New York- Covid-19 infection during pregnancy leads to distinct immune changes in mothers and babies, according to a study.
The researchers found that Covid-19 dysregulates maternal immune response, with different immune signatures between mothers with asymptomatic and severe disease.
"We know that pregnancy increases maternal risk for Covid-19, but relatively little is known about the long-term consequences of in-utero exposure for infants," said Jae Jung, Director of the Cleveland Clinic Global Center for Pathogen & Human Health Research.
The study highlights "how important it will be for long-term follow-up after pregnancy to catch and hopefully prevent any unforeseen long-term health conditions related to prenatal infection,"Jung added.
For the study, published in the journal Cell Reports Medicine, the team involved 93 mothers with Covid-19 and 45 of their infant children who were exposed to SARS-CoV-2, the virus that causes Covid-19.
The research team studied immune profiles for more than 1,400 cytokines and other inflammatory proteins collected from peripheral and cord blood samples.
The researchers compared maternal blood specimens collected close to the initial detection of SARS-CoV-2 and at different time points throughout pregnancy and delivery.
They found that compared to mild or moderate disease, pregnant women with severe Covid-19 exhibited significantly more inflammation and elevated levels of a protein called IFNL1 (interferon lambda 1) and the receptor it binds with, IFNLR1, which plays a critical role in protecting against viruses.
"This increase in interferon lambda signaling may help explain why we see relatively little direct transmission of Covid-19 between mother and baby during the period right before or after birth -- what we call vertical transmission," explained Suan-Sin (Jolin) Foo, a research associate in Dr. Jung's lab and co-first author on the paper.
Despite the lack of evidence for robust vertical transmission, the researchers found that SARS-CoV-2 infection alters maternal immunity at delivery and that gestational SARS-CoV-2 exposure alters infant immunity at birth.
At delivery, the women exhibited dysregulated levels of several cytokines that are associated with pregnancy complications, including MMP7, MDK, ESM1, BGN and CD209.
Among infants, prenatal exposure induced the expression of cytokines related to T cells, which are a type of immune cell involved in recognising and attacking specific antigens.
The majority of births within the cohort were healthy, but there was a high incidence of some complications, including preeclampsia and foetal growth restriction.
More research will be necessary to understand the extent to which the observed immune changes are related to these clinical outcomes, the team said.
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An immediate challenge today is the prevention of Diabetes among the youth and pregnant women, Union Minister of State Dr. Jitendra Singh said on Sunday.
The minister, also a renowned Diabetologist, called for a mandatory diabetes test in all maternity hospitals and for every pregnant women, adding that more than 70 per cent of India's population is below 40 years of age.
Calling for an integrated and holistic approach to fight Diabetes, Singh said: Covid has prompted us to discover new norms in adversity and underlined the importance of combining traditional Indian management modalities with the Allopathic System."
"Diabetes is a growing epidemic globally and more so in India. A total of 88 million adult populations in India has diabetes in 2019 as per the latest International Diabetes Federation (IDF) estimates and this is projected to rise by almost 74 per cent to 153 million by 2045, giving India the dubious distinction of becoming the diabetes capital of the world," Singh said.
Sharing the concerns about of Diabetes that is making fast inroads in rural India with huge economic bearing on poor families, Singh said that there is a need to popularise Telemedicine to provide easy and affordable access to the ailing population.
Talking about the National Digital Health Mission, Singh said it can revolutionise healthcare in India as citizens will be issued a health card that will have all their medical information.
He said, the details of medical tests, illnesses, doctors' prescriptions and medical reports will be on a single identity card and will be the first of its kind in the world.
The Union Minister was speaking at a webinar on diabetes on the occasion of World Diabetes Day, jointly organized by Swami Vivekananda Yoga Anusandhana Samasthana, S-VYASA, Bengaluru and Central Council for Research in Yoga and Naturopathy, CCRYN, New Delhi.
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COPD also known as chronic obstructive pulmonary disorders is a group of lung diseases that blocks airflow and makes it difficult to breathe. The most common of these diseases are emphysema and chronic bronchitis. Many people with COPD have both of these conditions. Emphysema slowly destroys air sacs in your lungs, which interferes with outward airflow. Bronchitis causes inflammation of the bronchi. COPD is a condition in which the disease worsens over time and it makes it difficult even to breathe. Asthma or Bronchitis is a very dangerous condition during pregnancy which causes fatigue, resulting in energy being diverted from the growing foetus.
