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1. Does transperineal ultrasound predict the risk of perineal trauma in women with term pregnancy? A prospective observational study

Author

Serena Xodo, Giulia Trombetta, Caterina Morassutto, Giovanni Baccarini, Lisa Celante, Lorenza Driul, and Ambrogio P Londero

Subjects
transperineal ultrasound, episiotomy, lam coactivation, operative vaginal delivery, pelvic floor muscles, Medical technology, R855-855.5
Abstract

Purpose This study was conducted to evaluate the prevalence of perineal trauma during childbirth and to assess the correlations of the pelvic floor dimensions and fetal head station with obstetric trauma in a prospectively recruited cohort of women. Methods The study included women with a gestational age of at least 37 weeks, who were carrying a single fetus in a cephalic presentation. Transperineal ultrasound (TPU) was performed prior to the onset of labor or labor induction. The purpose was to measure the anteroposterior diameter (APD) of the levator ani muscle (LAM) and the angle of progression, at both rest and maximum Valsalva maneuver. The head-perineum distance was assessed only at rest. Results A total of 296 women were included. Of the 253 women who delivered vaginally, 19% (48/253) experienced no perineal trauma, 18.2% (46/253) received an episiotomy during childbirth, 34.4% (87/253) sustained a first-degree laceration, 25.3% (64/253) had a second-degree laceration, and 3.2% had a third- or fourth-degree laceration (8/253). Women with episiotomy had a significantly shorter median APD under Valsalva than women without perineal trauma. Furthermore, women with LAM coactivation (identified by a negative difference between the APD at Valsalva and the APD at rest) were approximately three times more likely to undergo an operative vaginal delivery and over five times more likely to sustain a third- or fourth-degree tear during childbirth than women who exhibited normal relaxation of the LAM during the Valsalva maneuver. Conclusion TPU may predict the risk of perineal trauma in women with term pregnancy during childbirth.

Published
2024
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3. Suppression of the KRAS-NRF2 axis shifts arginine into the phosphocreatine energy system in pancreatic cancer cells

Author

Eros Di Giorgio, Himanshi Choudhary, Annalisa Ferino, Ylenia Cortolezzis, Emiliano Dalla, Francesca D’Este, Marina Comelli, Valentina Rapozzi, and Luigi E. Xodo

Subjects
Molecular biology, Cell biology, Cancer, Science
Abstract

Summary: In pancreatic ductal adenocarcinomas (PDAC), the KRASG12D-NRF2 axis controls cellular functions such as redox homeostasis and metabolism. Disruption of this axis through suppression of NRF2 leads to profound reprogramming of metabolism. Unbiased transcriptome and metabolome analyses showed that PDAC cells with disrupted KRASG12D-NRF2 signaling (NRF2−/− cells) shift from aerobic glycolysis to metabolic pathways fed by amino acids. Metabolome, RNA-seq and qRT-PCR analyses revealed a blockade of the urea cycle, making NRF2−/− cells dependent on exogenous arginine for survival. Arginine is channeled into anabolic pathways, including the synthesis of phosphocreatine, which generates an energy buffer essential for cell growth. A similar switch was observed in tumor clones that had survived FOLFIRINOX therapy or blockade of KRAS signaling. Inhibition of the creatine pathway with cyclocreatine reduced both ATP and invasion rate in 3D spheroids from NRF2-deficient PDAC cells. Our study provides basis for the rational development of combination therapies for pancreatic cancer.

Published
2023
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5. Dual-targeting peptides@PMO, a mimetic to the pro-apoptotic protein Smac/DIABLO for selective activation of apoptosis in cancer cells

Author

Eros Di Giorgio, Annalisa Ferino, Weizhe Huang, Sigrid Simonetti, Luigi Xodo, and Rossella De Marco

Subjects
Smac mimetics, nanoparticles, caspases, oxaliplatin, cervical cancer, colorectal cancer, Therapeutics. Pharmacology, RM1-950
Abstract

The refractoriness of tumor cells to apoptosis represents the main mechanism of resistance to chemotherapy. Smac/DIABLO mimetics proved to be effective in overcoming cancer-acquired resistance to apoptosis as a consequence of overexpression of the anti-apoptotic proteins XIAP, cIAP1, and cIAP2. In this work, we describe a dual-targeting peptide capable of selectively activating apoptosis in cancer cells. The complex consists of a fluorescent periodic mesoporous organosilica nanoparticle that carries the short sequences of Smac/DIABLO bound to the αvβ3–integrin ligand. The dual-targeting peptide @PMO shows significantly higher toxicity in αvβ3-positive HeLa cells with respect to αvβ3-negative Ht29 cells. @PMO exhibited synergistic effects in combination with oxaliplatin in a panel of αvβ3-positive cancer cells, while its toxicity is overcome by XIAP overexpression or integrin β3 silencing. The successful uptake of the molecule by αvβ3-positive cells makes @PMO promising for the re-sensitization to apoptosis of many cancer types.

Published
2023
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6. Rare spontaneous monochorionic dizygotic twins: a case report and a systematic review

Author

Giulia Trombetta, Dora Fabbro, Eliana Demori, Lorenza Driul, Giuseppe Damante, and Serena Xodo

Subjects
Monochorionic dizygotic twins, Situs inversus, Biliary atresia splenic malformation, Gynecology and obstetrics, RG1-991
Abstract

Abstract Background Monochorionic dizygotic twins are a rare condition, mostly related to assisted reproductive technology. This type of twinning is burdened by the same risk of pregnancy complications found in monochorionic monozygotic pregnancies. Case presentation We report a case of spontaneous monochorionic dizygotic twins sharing situs inversus abdominalis and isolated levocardia, with only one twin affected by biliary atresia with splenic malformation syndrome. We also conducted a literature review of the 14 available documented monochorionic dizygotic twin gestations spontaneously conceived. Conclusions It is still unclear how this unusual type of twinning can occur in spontaneous conception. The evidence so far suggest the importance to timely diagnose the chorionicity, in order to adequately manage the typical complications associated with monochorionicity.

