Journal articles: 'Prenatal transmission'

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Guibert, Floriane, Sophie Lumineau, Kurt Kotrschal, Erich Möstl, Marie-Annick Richard-Yris, and Cécilia Houdelier. "Trans-generational effects of prenatal stress in quail." Proceedings of the Royal Society B: Biological Sciences 280, no. 1753 (February 22, 2013): 20122368. http://dx.doi.org/10.1098/rspb.2012.2368.

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The prenatal environment is a source of phenotypic variability influencing the animal's characteristics. Prenatal stress affects not only the development of offspring, but also that of the following generation. Such effects have been best documented in mammals but can also be observed in birds, suggesting common processes across phylogenetic orders. We found previously that Japanese quail females stressed during laying produced offspring with higher fearfulness, probably related to modulation of testosterone levels in their eggs. Here, we evaluated long-term effects of prenatal stress by analysing reproductive traits of these F 1 offspring and, then, the development of their subsequent (F 2 ) offspring. The sexual behaviour of F 1 prenatally stressed (F1PS) males was impaired. F1PS females' eggs contained less yolk and more albumen, and higher yolk testosterone and progesterone levels than did F 1 prenatal control females. The fearfulness of F 2 prenatally stressed quail was greater than that of F 2 prenatal control quail. These F 2 behavioural differences paralleled those evidenced by their parents, suggesting trans-generational transmission of prenatal stress effects, probably mediated by egg compositions of F1PS females.

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Rodrigues, Celeste Souza, Mark Drew Crosland Guimarães, and Cibele Comini César. "Missed opportunities for congenital syphilis and HIV perinatal transmission prevention." Revista de Saúde Pública 42, no. 5 (October 2008): 851–58. http://dx.doi.org/10.1590/s0034-89102008000500010.

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OBJECTIVE: To estimate the prevalence of missed opportunities for congenital syphilis and HIV prevention in pregnant women who had access to prenatal care and to assess factors associated to non-testing of these infections. METHODS: Cross-sectional study comprising a randomly selected sample of 2,145 puerperal women who were admitted in maternity hospitals for delivery or curettage and had attended at least one prenatal care visit, in Brazil between 1999 and 2000. No syphilis and/or anti-HIV testing during pregnancy was a marker for missed prevention opportunity. Women who were not tested for either or both were compared to those who had at least one syphilis and one anti-HIV testing performed during pregnancy (reference category). The prevalence of missed prevention opportunity was estimated for each category with 95% confidence intervals. Factors independently associated with missed prevention opportunity were assessed through multinomial logistic regression. RESULTS: The prevalence of missed prevention opportunity for syphilis or anti-HIV was 41.2% and 56.0%, respectively. The multivariate analysis showed that race/skin color (non-white), schooling (<8 years), marital status (single), income (<3 monthly minimum wages), having sex during pregnancy, history of syphilis prior to the current pregnancy, number of prenatal care visits (<6), and last prenatal visit before the third trimester of gestation were associated with an increased risk of missed prevention opportunity. A negative association with missed prevention opportunity was found between marital status (single), prenatal care site (hospital) and first prenatal visit in the third trimester of gestation. CONCLUSIONS: High rates of non-tested women indicate failures in preventive and control actions for HIV infection and congenital syphilis. Pregnant women have been discontinuing prenatal care at an early stage and are failing to undergo prenatal screening for HIV and syphilis.

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Peters, Vicki, Kai-Lih Liu, Kenneth Dominguez, Toni Frederick, Sharon Melville, Ho-Wen Hsu, Idith Ortiz, Tamara Rakusan, Balwant Gill, and Pauline Thomas. "Missed Opportunities for Perinatal HIV Prevention Among HIV-Exposed Infants Born 1996–2000, Pediatric Spectrum of HIV Disease Cohort." Pediatrics 111, Supplement_1 (May 1, 2003): 1186–91. http://dx.doi.org/10.1542/peds.111.s1.1186.

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Objective. Despite dramatic reductions in perinatal human immunodeficiency virus (HIV) transmission in the United States, obstacles to perinatal HIV prevention that include lack of prenatal care; failure to test pregnant women for HIV before delivery; and lack of prenatal, intrapartum, or neonatal antiretroviral (ARV) use remain. The objective of this study was to describe trends in perinatal HIV prevention methods, perinatal transmission rates, and the contribution of missed opportunities for perinatal HIV prevention to perinatal HIV infection. Methods. We analyzed data obtained from infant medical records on 4755 HIV-exposed singleton deliveries in 1996–2000, from 6 US sites that participate in the Centers for Disease Control and Prevention’s Pediatric Spectrum of HIV Disease Project. HIV-exposed deliveries refer to deliveries in which the mother was known to have HIV infection during the pregnancy. Results. Of the 4287 women with data on prenatal care, 92% had prenatal care. From 1996 to 2000, among the 3925 women with prenatal care, 92% had an HIV test before delivery; the use of prenatal zidovudine (ZDV) alone decreased from 71% to 9%, and the use of prenatal ZDV with other ARVs increased from 6% to 70%. Complete data on maternal and neonatal ARVs were available for 3284 deliveries. Perinatal HIV transmission was 3% in 1651 deliveries with prenatal ZDV in combination with other ARVs, intrapartum ZDV, and neonatal ZDV; 6% in 1111 deliveries with prenatal, intrapartum, and neonatal ZDV alone; 8% in 152 deliveries with intrapartum and neonatal ZDV alone; 14% of 73 deliveries with neonatal ZDV only started within 24 hours of birth; and 20% in 297 deliveries with no prenatal, intrapartum, and neonatal ARVs. Complete data on prenatal events were available in 328 HIV-infected and 3258 HIV-uninfected infants. A total of 56% of mothers of HIV-infected infants had missed opportunities for perinatal HIV prevention versus 16% of mothers of HIV-uninfected infants. Forty-four percent of the infected infants were born to mothers who had prenatal care, a prenatal HIV diagnosis, and documented prenatal ARV therapy. Seventeen percent of women with reported illicit drug use had no prenatal care versus 3% of women with no reported drug use. In a multivariate analysis, maternal illicit drug use was significantly associated with lack of prenatal care. In a multivariate analysis, year of infant birth and the combination of lack of maternal HIV testing before delivery and lack of prenatal antiretroviral therapies were significantly associated with perinatal HIV transmission. Conclusions. Missed opportunities for perinatal HIV prevention contributed to more than half of the cases of HIV-infected infants. Prenatal care and HIV testing before delivery are major opportunities for perinatal HIV prevention. Illicit drug use was highly associated with lack of prenatal care, and lack of HIV testing before delivery was highly associated with perinatal HIV transmission.

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Boussemart, T., P. Babe, G. Sibille, C. Neyret, and C. Berchel. "Prenatal Transmission of Dengue: Two New Cases." Journal of Perinatology 21, no. 4 (June 2001): 255–57. http://dx.doi.org/10.1038/sj.jp.7200530.

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Andany, Nisha, Michelle Letchumanan, Lise Bondy, Kellie Murphy, and Mona R. Loutfy. "Amniocentesis in the HIV-Infected Pregnant Woman: Is There Still Cause for Concern in the Era of Combination Antiretroviral Therapy?" Canadian Journal of Infectious Diseases and Medical Microbiology 24, no. 3 (2013): e91-e95. http://dx.doi.org/10.1155/2013/185192.

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The current standard of care in Canadian obstetrical practice is to offer pregnant women the opportunity for prenatal investigation to diagnose congenital abnormalities. Prenatal amniocentesis is Canada’s most commonly practiced invasive procedure for the diagnosis of chromosomal and single gene disorders. The potential risk of intrapartum HIV transmission during amniocentesis raises several ethical concerns and limits the availability of prenatal genetic testing for HIV-positive pregnant women. Complete virological suppression with antiretroviral therapy may alleviate the risk of mother-to-child transmission during amniocentesis and increase accessibility of this important diagnostic tool in the HIV-positive population. The present report describes a case involving a 32-year-old HIV-positive pregnant woman whose plasma viral load was undetectable on antiretroviral therapy; she underwent successful prenatal amniocentesis without transmission of HIV to her infant.

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Reitter, A., A. U. Stücker, H. Buxmann, E. Herrmann, A. E. Haberl, R. Schlößer, and F. Louwen. "Prenatal Ultrasound Screening for Fetal Anomalies and Outcomes in High-Risk Pregnancies due to Maternal HIV Infection: A Retrospective Study." Infectious Diseases in Obstetrics and Gynecology 2013 (2013): 1–10. http://dx.doi.org/10.1155/2013/208482.