Asthma can be hard to diagnose. To find out if you have asthma, your doctor takes your health history, does a physical exam and listens to your breathing.. You also may get a lung function test called spirometry. This is a test that checks how well your lungs work. During the test, you take a deep breath and exhale (blow) into a machine called a spirometer. This machine measures the amount of air you breathe in and out. It also measures how fast you can breathe. When you're pregnant, normal changes in your body can make you short of breath. This test can help your doctor know if shortness of breath is a common complication of pregnancy or if it's caused by asthma.
Treatment: Breathing Exercises with COPD
Pursed lip breathing
Pursed Lip Breathing
Pursed lip breathing has a range of benefits:
It's been shown to reduce how hard you have to work to breathe.
It helps release the air trapped in the lungs.
It promotes relaxation.
It reduces shortness of breath.
Practising this technique 4 to 5 times daily can help. Here's how to practice pursed-lip breathing:
While keeping your mouth closed, take a deep breath in through your nose, count to 2. Follow this pattern by repeating in your head "inhale, 1, 2." The breath doesn't have to be deep. A typical inhale will do. Put your lips together as if you're starting to whistle or blow out candles on a birthday cake. This is known as "pursing" your lips. While continuing to keep your lips pursed, slowly breathe out by counting to 4. Don't try to force the air out, but instead breathe out slowly through your mouth.
Tip: Pursed lip breathing is best for performing strenuous activities, such as climbing stairs.
Feeling short of breath can cause anxiety that makes you hold your breath. To prevent this from occurring, you can practice coordinated breathing using these two steps:
Inhale through your nose before beginning an exercise.
While pursuing your lips, breathe out through your mouth during the most strenuous part of the exercise. An example could be when curling upward on a bicep curl.
Tip: Coordinated breathing can be performed when you're exercising or feeling anxious.
Deep breathing prevents air from getting trapped in your lungs, which can cause you to feel short of breath. As a result, you can breathe in the more fresh air.
Here's how to practice deep breathing:
Sit or stand with your elbows slightly back. This allows your chest to expand more fully.
Inhale deeply through your nose.
Hold your breath as you count to 5.
Release the air via a slow, deep exhale, through your nose, until you feel your inhaled air has been released.
Exercise tip: It's best to do this exercise with other daily breathing exercises that can be performed for 10 minutes at a time, 3 to 4 times per day.
When you have COPD, mucus can build up more easily in your lungs. The huffing is a breathing exercise designed to help you cough up mucus effectively without making you feel too tired.
Here's how to practice the huffing:
Place yourself in a comfortable seated position. Inhale through your mouth, slightly deeper than you would when taking a normal breath.
Activate your stomach muscles to blow the air out in three even breaths while making the sounds "ha, ha, ha." Imagine you're blowing onto a mirror to cause it to steam.
Exercise tip: A huff should be less tiring than a traditional cough, and it can keep you from feeling worn out when coughing up mucus.
The diaphragm is an important muscle involved in the work of breathing.
People with COPD tend to rely more on the accessory muscles of the neck, shoulders, and back to breathe, rather than on the diaphragm. Diaphragmatic or abdominal breathing helps to retrain this muscle to work more effectively. Here's how to do it:
While sitting or lying down with your shoulders relaxed, put a hand on your chest and place the other hand on your stomach.
Take a breath in through your nose for 2 seconds, feeling your stomach move outward. You're doing the activity correctly if your stomach moves more than your chest.
Purse your lips and breathe out slowly through your mouth, pressing lightly on your stomach. This will enhance your diaphragm's ability to release air.
Repeat the exercise as you are able to.
Protect Your Lungs during Pregnancy
Since you're essentially breathing for two, take these steps to protect your lung health and your infant's health:
Tell Your Doctor About Any Shortness of Breath- There can be many reasons for shortness of breath in pregnancy. Pregnant women are no strangers to shortness of breath. Early pregnancy hormone surges and, later, the weight and bulk of your expanding womb restrict your breathing. If you're feeling short of breath, and you're worried about it for any reason, let your doctor know.
Ask for A Lung Function Test- While the parameters for the test might change as your pregnancy progresses, the simple, noninvasive lung test called spirometry can help your doctor check on your breathing.
Manage Asthma- Uncontrolled asthma during pregnancy puts both babies and you at risk. If you've been lax about your asthma medications, it's time to update your routine for pregnancy and then stick to it.
Avoid Cigarette Smoke- Don't smoke, ban smoking at home, and avoid all environments where you are exposed to cigarette smoke.(Suryalakshmi Paleri, Executive Physiotherapist, Cloudnine Group Of Hospitals, Bengaluru (Malleshwaram))
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Navratri is the festival where nine days of fasting can be observed by a devotee. Many pregnant ladies wish to fast for their religious or personal beliefs. Though it is said that women during pregnancy should be very careful when it comes to fasting because it is not only the mother who needs all the essential nutrients but also the need of the fetus for healthy growth and development.
