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perinatal infection and development outcome

Sophie Desmonde, Tessa Goetghebuer, Claire Thorne, Valériane Leroy
PURPOSE OF REVIEW: The number of HIV-exposed but uninfected (HEU) infants exposed to both HIV and multiple antiretroviral drugs in utero and during prolonged breastfeeding is increasing in low-income countries where HIV prevalence is the highest. We review recent evidence on the effects of perinatal/postnatal exposure to maternal HIV and combined antiretroviral therapy (cART) on health outcomes of HEU children (mitochondrial and metabolic toxicity, adverse pregnancy outcomes, neurodevelopment, growth, infectious morbidity, and mortality)...
September 2016: Current Opinion in HIV and AIDS
William J Muller
Viral infections in the fetus or newborn often involve the central nervous system (CNS) and can lead to significant morbidity and mortality. Substantial progress has been made in identifying interventions decreasing adverse neurodevelopmental outcomes in this population. This review highlights progress in treatment of important viruses affecting the CNS in these susceptible hosts, focusing on herpes simplex (HSV), cytomegalovirus (CMV), human immunodeficiency virus (HIV), and enteroviruses. The observation that high-dose acyclovir improves mortality in neonatal HSV disease culminated decades of antiviral research for this disease...
September 27, 2016: Pediatric Research
Catherine M Herba, Vivette Glover, Paul G Ramchandani, Marta B Rondon
Studies examining mechanisms underlying associations between maternal depression and adverse child outcomes (including behaviour, socioemotional adjustment, and emotion regulation) indicate that during pregnancy, maternal depression could affect child outcomes through altered placental function, epigenetic changes in the child, and stress reactivity. Infection and dietary deficiencies in the mother and the child, together with the child's genetic vulnerability, might also affect outcome. Postnatally, associations between maternal depression and child outcome are influenced by altered mother-child interactions, sociodemographic or environmental influences, and social support...
October 2016: Lancet Psychiatry
Patrick Ryscavage, Thomas Macharia, Lino R Trinidad, Susan Lovelace, Vicki Tepper, Robert Redfield
Patients with perinatally acquired HIV may be at risk for the development of age-related non-AIDS diseases. The primary aim of this study was to describe patterns of systemic hypertension among a cohort of adults (≥18 years) with perinatally acquired HIV. A retrospective cohort study was conducted among adults (≥18 years) with perinatally acquired HIV infection. Primary outcomes included documentation of systemic hypertension as well as several additional non-AIDS-associated illnesses. Systemic hypertension incidence rates and rate ratios (RRs) were calculated among groups aged ≥18 and <18 years at the time of hypertension diagnosis...
September 19, 2016: Journal of the International Association of Providers of AIDS Care
Kristen A McLaurin, Rosemarie M Booze, Charles F Mactutus
Since the advent of combination antiretroviral therapy (cART), pediatric HIV-1 (PHIV) has evolved from a fatal disease to a chronic disease as children perinatally infected with HIV-1 survive into adulthood. The HIV-1 transgenic (Tg) rat, which expresses 7 of the 9 HIV-1 genes constitutively throughout development, was used to model the early development of chronic neurological impairment in PHIV. Male and female Fischer HIV-1 Tg and F344 N control rats, sampled from 35 litters, were repeatedly assessed during early development using multiple experimental paradigms, including somatic growth, locomotor activity, cross-modal prepulse inhibition (PPI) and gap-prepulse inhibition (gap-PPI)...
August 18, 2016: Journal of Neurovirology
D Hermetet-Lindsay Katrina, F Correia Katherine, L Williams Paige, Smith Renee, M Malee Kathleen, A Mellins Claude, M Rutstein Richard
Among perinatally HIV-infected (PHIV) and perinatally HIV-exposed, uninfected (PHEU) youth, we evaluated the contributions of home environment, psychosocial, and demographic factors and, among PHIV only, HIV disease severity and antiretroviral treatment (ART), to cognitive functioning (CF) and behavioral functioning (BF). A structural equation modeling (SEM) approach was utilized. Exploratory factor analysis was used to reduce predictor variables to major latent factors. SEMs were developed to measure associations between the latent factors and CF and BF outcomes...
July 30, 2016: AIDS and Behavior
Miguel A Garcia-Knight, Jennifer Slyker, Barbara Lohman Payne, Sergei L Kosakovsky Pond, Thushan I de Silva, Bhavna Chohan, Brian Khasimwa, Dorothy Mbori-Ngacha, Grace John-Stewart, Sarah L Rowland-Jones, Joakim Esbjörnsson
Antiretroviral therapy-naive HIV-1 infected infants experience poor viral containment and rapid disease progression compared to adults. Viral factors (e.g. transmitted cytotoxic T- lymphocyte (CTL) escape mutations) or infant factors (e.g. reduced CTL functional capacity) may explain this observation. We assessed CTL functionality by analysing selection in CTL-targeted HIV-1 epitopes following perinatal infection. HIV-1 gag, pol and nef sequences were generated from a historical repository of longitudinal specimens from 19 vertically infected infants...
