Perinatal Psychiatric Disorders During the SARS-CoV-2 Pandemic and Protective Factors
17.6 Intervention Options to Prevent Deterioration of Perinatal Mental Health During a Pandemic
17.7 Conclusion
References
Chapter 18: Collateral Damage of the COVID-19 Pandemic for the Next Generation: A Call to Action
18.1 Introduction
18.2 COVID-19 Effects on Pregnant Women’s Mental Health
18.3 Fetal Programming
18.4 Historical Lessons of Prenatal Maternal Stress
18.5 Lessons for Now and the Future
References
Chapter 19: Management of Mental Health in Pregnant Women During COVID-19
19.1 Introduction: Mental Health in Pregnant Women
19.2 Expectant Mother’s Mental Health During the COVID-19 Pandemic
19.2.1 Care Provision and Care-Seeking Behaviors in the Time of COVID-19
19.2.2 Risk and Protective Factors
19.3 Guidelines and Implications for Practice
References
Chapter 20: Ethical Issues of COVID-19 During Pregnancy and Childhood
20.1 Background
20.2 COVID-19 Can Be More Severe in Pregnant Women
20.2.1 Clinical Context
20.2.2 Ethical Issues
20.3 SARS-COV-2 Can Be Transmitted from Mother to Foetus/Neonate
20.3.1 Clinical Context
20.3.2 Ethical Issues
20.4 COVID-19 Can Severely Affect Paediatric Patients
20.4.1 Clinical Context
20.4.2 Ethical Issues
20.5 Indirect Ethical Consequences of COVID-19 for Pregnancy and Paediatric Care
References