However, fasting during pregnancy is not as hard as it allows the consumption of various healthy foods at appropriate intervals. But one thing should be remembered by all pregnant ladies that they should not go hungry for long intervals as a baby's nutrition depends on the mother. It is very important to take carbs during pregnancy while fasting. Carbohydrates play a vital role in our growth system. It is an important nutrient source that not only provides energy to muscles and the brain but using the right kind of carbs in the diet can effectively help to provide essential nutrients, build the desired body or accelerate fitness goals.
There are two types of carbs slow and fast carbs which depends on the Glycemic Index ( the rate at which carbs get digested as compared to glucose secretion).
Fast carbs have a high GI and release energy at a much higher pace and get used quickly which makes you feel hungry often and add to weight gain issues. Fast carbs include processed foods such as bread, sugars, starchy vegetables, fruit juices etc.
As compared to this, slow carbs have a low GI and release energy slowly into the body and help to maintain a "satisfied" feeling as your blood sugar levels are maintained.
There are many non-pregnant women who want to shed extra calories. Fasting will be the perfect time to start their fitness journey. To lose weight and stay healthy, the purpose should be to source the right kind of carbs, which release energy slowly and helps you in the long run. Hence, for that, focus on including slow carbs in your diet such as whole grains, seeds and nuts, beans and legumes, vegetables etc. It also tends to be high in fibre.
Should Carbs Be Taken During Fasting?
Although fasting is a very traditional and customary ritual and most people fast for spiritual purification, there is no denying that if you keep yourself nutritionally in check, it can be therapeutic for the body as it can act as a form of detox and keep you healthy as well. So, it is significant to choose the right food while you are on a fast diet to prevent yourself from being deficient in important nutrients as it can make you likely to develop health ailments like weakness, heart problems, skin issues, defective bone growth, etc.
Pregnant women with illnesses such as diabetes, anaemia, high blood pressure should avoid fasting as it could lead to various other complications.
Avoiding carbohydrates will be the last thing you need to do during fasting as it provides energy to the brain and muscles and make you energetic and more productive throughout the day. So, Make sure you are getting enough right kind of carbohydrates, proteins, minerals and vitamins from different sources and be vigilant about selecting healthy foods rather than munch on processed foods.
There are various food options that include slow carbs and few tips to make your fasting healthier:
Because you are fasting, you tend to eat lesser food than usual, and are hungry at odd times, eating slow carbs foods can help you keep fuller for longer as they take longer to digest and break down. Combine high carbohydrates like potatoes and sabudana (widely used in fasting) with other fibrous vegetables like spinach, cabbage, tomatoes, capsicum, bottle guard, etc. Also, try to bake, roast or grill vegetables instead of deep-frying them. Kuttu is a brilliant combination of carbohydrates (70-75 per cent) and protein (20-25 per cent). It is also rich in proteins, B-complex vitamins and minerals like phosphorus, magnesium, iron, zinc, copper and manganese. Use it to make chapatti instead of gorging on puris.
Samak rice is extremely easy to digest and provides energy, contains a high amount of fibre, B-complex vitamins and important minerals like iron and magnesium.
Try and adopt healthy snacking and don't binge on puris, sabudana vada, potato chips, and other delicacies as they are loaded with sugar, salt and fat content, Instead, opt for roasted makhana as they loaded with antioxidants or a mixture of nuts (almonds/raisins/walnut)/ baked chips, roasted peanuts, etc.)
Eat plenty of seasonal fruits and vegetables.
Eat small meals and do not starve yourself. This will help maintain blood glucose levels and prevent you from feeling low.
Keep yourself hydrated. Drink lots of water and fluids like coconut water, lemon water, and buttermilk without adding sugar. These beverages will keep you satisfied for a long time.
While you can gorge on the above-mentioned food items, also try out these healthy recipes this Navratri season:
Sweet potato chaat
1 bowl (250 gms)
Calories-304.5 Cal Carbs-62.09 gms
2-3 Sweet Potatoes (Boiled)
A handful of almonds, peanuts and walnuts
1 tsp Cumin powder and Black pepper
1 tsp chia seeds and roasted flax seeds
Rock salt for taste
1 lemon (for juice)
Boil sweet potatoes and peel them and cut them into small pieces
Now mix the nuts with sweet potatoes
Now add salt, cumin powder and black pepper to it and mix it properly, add lemon juice also
Sprinkle chia seeds and flax seeds
The chaat is now ready to eat
2 pieces (45 gms)
1 cup Kuttu ka Atta / Buckwheat Flour
1/2 cup Sour Curd
1 /4 tsp Ginger paste
Salt to taste
1 tbsp Fresh Coriander (Grated)
1 tsp Green Chilli (Chopped)
Clean and wash the buckwheat in enough water only once. Then drain the excess water using a strainer
Mix the buckwheat, sour curd and half a cup of water in a bowl. Cover it and soak it for at least 4 to 5 hours.