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Objective. To assess the prevalence of prenatal screening and of adverse outcome in high-risk pregnancies due to maternal HIV infection.Study Design. The prevalence of prenatal screening in 330 pregnancies of HIV-positive women attending the department for prenatal screening and/or during labour between January 1, 2002 and December 31, 2012, was recorded. Screening results were compared with the postnatal outcome and maternal morbidity, and mother-to-child transmission (MTCT) was evaluated.Results. One hundred of 330 women (30.5%) had an early anomaly scan, 252 (74.5%) had a detailed scan at 20–22 weeks, 18 (5.5%) had a detailed scan prior to birth, and three (0.9%) had an amniocentesis. In seven cases (2.12%), a fetal anomaly was detected prenatally and confirmed postnatally, while in eight (2.42%) an anomaly was only detected postnatally, even though a prenatal scan was performed. There were no anomalies in the unscreened group. MTCT occurred in three cases (0.9%) and seven fetal and neonatal deaths (2.1%) were reported.Conclusion. The overall prevalence of prenatal ultrasound screening in our cohort is 74.5%, but often the opportunity for prenatal ultrasonography in the first trimester is missed. In general, the aim should be to offer prenatal ultrasonography in the first trimester in all pregnancies. This allows early reassurance or if fetal disease is suspected, further steps can be taken.

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Manjarrez, Gabriel, Ignacia Cisneros, Rocio Herrera, Felipe Vazquez, Alejandro Robles, and Jorge Hernandez. "Prenatal Impairment of Brain Serotonergic Transmission in Infants." Journal of Pediatrics 147, no. 5 (November 2005): 592–96. http://dx.doi.org/10.1016/j.jpeds.2005.06.025.

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Amutah-Onukagha, Ndidiamaka, Tonia J. Rhone, Mandy J. Hill, Alecia McGregor, and Rebecca Cohen. "Prevalence of Prenatal HIV Screening in Massachusetts: Examining Patterns in Prenatal HIV Screening Using the Massachusetts Pregnancy Risk Assessment Monitoring System (PRAMS), 2007-2016." Journal of the International Association of Providers of AIDS Care (JIAPAC) 21 (January 2022): 232595822110697. http://dx.doi.org/10.1177/23259582211069767.

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Prenatal HIV screening is critical to eliminate mother-to-child (MTC) HIV transmission. Although Massachusetts (MA) has near-zero MTC transmission rates, recent trends in statewide prenatal HIV testing are unknown. This study examined variations in prenatal HIV screening across race/ethnicity, socioeconomic status, and prenatal care settings in MA, in the period following national and state-level changes in guidance encouraging routine prenatal HIV testing. According to the MA Pregnancy Risk Assessment Monitoring System (PRAMS) data, 68.3% of pregnant women in MA were screened for HIV between 2007 and 2016. There were significant differences in prenatal screening rates across race/ethnicity, with 83.38% of Black non-Hispanic (NH), 85.5% of Hispanic women, and 62.4% of White NH women reporting being tested for HIV at some point during their pregnancy ( P <.0001). Multivariate regression found that differences in screening were explained by race/ethnicity, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) status, prenatal care site, type of insurance, nativity, and marital status. Annual rates of prenatal HIV screening did not change significantly in MA from 2007 to 2016 ( P = .27). The results of the analysis revealed that prenatal HIV screening rates differ based on race/ethnicity, with higher rates in Black NH and Hispanic women when compared to White NH women. The racial disparities in prenatal HIV screening and lack of universal screening in MA raises questions about the effectiveness of the state's approach.

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Euler, Gary L., Karen G. Wooten, Andrew L. Baughman, and Walter W. Williams. "Hepatitis B Surface Antigen Prevalence Among Pregnant Women in Urban Areas: Implications for Testing, Reporting, and Preventing Perinatal Transmission." Pediatrics 111, Supplement_1 (May 1, 2003): 1192–97. http://dx.doi.org/10.1542/peds.111.s1.1192.

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Objectives. To estimate race/ethnicity-specific prevalence of hepatitis B surface antigen (HBsAg) in pregnant urban women and to evaluate factors associated with maternal HBsAg testing. Methods. A multicenter, retrospective chart review was conducted of a racially/ethnically stratified random sample of maternal/infant charts of 10 523 women who gave birth to live infants during 1990–1993 in 4 urban areas in the United States. Data were collected on multiple variables, including demographic variables, HBsAg test dates and results, prenatal care type, and amount and source of payment. Results. HBsAg prevalence among white non-Hispanics was 0.60% (95% confidence interval [CI]: 0.22–0.98), black non-Hispanics 0.97% (95% CI: 0.48–1.47), Hispanics 0.14% (95% CI: 0.01–0.26), and Asians 5.79% (95% CI: 4.42–7.16). HBsAg testing rates increased from 56.6% in 1990 to 78.2% in 1993. Factors associated with not being tested varied by urban area, but in the combined area model, they were having no or private prenatal care (odds ratios: 18.75 and 5.07, respectively) and being black (odds ratios: 2.08). Only 20.9% (95% CI: 19.1%–22.8%) of those not tested prenatally were tested at delivery. The expected number of infants born to HBsAg-positive study-area women was 3327 using study prevalence rates, compared with 1761 using national rates. Conclusions. To help ensure that all urban infants who are born to HBsAg-positive women receive appropriate prophylaxis, health officials in urban areas should use urban-area prevalence rates to ascertain completeness of reporting maternal HBsAg positivity. Needed steps to increase maternal HBsAg testing rates include ensuring that more pregnant women receive prenatal care, promoting testing by private providers, educating providers about testing in all racial and ethnic groups, and reminding providers to test at delivery those women not tested prenatally.

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Setyoboedi, Bagus, Avianita Kusumawardhani, Agung Widodo, and Muhammad Akbar. "Tenofovir Disoproxil Fumarate Prenatal as A Complementary Treatment to Prevent Vertical Transmission of Hepatitis B Virus: A Systematic Review." International Journal of Medical Reviews and Case Reports 5, Reports in Dental Medicine and (2021): 1. http://dx.doi.org/10.5455/ijmrcr.tenofovir-disoproxil-fumarate-prenatal.

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Blagowidow, Natalie, Beata Nowakowska, Erica Schindewolf, Francesca Romana Grati, Carolina Putotto, Jeroen Breckpot, Ann Swillen, et al. "Prenatal Screening and Diagnostic Considerations for 22q11.2 Microdeletions." Genes 14, no. 1 (January 6, 2023): 160. http://dx.doi.org/10.3390/genes14010160.

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Diagnosis of a chromosome 22q11.2 microdeletion and its associated deletion syndrome (22q11.2DS) is optimally made early. We reviewed the available literature to provide contemporary guidance and recommendations related to the prenatal period. Indications for prenatal diagnostic testing include a parent or child with the 22q11.2 microdeletion or suggestive prenatal screening results. Definitive diagnosis by genetic testing of chorionic villi or amniocytes using a chromosomal microarray will detect clinically relevant microdeletions. Screening options include noninvasive prenatal screening (NIPS) and imaging. The potential benefits and limitations of each screening method should be clearly conveyed. NIPS, a genetic option available from 10 weeks gestational age, has a 70–83% detection rate and a 40–50% PPV for most associated 22q11.2 microdeletions. Prenatal imaging, usually by ultrasound, can detect several physical features associated with 22q11.2DS. Findings vary, related to detection methods, gestational age, and relative specificity. Conotruncal cardiac anomalies are more strongly associated than skeletal, urinary tract, or other congenital anomalies such as thymic hypoplasia or cavum septi pellucidi dilatation. Among others, intrauterine growth restriction and polyhydramnios are additional associated, prenatally detectable signs. Preconception genetic counselling should be offered to males and females with 22q11.2DS, as there is a 50% risk of transmission in each pregnancy. A previous history of a de novo 22q11.2 microdeletion conveys a low risk of recurrence. Prenatal genetic counselling includes an offer of screening or diagnostic testing and discussion of results. The goal is to facilitate optimal perinatal care.

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Yunes, Roberto, Cecilia R. Estrella, Sebastián García, Hernán E. Lara, and Ricardo Cabrera. "Postnatal Administration of Allopregnanolone Modifies Glutamate Release but Not BDNF Content in Striatum Samples of Rats Prenatally Exposed to Ethanol." BioMed Research International 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/734367.

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Ethanol consumption during pregnancy may induce profound changes in fetal CNS development. We postulate that some of the effects of ethanol on striatal glutamatergic transmission and neurotrophin expression could be modulated by allopregnanolone, a neurosteroid modulator ofGABAAreceptor activity. We describe the acute pharmacological effect of allopregnanolone (65 μg/kg, s.c.) administered to juvenile male rats (day 21 of age) on the corticostriatal glutamatergic pathway, in both control and prenatally ethanol-exposed rats (two ip injections of 2.9 g/kg in 24% v/v saline solution on gestational day 8). Prenatal ethanol administration decreased the K+-induced release of glutamate regarding the control group. Interestingly, this effect was reverted by allopregnanolone. Regarding BDNF, allopregnanolone decreases the content of this neurotrophic factor in the striatum of control groups. However, both ethanol alone and ethanol plus allopregnanolone treated animals did not show any change regarding control values. We suggest that prenatal ethanol exposure may produce an alteration ofGABAAreceptors which blocks the GABA agonist-like effect of allopregnanolone on rapid glutamate release, thus disturbing normal neural transmission. Furthermore, the reciprocal interactions found between GABAergic neurosteroids and BDNF could underlie mechanisms operating during the neuronal plasticity of fetal development.