2016: Scientific Reports
Dubravko Habek, Tatjana Dujaković, Jasna Cerkez Habek, Ivana Jurković
Results of the first research of this kind on the 23-year long-term outcome in children born during the war in Vukovar are presented. This retrospective clinical study surveyed the potential 23-year long-term consequences and morbidity of children born between May 1, 1991 and November 19, 1991, during the siege and occupation of Vukovar. Data were obtained from women having delivered their babies in that period and from delivery protocols of the Department of Gynecology and Obstetrics, Vukovar County Hospital...
March 2016: Acta Clinica Croatica
Anna-Barbara Moscicki, Tzy-Jyun Yao, Mark I Ryder, Jonathan S Russell, Stephen S Dominy, Kunjal Patel, Matt McKenna, Russell B Van Dyke, George R Seage, Rohan Hazra
OBJECTIVE: To compare oral health parameters in perinatally HIV-infected (PHIV) and perinatally HIV-exposed but uninfected youth (PHEU). METHODS: In a cross-sectional substudy within the Pediatric HIV/AIDS Cohort Study, participants were examined for number of decayed teeth (DT), Decayed, Missing, and Filled Teeth (DMFT), oral mucosal disease, and periodontal disease (PD). Covariates for oral health parameters were examined using zero-inflated negative binomial regression and ordinal logistic regression models...
2016: PloS One
Ali Judd, Annette H Sohn, Intira J Collins
PURPOSE OF REVIEW: There is an increasing number of deaths among adult survivors of perinatal HIV. Multiple and complex factors drive this mortality, including problems with retention in care and adherence during adolescence, coupled with the critical period of transition from paediatric to adult care, increasing their risk of treatment failure and severe immunosuppression. We reviewed studies that evaluated the impact of service delivery interventions to improve the health of perinatally infected adolescents living with HIV (P-ALHIV) to gain insight into what might help them survive the vulnerable period of adolescence...
June 6, 2016: Current Opinion in HIV and AIDS
T Yee Khong, Eoghan E Mooney, Ilana Ariel, Nathalie C M Balmus, Theonia K Boyd, Marie-Anne Brundler, Hayley Derricott, Margaret J Evans, Ona M Faye-Petersen, John E Gillan, Alex E P Heazell, Debra S Heller, Suzanne M Jacques, Sarah Keating, Peter Kelehan, Ann Maes, Eileen M McKay, Terry K Morgan, Peter G J Nikkels, W Tony Parks, Raymond W Redline, Irene Scheimberg, Mirthe H Schoots, Neil J Sebire, Albert Timmer, Gitta Turowski, J Patrick van der Voorn, Ineke van Lijnschoten, Sanne J Gordijn
CONTEXT: -The value of placental examination in investigations of adverse pregnancy outcomes may be compromised by sampling and definition differences between laboratories. OBJECTIVE: -To establish an agreed-upon protocol for sampling the placenta, and for diagnostic criteria for placental lesions. Recommendations would cover reporting placentas in tertiary centers as well as in community hospitals and district general hospitals, and are also relevant to the scientific research community...
July 2016: Archives of Pathology & Laboratory Medicine
Mary Ellen Burke Sosa
There has been an increasing incidence worldwide of invasive group A streptococcal disease in pregnancy and the puerperal period over the past 30 years. Group A Streptococcus (GAS) was identified as the major cause of maternal morbidity and mortality from sepsis before the identification that hand washing techniques could prevent the transmission of the bacteria. Hand washing remains the cornerstone of prevention as transmission can occur directly from an asymptomatic colonized healthcare provider, other patients, or a community-acquired source...
April 2016: Journal of Perinatal & Neonatal Nursing
Deanne K Thompson, Jian Chen, Richard Beare, Christopher L Adamson, Rachel Ellis, Zohra M Ahmadzai, Claire E Kelly, Katherine J Lee, Andrew Zalesky, Joseph Y M Yang, Rodney W Hunt, Jeanie L Y Cheong, Terrie E Inder, Lex W Doyle, Marc L Seal, Peter J Anderson
OBJECTIVE: To use structural connectivity to (1) compare brain networks between typically and atypically developing (very preterm) children, (2) explore associations between potential perinatal developmental disturbances and brain networks, and (3) describe associations between brain networks and functional impairments in very preterm children. METHODS: 26 full-term and 107 very preterm 7-year-old children (born <30weeks' gestational age and/or <1250g) underwent T1- and diffusion-weighted imaging...
