Karl Wehbe

and 6 more

BACKGROUND. Hygiene measures are recommended to prevent toxoplasmosis during pregnancy, although screening for seroconversion in pregnant women currently are debated and practices vary among countries. The purpose of this systematic literature review was to assess the efficiency of hygiene measures during pregnancy to prevent toxoplasmosis infection. MATERIAL AND METHODS. We followed the standard MOOSE and PRISMA criteria when conducting this systematic review and reporting the results. A systematic literature search was conducted for studies on congenital toxoplasmosis prevention, toxoplasmosis prevention during pregnancy, toxoplasmosis prevention and hygiene measures, which were published between 1970 and August 2020, using the databases of PubMed, Scope Med, EMBASE, and the Cochrane library. RESULTS Our literature search identified 3964 articles, 3757 were excluded after review of title or abstract and 67 studies were considered relevant to the subject. We reviewed risk factors for toxoplasmosis infection during pregnancy and for congenital toxoplasmosis, preventive measures for toxoplasmosis during pregnancy, including: dietary recommendations, pet care measures, environmental measures, knowledge of risk factors and ways to control toxoplasmosis infection, knowledge of risk factors for infection by health professionals, knowledge of primary prevention measures by pregnant women. CONCLUSION. Hygiene measures are effective and applicable primary prevention to reduce toxoplasmosis and avoid congenital toxoplasmosis and its consequences.

Sarah Tebeka

and 11 more

Objective To identify risk factors of early and late postpartum depression (PPD) among a wide range of variables including sociodemographic characteristics, childhood trauma, stressful life events during pregnancy, and history of personal and family psychiatric disorders; and to assess the contribution of each risk factor. Design Nested case-control in a prospective longitudinal cohort study. Setting Eight maternity departments in Paris metropolitan area, France. Sample 3310 women with deliveries between November 2011 and June 2016 Methods Cases were identified as women with early or late PPD. Controls were all cohort participants without either early or late PPD. Main Outcome Measures Early and late PPD are assessed respectively at 2 months and one year postpartum. Results: Stressful life events during pregnancy have a dose response relationship with both early and late PPD: each additional event increased the risk of PPD. In multivariable models, early PPD was independently associated with emotional neglect during childhood (aOR:1.6, 95%CI:1.0-2.6), stressful life event during pregnancy (aOR:1.8, 95%CI:1.4-2.4), physical concomitant chronic disease during pregnancy (aOR:1.5, 95%CI:1.0-2.1), and a history of depression (aOR:1.8, 95%CI:1.4-2.4); whereas late PPD was significantly associated with unemployment (aOR:1.8, 95%CI:1.1-2.8), emotional abuse during childhood (aOR:2.2, 95%CI:1.3-3.9), stressful life event during pregnancy (aOR:2.2, 95%CI:1.6-2.9), emergency consultation during pregnancy (aOR:1.4, 95%CI:1.0-1.8), serious postpartum complications (aOR:1.7; 95%CI:1.0-2.8) and personal and family history of mood disorder (aOR:1.5, 95%CI:1.1-2.0, and aOR:1.4, 95%CI:1.0-1.8). Conclusion: Early and late PPD presented distinct patterns of correlates, with sociodemographic, psychiatric and trauma factors. These results have important consequences in terms of prevention and specific care

laurent abramowitz

and 7 more

Objective: To determine whether planned cesarean section (CS) for a second delivery protects anal continence in women with obstetrical anal sphincter lesions. Design: Randomized trial. Setting: 6 maternity units in the Paris area. Sample : Women at high risk of sphincter lesions (first delivery with 3d degree laceration and/or forceps) but no symptomatic anal incontinence. Methods : Endoanal ultrasound was performed in the third trimester of the second pregnancy. Women with sphincter lesions were randomized to planned CS or vaginal delivery (VD). Main outcome measures : Anal continence at 6 months post-partum. Secondary outcomes were urinary continence, sexual morbidity, maternal and neonatal morbidities and worsening of external sphincter lesions. Results : Anal sphincter lesions were detected by ultrasound in 264/434 women enrolled (60.8%) ; 112 were randomized to planned VD and 110 to planned CS. At 6-8 weeks after delivery, there was no significant difference in anal continence between the 2 groups. At 6 months after delivery, median Vaizey scores of anal continence were 1 [IQR 0-4] in the CS group and 1 [IQR 0-3] in the VD group (p = 0.34). There were no significant differences for urinary continence, sexual functions or for other maternal and neonatal morbidities. Conclusions : In women with asymptomatic obstetrical anal sphincter lesions diagnosed by ultrasound, planning a CS had no significant impact on anal continence 6 months after the second delivery. These results do not support advising systematic CS for this indication.