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Brodie, S. J., A. de la Concha-Bermejillo, G. Koenig, G. D. Snowder, and J. C. DeMartini. "Maternal Factors Associated with Prenatal Transmission of Ovine Lentivirus." Journal of Infectious Diseases 169, no. 3 (March 1, 1994): 653–57. http://dx.doi.org/10.1093/infdis/169.3.653.

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Schwerdtfeger, Kami L., and Briana S. Nelson Goff. "Intergenerational transmission of trauma: Exploring mother–infant prenatal attachment." Journal of Traumatic Stress 20, no. 1 (2007): 39–51. http://dx.doi.org/10.1002/jts.20179.

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Figueiredo, Elisabeth N., Lucila A. C. Vianna, Marina B. Peixe, Valdete M. Ramos, and Regina C. M. Succi. "The challenge of the reference and counter-reference system in the prenatal assistance to pregnant women with infectious diseases." Anais da Academia Brasileira de Ciências 81, no. 3 (September 2009): 551–58. http://dx.doi.org/10.1590/s0001-37652009000300018.

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The objective of this study was to determine the prevalence of infectious diseases, such as syphilis, acquired immune deficiency syndrome (AIDS) and hepatitis B and C, in pregnant women who undertook their prenatal care in thirteen basic health units (BHU) in São Paulo city. The efficiency of the reference and counter-reference system in such prenatal infectious diseases was evaluated considering the medical recordings of the final result of the pregnancy and the vertical transmission rates of these diseases. It consists of an epidemiologic study whose observations were based on the notes of the prenatal medical and nurse records of pregnant women who had infectious diseases susceptible to vertical transmission and final infectious status registers of their concepts. Women's syphilis prevalence was 0. 86%, HIV and Hepatitis B was 0. 22% and Hepatitis C was 0. 36%. It's possible to conclude that there is no register of the reference and counter-reference system of these infectious diseases analyzed at the thirteen basic health units of the south-east region of São Paulo city evaluated in 2005. This lack of register makes it impossible to know the preventive measures taken and the vertical transmission rates. Making the professionals and the Health Coordination authorities aware of the importance of the dynamic of the prenatal attendance is necessary.

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Bell, Susan Givens. "Highly Active Antiretroviral Therapy in Neonates and Young Infants." Neonatal Network 23, no. 2 (March 2004): 55–64. http://dx.doi.org/10.1891/0730-0832.23.2.55.

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SINCE THE U.S. PUBLIC HEALTH Service published its guidelines for the reduction of vertical transmission of human immunodeficiency virus (HIV) in 1994, Pediatric AIDS Clinical Trials Group (PACTG) 076 zidovudine (ZDV) regimen (Table 1) has been the standard of care in developed countries.1 The initial study of ZVD administration in mother-infant pairs demonstrated a significant reduction in vertical transmission of HIV-1: 7.6 percent in the treatment group versus 22.6 percent in the placebo group.2 Clearly, early and adequate prenatal care for the management of the HIVinfected pregnant woman is the key to providing the best possible outcome for the mother and her infant. However, women seek prenatal care at various stages of their pregnancies, and some present to labor and delivery suites having had no prenatal care. Thus, the Perinatal HIV Guidelines Working Group developed recommendations for prophylaxis against mother-to-child transmission of HIV that cover a variety of clinical scenarios.3 Discussion of these recommendations is beyond the scope of this article, but readers can find the recommendations at http://AIDSinfo.nih.gov.

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Unternaehrer, E., K. Greenlaw, S. Hari Dass, L. M. Chen, A. A. Bouvette-Turcot, K. Cost, K. J. O’Donnell, et al. "Intergenerational Transmission of Well Being–Genetic and Epigenetic Mechanisms." European Psychiatry 41, S1 (April 2017): S29—S30. http://dx.doi.org/10.1016/j.eurpsy.2017.01.146.

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IntroductionMaternal mental well being influences offspring development. Research suggests that an interplay between genetic and environmental factors underlies this familial transmission of mental disorders.ObjectivesTo explore an interaction between genetic and environmental factors to predict trajectories of maternal mental well being, and to examine whether these trajectories are associated with epigenetic modifications in mothers and their offspring.MethodWe assessed maternal childhood trauma and rearing experiences, prenatal and postnatal symptoms of depression and stress experience from 6 to 72 months postpartum, and genetic and epigenetic variation in a longitudinal birth-cohort study (n = 262) (Maternal adversity, vulnerability and neurodevelopment project). We used latent class modeling to describe trajectories in maternal depressive symptoms, parenting stress, marital stress and general stress, taking polygenetic risk for major depressive disorder (MDD), a composite score for maternal early life adversities, and prenatal depressive symptoms into account.ResultsGenetic risk for MDD associated with trajectories of maternal well being in the postpartum, conditional on the experience of early life adversities and prenatal symptoms of depression. We will explore whether these trajectories are also linked to DNA methylation patterns in mothers and their offspring. Preliminary analyses suggest that maternal early life adversities associate with offspring DNA methylation age estimates, which is mediated through maternal mental well being and maternal DNA methylation age estimates.ConclusionWe found relevant gene-environment interactions associated with trajectories of maternal well being. Our findings inform research on mechanisms underlying familial transmission of vulnerability for psychopathology and might thus be relevant to prevention and early intervention programs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Zhu, Yi-Yang, Ying-Zi Mao, Wei-Ling Wu, Qun-Xi Cai, and Xian-Hua Lin. "Does Hepatitis B Virus Prenatal Transmission Result in Postnatal Immunoprophylaxis Failure?" Clinical and Vaccine Immunology 17, no. 12 (October 13, 2010): 1836–41. http://dx.doi.org/10.1128/cvi.00168-10.

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ABSTRACT The objective of this work was to evaluate whether postnatal hepatitis B immunization failure in children is caused by prenatal infections. A prospective study was conducted from October 2006 to September 2008. Fetal samples from HBsAg-positive mothers were retrieved by either amniocentesis or cordocentesis (percutaneous umbilical blood sampling [PUBS]). Hepatitis B virus (HBV) serologic markers (HBVM) and quantitative HBV DNA assays were performed to assess prenatal infection. All neonates were given combined HBV immunoprophylaxis after delivery. The newborns were followed up with HBV serologic testing at 1 year old. For the 252 pregnant women recruited, 16 fetuses were found to be HBV DNA positive, with all HBV DNA levels under 104 copies/ml. HBsAg and HBV DNA detected in the uterus were uncommon and were expressed at low levels. In contract to the case with prenatal statuses, neonatal serologies were more similar to their mothers'. The response rate of vaccination was 95%. Six children for whom immunoprophylaxis failed were born to HBeAg-positive mothers with high HBV DNA levels (>108 copies/ml), but only one of them was found to be positive for intrauterine HBV DNA (8.5 × 102 copies/ml). The presence of intrauterine hepatitis B antigen and DNA does not indicate postnatal HBV infection and vaccination failure.

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Szlachta-McGinn, Alec, Alexandra Aserlind, Lunthita Duthely, Sean Oldak, Ruchi Babriwala, Emily Montgomerie, and JoNell Potter. "HIV Screening During Pregnancy in a U.S. HIV Epicenter." Infectious Diseases in Obstetrics and Gynecology 2020 (May 7, 2020): 1–7. http://dx.doi.org/10.1155/2020/8196342.

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Background. The CDC and ACOG have issued guidelines for HIV screening in pregnancy for patients living in areas with high prevalence of HIV in order to minimize perinatal vertical transmission. There is a lack of data examining providers’ compliance with these guidelines in at-risk patient populations in the United States. Objective. To evaluate if HIV screening in pregnant women was performed according to guidelines at a large, urban, tertiary care medical center in South Florida. Study Design. A retrospective review was performed on 1270 prenatal and intrapartum records from women who delivered a live infant in 2015 at a single institution. Demographic and outcome data were chart abstracted and analyzed using arithmetic means and standard deviations. Results. Of the 1270 patients who met inclusion criteria, 1090 patients initiated prenatal care in the first or second trimester and delivered in the third trimester. 1000 (91.7%) patients were screened in the first or second trimester; however, only 822 (82.2%) of these were retested in the third trimester during prenatal care. Among the 178 patients lacking a third trimester test, 159 (89.3%) received rapid HIV testing upon admission for delivery. Of the 1090 patients who initiated prenatal care in the first or second trimester and delivered in the third trimester, 982 (90.1%) were screened in accordance with recommended guidelines. Of the 1270 patients initiating care in any trimester, 24 (1.9%) had no documented prenatal HIV test during prenatal care, however 22 (91.7%) had a rapid HIV test on admission for delivery. Two (0.16%) patients were not tested prenatally or prior to delivery. Conclusion. Despite 99.8% of women having at least one HIV screening test during pregnancy, there is room for improvement in routine prenatal screening in both early pregnancy and third trimester prior to onset of labor in this high-risk population.