July 1, 2016: NeuroImage
Anne Njeri Maina, Joshua Kimani, Omu Anzala
BACKGROUND: Sexually transmitted infections (STIs) are a major public health problem, especially in developing countries. The complications of untreated STIs in the female genital tract and their role in adverse pregnancy and perinatal outcomes have been well documented. The prevalence of STIs in Kenya among women in the general population has not been extensively studied and there is a lack of guidelines for screening of non-pregnant women. Knowledge of the prevalence of curable STIs among this population can provide a basis for integrating STI screening in family planning clinics...
2016: BMC Research Notes
Betsy Ostrander, Tyler Bardsley, Ernest Kent Korgenski, Tom Greene, Joshua L Bonkowsky
OBJECTIVE: Elevated rates of epilepsy and motor impairments including cerebral palsy are observed in children who were born prematurely. Maternal antenatal magnesium supplementation has been associated with decreased rates of cerebral palsy in infants born prematurely. Our objective was to determine whether the neonatal serum magnesium level between 24 and 48 hours after birth is associated with better long-term neurodevelopmental outcomes (epilepsy, motor impairment) in premature infants...
June 2016: Pediatric Neurology
Gianfranca Cabiddu, Santina Castellino, Giuseppe Gernone, Domenico Santoro, Gabriella Moroni, Michele Giannattasio, Gina Gregorini, Franca Giacchino, Rossella Attini, Valentina Loi, Monica Limardo, Linda Gammaro, Tullia Todros, Giorgina Barbara Piccoli
Pregnancy is increasingly undertaken in patients with chronic kidney disease (CKD) and, conversely, CKD is increasingly diagnosed in pregnancy: up to 3 % of pregnancies are estimated to be complicated by CKD. The heterogeneity of CKD (accounting for stage, hypertension and proteinuria) and the rarity of several kidney diseases make risk assessment difficult and therapeutic strategies are often based upon scattered experiences and small series. In this setting, the aim of this position statement of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology is to review the literature, and discuss the experience in the clinical management of CKD in pregnancy...
June 2016: Journal of Nephrology
Haleema Alserehi, Ghassan Wali, Abeer Alshukairi, Basem Alraddadi
BACKGROUND: Middle East Respiratory Syndrome coronavirus (MERS-CoV) is a viral respiratory disease. Most people infected with MERS-CoV develop severe acute respiratory illness. It was first reported in Saudi Arabia in 2012 and has since spread to several other countries. We report the clinical course of MERS-CoV infection in a pregnant woman who acquired the infection during the last trimester. CASE PRESENTATION: The patient is a 33-year-old female working as a critical care nurse...
2016: BMC Infectious Diseases
Francesca Gaccioli, Susanne Lager
Intrauterine growth restriction refers to the inability of the fetus to reach its genetically determined potential size. Fetal growth restriction affects approximately 5-15% of all pregnancies in the United States and Europe. In developing countries the occurrence varies widely between 10 and 55%, impacting about 30 million newborns per year. Besides having high perinatal mortality rates these infants are at greater risk for severe adverse outcomes, such as hypoxic ischemic encephalopathy and cerebral palsy...
2016: Frontiers in Physiology
Hilda Tanimia, Skandarupan Jayaratnam, Glen L Mola, Apeawusu B Amoa, Caroline de Costa
BACKGROUND: The World Health Organization (WHO) defines 'maternal near-miss' as 'a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of her pregnancy'. With declining rates of maternal mortality, near-miss analysis is being examined in both developed and developing country settings for the assessment of obstetric care. AIMS: Over a 15-month period, details of cases that could be classified as 'near-misses' were collected at Port Moresby General Hospital (PMGH), to assess the practicality of collecting such data routinely and determine near-miss rates for the hospital...
April 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Fu-Kuei Huang, Hsiu-Lin Chen, Peng-Hong Yang, Hung-Chih Lin
Though the incidence of neonatal infection in term and near-term infants is relatively low, incidence of infection in preterm very low birth weight infants is as high as 20-30% and may result in neurodevelopmental impairment or mortality. Pediatricians should be familiar with recognition and emergency management of life-threatening neonatal infections, such as congenital pneumonia, early onset sepsis, late onset sepsis, bacterial and fungal meningitis, disseminated neonatal herpes simplex virus (HSV), and HSV meningoencephalitis...
June 2016: Pediatrics and Neonatology
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