Published
2022
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8. Examining the Aryl Hydrocarbon Receptor Network in the Placental Tissues of Pregnancies Complicated by Pre-Eclampsia: An Explorative Case–Control Analysis

Author

Serena Xodo, Ambrogio P. Londero, Maria Orsaria, Stefania Marzinotto, Gianluca Colussi, Angelo Cagnacci, Laura Mariuzzi, and Giorgia Gri

Subjects
pre-eclampsia, aryl hydrocarbon receptor, AhR, IDO1, S100A4, CYP1B1, Science
Abstract

Severe maternal and newborn morbidity and mortality associated with pre-eclampsia, which are caused partly by premature delivery, affect a factual proportion of pregnancies. Despite its prevalence, the underlying causes of pre-eclampsia remain elusive, with emerging evidence implicating the aryl hydrocarbon receptor (AhR) in its pathogenesis. This study sought to elucidate the involvement of the AhR and its associated pathway in pre-eclampsia by comparing placental components of the AhR pathway in pregnant individuals with and without pre-eclampsia. This case–control investigation was conducted at the University Hospital of Udine from May 2021 to February 2023. The AhR was assessed using immunohistochemistry and immunofluorescence, and its mRNA was evaluated using a Real-Time Quantitative Reverse Transcription PCR. Levels of mRNA expression were also estimated for other components of the AhR pathway (CYP1B1, IDO1, ARNT, TIPARP, S100A4, and AHRR). Our findings show decreased levels of expression of AhR, IDO1, ARNT, TiPARP, and S100A4 in the placental tissues of individuals with pre-eclampsia compared to controls (p < 0.05). The AhR exhibited a distinct localization within the syncytiotrophoblast (nuclei and cytoplasm) and CD45-positive cells (nuclei and cytoplasm). Furthermore, a significant positive correlation between the AhR and S100A4 (rho = 0.81) was observed in normal placentas, while CYP1B1 displayed a significant negative correlation with the AhR (rho = −0.72), within addition to its negative correlation with TiPARP (rho = −0.83). This study illuminates pre-eclampsia’s molecular aberrations, suggesting new diagnostic, therapeutic, and mechanistic approaches. This study emphasizes the need for more research to validate and broaden these findings to improve the management of this complex pregnancy condition.

Published
2023
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13. Partial vs. complete course of antenatal corticosteroid prophylaxis: An Italian single center retrospective study

Author

Serena Xodo, Giulia Trombetta, Lisa Celante, Carla Pittini, Lorenza Driul, Angelo Cagnacci, and Ambrogio P. Londero

Subjects
betamethasone, antenatal corticosteroid prophylaxis, preterm birth, respiratory distress syndrome, intraventricular hemorrhage, Pediatrics, RJ1-570
Abstract

IntroductionThis study aimed to compare the outcomes of preterm infants given 12 vs. 24mg of betamethasone prophylaxis to understand whether a partial course of antenatal corticosteroids (CCS) could prevent or mitigate the major preterm birth complications.MethodsThis is a retrospective single-center cohort study including neonates born between 24 and 34 weeks of gestation from 2001 to 2019 at the University Hospital of Udine. The study population was divided into two groups: one group received 12mg, and another received a 24mg dose of betamethasone before the delivery. A separate analysis was performed for single and multiple pregnancies. The two groups were evaluated for various neonatal outcomes.ResultsThe study population included a total of 1,258 pregnancies and 1,543 neonates delivered between 24 and 34 weeks of gestation, of which 1,022 (803 single and 219 multiple pregnancies) were exposed to the complete CCS prophylaxis, whereas 236 (192 single and 44 multiple pregnancies) received the incomplete CCS prophylaxis. In single pregnancies, as for maternal characteristics, the most significant differences observed between the two groups are the following: a higher prevalence of spontaneous vaginal deliveries in the incomplete CCS prophylaxis (36.46 vs. 23.91%) and, by contrast, a higher prevalence of cesarean deliveries in the complete CCS prophylaxis group (75.72 vs. 63.02%). As for neonatal outcomes, the low Apgar score in the first and fifth min was significantly more prevalent in the incomplete CCS prophylaxis group compared with the complete CCS prophylaxis group. The group of incomplete CCS prophylaxis reported a higher occurrence of the following outcomes: IVH grade 3-4 (7.81 vs. 3.74%, p < 0.05), PVL (7.29 vs. 1.99% p < 0.05), ROP (23.96 vs. 18.06% p = 0.062), and RDS (84.38 vs. 78.83% p = 0.085). After adjusting for covariates, the complete CCS prophylaxis group in single pregnancies was significantly protective for IVH grade 3-4, PVL, and low Apgar's scores. Similar results were found in multiple pregnancies except for RDS.DiscussionThis retrospective single-center cohort study found that, compared with preterm infants treated with 24mg betamethasone in utero, those given half course of betamethasone had a significantly higher prevalence of IVH grade 3-4, PVL, RDS, and lower Apgar scores at 1 and 5 min. In conclusion, the evidence from this single-center retrospective study supports the preference for the complete CCS prophylaxis in women at risk of preterm birth because of its beneficial effect on the main adverse outcomes.

Published
2022
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14. Capaci e meritevoli. Il valore democratico del merito

Author

Carla Xodo

Subjects
Merit, Meritocracy, Democracy, Education, Education (General), L7-991, Theory and practice of education, LB5-3640
Abstract

In contemporary societies merit, one of the cornerstones of our Constitution, is losing its original moral connotation. The economy of the global market, which now tends to disregard politics, actually supports a kind of meritocratic ideology whose perspective, extensively discussed in these pages, fades over time to obtain the opposite effect. This article highlights the contradictions of meritocracy, without endorsing the incompatibility between democracy and merit that it raises as an opportunity for each and everyone through education.

Published
2022
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15. Endogenous Retroviruses (ERVs): Does RLR (RIG-I-Like Receptors)-MAVS Pathway Directly Control Senescence and Aging as a Consequence of ERV De-Repression?

Author

Eros Di Giorgio and Luigi E. Xodo

Subjects
endogenous retrovirus, dsRNA, MAVS, RLR, senescence, Immunologic diseases. Allergy, RC581-607
Abstract

Bi-directional transcription of Human Endogenous Retroviruses (hERVs) is a common feature of autoimmunity, neurodegeneration and cancer. Higher rates of cancer incidence, neurodegeneration and autoimmunity but a lower prevalence of autoimmune diseases characterize elderly people. Although the re-expression of hERVs is commonly observed in different cellular models of senescence as a result of the loss of their epigenetic transcriptional silencing, the hERVs modulation during aging is more complex, with a peak of activation in the sixties and a decline in the nineties. What is clearly accepted, instead, is the impact of the re-activation of dormant hERV on the maintenance of stemness and tissue self-renewing properties. An innate cellular immunity system, based on the RLR-MAVS circuit, controls the degradation of dsRNAs arising from the transcription of hERV elements, similarly to what happens for the accumulation of cytoplasmic DNA leading to the activation of cGAS/STING pathway. While agonists and inhibitors of the cGAS–STING pathway are considered promising immunomodulatory molecules, the effect of the RLR-MAVS pathway on innate immunity is still largely based on correlations and not on causality. Here we review the most recent evidence regarding the activation of MDA5-RIG1-MAVS pathway as a result of hERV de-repression during aging, immunosenescence, cancer and autoimmunity. We will also deal with the epigenetic mechanisms controlling hERV repression and with the strategies that can be adopted to modulate hERV expression in a therapeutic perspective. Finally, we will discuss if the RLR-MAVS signalling pathway actively modulates physiological and pathological conditions or if it is passively activated by them.