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Hentges, Rochelle F., Susan A. Graham, Andre Plamondon, Suzanne Tough, and Sheri Madigan. "A Developmental Cascade from Prenatal Stress to Child Internalizing and Externalizing Problems." Journal of Pediatric Psychology 44, no. 9 (June 5, 2019): 1057–67. http://dx.doi.org/10.1093/jpepsy/jsz044.

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Abstract Objective This study utilized a developmental cascade approach to test alternative theories about the underlying mechanisms behind the association of maternal prenatal stress and child psychopathology. The fetal programming hypothesis suggests that prenatal stress affects fetal structural and physiological systems responsible for individual differences in child temperament, which further increases risk for internalizing and externalizing problems. Interpersonal models of stress transmission suggest that maternal stress influences child mental health via early parenting behaviors. We also examined a continuation of stress hypothesis, in which prenatal stress predicts child mental health via the continuation of maternal stress in the postpartum period. Methods Participants were 1,992 mother–child pairs drawn from a prospective pregnancy cohort. Mothers reported on their perceived stress, anxiety, and depression during pregnancy and at 4-month postpartum. Birthweight was assessed via medical records of birthweight. At 4-month postpartum, hostile-reactive parenting behaviors were assessed. Child temperamental negative affect was measured at age 3. Child internalizing and externalizing problems were assessed at age 5. Results Prenatal stress was associated with both internalizing and externalizing problems via postnatal stress and child temperament. Prenatal stress was also associated with externalizing behaviors via increased hostile-reactive parenting. After accounting for postnatal factors, prenatal stress continued to have a direct effect on child internalizing, but not externalizing, symptoms. Conclusion Results provide support for the fetal programming, interpersonal stress transmission, and continuation of stress models. Findings highlight the need for prenatal preventative programs that continue into the early postnatal period, targeting maternal stress and parenting behaviors.

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Soeiro, Claudia Marques de Oliveira, Angélica Espinosa Miranda, Valeria Saraceni, Noaldo Oliveira de Lucena, Sinésio Talhari, and Luiz Carlos de Lima Ferreira. "Mother-to-child transmission of HIV infection in Manaus, State of Amazonas, Brazil." Revista da Sociedade Brasileira de Medicina Tropical 44, no. 5 (October 2011): 537–41. http://dx.doi.org/10.1590/s0037-86822011000500001.

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INTRODUCTION: Reduction in the vertical transmission of HIV is possible when prophylactic measures are implemented. Our objective was to determine demographic characteristics of HIV-infected pregnant women and the rate of mother-to-child transmission of HIV in Manaus, Amazonas, Brazil. METHODS: A descriptive study was conducted using notification, and investigating data from the Notifiable Diseases Data System in the Brazilian State of Amazonas, between 2007 and 2009. RESULTS: During the study period, notification was received of 509 HIV-positive pregnant women. The vertical transmission was 9.9% (95% CI: 7.2-12.6%). The mean age of women was 27 years (SD: 5.7), and the majority (54.8%) had not completed elementary school (eighth grade). Diagnosis of HIV seropositivity was made prior to pregnancy in 115 (22.6%) women, during prenatal care in 302 (59.3%), during delivery in 70 (13.8%), and following delivery in 22 (4.3%). Four hundred four of these women (79.4%) had had prenatal care, with 79.4% of patients receiving antiretroviral during pregnancy and 61.9% of the newborn infants receiving prophylaxis. In the final multivariate logistic regression model, living in urban area [OR = 0.7 (95% CI: 0.35-0.89)] and having had prenatal care [OR = 0.1 (95% CI: 0.04-0.24)] remained as protective factors against vertical HIV transmission in this population. CONCLUSIONS: The relevance of adequate compliance with the measures already established as being effective in guaranteeing a reduction in HIV transmission within the maternal and infant population should be emphasized.

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Goodman, Sherryl H., Katherine A. Cullum, Sona Dimidjian, Laura M. River, and Christine Youngwon Kim. "Opening windows of opportunities: Evidence for interventions to prevent or treat depression in pregnant women being associated with changes in offspring's developmental trajectories of psychopathology risk." Development and Psychopathology 30, no. 3 (August 2018): 1179–96. http://dx.doi.org/10.1017/s0954579418000536.

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AbstractAlthough animal models and correlational studies support a model of fetal programming as a mechanism in the transmission of risk for psychopathology from parents to children, the experimental studies that are required to empirically test the model with the human prenatal dyad are scarce. With a systematic review and meta-analysis of the literature, we critically examined the evidence regarding the neurobiological and behavioral changes in infants as a function of randomized clinical trials to prevent or reduce maternal depression during pregnancy, treating randomized clinical trials as experiments testing the fetal programming model. Based on 25 articles that met inclusion criteria, we found support for interventions designed to change maternal prenatal mood being associated with changes in offspring functioning, but with a very small effect size. Effect sizes ranged broadly, and were higher for younger children. The findings enhance understanding of putative mechanisms in the transmission of risk from women's prenatal depression to infants’ vulnerabilities to, and early signs of, the development of psychopathology. We note limitations of the literature and suggest solutions to advance understanding of how preventing or treating depression in pregnant women might disrupt the transmission of risk to the infants.

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Guadagno, Marie, Michael Mackert, and Aaron Rochlen. "Improving Prenatal Health." American Journal of Men's Health 7, no. 6 (May 30, 2013): 523–26. http://dx.doi.org/10.1177/1557988313490785.

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The U.S. infant mortality rate is among the highest in the developed world, with recent vital statistics reports estimating 6.14 infant deaths per 1,000 live births. Traditional health education and promotion to improve maternal, infant, and child health in the United States has focused only on women, leaving men out of important health messages that may affect pregnancy outcomes as well as family well-being. Recently, public health scholars have suggested that men be included in prenatal health education in an effort to improve birth outcomes and reduce infant mortality. Incorporating men in prenatal health promotion and education has been found to improve overall birth preparedness, reduce the risk of maternal–infant HIV transmission, and reduce perinatal mortality in less-developed nations. Although these results are positive, research on paternal impact in pregnancy outcomes in the United States to date is lacking. This article proposes a U.S.-specific research agenda to understand the current role of men in pregnancy health, as well as actual involvement, barriers, and the influence men can have in prenatal health. A discussion of culture, individual motivations, health care providers, and social marketing is also considered.

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Alexander, Thomas S., Joanne Lee, and Belinda Yen-Lieberman. "Incidence of Human Immunodeficiency Virus Antibody in a Prenatal Population at a Community Hospital." Clinical Diagnostic Laboratory Immunology 6, no. 1 (January 1, 1999): 140–41. http://dx.doi.org/10.1128/cdli.6.1.140-141.1999.

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ABSTRACT Prenatal human immunodeficiency virus (HIV) screening may reduce vertical HIV transmission. We screened 4,419 prenatal sera and found 38 repeatedly reactive specimens with an HIV-1–HIV-2 enzyme-linked immunosorbent assay. Western blot analysis confirmed four of these specimens as positive for HIV-1 antibodies. Screening detects previously unidentified HIV infections, but false-positive results may also occur.

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Siqueira, Poliana Germano Bezerra de Sá, Gabriella Morais Duarte Miranda, Wayner Vieira de Souza, Gerlane Alves Pontes da Silva, and Antonio da Cruz Gouveia Mendes. "Hierarchical analysis of determinants of HIV vertical transmission: a case-control study." Revista Brasileira de Saúde Materno Infantil 20, no. 4 (December 2020): 985–95. http://dx.doi.org/10.1590/1806-93042020000400005.

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Abstract Objectives: to analyze the association of socioeconomic, obstetric, pediatric and prophylactic factors to the vertical transmission of HIV in children followed at a reference service in Recife between 2010 and 2015. Methods: case-control nested the cohort of children exposed to vertical transmission of HIV. A univariate and multivariate statistical analysis was performed on the association of socioeconomic, obstetric, pediatric and prophylactic measures with the outcome. We considered two multivariate approaches, conventional and hierarchical, the latter made it possible to consider different levels of determination. Results: 46.5% of the mothers had low schooling, 69.6% without work-related wages and 35.7% received a family grant. Women with postpartum diagnosis and less than 6 prenatal appointments had a greater chance of vertical transmission. Prophylactic measures were statistically associated with prevention of transmission (p<0.1%). Conclusions: vertical risk factors for HIV transmission were identified: no sewage system, at least six prenatal consultations, first care of the child with more than two months and no prophylaxis in pregnancy and childbirth. Determining factors for which specific policies and programs exist and their non-access social determination evidence of HIV vertical transmission.

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Veloso, Valdiléa G., Margareth C. Portela, Mauricio T. L. Vasconcellos, Luiz A. Matzenbacher, Ana Lúcia R. de Vasconcelos, Beatriz Grinsztejn, and Francisco I. Bastos. "HIV testing among pregnant women in Brazil: rates and predictors." Revista de Saúde Pública 42, no. 5 (October 2008): 859–67. http://dx.doi.org/10.1590/s0034-89102008000500011.

