Expecting a baby is, in itself, an important reason to take more care of female health. Now with the coronavirus pandemic, many pregnant women and women who have recently given birth are concerned about the risks that the new disease can bring to their babies and to themselves. Unlike other diseases, so far pregnant women have not been included in Covid-19 risk groups. However, as this type of coronavirus that is in circulation is still new to medicine, it is necessary to pay attention to the immediate and long-term effects that it can cause in different population groups.
To monitor the health of pregnant women and gather important data on how the pandemic has influenced the lives of this population, the Center for Comprehensive Attention to Women's Health (Caism) from Unicamp intends to begin long-term multidisciplinary research with patients treated in reference hospitals for high-risk pregnancies in various regions of Brazil. The project is being finalized to be put into practice and is an initiative of the Research Group on Severe Maternal Morbidity at Unicamp, which includes professors Rodolfo de Carvalho Pacagnella, Maria Laura Costa do Nascimento, José Guilherme Cecatti, Giuliane Jesus Lajos, as well as by postdoctoral student Renato Teixeira Souza and doctoral, master's and undergraduate students.
The data will be obtained from some institutions in an integrated network of around 30 hospitals and research centers in the country that are part of the Brazilian Network of Studies in Maternal and Perinatal Healthl, of which Caism is coordinator. With the work carried out in a network, it will be possible to offer health authorities, bodies that work with the development of public policies and also researchers a portrait of how pregnant women in the country experienced the coronavirus pandemic. According to Rodolfo Pacagnella, there is still the possibility of the research being extended to other countries in Latin America through the Latin American Center for Perinatology, Women's and Reproductive Health, a body linked to the World Health Organization (WHO).
Study carried out on three fronts
Rodolfo explains that the initiative to start the study arose from the fear that, as they were not included in the Covid-19 risk groups, pregnant women could suffer effects linked to the disease that would go unnoticed. "It seems that, unlike what happened with H1N1, pregnant women are not at risk of higher mortality from the coronavirus. But it may be that those who have some type of pregnancy complication, such as hypertensive syndromes and diabetes, have a higher risk complications due to virus infection", analyzes the professor.
In the search for an integrated approach, research should focus on three main aspects. In the first three months, a period in which health authorities predict the peak of the pandemic in the country, the study will map the prevalence of coronavirus in the pregnant population, checking how many women have the disease, whether they are part of any risk group due to other factors , among other aspects. Another front of analysis will be dedicated to patients who are diagnosed with Covid-19. With them, monitoring will be carried out throughout the pregnancy until delivery, to identify possible complications that the disease could bring to the pregnancy and female health.
Throughout the research, studies will also be carried out on the dissemination of information about the coronavirus and the relationship between the disease and pregnancy. The researchers intend to check how pregnant women find out about the pandemic, where they look for news, and what content they are interested in. Rodolfo comments that these are the three main fronts, but that other observations must be made. He cites the example of the possibility of seeing a reduction in birth rates caused by couples' concern about having children amid the pandemic.
Artificial Intelligence and data analysis
In addition to clinical monitoring of patients, the group intends to count on the help of data science and artificial intelligence resources to analyze what numerical information obtained throughout the research can indicate about the disease situation and facilitate decision-making for the future. According to Cristiano Torezzan, professor at the Faculty of Applied Sciences (FCA) from Unicamp and participant in the project in developing computational modeling solutions for the data, there are application possibilities that are being analyzed.
He explains that, currently, two actions can be carried out. The first involves the use of data obtained during screening sessions that may indicate a greater or lesser tendency for positive diagnoses of the disease. This would be done by integrating this data with other clinical information, which could also facilitate remote monitoring of patients. "We are going to study the integration of pre-screening data with some clinical data that could be used for a diagnosis prediction model. This would be done anonymously, without any identification of the patient", informs Cristiano.
Another possibility is to carry out online surveys, which would be answered anonymously and voluntarily, to map suspected and confirmed cases of Covid-19 through georeferencing, indicating areas of highest incidence. Cristiano comments that, in this case, it would not be an application directly related to monitoring patients, but that it can help in planning and developing health policies and actions.