Published
2022
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16. Birth control knowledge among freshmen of four Italian universities

Author

L. Cegolon, M. Bortolotto, S. Bellizzi, A. Cegolon, G. Mastrangelo, and C. Xodo

Subjects
Medicine, Science
Abstract

Abstract Since sexual health education (SHE) is not mandatory in Italian schools, we conducted a survey on freshmen of four Italian university campuses in 2012 to investigate the respective level of sexual health knowledge (SHK) in relation to birth control, with the aim to inform public health policy makers. A convenience strategy was employed to sample 4,552 freshmen registered with various undergraduate courses at four Italian universities: Padua university (Veneto Region); university of Milan (Lombardy Region); university of Bergamo (Lombardy Region); university of Palermo (Sicily Region). We investigated the level of SHK on birth control using 6 proxy indicators: (1) the average length of a woman’s period [outcome with 3 levels: wrong (base) vs. acceptable vs. correct]; (2) the most fertile interval within a woman’s period (binary outcome: correct vs. wrong answer); (3) the event between the end of a period and the beginning of the next cycle (binary outcome: correct vs. wrong answer); (4) the average survival of spermatozoa in the womb (binary outcome: correct vs. wrong answer); (5) the concept of contraception (binary outcome: correct vs. wrong answer); (6) the efficacy of various contraceptives to prevent unintended pregnancies (linear score: 0–17). We fitted 6 separate models of multiple regression: multinomial for outcome 1; logistic for outcomes 2, 3, 4, 6; linear for outcome 6. Statistical estimates were adjusted for a number of socio-demographic factors. Results were expressed as odds ratios (OR) for the 4 multiple logistic regression models, linear coefficients (RC) for the linear regression model and relative risk ratio (RRR) for the multinomial logistic regression model. The level of significance of each risk estimate was set at 0.05. The level of SHK of freshmen sampled was rather low, as 60% interviewees did not know the average length of a woman’s period, the average survival of spermatozoa in the womb and the concept of contraception, whilst the most fertile interval within a woman’s period was known only to 55% of interviewees. The mean score of SHK on the efficacy of various contraceptive methods was only 5 (scale 0–17). Some categories of students were consistently and significantly less knowledgeable on birth control at multivariable analysis: males; students from the university of Palermo; those with vocational secondary school education and those not in a romantic relationship at the time the survey was conducted. The results of this survey clearly call for the introduction of SHE programs in Italian schools, as already done in several European countries. School SHE should start as early as possible, ideally even before secondary school. SHE should be holistic and delivered with a multiple agency coordinated approach involving the Ministry of Health, the Ministry of Education, University and Scientific Research (MIUR), families, schools, public health departments, primary health care providers, pharmacists, media, other.

Published
2020
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17. A Propensity Matched Comparison of Distal Active Fixation versus Standard Stent Graft Performances in Challenging Distal Landing Zone After Thoracic Endovascular Aortic Aneurysm Repair

Author

Nicola Leone, Stefano Gennai, Angelos Karelis, Andrea Xodo, Luca Mezzetto, Aaron Fargion, Mattia Migliari, Francesco Andreoli, Luigi Alberto Maria Bartolotti, Lorenzo Scorsone, Davide Mastrorilli, Rachele Petroni, Michele Antonello, Gian Franco Veraldi, Nuno Dias, Björn Sonesson, Carlo Pratesi, and Roberto Silingardi

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811
Published
2022
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18. Does Delayed Cord Clamping Improve Long-Term (≥4 Months) Neurodevelopment in Term Babies? A Systematic Review and a Meta-Analysis of Randomized Clinical Trials

Author

Serena Xodo, Luigi Xodo, Giovanni Baccarini, Lorenza Driul, and Ambrogio P. Londero

Subjects
delayed cord clamping, neurodevelopment, placental transfusion, third stage of labor, cord clamping time, Pediatrics, RJ1-570
Abstract

Background: Recently, the literature suggested that placental transfusion facilitated by delayed cord clamping (DCC), besides having benefits on hematological parameters, might improve the infants' brain development.Objective: The present review primarily evaluates the Ages and Stages Questionnaire (ASQ) total score mean difference (MD) at long-term follow-up (≥4 months) comparing DCC (>90 or >180 s) to early cord clamping (ECC). Secondary aims consisted of evaluating the ASQ domains' MD and the results obtained from other methods adopted to evaluate the infants' neurodevelopment.Methods: MEDLINE, Scopus, Cochrane, and ClinicalTrials.gov databases were searched (up to 2nd November 2020) for systematic review and meta-analysis. All randomized controlled trials (RCTs) of term singleton gestations received DCC or ECC. Multiple pregnancies, pre-term delivery, non-randomized studies, and articles in languages other than English were excluded. The included studies were assessed for bias and quality. ASQ data were pooled stratified by time to follow up.Results: This meta-analysis of 4 articles from 3 RCTs includes 765 infants with four-month follow-up and 672 with 12 months follow-up. Primary aim (ASQ total score) pooled analysis was possible only for 12 months follow-up, and no differences were found between DCC and ECC (MD 1.1; CI 95: −5.1; 7.3). DCC approach significantly improves infants' communication domains (MD 0.6; CI 95: 0.1; 1.1) and personal-social assessed (MD 1.0; CI 95: 0.3; 1.6) through ASQ at 12 months follow-up. Surprisingly, the four-month ASQ personal social domain (MD −1.6; CI 95: −2.8; −0.4) seems to be significantly lower in the DCC group than in the ECC group.Conclusions: DCC, a simple, non-interventional, and cost-effective approach, might improve the long-term infants' neurological outcome. Single-blinding and limited studies number were the main limitations. Further research should be performed to confirm these observations, ideally with RCTs adopting standard methods to assess infants' neurodevelopment.Trial registration: NCT01245296, NCT01581489, NCT02222805, NCT01620008, IRCT201702066807N19, and NCT02727517

Published
2021
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22. Parkinson's Disease in Pregnancy: A Case Report and Review of the Literature

Author

Sara Olivola, Serena Xodo, Enrica Olivola, Fabiana Cecchini, Ambrogio Pietro Londero, and Lorenza Driul

Subjects
Parkinson's disease, pregnancy, L-Dopa, literature review, case report, Neurology. Diseases of the nervous system, RC346-429
Abstract

Background: Pregnancy in Parkinson's disease is a rare occurrence, and to date, clinical experience with its management is rather limited. In clinical practice, doubts concern mainly the impact of PD on gestation, labor, and delivery as well as the safety of dopaminergic drugs.Case and review of the literature: We report the case of a 40-year-old woman with an 8-year history of PD. In the first trimester of her pregnancy, her motor status was similar to the pre-conceptional period. In gestation week 16, her motor status dramatically worsened and she complained of predictable “off” periods in the afternoon. For this reason, her dose of L-DOPA/carbidopa was increased up to 500/125 mg per day. At 39 gestational weeks, she gave birth to a healthy girl with an Apgar score of 9 by an uncomplicated cesarean delivery. The child was not breast fed to avoid exposure to antiparkinsonian drugs. The L-DOPA/carbidopa dosage remained constant during the postpartum period. We performed a systematic review of the literature using Ovid Medline, Scopus, and PubMed (including Cochrane database). We used the search terms “Parkinson disease” AND “pregnancy.” We identified 20 studies of PD in pregnancy with a total of 37 pregnant women with PD. The most important available data concern the safety of L-DOPA therapy during pregnancy. There seems to be some risk of worsening of the condition or upcoming of new PD symptoms during or shortly after pregnancy.Conclusion: More data concerning the safety of antiparkinsonian drugs in PD treatment, as well as the effect of pregnancy on parkinsonian symptoms are needed. According to the current state of the art, L-DOPA therapy should be considered preferable to other drugs during pregnancy.