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OBJECTIVE: To assess rates of offering and uptake of HIV testing and their predictors among women who attended prenatal care. METHODS: A population-based cross-sectional study was conducted among postpartum women (N=2,234) who attended at least one prenatal care visit in 12 cities. Independent and probabilistic samples were selected in the cities studied. Sociodemographic data, information about prenatal care and access to HIV prevention interventions during the current pregnancy were collected. Bivariate and multivariate analyses were carried out to assess independent effects of the covariates on offering and uptake of HIV testing. Data collection took place between November 1999 and April 2000. RESULTS: Overall, 77.5% of the women reported undergoing HIV testing during the current pregnancy. Offering of HIV testing was positively associated with: previous knowledge about prevention of mother-to-child transmission of HIV; higher number of prenatal care visits; higher level of education and being white. HIV testing acceptance rate was 92.5%. CONCLUSIONS: The study results indicate that dissemination of information about prevention of mother-to-child transmission among women may contribute to increasing HIV testing coverage during pregnancy. Non-white women with lower level of education should be prioritized. Strategies to increase attendance of vulnerable women to prenatal care and to raise awareness among health care workers are of utmost importance.

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Lou, Haiqin, Xiaoyun Ge, Biyun Xu, Weiwei Liu, and Yi-Hua Zhou. "Prevention of Mother-to-Child Transmission of HIV: Data Analysis Based on Pregnant Women Population from 2012 to 2018, in Nantong City, China." Current HIV Research 18, no. 6 (November 9, 2020): 458–65. http://dx.doi.org/10.2174/1570162x18666200810134025.

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Background: China has implemented a nation-wide policy to control mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) since 2011, yet the efficacy of the control policy is less studied. The aim of the present study was to report the data in the prevention of MTCT of HIV in Nantong city, China. Methods: The screening and prevalence of HIV in pregnant women and the efficacy of prophylaxis in Nantong city, China, January 2012 through December 2018, were analyzed. Results: Among a total population of 410,044 pregnant women, anti-HIV was tested prenatally in 393,658 (96.0%) women and in 16,287 (3.97%) women at delivery. In total, 51 women were confirmed with HIV infection. After exclusion of repeat pregnancies, the overall prevalence of HIV infection was 1.20/10 000 (48/400,377). The prevalence (6.75/10,000) in women tested at delivery was >5-fold higher than that (1.02/10,000) in prenatally screened women. Of 48 HIV-infected women, 12 terminated their pregnancies and 36 others delivered 36 neonates, of whom 35 were followed up. No HIV infection occurred in 24 children born to mothers with antiretroviral therapy (ART) during pregnancy along with other preventive measures. Among 11 children born to mothers who did not receive ART during pregnancy because of the absence of prenatal anti-HIV test, none of the 6 children who were delivered by cesarean section and timely administered neonatal antiretroviral prophylaxis was infected, but 2 (40%) of 5 children who were spontaneously delivered and administered delayed antiretroviral prophylaxis were infected. Conclusions: Prenatal identification of HIV infection and timely administration of all preventive measures can completely block MTCT of HIV. The data indicate that more efforts must be taken to ensure that all pregnant women are tested for anti-HIV during pregnancy. For pregnant women who missed prenatal screening, a positive result in rapid anti-HIV test at delivery should be sufficient to take preventive measures to prevent MTCT of HIV.

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Jacobs, L. J. A. M., I. F. M. de Coo, J. G. Nijland, R. J. H. Galjaard, F. J. Los, K. Schoonderwoerd, M. F. Niermeijer, J. P. M. Geraedts, H. R. Scholte, and H. J. M. Smeets. "Transmission and prenatal diagnosis of the T9176C mitochondrial DNA mutation." MHR: Basic science of reproductive medicine 11, no. 3 (March 1, 2004): 223–28. http://dx.doi.org/10.1093/molehr/gah152.

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Niaura, Raymond, Beth Bock, Elizabeth E. Lloyd, Richard Brown, Lewis P. Lipsitt, and Stephen Buka. "Maternal Transmission of Nicotine Dependence: Psychiatric, Neurocognitive and Prenatal Factors." American Journal on Addictions 10, no. 1 (January 1, 2001): 16–29. http://dx.doi.org/10.1080/105504901750160420.

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Henckaerts, Liesbet, Robert Vlietinck, Catherine Derom, Steven Boonen, Paul Rutgeerts, and Severine Vermeire. "Transmission Ratio Distortion of DLG5 R30Q: Evidence for Prenatal Selection?" Inflammatory Bowel Diseases 16, no. 6 (June 2010): 910–11. http://dx.doi.org/10.1002/ibd.21109.

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Guimiot, F., C. Dupont, A. Fuentes-Duarte, A. Aboura, A. Bazin, S. Khung-Savatovsky, I. Tillous-Borde, A. L. Delezoide, and A. Azancot. "Maternal transmission of interstitial 8p23.1 deletion detected during prenatal diagnosis." American Journal of Medical Genetics Part A 161, no. 1 (December 14, 2012): 208–13. http://dx.doi.org/10.1002/ajmg.a.35690.

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Jiang, Li, and Lorna W. Role. "Facilitation of Cortico–Amygdala Synapses by Nicotine: Activity-Dependent Modulation of Glutamatergic Transmission." Journal of Neurophysiology 99, no. 4 (April 2008): 1988–99. http://dx.doi.org/10.1152/jn.00933.2007.

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The basolateral nucleus of the amygdala (BLA) receives cholinergic innervation from the basal forebrain and nicotine, via activation of neuronal nicotinic acetylcholine receptors (nAChRs), can improve performance in amygdala-based learning tasks. We tested the hypothesis that acute and prenatal nicotine exposure modulates cortico–amygdala synaptic transmission. We found that low-dose, single-trial exposures to nicotine can elicit lasting facilitation, the extent of which is dependent on the level of stimulation of the cortical inputs to the BLA. In addition, sustained facilitation is ablated by prenatal exposure to nicotine. This study examined synaptic transmission in 238 patch-clamp recordings from BLA neurons in acute slice from mouse brain. Pharmacological studies in wild-type and nAChR subunit knock-out mice reveal that activation of presynaptic α7, containing (α7*) and non-α7* nAChRs, facilitates glutamatergic transmission in an activity-dependent manner. Without prior stimulation, application of nicotine elicits modest and transient facilitation of glutamatergic postsynaptic currents (PSCs) in about 40% of BLA neurons. With low-frequency stimulation of cortical inputs nicotine elicits robust facilitation of transmission at about 60% of cortico–BLA synapses and synaptic strength remains elevated at about 40% of these connections for >15 min after nicotine washout. Following paired-pulse stimulation nicotine elicits long-lasting facilitation of glutamatergic transmission at about 70% of cortico–BLA connections. Nicotine reduces the threshold for activation of long-term potentiation of cortico–BLA synapses evoked by patterned stimulation. Prenatal exposure to nicotine reduced subsequent modulatory responses to acute nicotine application.

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Astawesegn, Feleke Hailemichael, Elizabeth Conroy, Haider Mannan, and Virginia Stulz. "Measuring socioeconomic inequalities in prenatal HIV test service uptake for prevention of mother to child transmission of HIV in East Africa: A decomposition analysis." PLOS ONE 17, no. 8 (August 23, 2022): e0273475. http://dx.doi.org/10.1371/journal.pone.0273475.

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Background Despite efforts made towards the elimination of mother-to-child HIV transmission, socioeconomic inequality in prenatal HIV test uptake in East Africa is not well understood. Therefore, this study aimed at measuring socioeconomic inequalities in prenatal HIV test uptake and explaining its main determinants in East Africa Method We analysed a total weighted sample of 45,476 women aged 15–49 years who birthed in the two years preceding the survey. The study used the most recent DHS data from ten East African countries (Burundi, Comoros, Ethiopia, Kenya, Malawi, Mozambique, Rwanda, Uganda, Zambia, and Zimbabwe). The socioeconomic inequality in prenatal HIV test uptake was measured by the concentration index and illustrated by the concentration curve. Then, regression based Erreygers decomposition method was applied to quantify the contribution of socioeconomic factors to inequalities of prenatal HIV test uptake in East Africa. Results The concentration index for prenatal HIV test uptake indicates that utilization of this service was concentrated in higher socio-economic groups with it being 15.94% higher among these groups in entire East Africa (p <0.001), 40.33% higher in Ethiopia (p <0.001) which was the highest and only 1.87% higher in Rwanda (p <0.01) which was the lowest. The decomposition analysis revealed that household wealth index (38.99%) followed by maternal education (13.69%), place of residence (11.78%), partner education (8.24%), watching television (7.32%), listening to the radio (7.11%) and reading newsletters (2.90%) made the largest contribution to socioeconomic inequality in prenatal HIV test in East Africa. Conclusion In this study, pro-rich inequality in the utilization of prenatal HIV tests was evident. The decomposition analysis findings suggest that policymakers should focus on improving household wealth, educational attainment, and awareness of mother-to-child transmission of HIV (MTCT) through various media outlets targeting disadvantaged sub-groups.

