Analyse rétrospective de la Mortalité périnatale sans facteur de risque préalablement décelé aux Cliniques Universitaires de Kinshasa: Retrospective analysis of Perinatal mortality without risk factor previously detected at Kinshasa University Hospital

Context and objective. Perinatal mortality (PNM) remains high in developing countries. The present study analyzed fetal-maternal parameters associated with PNM with no known risk factor. Methods. The analysis concerned all pregnant women at full term pregnancy, single fetus, without anomaly and alive at the onset of labor, having given birth in Kinshasa University Hospital over a decade. The risk of PNM was modeled in a multiple logistic regression. Results. Of the 4,390 newborns, birth weight 3,085±416g, 52.8% were boys. Gestational age averaged 38.2±1.1 amenorhee week. PNM (n=354; 81 %) was similar for girls and boys (p=0.5111). The BW of deceased and alive babies was also similar (p = 0.219). Maternal weight (p=0.034), height (p<0.0001), number of antenatal care (p=0.0001) and gestational age (p<0.0001) were greater in mothers with deceased infants. The PNM was directly proportional (p<0.0001) to birth weight, number of antenatal care, mode of delivery, and gestional age but negatively (p<0.0001) proportional to Apgar score. The PNM was lower for Apgar “Good” (ORa: 0.005; 95% CI [0.003-0.009]; p<0001) and antenatal care ≥ 4 (ORa: 0.256 [0.126-0.523]; p=0.0004), higher for boys (ORa: 1.692 [1.095-2.616];p=0.0173), non eutocia delivery (ORa: 3.586[2.383–5.396]; p<0001) and higher gestional age (ORa: 5.657 [3.194-10.019]; p<0001). Conclusion. Excessive PNM is linked to gender, mode of delivery and gestional age suggesting early post-maturity onset in African women. Contexte et objectif. La mortalité périnatale (MPN) reste élevée dans les régions en développement. La présente étude a analysé des paramètres fœto–maternels associés à la MPN sans facteur de risque connu. Méthodes. L’analyse a concerné des gestantes avec fœtus unique, normal et vivant à l’entrée en travail, ayant accouché aux Cliniques Universitaires de Kinshasa au cours d’une décennie. Le risque de MPN est modélisé dans une régression logistique multiple. Résultats. Des 4390 nouveau-nés, poids de naissance=3085±416g, 52,8% étaient garçons. L’âge gestationnel était 38,2±1,1 semaines d’amenorhée. La MPN (n=354 ; 81‰) était similaire (p=0,5111) pour filles et garçons ; de même le poids de naissance des nouveau-nés décédés et vivants. Le poids (p=0,034), la taille (p<0,0001), le nombre de consultation prénatale (p=0,0001) et l’age gestationnel (p=0,0001) des mères avec nouveau-nés décédés étaient plus importants. La MPN était directement proportionnelle (p<0,0001) au poids de naissance, au nombre de consultation prénatale, à l’âge gestationnel et au mode d’accouchement et négativement proportionnelle (p<0,0001) au score d’Apgar. La MPN était moindre pour Apgar « Bon » (ORa: 0,005 IC 95% [0,003-0,009]; p<0001) et consultation prénatale ≥ 4 (ORa: 0,256 [0,126-0,523]; p=0,0004), plus élevée pour les garçons (ORa: 1,692[1,095-2,616]; p=0,0173), l’accouchement non eutocique (ORa: 3,586 [2,383–5,396]; p<0001) et l’âge gestationnel important (ORa: 5,657[3,194–10,019]; p< 0001). Conclusion. La MPN excessive est liée au sexe, au mode d’accouchement et à l’âge gestationnel suggérant une post-maturité précoce chez l’africaine

Pre-Pandemic Cross-Reactive Immunity against SARS-CoV-2 among Central and West African Populations

For more than two years after the emergence of COVID-19 (Coronavirus Disease-2019), significant regional differences in morbidity persist. These differences clearly show lower incidence rates in several regions of the African and Asian continents. The work reported here aimed to test the hypothesis of a pre-pandemic natural immunity acquired by some human populations in central and western Africa, which would, therefore, pose the hypothesis of an original antigenic sin with a virus antigenically close to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). To identify such pre-existing immunity, sera samples collected before the emergence of COVID-19 were tested to detect the presence of IgG reacting antibodies against SARS-CoV-2 proteins of major significance. Sera samples from French blood donors collected before the pandemic served as a control. The results showed a statistically significant difference of antibodies prevalence between the collected samples in Africa and the control samples collected in France. Given the novelty of our results, our next step consists in highlighting neutralizing antibodies to evaluate their potential for pre-pandemic protective acquired immunity against SARS-CoV-2. In conclusion, our results suggest that, in the investigated African sub-regions, the tested populations could have been potentially and partially pre-exposed, before the COVID-19 pandemic, to the antigens of a yet non-identified Coronaviruses