Published
2020
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26. Does transperineal ultrasound predict the risk of perineal trauma in women with term pregnancy? A prospective observational study.

Author

Xodo, Serena, Trombetta, Giulia, Morassutto, Caterina, Baccarini, Giovanni, Celante, Lisa, Driul, Lorenza, and Londero, Ambrogio P.

Subjects
*FETAL ultrasonic imaging, *CHILDBIRTH, *DELIVERY (Obstetrics), *PREGNANCY, *LONGITUDINAL method, *PELVIC floor, *ULTRASONIC imaging
Abstract

Purpose: This study was conducted to evaluate the prevalence of perineal trauma during childbirth and to assess the correlations of the pelvic floor dimensions and fetal head station with obstetric trauma in a prospectively recruited cohort of women. Methods: The study included women with a gestational age of at least 37 weeks, who were carrying a single fetus in a cephalic presentation. Transperineal ultrasound (TPU) was performed prior to the onset of labor or labor induction. The purpose was to measure the anteroposterior diameter (APD) of the levator ani muscle (LAM) and the angle of progression, at both rest and maximum Valsalva maneuver. The head-perineum distance was assessed only at rest. Results: A total of 296 women were included. Of the 253 women who delivered vaginally, 19.0% (48/253) experienced no perineal trauma, 18.2% (46/253) received an episiotomy during childbirth, 34.4% (87/253) sustained a first-degree laceration, 25.3% (64/253) had a second-degree laceration, and 3.2% had a third- or fourth-degree laceration (8/253). Women with episiotomy had a significantly shorter median APD under Valsalva than women without perineal trauma. Furthermore, women with LAM coactivation (identified by a negative difference between the APD at Valsalva and the APD at rest) were approximately three times more likely to undergo an operative vaginal delivery and over five times more likely to sustain a third- or fourth-degree tear during childbirth than women who exhibited normal relaxation of the LAM during the Valsalva maneuver. Conclusion: TPU may predict the risk of perineal trauma in women with term pregnancy during childbirth. [ABSTRACT FROM AUTHOR]

Published
2024
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27. Evaluating the best treatment for multifocal hepatocellular carcinoma: A propensity score-matched analysis

Author

Matteo Risaliti, Ilenia Bartolini, Claudia Campani, Umberto Arena, Carlotta Xodo, Valentina Adotti, Martina Rosi, Antonio Taddei, Paolo Muiesan, Amedeo Amedei, Giacomo Batignani, and Fabio Marra

Subjects
End Stage Liver Disease, Carcinoma, Hepatocellular, Treatment Outcome, Liver Neoplasms, Gastroenterology, Hepatectomy, Humans, alpha-Fetoproteins, General Medicine, Chemoembolization, Therapeutic, Propensity Score, Severity of Illness Index, Retrospective Studies
Abstract

Hepatocellular carcinoma (HCC) is a common tumour often diagnosed with a multifocal presentation. Patients with multifocal HCC represent a heterogeneous group. Although Trans-Arterial ChemoEmbolization (TACE) is the most frequently employed treatment for these patients, previous data suggested that liver resection (LR) could be a safe and effective procedure.To compare LR and TACE in patients with multifocal HCC in terms of procedure-related morbidity and oncologic outcomes.All patients with multifocal HCC who underwent LR or TACE as the first procedure between May 2011 and March 2021 were enrolled. The decision to perform surgery or TACE was made after a multidisciplinary team evaluation. Only patients in Child-Pugh class A or B7 and stage B (according to the Barcelona Clinic Liver Cancer staging system, without severe portal hypertension, vascular invasion, or extrahepatic spread) were included in the final analysis. Propensity score matching was used to adjust the baseline differences between patients undergoing LR and the TACE group [number and diameter of lesions, presence of cirrhosis, alpha-fetoprotein (AFP) levels, and Model for End-Stage Liver Disease score]. The Kaplan-Meier method was used to estimate overall survival (OS) and disease-free survival (DFS). The outcomes of LR and TACE were compared using the log-rank test.After matching, 30 patients were eligible for the final analysis, 15 in each group. Morbidity rates were 42.9% and 40% for LR and TACE, respectively (In a small cohort of patients with multifocal HCC, LR confers longer DFS compared with TACE, with similar OS and post-procedural morbidity.

Published
2022

28. Aβ1-6A2V(D) peptide, effective on Aβ aggregation, inhibits tau misfolding and protects the brain after traumatic brain injury

Author

Luisa Diomede, Elisa R. Zanier, Federico Moro, Gloria Vegliante, Laura Colombo, Luca Russo, Alfredo Cagnotto, Carmina Natale, Federica Marta Xodo, Ada De Luigi, Michele Mosconi, Marten Beeg, Marcella Catania, Giacomina Rossi, Fabrizio Tagliavini, Giuseppe Di Fede, and Mario Salmona

Subjects
Cellular and Molecular Neuroscience, Psychiatry and Mental health, Molecular Biology
Abstract

Alzheimer’s disease (AD), the leading cause of dementia in older adults, is a double proteinopathy characterized by amyloid-β (Aβ) and tau pathology. Despite enormous efforts that have been spent in the last decades to find effective therapies, late pharmacological interventions along the course of the disease, inaccurate clinical methodologies in the enrollment of patients, and inadequate biomarkers for evaluating drug efficacy have not allowed the development of an effective therapeutic strategy. The approaches followed so far for developing drugs or antibodies focused solely on targeting Aβ or tau protein. This paper explores the potential therapeutic capacity of an all-D-isomer synthetic peptide limited to the first six amino acids of the N-terminal sequence of the A2V-mutated Aβ, Aβ1-6A2V(D), that was developed following the observation of a clinical case that provided the background for its development. We first performed an in-depth biochemical characterization documenting the capacity of Aβ1-6A2V(D) to interfere with the aggregation and stability of tau protein. To tackle Aβ1-6A2V(D) in vivo effects against a neurological decline in genetically predisposed or acquired high AD risk mice, we tested its effects in triple transgenic animals harboring human PS1(M146 V), APP(SW), and MAPT(P301L) transgenes and aged wild-type mice exposed to experimental traumatic brain injury (TBI), a recognized risk factor for AD. We found that Aβ1-6A2V(D) treatment in TBI mice improved neurological outcomes and reduced blood markers of axonal damage. Exploiting the C. elegans model as a biosensor of amyloidogenic proteins’ toxicity, we observed a rescue of locomotor defects in nematodes exposed to the brain homogenates from TBI mice treated with Aβ1-6A2V(D) compared to TBI controls. By this integrated approach, we demonstrate that Aβ1-6A2V(D) not only impedes tau aggregation but also favors its degradation by tissue proteases, confirming that this peptide interferes with both Aβ and tau aggregation propensity and proteotoxicity.