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Astawesegn, Feleke Hailemichael, Virginia Stulz, Kingsley E. Agho, Haider Mannan, Elizabeth Conroy, and Felix Akpojene Ogbo. "Prenatal HIV Test Uptake and Its Associated Factors for Prevention of Mother to Child Transmission of HIV in East Africa." International Journal of Environmental Research and Public Health 18, no. 10 (May 16, 2021): 5289. http://dx.doi.org/10.3390/ijerph18105289.

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Identifying the socioeconomic and structural issues that act as enablers and/or barriers to HIV testing services is critical in combatting HIV/AIDS amongst mothers and children in Africa. In this study, we used a weighted sample of 46,645 women aged 15–49 who gave birth in the two years preceding the survey from the recent DHS dataset of ten East African countries. Multivariable logistic regression was used to investigate the factors associated with prenatal HIV test uptake in East Africa. The overall prenatal HIV test uptake for the prevention of mother-to-child transmission (PMTCT) of HIV was 80.8% (95% CI: 74.5–78.9%) in East Africa, with highest in Rwanda (97.9%, 95% CI: 97.2–98.3%) and lowest in Comoros (17.0%, 95% CI: 13.9–20.7%). Common factors associated with prenatal HIV test service uptake were higher maternal education level (AOR = 1.29; 95% CI: 1.10–1.50 for primary education and AOR = 1.96; 95% CI: 1.53–2.51 for secondary or higher education), higher partner education level (AOR = 1.24; 95% CI: 1.06–1.45 for primary education and AOR = 1.56; 95% CI: 1.26–1.94 for secondary or higher school), women from higher household wealth index (AOR = 1.29; 95% CI: 1.11–1.50 for middle wealth index; AOR = 1.57; 95% CL: 1.17–2.11 for rich wealth index), improved maternal exposure to the media, and increased awareness about MTCT of HIV. However, residents living in rural communities (AOR = 0.66; 95% CI: 0.51–0.85) and travelling long distances to the health facility (AOR = 0.8; 95% CI: 0.69–0.91) were associated with non-use of prenatal HIV test service in East African countries. In each East African country, factors associated with prenatal HIV test uptake for PMTCT varied. In conclusion, the pooled prenatal HIV test uptake for PMTCT of HIV was low in East Africa compared to the global target. Scaling up interventions to improve enablers whilst addressing barriers to the use of prenatal HIV test services are essential to end the HIV/AIDS epidemic in East African countries.

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Ramos Jr., Alberto Novaes, Luiza Harunari Matida, Valéria Saraceni, Maria Amélia de S. M. Veras, and Ricardo José Soares Pontes. "Control of mother-to-child transmission of infectious diseases in Brazil: progress in HIV/AIDS and failure in congenital syphilis." Cadernos de Saúde Pública 23, suppl 3 (2007): S370—S378. http://dx.doi.org/10.1590/s0102-311x2007001500005.

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In Brazil, syphilis and HIV infection are considered serious public health problems. However, in practice, epidemiological surveillance, prevention measures, and prenatal care seem to be more effective in the control of mother-to-child transmission of the HIV than in the control of transmission of the Treponema pallidum. Here we discuss the differences in surveillance, prenatal care, and care of the newborn. Important differences were identified. It is concluded that there is an urgent need to establish prevention of mother-to-child transmission of syphilis as a public health priority, using an integrated approach including women's health, children's health, primary health care, and STD/AIDS programs on all governmental levels. These issues also need to be discussed with all stakeholders involved. Important aspects related to the problem are the training of public health professionals, as well as the participation of the community. The elimination of congenital syphilis does not require expensive drugs, and diagnostic tools, but a long-term sustainable approach.

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Lazzarotto, T., B. Guerra, P. Spezzacatena, S. Varani, L. Gabrielli, P. Pradelli, F. Rumpianesi, C. Banzi, L. Bovicelli, and M. P. Landini. "Prenatal Diagnosis of Congenital Cytomegalovirus Infection." Journal of Clinical Microbiology 36, no. 12 (1998): 3540–44. http://dx.doi.org/10.1128/jcm.36.12.3540-3544.1998.

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We report here the results of a study on the prenatal diagnosis of congenital cytomegalovirus (CMV) infection. The study was carried out by both PCR and virus isolation from amniotic fluid (AF) for 82 pregnant women at risk of transmitting CMV for the detection of (i) seroconversion to CMV immunoglobulin G (IgG) positivity during the first trimester of pregnancy, (ii) symptomatic CMV infection in the mother during the first trimester of pregnancy or intrauterine growth retardation detected by ultrasound or abnormal ultrasonographic findings suggestive of fetal infections, and (iii) seropositivity for CMV-specific IgM. For 50 women, fetal blood (FB) was also obtained and tests for antigenemia and PCR were performed. The results indicate that AF is better than FB for the prenatal diagnosis of CMV infection. PCR with AF has a sensitivity (SNS) of 100%, a specificity (SPE) of 83.3%, a positive predictive value (PPV) of 40%, and a negative predictive value (NPV) of 100%; rapid virus isolation with the same material has an SNS of 50%, an SPE of 100%, a PPV of 100%, and an NPV of 94.7%. Fewer than 10% of the women positive for IgM by enzyme immunoassay (EIA) had a congenitally infected fetus or newborn infant. When EIA IgM positivity was confirmed by Western blotting (WB) and the WB profile was considered, the percent transmission detected among women with an “at-risk” profile was higher than that observed among IgM-positive women and was the same as that among women who seroconverted during the first trimester of pregnancy (transmission rates of 29 and 25%, respectively).

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Yeganeh, Nava, Tara Kerin, Mariana Simon, Karin Nielsen-Saines, Jeffrey D. Klausner, Breno Santos, Marineide Melo, Samantha Fitter, and Pamina M. Gorbach. "Challenges and motivators for male partner involvement in prenatal care for HIV testing in a tertiary setting in Brazil." International Journal of STD & AIDS 30, no. 9 (June 3, 2019): 875–84. http://dx.doi.org/10.1177/0956462419845225.

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Male partner involvement in prenatal care has been shown to improve outcomes for the entire family in low- and middle income countries. In Brazil, partners of pregnant women are encouraged to attend prenatal care for HIV testing. From November 2016 to July 2017, male partners of women delivering at Hospital Conceiçao were interviewed using computer-assisted telephone interviews regarding individual, relationship and system-wide facilitators and barriers to attending prenatal care. Of 403 men interviewed, 202 attended prenatal care and 201 did not. Individual factors that predicted prenatal care attendance included over-estimating the risk of mother to child transmission (AOR 2.13, 95% CI: 1.35–3.4), and endorsing that HIV-infected individuals can live satisfying lives (AOR 7.24, 95% CI: 1.9–47.5). Partnership factors associated with attendance included invitation by partner (AOR 5.6, 95% CI: 2.4–15.6). Systemic factors negatively associated with prenatal care attendance included a history of not being able to afford medical care (AOR 0.3, 95% CI: 0.15–0.6) and identifying work as a barrier to prenatal care attendance (AOR 0.19 95% CI: 0.11–0.31). Partners should be actively invited to prenatal care during flexible flexible hours. Once involved, almost all would accept HIV and sexually transmitted infection (STI) testing to protect partners and unborn infants during this vulnerable period.

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Hardy, Erica, and Susan Cu-Uvin. "Care of the HIV-infected pregnant woman in the developed world." Obstetric Medicine 8, no. 1 (May 8, 2014): 13–17. http://dx.doi.org/10.1177/1753495x14531753.

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The reduction of human immunodeficiency virus (HIV) transmission from mother to child is one of the success stories of modern medicine and public health. In the developed world, with universal HIV counseling and testing, antiretroviral prophylaxis, scheduled Caesarean delivery if indicated, and avoidance of breastfeeding, HIV transmission from mother to infant can be <2%. Despite this, transmissions continue to occur, often due to lack of knowledge of HIV status. Missed opportunities for prevention and prevention challenges include late prenatal care, lack of HIV testing in pregnancy, lack of preconception counseling, unintended pregnancy, and substance abuse. We review preconception counseling including options for serodiscordant couples, and antepartum, peripartum and postpartum care of the HIV-infected woman in the developed world, and advocate for a comprehensive, collaborative, multidisciplinary approach.

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Barral, Maria F. M., Gisele R. de Oliveira, Rubens C. Lobato, Raul A. Mendoza-Sassi, Ana M. b. Martínez, and Carla V. Gonçalves. "RISK FACTORS OF HIV-1 VERTICAL TRANSMISSION (VT) AND THE INFLUENCE OF ANTIRETROVIRAL THERAPY (ART) IN PREGNANCY OUTCOME." Revista do Instituto de Medicina Tropical de São Paulo 56, no. 2 (April 2014): 133–38. http://dx.doi.org/10.1590/s0036-46652014000200008.

