Browsing by Author "Budhram, Samantha"

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    Effect of SARS-CoV-2 infection in pregnancy on maternal and neonatal outcomes in research collaboration
    (2020-12) Nachega, Jean B; Sam-Agudu, Nadia A; Budhram, Samantha
    In the African context, there is a paucity of data on SARS-CoV-2 infection and associated COVID-19 in pregnancy. Given the endemicity of infections such as malaria, HIV, and tuberculosis (TB) in sub-Saharan Africa (SSA), it is important to evaluate coinfections with SARS-CoV-2 and their impact on maternal/infant outcomes. Robust research is critically needed to evaluate the effects of the added burden of COVID-19 in pregnancy, to help develop evidence-based policies toward improving maternal and infant outcomes. In this perspective, we briefly review current knowledge on the clinical features of COVID-19 in pregnancy; the risks of preterm birth and cesarean delivery secondary to comorbid severity; the effects of maternal SARS-CoV-2 infection on the fetus/neonate; and in utero mother-to-child SARS-CoV-2 transmission. We further highlight the need to conduct multicountry surveillance as well as retrospective and prospective cohort studies across SSA. This will enable assessments of SARS-CoV-2 burden among pregnant African women and improve the understanding of the spectrum of COVID-19 manifestations in this population, which may be living with or without HIV, TB, and/or other coinfections/comorbidities. In addition, multicountry studies will allow a better understanding of risk factors and outcomes to be compared across countries and subregions. Such an approach will encourage and strengthen much-needed intra-African, south-to-south multidisciplinary and interprofessional research collaborations. The African Forum for Research and Education in Health’s COVID-19 Research Working Group has embarked upon such a collaboration across Western, Central, Eastern and Southern Africa.
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    A prospective study evaluating the association of specific risk factors with the development of preeclampsia
    (Stellenbosch : Stellenbosch University, 2015-12) Budhram, Samantha; Steyn, D. W.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Obstetrics and Gynaecology.
    ENGLISH ABSTRACT: OBJECTIVE: To determine the association, if any, between certain risk factors for preeclampsia (PE) and the subsequent development of PE in a local cohort of South African women. DESIGN: A prospective study of women with any risk factor for PE for the duration of their pregnancy. METHOD: A prospective study was performed on selected women referred to Tygerberg Hospital, High-risk antenatal clinic, with specific risk factors for the development of PE. A history-based questionnaire was completed by participants at enrolment and biophysical parameters were recorded at each subsequent antenatal visit, admission and at confinement. All data was captured according to the attached data sheet. All information was kept confidential and was strictly for the purposes of this study. STATISTICS: Statistics were performed using the SPSS statistics software version 17.0. Pearson Chi-square test of independence was used for correlating maternal historical factors, mean arterial pressures (MAP) and cardio-metabolic risk with the development of PE in the index pregnancy. p values were considered significant at values < 0.05. RESULTS: The incidence of PE in the cohort was 11.4%. The age of the patient, parity, history of diabetes mellitus, MAP at booking and MAP at 24 weeks showed no significant association with the development of PE at any gestational age. There was a significant association between a history of PE in a previous pregnancy and the development of PE at any gestational age in the index pregnancy (p < 0.05). There were a significantly higher number of women with a history of chronic hypertension that developed PE in the index pregnancy (p < 0.0001). There were also a significantly greater number of obese women that developed PE at any gestational age in the index pregnancy (p < 0.05). The presence of any one or, a combination of cardio-metabolic risk factors was significantly associated with the development of PE at any gestational age (p < 0.005). CONCLUSION: The changing cardio-metabolic milieu, paralleling the pandemic in obesity, may be impacting on the development of PE. Screening for PE in South Africa may mean; validation of historical factors and MAP in prediction of PE in the local population, and if validated, incorporating it with the cardio-metabolic risk profile to triage women to appropriate levels of care. The pre-pregnancy, antenatal, postpartum and inter-pregnancy intervals can be used to optimise cardio-metabolic risk factors and these women, at the end of their reproductive careers, may benefit from life-long surveillance for cardiovascular disease.