Published
2023

29. Is Glycated Hemoglobin A1c Level Associated with Adverse Pregnancy Outcomes of Women Affected by Pre-Gestational Diabetes?

Author

Serena Xodo, Ambrogio Pietro Londero, Martina D’Agostin, Alice Novak, Silvia Galasso, Carla Pittini, Giovanni Baccarini, Franco Grimaldi, and Lorenza Driul

Subjects
pre-gestational diabetes, glycated haemoglobin, glycemic control, Medicine (General), R5-920
Abstract

Background and Objectives: This observational study aims to determine the correlation between glycemic control with the HbA1c value and adverse obstetric outcome in women affected by pre-gestational diabetes. Materials and Methods: A retrospective analysis has been performed at the University Hospital of Udine. Only patients with a singleton pregnancy, pre-gestational diabetes, and known level of Hb A1c throughout pregnancy were included in the study. Results: According to the HbA1c level, at the beginning of pregnancy, 49 patients with HbA1c ≤ 7.0% were compared with 45 patients with HbA1c > 7.0%. Maternal age at diagnosis of the disease was significantly higher in the group with HbA1c ≤ 7% than in the group with HbA1c > 7%, 26.00 (18.00–32.00) vs. 20.00 (12.50–27.00). Women with HbA1c ≤ 7.0% reached, at term of pregnancy, significantly lower levels of HbA1c, 5.8% (5.7–6.0) vs. 6.7% (6.3–7.3). Daily insulin units were statistically different between the two groups at the end of pregnancy (47.92 (39.00–67.30) vs. 64.00 (48.00–82.00)). Proteinuria was significantly higher in the group with HbA1c > 7.0%, who delivered at earlier gestational age (37.57 (35.57–38.00) vs. 38.14 (38.00–38.43). Moreover, women with HbA1c > 7.0% had a significantly higher prevalence of an adverse composite outcome. Of note, in multivariate logistic regression analysis, pregnancy complications were significantly correlated to pre-pregnancy HbA1c > 7.0% (OR 2.95 CI.95 1.16–7.48, p < 0.05) independently of age, insulin treatment, and type of diabetes. Conclusions: Our data, obtained from a single-center cohort study, suggest that starting pregnancy with poor glycemic control might predict more complex management of diabetes in the following trimesters.

Published
2021
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30. Multiple Parallel Grafts for Urgent Endovascular Repair of a Ruptured Mycotic Aortic Aneurysm

Author

Andrea Xodo, Michele Piazza, Jacopo Taglialavoro, Marco Zavatta, Franco Grego, and Michele Antonello

Subjects
Radiology, Nuclear Medicine and imaging, Surgery, Cardiology and Cardiovascular Medicine
Abstract

A 73-year-old woman underwent urgent endovascular repair of a ruptured mycotic aortic aneurysm. A thoracic stent graft was employed as the main endograft, while the celiac trunk and superior mesenteric artery were revascularized by the chimney technique and the renal arteries through the periscope technique. Postoperative computed tomography revealed a Type A1 gutter, treated by detachable coils and peripheral occlusion devices. Six-month follow-up revealed patency of the stent grafts, without endoleak or stent graft infection signs.

Published
2022

31. Oxidative Stress Is Increased in Combined Oral Contraceptives Users and Is Positively Associated with High-Sensitivity C-Reactive Protein

Author

Sabina Cauci, Serena Xodo, Cinzia Buligan, Chiara Colaninno, Mattia Barbina, Giuseppe Barbina, and Maria Pia Francescato

Subjects
lipid peroxidation, free radicals, inflammation, contraceptive pill, thromboembolism, hormonal contraception, Organic chemistry, QD241-441
Abstract

Information concerning the mechanisms underlying oxidative stress and low-grade inflammation in young healthy women predisposing eventually to future diseases is scarce. We investigated the relationship of oxidative stress and high-sensitivity C-reactive protein (hsCRP) in fertile-age women by oral combined contraceptive (OC) use. Caucasian Italian healthy non-obese women (n = 290; 100 OC-users; 190 non-OC-users; mean age 23.2 ± 4.7 years) were analyzed. Blood hydroperoxides, as oxidative stress biomarkers, were assessed by Free Oxygen Radical Test (FORT). Serum hsCRP was determined by an ultra-sensitive method (hsCRP). Markedly elevated oxidative stress (≥400 FORT Units) was found in 77.0% of OC-users and 1.6% of non-OC-users, odds ratio (OR) = 209, 95% CI = 60.9–715.4, p < 0.001. Elevated hsCRP levels ≥ 2.0 mg/L, considered risky for cardiovascular diseases (CVDs), were found in 41.0% of OC-users and 9.5% of non-OC-users, OR = 6.6, 95%CI 3.5–12.4, p < 0.001. Hydroperoxides were strongly positively correlated to hsCRP in all women (rs = 0.622, p < 0.001), in OC-users (rs = 0.442, p < 0.001), and in non-OC-users (rs = 0.426, p < 0.001). Women with hydroperoxides ≥ 400 FORT Units were eight times as likely to have hsCRP ≥ 2 mg/L. In non-OC-users only, hydroperoxides values were positively correlated with weight and body mass index, but negatively correlated with red meat, fish and chocolate consumption. Our research is the first finding a strong positive correlation of serum hydroperoxides with hsCRP, a marker of low-grade chronic inflammation, in young healthy women. Further research is needed to elucidate the potential role of these two biomarkers in OC-use associated side-effects, like thromboembolism and other CVDs.

Published
2021
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32. Effect of DNA Glycosylases OGG1 and Neil1 on Oxidized G-Rich Motif in the KRAS Promoter

Author

Annalisa Ferino and Luigi E. Xodo

Subjects
G4 DNA, OGG1, Neil1, 8-oxoguanine, KRAS, Biology (General), QH301-705.5, Chemistry, QD1-999
Abstract

The promoter of the Kirsten ras (KRAS) proto-oncogene contains, upstream of the transcription start site, a quadruplex-forming motif called 32R with regulatory functions. As guanine under oxidative stress can be oxidized to 8-oxoguanine (8OG), we investigated the capacity of glycosylases 8-oxoguanine glycosylase (OGG1) and endonuclease VIII-like 1 (Neil1) to excise 8OG from 32R, either in duplex or G-quadruplex (G4) conformation. We found that OGG1 efficiently excised 8OG from oxidized 32R in duplex but not in G4 conformation. By contrast, glycosylase Neil1 showed more activity on the G4 than the duplex conformation. We also found that the excising activity of Neil1 on folded 32R depended on G4 topology. Our data suggest that Neil1, besides being involved in base excision repair pathway (BER), could play a role on KRAS transcription.