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In the absence of intervention, the rate of vertical transmission of HIV can range from 15-45%. With the inclusion of antiretroviral drugs during pregnancy and the choice of delivery route this amounts to less than 2%. However ARV use during pregnancy has generated several questions regarding the adverse effects of the gestational and neonatal outcome. This study aims to analyze the risk factors for vertical transmission of HIV-1 seropositive pregnant women living in Rio Grande and the influence of the use of ARVs in pregnancy outcome. Among the 262 pregnant women studied the rate of vertical transmission of HIV was found to be 3.8%. Regarding the VT, there was a lower risk of transmission when antiretroviral drugs were used and prenatal care was conducted at the referral service. However, the use of ART did not influence the outcome of pregnancy. However, initiation of prenatal care after the first trimester had an influence on low birth weight, as well as performance of less than six visits increased the risk of prematurity. Therefore, the risk factors analyzed in this study appear to be related to the realization of inadequate pre-natal and maternal behavior.

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Hughes, Christine A., Dalyce Zuk, Michelle Foisy, Joan Robinson, Ameeta E. Singh, and Stan Houston. "Prenatal Screening and Perinatal HIV Transmission in Northern Alberta, 1999–2006." American Journal of Public Health 99, S2 (October 2009): S412—S416. http://dx.doi.org/10.2105/ajph.2007.133306.

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Rothnagel, Joseph A., Michael T. S. Lin, Mary A. Longley, Rhanda A. Holder, Paul G. Hazen, Moise L. Levy, and Dennis R. Roop. "Prenatal diagnosis for keratin mutations to exclude transmission of epidermolytic hyperkeratosis." Prenatal Diagnosis 18, no. 8 (August 1998): 826–30. http://dx.doi.org/10.1002/(sici)1097-0223(199808)18:8<826::aid-pd360>3.0.co;2-5.

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Saldan, Alda, Gabriella Forner, Carlo Mengoli, Nadia Gussetti, Giorgio Palù, and Davide Abate. "Testing for Cytomegalovirus in Pregnancy." Journal of Clinical Microbiology 55, no. 3 (December 28, 2016): 693–702. http://dx.doi.org/10.1128/jcm.01868-16.

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ABSTRACT Congenital cytomegalovirus (CMV) infection represents a relevant cause of deafness and neurological damage in newborns. Intrauterine CMV transmission might result after primary or nonprimary infections, though at different rates (30% versus 0.2%, respectively). At present, a prenatal diagnosis of CMV infection is based mainly on maternal serology, the detection of CMV-DNA in amniotic fluid and fetal blood, and ultrasound (US) and magnetic resonance imaging (MRI). Recent evidences suggest that congenital CMV infection may be an immune-mediated disease and that evaluation of humoral and especially T-cell immunities may improve the overall prenatal diagnosis. This review summarizes the most recent advancements in the diagnosis of maternal and prenatal CMV infections.

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BITTENCOURT, Achiléa Lisboa. "VERTICAL TRANSMISSION OF HTLV-I/II: A review." Revista do Instituto de Medicina Tropical de São Paulo 40, no. 4 (July 1998): 245–51. http://dx.doi.org/10.1590/s0036-46651998000400008.

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The vertical transmission of the human T-cell lymphotropic virus type I (HTLV-I) occurs predominantly through breast-feeding. Since some bottle-fed children born to carrier mothers still remain seropositive with a frequency that varies from 3.3% to 12.8%, an alternative pathway of vertical transmission must be considered. The prevalence rate of vertical transmission observed in Japan varied from 15% to 25% in different surveys. In Brazil there is no evaluation of this form of transmission until now. However, it is known that in Salvador, Bahia, 0.7% to 0.88% of pregnant women of low socio-economic class are HTLV-I carriers. Furthermore the occurrence of many cases of adult T-cell leukemia/lymphoma and of four cases of infective dermatitis in Salvador, diseases directly linked to the vertical transmission of HTLV-I, indicates the importance of this route of infection among us. Through prenatal screening for HTLV-I and the refraining from breast-feeding a reduction of ~ 80% of vertical transmission has been observed in Japan. We suggest that in Brazil serologic screening for HTLV-I infection must be done for selected groups in the prenatal care: pregnant women from endemic areas, Japanese immigrants or Japanese descendents, intravenous drug users (IDU) or women whose partners are IDU, human immunodeficiency virus carriers, pregnant women with promiscuous sexual behavior and pregnant women that have received blood transfusions in areas where blood donors screening is not performed. There are in the literature few reports demonstrating the vertical transmission of HTLV-II.

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Hoffmann, Izabel Cristina, Wendel Mombaque dos Santos, Stela Maris de Mello Padoin, and Sonia Maria Oliveira de Barros. "A five-year review of vertical HIV transmission in a specialized service: cross-sectional study." Sao Paulo Medical Journal 134, no. 6 (November 10, 2016): 508–12. http://dx.doi.org/10.1590/1516-3180.2016.0139140616.

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ABSTRACT CONTEXT AND OBJECTIVE: Healthcare professionals need to instill the process of prevention, control and treatment of people infected with HIV into care practice. Through maintaining preventive treatment among HIV-infected pregnant women, it has been demonstrated that prophylactic antiretroviral therapy, scheduled cesarean section and the prohibition of breastfeeding significantly reduce vertical HIV transmission. This study aimed to assess the rates of vertical HIV transmission in a specialized service and identify the factors associated with it. DESIGN AND SETTING: Cross-sectional study developed at the University Hospital of Santa Maria (RS), Brazil. METHODS: A cross-sectional study was conducted on a sample of 198 notification forms and medical records of HIV-positive pregnant women and exposed children. RESULTS: The vertical transmission rate was 2.4%, and three children had been infected by vertical HIV transmission. The statistically significant risk factor was the use of injectable drugs. Delayed reporting of pregnancy, absence of antiretroviral therapy during pregnancy, lack of proper prenatal care, incapacity to perform viral load detection tests and CD4+ T cell counts and obstetric and maternal clinical complications were reported. CONCLUSIONS: The vertical transmission rate was high and the recommended intervention measures were not adopted in full. Adequate prophylactic measures need to be implemented in HIV-positive pregnant women prenatally and during the antenatal, delivery and postpartum periods.

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Parker, Paul J., Theresa W. Gyorkos, Joseph S. Dylewski, Arvind K. Joshi, and Elaine D. Franco. "Prevention of Perinatal Hepatitis B Virus Transmission in an Obstetric/Infant Population." Canadian Journal of Infectious Diseases 4, no. 5 (1993): 288–91. http://dx.doi.org/10.1155/1993/986932.

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Study Design: This retrospective study reviewed the screening practice and seroprevalence of hepatitis B surface antigen (HBsAg) among all mothers with live births at a teaching hospital in Montreal between November 1, 1990 and April 30, 1991.Results: Most women (94%) were screened prenatally and 5.2% postnatally. Screening status could not be determined for 0.8% of women. One-quarter of all postnatal screening results were available only at 48 h or more postdelivery. No infants born to women with postnatal screening or to women with unknown screening status were immunized expectantly. The maternal seroprevalence was 1.08% (95% confidence interval from 0.6, 1.4). All 22 infants born to HBsAg-positive mothers had received hepatitis B immune globulin within 12 h of birth and the first dose of hepatitis B vaccine within 24 h. Follow-up of infants revealed that only 50% had received the second and third doses according to the recommended protocol, with 83% completing the immunization series.Conclusion: These results indicate that a program of prenatal HBsAg screening and neonatal prophylaxis against hepatitis B can be successfully instituted in a high volume obstetric hospital, and that better monitoring of infants is required to ensure completion of vaccination.

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Jašarević, Eldin. "356 Microbial origins in the developmental programming of offspring health." Journal of Animal Science 98, Supplement_4 (November 3, 2020): 93–94. http://dx.doi.org/10.1093/jas/skaa278.170.

