THU0386 Aphaeretic Procedures and Intravenous Immunoglobulins in Addition to Conventional Therapy to Treat Pregnant Women with High-Risk Antiphospholipid Antibody Syndrome. A Prospective Cohort Study

Abstract Background Cardiovascular diseases (CVD) are cause of increased morbidity and mortality in spite of advances for diagnosis and treatment. Changes during pregnancy affect importantly the maternal CV system. Pregnant women that develop preeclampsia (PE) have higher risk (up to 4 times) of clinical CVD in the short- and long-term. Predominance of an anti-angiogenic environment during pregnancy is known as main cause of PE, but its relationship with CV complications is still under research. We hypothesize that angiogenic factors are associated to maternal cardiac dysfunction/remodeling and that these may be detected by new cardiac biomarkers and maternal echocardiography. Methods Prospective cohort study of pregnant women with high-risk of PE in first trimester screening, established diagnosis of PE during gestation, and healthy pregnant women (total intended sample size n = 440). Placental biochemical and biophysical cardiovascular markers will be assessed in the first and third trimesters of pregnancy, along with maternal echocardiographic parameters. Fetal cardiac function at third trimester of pregnancy will be also evaluated and correlated with maternal variables. Maternal cardiac function assessment will be determined 12 months after delivery, and correlation with CV and PE risk variables obtained during pregnancy will be evaluated. Discussion The study will contribute to characterize the relationship between anti-angiogenic environment and maternal CV dysfunction/remodeling, during and after pregnancy, as well as its impact on future CVD risk in patients with PE. The ultimate goal is to improve CV health of women with high-risk or previous PE, and thus, reduce the burden of the disease. Trial registration NCT04162236

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High-risk pregnancies and their association with severe maternal morbidity in Nepal: A prospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0244072 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244072

Author(s):

Sushma Rajbanshi ◽

Mohd Noor Norhayati ◽

Nik Hussain Nik Hazlina

Keyword(s):

Cohort Study ◽

High Risk ◽

Risk Stratification ◽

Antenatal Care ◽

Pregnant Women ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Maternal Morbidity ◽

Low Risk ◽

Severe Maternal Morbidity

Background The early identification of pregnant women at risk of developing complications at birth is fundamental to antenatal care and an important strategy in preventing maternal death. This study aimed to determine the prevalence of high-risk pregnancies and explore the association between risk stratification and severe maternal morbidity. Methods This hospital-based prospective cohort study included 346 pregnant women between 28–32 gestational weeks who were followed up after childbirth at Koshi Hospital in Nepal. The Malaysian antenatal risk stratification approach, which applies four color codes, was used: red and yellow denote high-risk women, while green and white indicate low-risk women based on maternal past and present medical and obstetric risk factors. The World Health Organization criteria were used to identify women with severe maternal morbidity. Multivariate confirmatory logistic regression analysis was performed to adjust for possible confounders (age and mode of birth) and explore the association between risk stratification and severe maternal morbidity. Results The prevalence of high-risk pregnancies was 14.4%. Based on the color-coded risk stratification, 7.5% of the women were categorized red, 6.9% yellow, 72.0% green, and 13.6% white. The women with high-risk pregnancies were 4.2 times more likely to develop severe maternal morbidity conditions during childbirth. Conclusions Although smaller in percentage, the chances of severe maternal morbidity among high-risk pregnancies were higher than those of low-risk pregnancies. This risk scoring approach shows the potential to predict severe maternal morbidity if routine screening is implemented at antenatal care services. Notwithstanding, unpredictable severe maternal morbidity events also occur among low-risk pregnant women, thus all pregnant women require vigilance and quality obstetrics care but high-risk pregnant women require specialized care and referral.

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Validation of scoring systems and (1, 3)-beta-D-glucan assay for early diagnosis of invasive candidiasis in high-risk non-neutropenic patients in Siriraj Hospital: a prospective cohort study

10.26226/morressier.56d6be7cd462b80296c958d4 ◽

2016 ◽

Author(s):

Supitcha Ongkittikul

Keyword(s):

Cohort Study ◽

High Risk ◽

Early Diagnosis ◽

Prospective Cohort Study ◽

Invasive Candidiasis ◽

Prospective Cohort ◽

Scoring Systems ◽

Siriraj Hospital ◽

Neutropenic Patients

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Iron Deficiency Anemia Among Chinese Pregnant Women: a Multi-center Prospective Cohort Study

Case Medical Research ◽

10.31525/ct1-nct03961074 ◽

2019 ◽

Author(s):

Keyword(s):

Cohort Study ◽

Iron Deficiency ◽

Pregnant Women ◽

Iron Deficiency Anemia ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Deficiency Anemia

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Nurse-led PrEP-RN clinic: a prospective cohort study exploring task-Shifting HIV prevention to public health nurses

BMJ Open ◽

10.1136/bmjopen-2020-040817 ◽

2021 ◽

Vol 11 (1) ◽

pp. e040817

Author(s):

Patrick O'Byrne ◽

Amanda Vandyk ◽

Lauren Orser ◽

Marlene Haines

Keyword(s):

Public Health ◽

Cohort Study ◽

High Risk ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Secondary Outcome ◽

Bivariate Analysis ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Risk Criteria

ObjectiveTo report the results of a nurse-led pre-exposure prophylaxis (PrEP) delivery service.DesignThis was a prospective cohort study conducted from 5 August 2018 to 4 March 2020. It involved manual chart review to collect data. Variables were described using frequencies and percentages and analysed using χ2 testing. Those significant in bivariate analysis were retained and entered into a binary multiple logistic regression. Hierarchical modelling was used, and only significant factors were retained.SettingThis study occurred in an urban public health unit and community-based sexually transmitted infection (STI) clinic in Ottawa, Canada.ParticipantsOf all persons who were diagnosed with a bacterial STI in Ottawa and everyone who presented to our STI clinic during the study period, there were 347 patients who met our high-risk criteria for PrEP; these criteria included patients who newly presented with any of the following: HIV contacts, diagnosed with a bacterial STI or single use of HIV PEP. Further, eligibility could be determined based on clinical judgement. Patients who met the foregoing criteria were appropriate for PrEP-RN, while lower-risk patients were referred to elsewhere. Of the 347 patients who met our high-risk criteria, 47% accepted and 53% declined. Of those who accepted, 80% selected PrEP-registered nurse (RN).Primary and secondary outcome measuresUptake, acceptance, engagement and attrition factors of participants who obtained PrEP through PrEP-RN.Findings69% of participants who were eligible attended their intake PrEP-RN visit. 66% were retained in care. Half of participants continued PrEP and half were lost to follow-up. We found no significant differences in the uptake, acceptance, engagement and attrition factors of participants who accessed PrEP-RN regarding reason for referral, age, ethnicity, sexual orientation, annual income, education attainted, insurance status, if they have a primary care provider, presence or absence of depression or anxiety and evidence of newly acquired STI during the study period.ConclusionsNurse-led PrEP is an appropriate strategy for PrEP delivery.

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