Publications by authors named "Martina L Badell"

This study describes the largest cohort to date (n = 147) of pregnant patients with human immunodeficiency virus (HIV) on bictegravir (BIC). BIC in pregnancy was associated with high levels of viral suppression and perinatal outcomes similar to those in the published literature. These findings support consideration for the use of BIC in managing HIV during pregnancy.

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  • Maternal vaccination with mRNA COVID-19 vaccines can help protect infants from COVID-19 by passing antibodies through the placenta during pregnancy.
  • Infants born to mothers who received a booster shot had higher levels of protective antibodies and were 56% less likely to contract COVID-19 in their first 6 months compared to those whose mothers did not receive a booster.
  • The study suggests that higher antibody levels at delivery reduce infection risk significantly, emphasizing the importance of maternal vaccination until infants can be vaccinated themselves.
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More than 290 million people worldwide, and almost 2 million people in the United States, are infected with hepatitis B virus, which can lead to chronic hepatitis B, a vaccine-preventable communicable disease. The prevalence of chronic hepatitis B infection in pregnancy is estimated to be 0.7% to 0.

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  • The study investigates the link between socioeconomic status (SES) and maternal serum cytokine profiles during pregnancy, focusing on how lower SES correlates with chronic inflammation.
  • Researchers compared cytokine levels in pregnant women from low SES (Medicaid-insured) and high SES (privately-insured) backgrounds, finding significant differences in inflammatory markers.
  • Results indicated higher levels of IL-6 (linked to chronic inflammation) in the low SES group and lower levels of IL-1β and TNF-α, suggesting that SES may impact inflammation and thereby affect pregnancy outcomes.
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  • Pregnant patients are more vulnerable to severe COVID-19 outcomes compared to non-pregnant individuals, and high levels of inflammatory markers have been linked to adverse pregnancy events.
  • A study analyzed the inflammatory cytokine profiles of pregnant women who had acute or past SARS-CoV-2 infections, focusing on those with positive COVID-19 test results within a certain timeframe.
  • The results showed that patients with acute/post-acute infections had higher levels of specific inflammatory markers (IL-10, IL-1β, IL-8) compared to those with previous exposure, highlighting differences in immune response during pregnancy.
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  • A multicenter study analyzed the immune responses to COVID-19 vaccinations in pregnant women, focusing on both primary doses and boosters from July 2021 to January 2022.
  • Results showed that booster vaccinations led to significantly higher antibody levels in mothers and their newborns, particularly against the Omicron BA.1 variant, compared to those who received only the primary 2-dose series.
  • Efficient transplacental antibody transfer was observed for all vaccination regimens, indicating robust immune responses in mothers and effective protection for infants.
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Importance: Existing reports of pregnant patients with COVID-19 disease who require extracorporeal membrane oxygenation (ECMO) are limited, with variable outcomes noted for the maternal-fetal dyad.

Objective: To examine maternal and perinatal outcomes associated with ECMO used for COVID-19 with respiratory failure during pregnancy.

Design, Setting, And Participants: This retrospective multicenter cohort study examined pregnant and postpartum patients who required ECMO for COVID-19 respiratory failure at 25 hospitals across the US.

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Viral infections pose unique threats to pregnant persons and their infants. As the frequency of epidemics caused by novel pathogens increases, understanding pregnancy-specific considerations for antiviral treatments is critical for obstetric and nonobstetric providers alike. The use of pharmacologic therapeutics in pregnancy, which include antivirals, pathogen-specific antibodies, and vaccines, is limited due to the lack of purposeful, methodologic, pharmacometrics analyses in this special population.

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The majority of pediatric human immunodeficiency virus (HIV) infections are the result of vertical transmissions that occur during pregnancy, childbirth, and breastfeeding. The treatment of all pregnant persons living with HIV remains a global health initiative. Early and consistent use of antiretroviral therapy throughout pregnancy and childbirth drastically reduces the risk of perinatal transmission of HIV, resulting in fewer children living with the disease worldwide.

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Objective: To improve our understanding of the immune response, including the neutralization antibody response, following COVID-19 vaccination in pregnancy.

Methods: This was a prospective cohort study comprising patients with PCR-confirmed SARS-CoV-2 infection and patients who received both doses of mRNA COVID-19 vaccine (mRNA-1273, BNT162b2) in pregnancy recruited from two hospitals in Atlanta, GA, USA. Maternal blood and cord blood at delivery were assayed for anti-receptor binding domain (RBD) IgG, IgA and IgM, and neutralizing antibody.

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Persons with HIV can receive mixed messages about the safety of breastfeeding. We sought to assess if they felt coerced to formula feed when counseled about practices to reduce HIV transmission. Persons with HIV who had given birth were eligible to complete a survey to describe their experiences with infant feeding counseling and if they felt coerced to formula feed.