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Abstract Adverse parental lifetime experiences, such as stress and malnutrition, are implicated in the risk for offspring metabolic, cardiovascular, and neurodevelopmental disorders. In recent years, the maternal microbiome has emerged as an important factor that affects maternal health and infant development during pregnancy and beyond. Using mouse models of maternal stress experience during pregnancy, we examined the hypothesis that maternal stress experience alters the composition of the maternal microbiota and this altered community is transmitted to offspring to mediate effects of prenatal stress. As maternal stress exposure exhibits disruptive effects on both in utero environment and maternal microbiota, it has been difficult to assess the mechanistic involvement of the maternal microbiome to the prenatal stress phenotype independent of stress effects on the fetal environment. To circumvent this, we developed a maternal microbiota transplantation method in which embryonic day 18.5 mouse pups were delivered by caesarean section, thereby preventing natural colonization, and then transplanted with various maternal microbiota communities via orogastric gavage. Transplantation of maternal microbiota from stressed dams into naïve pups delivered by caesarean section recapitulated phenotypes that resembled those seen in prenatally stressed males, including reduced body weight and increased neuroendocrine response to acute stressors. However, transplantation of control maternal vaginal microbiota into prenatally stressed pups delivered by caesarean section did not rescue the prenatal stress phenotype. We showed that the inability to rescue the prenatal stress phenotype is related to transcriptional reprogramming to pathways involved in the regulation of innate immunity in the fetal gut and brain prior to birth and colonization by maternal microbiota. These results are interesting in light of recent studies demonstrating a critical role of the maternal microbiome on homeostasis of immune cell populations in the offspring brain. As an important requirement for normal growth and development, metabolites produced by the maternal gut microbiota cross the placental barrier and gain access to fetal circulation. Thus, we examined the hypothesis that maternal stress experience during pregnancy significantly alters the availability of maternal gut microbiota-derived metabolites, thereby shifting the availability of these metabolites required for the developing brain. Metabolomic profiling of the maternal compartment and fetal brain showed stress-induced reduction in a class of microbiota-derived metabolites involved in immune homeostasis and chromatin remodeling. Indeed, functional profiling of immune populations in the fetal brain revealed an association between reduced metabolite availability and increased infiltration of proinflammatory monocytes in the fetal brain. Further, as the gut microbiome is fairly accessible within clinical settings, we are now also asking how our mouse model translates to humans in a cohort of pregnant women exposed to childhood adversity. Collectively, our results suggest that intergenerational transmission of stress exposure occur via the maternal microbiota through two novel mechanisms. First, stress alterations during pregnancy impact the available pool of maternal gut microbiota-derived metabolites necessary for normal prenatal growth and development. Second, transmission of stress-altered vaginal microbiota may alter critical immune and metabolic processes underlying neurodevelopment.

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Pícoli, Renata Palópolí, and Luiza Helena de Oliveira Cazola. "Missed opportunities in preventing mother-to-child transmission of syphilis in the indigenous population in central Brazil." Revista Brasileira de Saúde Materno Infantil 22, no. 4 (December 2022): 823–31. http://dx.doi.org/10.1590/1806-9304202200040006.

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Abstract Objectives: to estimate the detection rate of syphilis in pregnant women, the occurrence of congenital syphilis, and the rate of mother-to-child transmission of syphilis, in addition to analyzing missed opportunities in the prevention of mother-to-child transmission in the indigenous population. Methods: descriptive study of cases of pregnant indigenous women with syphilis resulting or not in a case of congenital syphilis. The data were obtained from the Sistema de Informação de Agravos de Notificação (Information System of Notifable Diseases), the records of the Infecções Sexualmente Transmissíveis do Distrito Sanitário Especial Indígena (Sexually Transmitted Infections in the Special Indigenous Health District), and the medical records of pregnant indigenous women in 2015. The database and the calculation of syphilis rates in pregnant women, congenital syphilis, and mother-to-child transmission were carried out. Data on prenatal, diagnosis and treatment of syphilis during pregnancy were collected from the medical records. Results: the detection rate of syphilis in pregnant women reached 35.2/1,000 live births (LB), the occurrence of congenital syphilis encompassed 15.7/1.000 LB, and the rate of mother-to-child transmission was 44.8%. Six (24%) pregnant women started prenatal care in the first trimester and seven (28%) attended seven or more consultations. The diagnosis of syphilis was late and only nine (36%) women were properly treated. Conclusions: failures in the diagnosis and the adequate treatment of pregnant women with syphilis compromised the prevention of mother-to-child transmission of the disease.

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Aguiar, Debora Melo de, Andréia Moreira de Andrade, Alanderson Alves Ramalho, Fernanda Andrade Martins, Rosalina Jorge Koifman, Simone Perufo Opitz, and Ilce Ferreira da Silva. "Effect of prenatal care quality on the risk of low birth weight, preterm birth and vertical transmission of HIV, syphilis, and hepatitis." PLOS Global Public Health 3, no. 3 (March 29, 2023): e0001716. http://dx.doi.org/10.1371/journal.pgph.0001716.

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Background Averse birth-outcomes still affect newborns worldwide. Although high-quality prenatal care is the main strategy to prevent these outcomes, the effect of prenatal care based on Kotelchuck index combined with consultation contents is still unclear. Thus, this article to evaluate the effect of the quality of prenatal care (PC) process on birth indicators in a cohort of puerperaes who attended maternity hospitals in Brazilian western Amazon, city of Rio Branco, in the state of Acre, Brazil, in 2015. Methods This research was a hospital-based cohort study. The sample consisted of 1,030 women who gave birth in maternity hospitals in the city between April 6 and June 30, 2015. This research was a hospital-based cohort study. The sample consisted of 1,030 women who gave birth in maternity hospitals in Rio Branco between April 6th. and June 30th., 2015. Prenatal care was classified as fully adequate when started ≤4th month; ≥80.0–109% expected consultations for GA according to the Kotelchuck Index; ≥5 records of blood pressure, weight, GA, fundal height, ≥4 records of fetal heart rate, fetal movements or equivalent to 75% of the number of consultations; in addition to recording ABO/RH, hemoglobin, VDRL, urine, glucose, anti-HIV and anti-toxoplamosis during the 1st trimester. The evaluated outcomes were low birth weight (LBW), preterm birth and vertical transmission of human immunodeficiency virus (HIV)/hepatitis/syphilis. Differences between proportions were assessed using the X² test, and the crude and adjusted odds ratios (OR) (95% CI) were estimated using unconditional logistic regression. Results Overall cohort, the outcomes incidences were 8.8% for LBW, 9.2% for preterm birth, and 1.1% for vertical transmission (syphilis/HIV/hepatitis). Crude and adjusted OR showed that inadequate PC increased the risk statistically significant of LBW (ORcrude: 1.84; 95%CI: 0.99–3.44; ORadjusted: 1.87; 95%CI: 1.00–3.52), and preterm birth (ORcrude: 1.79; 95%CI: 1.00–3.29; ORadjusted: 3.98; 95%CI: 1.40–11.29). Conclusion The results draw attention to the importance of quality PC in reducing the risks of LBW, preterm birth, and vertical transmission of syphilis/HIV/hepatitis. Moreover, using this proposed quality prenatal care indicator based on Kotelchuck index combined with consultations contents adjusted by GA may accurately predict unfavorable outcomes.

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Yu, Yang, Yuting Jiang, Xiaonan Hu, Hongguo Zhang, Ruizhi Liu, and Ruixue Wang. "Two-Generation Transmission of Trisomy 18p: Prenatal Diagnosis in a Woman with Mild Intellectual Disability." Cytogenetic and Genome Research 157, no. 4 (2019): 220–26. http://dx.doi.org/10.1159/000499173.

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Trisomy 18p is a rarely observed chromosomal aberration. Only 31 cases have previously been described in the literature. Trisomy 18p is associated with mild to moderate phenotypic anomalies and intellectual disability. Here, we report on a pregnant woman in whom noninvasive prenatal testing indicated a high risk of fetal trisomy 18. Prenatal diagnosis and karyotyping of the parents were performed and demonstrated that both the mother and the fetus had a derivative chromosome 15 with a segment of unknown origin. Chromosomal microarray analysis and FISH revealed a 14.9-Mb duplication of 18p and detected 3 centromeres of chromosome 18. To our knowledge, this is the first study reporting trisomy 18p due to an unbalanced translocation of 18p onto chromosome 15q showing 2-generation transmission. The results suggest that trisomy 18p can be considered a euchromatic variant.

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Melo, Bruna C. S., Ana Portocarrero, Cláudia Alves, André Sampaio, and Luisa Mota-Vieira. "Paternal Transmission of Small Supernumerary Marker Chromosome 15 Identified in Prenatal Diagnosis Due to Advanced Maternal Age." Clinical Medicine Insights: Case Reports 8 (January 2015): CCRep.S31958. http://dx.doi.org/10.4137/ccrep.s31958.

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The detection of supernumerary marker chromosomes (SMCs) in prenatal diagnosis is always a challenge. In this study, we report a paternally inherited case of a small SMC(15) that was identified in prenatal diagnosis due to advanced maternal age. A 39-year-old woman underwent amniocentesis at 16 weeks of gestation. A fetal abnormal karyotype − 47,XX,+mar − with one sSMC was detected in all metaphases. Since this sSMC was critical in the parental decision to continue or interrupt this pregnancy, we proceeded to study the fetus and their parents. Cytogenetic and molecular analyses revealed a fetal karyotype 47,XX,+mar pat.ish idic(15)(ql2)(D15Zl++,SNRPN−-), in which the sSMC(15) was a paternally inherited inverted duplicated chromosome and did not contain the critical region of Prader–Willi/Angelman syndromes. Moreover, fetal uniparental disomy was excluded. Based on this information and normal obstetric ultrasounds, the parents decided to proceed with the pregnancy and a phenotypically normal girl was born at 39 weeks of gestation. In conclusion, the clinical effects of sSMCs need to be investigated, especially when sSMCs are encountered at prenatal diagnosis. Here, although the paternal sSMC(15) was not associated with an abnormal phenotype, its characterization allows more accurate genetic counseling for the family progeny.

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Journal articles on the topic 'Prenatal transmission'

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