Published
2021
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33. Antiviral Activity of the G-Quadruplex Ligand TMPyP4 against Herpes Simplex Virus-1

Author

Sara Artusi, Emanuela Ruggiero, Matteo Nadai, Beatrice Tosoni, Rosalba Perrone, Annalisa Ferino, Irene Zanin, Luigi Xodo, Louis Flamand, and Sara N. Richter

Subjects
HSV-1, G-quadruplex, TMPyP4, TMPyP2, G-quadruplex ligands, antiviral activity, Microbiology, QR1-502
Abstract

The herpes simplex virus 1 (HSV-1) genome is extremely rich in guanine tracts that fold into G-quadruplexes (G4s), nucleic acid secondary structures implicated in key biological functions. Viral G4s were visualized in HSV-1 infected cells, with massive virus cycle-dependent G4-formation peaking during viral DNA replication. Small molecules that specifically interact with G4s have been shown to inhibit HSV-1 DNA replication. We here investigated the antiviral activity of TMPyP4, a porphyrin known to interact with G4s. The analogue TMPyP2, with lower G4 affinity, was used as control. We showed by biophysical analysis that TMPyP4 interacts with HSV-1 G4s, and inhibits polymerase progression in vitro; in infected cells, it displayed good antiviral activity which, however, was independent of inhibition of virus DNA replication or entry. At low TMPyP4 concentration, the virus released by the cells was almost null, while inside the cell virus amounts were at control levels. TEM analysis showed that virus particles were trapped inside cytoplasmatic vesicles, which could not be ascribed to autophagy, as proven by RT-qPCR, western blot, and immunofluorescence analysis. Our data indicate a unique mechanism of action of TMPyP4 against HSV-1, and suggest the unprecedented involvement of currently unknown G4s in viral or antiviral cellular defense pathways.

Published
2021
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34. Peri-Operative Management of Patients Undergoing Fenestrated-Branched Endovascular Repair for Juxtarenal, Pararenal and Thoracoabdominal Aortic Aneurysms:Preventing, Recognizing and Treating Complications to Improve Clinical Outcomes

Author

Andrea Xodo, Mario D’Oria, Bernardo Mendes, Luca Bertoglio, Kevin Mani, Mauro Gargiulo, Jacob Budtz-Lilly, Michele Antonello, Gian Franco Veraldi, Fabio Pilon, Domenico Milite, Cristiano Calvagna, Filippo Griselli, Jacopo Taglialavoro, Silvia Bassini, Anders Wanhainen, David Lindstrom, Enrico Gallitto, Luca Mezzetto, Davide Mastrorilli, Sandro Lepidi, Randall DeMartino, Xodo, Andrea, D'Oria, Mario, Mendes, Bernardo, Bertoglio, Luca, Mani, Kevin, Gargiulo, Mauro, Budtz-Lilly, Jacob, Antonello, Michele, Veraldi, Gian Franco, Pilon, Fabio, Milite, Domenico, Calvagna, Cristiano, Griselli, Filippo, Taglialavoro, Jacopo, Bassini, Silvia, Wanhainen, Ander, Lindstrom, David, Gallitto, Enrico, Mezzetto, Luca, Mastrorilli, Davide, Lepidi, Sandro, and DeMartino, Randall

Subjects
Kardiologi, complications, outcome, review, Medicine (miscellaneous), Cardiac and Cardiovascular Systems, complication, aortic disease, outcomes, aortic aneurysm, fenestrated-branched endovascular repair
Abstract

The advent and refinement of complex endovascular techniques in the last two decades has revolutionized the field of vascular surgery. This has allowed an effective minimally invasive treatment of extensive disease involving the pararenal and the thoracoabdominal aorta. Fenestrated-branched EVAR (F/BEVAR) now represents a feasible technical solution to address these complex diseases, moving the proximal sealing zone above the renal-visceral vessels take-off and preserving their patency. The aim of this paper was to provide a narrative review on the peri-operative management of patients undergoing F/BEVAR procedures for juxtarenal abdominal aortic aneurysm (JAAA), pararenal abdominal aortic aneurysm (PRAA) or thoracoabdominal aortic aneurism (TAAA). It will focus on how to prevent, diagnose, and manage the complications ensuing from these complex interventions, in order to improve clinical outcomes. Indeed, F/BEVAR remains a technically, physiologically, and mentally demanding procedure. Intraoperative adverse events often require prolonged or additional procedures and complications may significantly impact a patient’s quality of life, health status, and overall cost of care. The presence of standardized preoperative, perioperative, and postoperative pathways of care, together with surgeons and teams with significant experience in aortic surgery, should be considered as crucial points to improve clinical outcomes. Aggressive prevention, prompt diagnosis and timely rescue of any major adverse events following the procedure remain paramount clinical needs.

Published
2022

35. Role of Poly [ADP-ribose] Polymerase 1 in Activating the Kirsten ras (KRAS) Gene in Response to Oxidative Stress

Author

Giorgio Cinque, Annalisa Ferino, Erik B. Pedersen, and Luigi E. Xodo

Subjects
G4 DNA, KRAS, oxidative stress, 8-oxoguanine, PARP-1, transcription factors, Biology (General), QH301-705.5, Chemistry, QD1-999
Abstract

In pancreatic Panc-1 cancer cells, an increase of oxidative stress enhances the level of 7,8-dihydro-8-oxoguanine (8OG) more in the KRAS promoter region containing G4 motifs than in non-G4 motif G-rich genomic regions. We found that H2O2 stimulates the recruitment to the KRAS promoter of poly [ADP-ribose] polymerase 1 (PARP-1), which efficiently binds to local G4 structures. Upon binding to G4 DNA, PARP-1 undergoes auto PARylation and thus becomes negatively charged. In our view this should favor the recruitment to the KRAS promoter of MAZ and hnRNP A1, as these two nuclear factors, because of their isoelectric points >7, are cationic in nature under physiological conditions. This is indeed supported by pulldown assays which showed that PARP-1, MAZ, and hnRNP A1 form a multiprotein complex with an oligonucleotide mimicking the KRAS G4 structure. Our data suggest that an increase of oxidative stress in Panc-1 cells activates a ROS-G4-PARP-1 axis that stimulates the transcription of KRAS. This mechanism is confirmed by the finding that when PARP-1 is silenced by siRNA or auto PARylation is inhibited by Veliparib, the expression of KRAS is downregulated. When Panc-1 cells are treated with H2O2 instead, a strong up-regulation of KRAS transcription is observed.