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Objective: Historically, individuals with HIV have reported feeling coerced during contraceptive counseling or experienced forced sterilization. The purpose of this study was to assess perceptions of coercion related to counseling and influence on postpartum contraceptive choice among individuals with HIV.

Methods: This is a mixed methods study conducted in Georgia, North Carolina, Pennsylvania, and South Carolina between March 2020 and June 2021.

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Pregnancy is an independent risk factor for severe covid-19. Vaccination is the best way to reduce the risk for SARS-CoV-2 infection and limit its morbidity and mortality. The current recommendations from the World Health Organization, Centers for Disease Control and Prevention, and professional organizations are for pregnant, postpartum, and lactating women to receive covid-19 vaccination.

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Background: We examined the relationship between placental histopathology and transplacental antibody transfer in pregnant patients after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Methods: Differences in plasma concentrations of anti-receptor biding domain (RBD) immunoglobulin (Ig)G antibodies in maternal and cord blood were analyzed according to presence of placental injury.

Results: Median anti-RBD IgG concentrations in cord blood with placental injury (n = 7) did not differ significantly from those without injury (n = 16) (median 2.

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Importance: COVID-19 vaccination is recommended during pregnancy for the protection of the mother. Little is known about the immune response to booster vaccinations during pregnancy.

Objective: To measure immune responses to COVID-19 primary and booster mRNA vaccination during pregnancy and transplacental antibody transfer to the newborn.

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Background: Pregnant patients with SARS-CoV-2 infection are at increased risk for severe disease including hospitalization, intensive care admission, ventilatory support, and death. Although pregnant patients were excluded from investigational trials for pharmacologic treatments for COVID-19 illness, the National Institutes of Health treatment guidelines state that efficacious treatments should not be withheld from pregnant patients. An infusion of casirivimab and imdevimab (REGEN-COV), a monoclonal antibody therapy, was shown to reduce the risk of COVID-19-related hospitalization or death from any cause and resolved symptoms and reduced SARS-CoV-2 viral load more rapidly than placebo.

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  • The use of frozen embryo transfer (FET) in assisted reproductive technology (ART) has grown since the 1980s, but it is linked to higher rates of certain complications, especially hypertensive disorders during pregnancy, compared to fresh transfers.
  • Coordination between an embryo's stage of development and the endometrial environment is crucial for successful FET, which can be performed in either natural or programmed cycles.
  • There is no clear consensus on the best method for preparing the endometrium before FET, and while some studies suggest programmed cycles may lead to worse maternal and neonatal outcomes, further research is needed to clarify these findings and their implications for ART practices.*
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Background: Gestational weight gain above Institute of Medicine recommendations is associated with increased risk of pregnancy complications. The goal was to analyze the association between newer HIV antiretroviral regimens (ART) on gestational weight gain.

Methods: A retrospective cohort study of pregnant women with HIV-1 on ART.

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Background: This study evaluated atazanavir and cobicistat pharmacokinetics during pregnancy compared with postpartum and in infant washout samples.

Setting: A nonrandomized, open-label, parallel-group, multicenter prospective study of atazanavir and cobicistat pharmacokinetics in pregnant women with HIV and their children.

Methods: Intensive steady-state 24-hour pharmacokinetic profiles were performed after administration of 300 mg of atazanavir and 150 mg of cobicistat orally in fixed-dose combination once daily during the second trimester, third trimester, and postpartum.

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  • The study aimed to explore how the maternal immune response works during SARS-CoV-2 infection in pregnant women and how effectively antibodies transfer from mother to fetus.
  • It involved analyzing blood samples from 32 pregnant women who tested positive for the virus, measuring various antibodies (IgG, IgA, IgM) linked to the virus' spike protein.
  • Results showed that while most mothers had detectable antibodies, only a quarter of the newborns had them, with symptomatic infections resulting in higher antibody levels compared to asymptomatic cases.
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Preeclampsia (PE) is a prevalent pregnancy disorder that leads to high maternal and fetal morbidity and mortality. While defective vascular development and angiogenesis in placenta are known as crucial pathological findings, its pathophysiological mechanism remains elusive. To better understand the effects of PE on angio-vasculogenesis and inflammatory networks in the fetus and to identify their biological signatures, we investigated the quantitative and functional characteristics of cord blood-derived mononuclear cells (CB-MNCs) and CD31-positive MNCs.

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We conducted a cohort study to determine sociodemographic risk factors for severe acute respiratory syndrome coronavirus 2 infection among obstetric patients in 2 urban hospitals in Atlanta, Georgia, USA. Prevalence of infection was highest among women who were Hispanic, were uninsured, or lived in high-density neighborhoods.

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