Now add green chilli, ginger paste and salt to the batter and mix very well
Pour the batter into a greased thali and spread evenly by rotating the thali clockwise. Also, Sprinkle freshly chopped coriander
Steam in a steamer for 10-12 min. Or till the Dhoklas are cooked
Cool slightly, cut into pieces and serve immediately with green chutney.
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Many people believe that heart disease typically affects men. Unfortunately, this is far from the truth. Coronary heart disease is the leading cause of mortality not only among men, but also among women. But women are actually at greater risk if not detected early, and this exacerbates the issue.
Signs of poor heart health do not appear as visibly in women as it does in men. What this means is that if a man has a heart issue, there are specific symptoms like angina which can be spotted easily and the right course of action be recommended. The same issue in a woman may not result in a sign or symptom that can be easily spotted. So often, their symptoms go ignored or unrecognised and they do not receive timely intervention to correct the problem. The issue is so acute that today 1 in 3 deaths among women is due to coronary heart disease.
There is also a significant lack of self-awareness among women about risk factors and the prevention of CVDs. Women don't only attend to matters of the home, but they hold positions at leading companies, and continue to rise to the occasion and meet impossible demands on their time. Through all of this, they take care of the emotional needs of their family members and loved ones; and still culturally are predisposed to putting the needs of others before their own. The stress they experience, among other common risk factors, often goes unnoticed by those around them. And stress has a greater influence on CVD risk in women vs men. Along with stress, other factors like diet quantity and quality also have a greater influence on CVD risk in women vs men. Additionally, women are also impacted by female-specific risk factors for CVD like polycystic Ovarian syndrome PCOS, preeclampsia, pregnancy induced hypertension and gestational diabetes.
In such a situation where symptoms of a heart problem do not manifest visibly, it is extremely important for women to be aware of their own risk factors and adopt proactive measures to take care of their heart health. For example, one risk factor, stress has been linked to a greater intake of energy and nutrient-dense foods, mainly sources of sugar and fat, and to poor diet quality. Women can take simple steps like reducing unhealthy fats and products with high content of sugar and salt to improve the quality of their diet. Choose ingredients that are good for the heart, like oatmeal, wholegrains, fiber rich vegetables, blended oils with the right balance of fatty acids, legumes, soy products, and the like. Regular and consistent exercise, adequate sleep, and other such lifestyle modifications can help maintain heart health in the long term.
Furthermore with signs of poor heart health not manifesting visibly in women, it is crucial that they get regular health check-ups done to assess their risk proactively. Self-awareness and early identification of cardiovascular risk factors can lead to better prevention of CVD in women.
This World Heart Day, let's choose self-care. Get a simple heart check-up done and encourage other women in yourselves too, to get the same done. Take proactive steps for heart health today.
(By Brajesh Kunwar)
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London- A team of researchers has discovered that the more severely a mother is infected with Covid-19, the more likely she is to experience preterm birth.
The researchers reported that the rate of preterm birth in nearly 1,000 pregnant women, who tested positive for SARS-CoV-2, the virus that causes Covid-19, was a function of the severity of infection.
"The more severe the SARS-CoV-2 infection, the greater the risk of preterm birth," said researcher Roberto Romero from the Wayne State University School of Medicine in the US.
"There was a dose-dependent relationship between the severity of SARS-CoV-2 infection and the risk of prematurity," Romero added.
For the study published in the American Journal of Obstetrics and Gynecology, the team included data from 14 National Health Service (NHS) maternity hospitals in the UK to assess the effects of SARS-CoV-2 infection in pregnancy.
The excess rate of premature birth, they report, is largely due to medically-induced preterm birth brought about by concerns for health of the mother, such as preeclampsia.
Preterm birth, the leading cause of perinatal morbidity and mortality worldwide, is defined as one that occurs before 37 weeks of gestation.
Two-thirds of preterm births are due to the spontaneous onset of preterm labour. The remaining third is due to medical conditions that affect either the mother or the unborn baby that necessitate delivery.
The more severe the Covid-19 infection, the greater the risk of preeclampsia, a sudden increase in blood pressure after the 20th week of pregnancy.
The condition is responsible for 76,000 maternal deaths and more than 5,00,000 infant deaths every year.
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