Published
2020
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36. hnRNPA1/UP1 Unfolds KRAS G-Quadruplexes and Feeds a Regulatory Axis Controlling Gene Expression

Author

Gilmar F. Salgado, Jean-Louis Mergny, Giorgio Cinque, Coralie Robert, Luigi E. Xodo, Annalisa Ferino, Raffaella Picco, Julien Marquevielle, Anne Bourdoncle, Himanshi Choudhary, Université de Bordeaux (UB), Laboratoire d'Optique et Biosciences (LOB), and Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École polytechnique (X)

Subjects
0303 health sciences, Oncogene, General Chemical Engineering, [SDV.CAN]Life Sciences [q-bio]/Cancer, General Chemistry, Biology, G-quadruplex, medicine.disease, medicine.disease_cause, Article, Cell biology, Chemistry, 03 medical and health sciences, 0302 clinical medicine, Transcription (biology), 030220 oncology & carcinogenesis, Pancreatic cancer, Gene expression, medicine, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, KRAS, QD1-999, ComputingMilieux_MISCELLANEOUS, 030304 developmental biology
Abstract

Recent studies have proven that the genetic landscape of pancreatic cancer is dominated by the KRAS oncogene. Its transcription is controlled by a G-rich motif (called 32R) located immediately upstream of the TSS. 32R may fold into a G-quadruplex (G4) in equilibrium between two G4 conformers: G9T (TM = 61.2 °C) and G25T (TM = 54.7 °C). We found that both G4s bind to hnRNPA1 and its proteolytic fragment UP1, promoting several contacts with the RRM protein domains. 1D NMR analysis of DNA imino protons shows that, upon binding to UP1, G25T is readily unfolded at both 5′ and 3′ tetrads, while G9T is only partially unfolded. The impact of hnRNPA1 on KRAS expression was determined by comparing Panc-1 cells with two Panc-1 knockout cell lines in which hnRNPA1 was deleted by the CRISPR/Cas9 technology. The results showed that the expression of KRAS is inhibited in the knockout cell lines, indicating that hnRNPA1 is essential for the transcription of KRAS. In addition, the knockout cell lines, compared to normal Panc-1 cells, show a dramatic decrease in cell growth and capacity of colony formation. Pull-down and Western blot experiments indicate that conformer G25T is a better platform than conformer G9T for the assembly of the transcription preinitiation complex with PARP1, Ku70, MAZ, and hnRNPA1. Together, our data prove that hnRNPA1, being a key transcription factor for the activation of KRAS, can be a new therapeutic target for the rational design of anticancer strategies.

Published
2021

39. A Survey on Knowledge, Prevention, and Occurrence of Sexually Transmitted Infections among Freshmen from Four Italian Universities

Author

Luca Cegolon, Melania Bortolotto, Saverio Bellizzi, Andrea Cegolon, Luciano Bubbico, Giuseppe Pichierri, Giuseppe Mastrangelo, Carla Xodo, Cegolon, L, Bortolotto, M, Bellizzi, S, Bubbico, L, Cegolon, A, Pichierri, G, Mastrangelo, G, and Xodo, C

Subjects
Adult, Male, sexually transmitted infections, university students, sexual health education, sexual health knowledge, sexual health prevention, young adults, Health Knowledge, Attitudes, Practice, Adolescent, Universities, Sexual Behavior, Health, Toxicology and Mutagenesis, education, Sexually Transmitted Diseases, Article, history of sexually transmitted infections, Condoms, adolescents, sexual health education, sexually transmitted infections, university students, Settore M-PED/01 - Pedagogia Generale e Sociale, Young Adult, Surveys and Questionnaires, Humans, sexually transmitted infection, Aged, history of sexually transmitted infection, university student, Public Health, Environmental and Occupational Health, adolescent, Medicine, Female
Abstract

Background. The peak of sexually transmitted infections (STI) among adolescents/young adults suggests a low level of prevention. In order to assess whether the level of sexual health education (SHE), received by several channels, was effective at improving sexual behaviors, we conducted a survey among freshmen from four Italian universities. Methods. This observational cross-sectional study was carried out with an anonymous self-reported paper questionnaire, administered during teaching lectures to university freshmen of the northern (Padua, Bergamo, and Milan campuses) and southern (Palermo campus) parts of the country. Knowledge of STI (a linear numerical score), knowledge of STI prevention (dichotomous variable: yes vs. no) and previous STI occurrence (polytomous variable: “no”; “don’t know”; “yes”) were the outcomes in the statistical analysis. Results. The final number of freshmen surveyed was 4552 (97.9% response rate). The mean age of respondents was 21.4 ± 2.2 years and most of them (70.3%) were females. A total of 60% of students were in a stable romantic relationship. Only 28% respondents knew the most effective methods to prevent STI (i.e., condom and sexual abstinence), with a slightly higher prevalence of correct answers among females (31.3%) than males (25.8%). Students with history of STIs were 5.1%; they reported referring mostly to their general practitioner (GP) (38.1%) rather than discussing the problem with their partner (13.1%). At multivariable analysis, a significantly higher level of STI knowledge was observed in older students (25+ years of age), biomedical students, and those from a non-nuclear family; lower levels were found among students of the University of Palermo, and those who completed a vocational secondary school education. Those who had less knowledge about the most effective tools to prevent STIs included males, students from the University of Palermo, students registered with educational sciences, economics/political sciences, those of foreign nationality, and those whose fathers had lower educational levels. The risk of contracting a STI was significantly lower only in students not in a stable relationship (relative risk ratio, RRR = 0.67; 95% confidence interval, 95%CI = 0.48; 0.94), whereas such risk was significantly higher in students with higher STI knowledge (RRR = 1.15; 95%CI = 1.08; 1.22). Discussion and Conclusions. University freshmen investigated in this study had poor knowledge of STIs and their prevention. Unexpectedly, those with higher levels of knowledge had an increased risk of STIs. There have been no educational interventions—with good quality and long-term follow-ups—that increased the confidence that such SHE programs could have population level effects. A new high-quality study is therefore recommended to assess the effectiveness of an intervention generating behavioral changes; increasing only STI knowledge may not be sufficient.

Published
2022

41. Androgen Receptor (AR) Gene (CAG)n and (GGN)n Length Polymorphisms and Symptoms in Young Males With Long-Lasting Adverse Effects After Finasteride Use Against Androgenic Alopecia

Author

Sabina Cauci, PhD, Giovanni Chiriacò, MD, Erika Cecchin, MS, Giuseppe Toffoli, MD, Serena Xodo, MD, Giuseppe Stinco, MD, and Carlo Trombetta, MD

Subjects
5α-Reductase Inhibitor, Post-Finasteride Syndrome, Male Pattern Hair Loss, Androgenic Alopecia, Androgen Receptor, CAG Polymorphism, GGN Polymorphism, Erectile Dysfunction, Sexual Dysfunction, Loss of Libido, Finasteride Side Effects, Finasteride Safety, Medicine
Abstract

Introduction: Long-term adverse symptoms of men who used oral finasteride against androgenic alopecia have been recently described as post-finasteride syndrome (PFS). Aim: To determine whether (CAG)n-rs4045402 and (GGN)n-rs3138869 polymorphisms in the androgen receptor (AR) gene are implicated in PFS. Methods: AR polymorphisms were studied according to PFS symptoms in 66 white participants (31.8% Italian, 28.8% American, and 39.4% other). Main Outcome Measures: Symptoms were investigated by an ad hoc 100-item questionnaire and the Arizona Sexual Experience Scale and Aging Male Symptom Scale (AMS). (CAG)n and (GGN)n repeats were categorized as short ([CAG]9–19, [GGN]23). Results: Median age was 32 years, duration of finasteride use was 360 days, and time from finasteride discontinuation was 1,053 days. We observed several frequency differences in symptoms according to (CAG)n and (GGN)n repeat numbers. Three AMS items were worse for medium (GGN)23 than for long (GGN)>23 carriers and one item was worse for short (GGN)2 kg), increased skin dryness, and onset of symptoms after finasteride use. Conclusion: This study showed that short and/or long (CAG)n and (GGN)n repeats had different frequencies according to symptoms reported by patients with PFS, likely reflecting the vast array of genes modulated by the AR. This study showed a U-curvilinear profile of (CAG)n repeats for skin dryness symptoms, where the two extremes exhibited a worse condition than medium repeats. Further studies are necessary to investigate the PFS pathophysiology using a precision medicine approach.

Published
2017
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42. Is It Time to Redefine Fetal Decelerations in Cardiotocography?

Author

Serena Xodo and Ambrogio P. Londero

Subjects
Medicine (miscellaneous)
Abstract

Historically, fetal heart rate (FHR) decelerations were classified into “early”, “late”, and “variable” based on their relationship with uterine contractions. So far, three different putative etiologies were taken for granted. Recently, this belief, passed down through generations of birth attendants, has been questioned by physiologists. This narrative review aimed to assess the evidence on pathophysiology behind intrapartum FHR decelerations. This narrative review is based on information sourced from online peer-reviewed articles databases and recommendations from the major scientific societies in the field of obstetrics. Searches were performed in MEDLINE/PubMed, EMBASE, and Scopus and selection criteria included studies in animals and humans, where the physiology behind FHR decelerations was explored. The greater affinity for oxygen of fetal hemoglobin than the maternal, the unicity of fetal circulation, and the high anaerobic reserve of the myocardium, ensure adequate oxygenation to the fetus, under basal conditions. During acute hypoxic stress the efficiency of these mechanisms are increased because of the peripheral chemoreflex. This reflex, activated at each uterine contraction, is characterized by the simultaneous activation of two neural arms: the parasympathetic arm, which reduces the myocardial consumption of oxygen by decreasing the FHR and the sympathetic component, which promotes an intense peripheric vasoconstriction, thus centralizing the fetal blood volume. This review summarizes the evidence supporting the hypoxic origin of FHR decelerations, therefore archiving the historical belief that FHR decelerations have different etiologies, according to their shape and relationship with uterine contractions. The present review suggests that it is time to welcome the new scientific evidence and to update the CTG classification systems.

Published
2022

43. Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19

Author

Eran Hadar, Chiara Benedetto, Agnese Maria Chiara Rapisarda, Renato Augusto Moreira de Sá, Deena Elkafrawi, Daniela Luvero, Noa A Brzezinski Sinai, Alicia Martínez-Varea, Antonio Schiattarella, Anna Nunzia Della Gatta, Giovanni Scambia, Albert Lila, Luciano Di Tizio, Andrea Carosso, Giovanni Nazzaro, G. Schera, Giuseppe Rizzo, Giuseppe Maria Maruotti, Giusella D'Urso, Albaro José Nieto-Calvache, Ilenia Mappa, Ozlem Uyaniklar, Fabio Barra, Gilles Faron, Luigi Nappi, Jacopo Ferrari, Giulio Sozzi, Simone Ferrero, Mirjam Druškovič, Tanja Premru-Srsen, Leonardo Borrello, Fabiana Cecchini D, George Daskalakis, Giuliano Petriglia, Caroline Kadji, Felipe Mercado-Olivares, Zeliha Atak, Aylin Pelin Cil, Claudio Gustavino, Axelle Pintiaux, Pantaleo Greco, Rita Figueiredo, Stefano Cosma, Ludovica Puri, Valentina Esposito, Anupam Parange, Simone Garzon, Alessandra Gatti, Ioannis Kyvernitakis, Roberto Brunelli, Maddalena Morlando, Attilio Di Spiezio Sardo, Ignacio Cueto Hernández, Giuseppe Zoccali, Brian Rodriguez, Antonio Mollo, Flaminia Vena, Cihat Sen, Ciuhodaru Madalina, Felice Sorrentino, Francesca Di Sebastiano, Gennady T. Sukhikh, Ilma Floriana Carbone, Andrea Villasco, Blanka Zlatohlavkova, Gabriele Saccone, Erasmo Huertas, Marcel Malan, Leonardo Gucciardo, Eutalia Esposito, Otto Henrique May Feuerschuette, Sarah Dollinger, María de Los Angeles Anaya Baz, Jun Yoshimatsu, Sifa Turan, Vincente Diago, Alicia Yeliz Aykanat, Ignacio Herraiz, Javier Alfonso Schvartzman, Diego Gazzolo, Natalina Buono, Milan Stanojević, Erich Cosmi, Valentina De Robertis, Elena Costa, Angelo Cagnacci, Eleonora Valori, Nicoletta Biglia, Şerife Özlem Genç, Vincenzo Berghella, Francesco Maria Colaleo, Esther Vanessa Aguilar Galán, Gabriela Loscalzo, Marco Palumbo, Fabrizio Sandri, Irmeli Nupponen, Antonio Lanzone, Juan Antonio De León Luis, Amos Grunebaum, Giuseppe Bifulco, Marinella Lenzi, Serena Xodo, Fulvio Zullo, Ozhan Turan, Josefine Königbauer, Anna Luengo Piqueras, Nicola Volpe, Holger Maul, Chiara Taccaliti, Juan Manuel Burgos-Luna, Giovanni Sisti, Rosanna Esposito, Alfredo Ercoli, Panos Antsaklis, Dolores Esteban Oliva, Aly Youssef, Pedro Viana Pinto, Alberto Galindo, Asim Kurjak, Erhan Okuyan, Roberto Angioli, Maria Luisa Gonzalez-Duran, Ana Concheiro Guisan, Massimo Franchi, Maria Carmela Di Dedda, Giovanni Gerosolima, Francesco D'Antonio, Caroline Daelemans, Quintino Cesare Ianniciello, Pasquale De Franciscis, Maurizio Guida, Maria Cristina Rovellotti, Liana Ples, Frank A. Chervenak, Nicola Colacurci, Lilijana Kornhauser Cerar, Zulfiya Khodjaeva, Valentina Longo, Francesca Stollagli, Daniele Di Mascio, Mariavittoria Locci, Amadeo Sanchez, Angelo Sirico, Stefania Fieni, Rebeca Garrote Molpeceres, Pierluigi Benedetti Panici, Vito Chiantera, Esra Tustas Haberal, Liviu Cojocaru, Maria Elena Flacco, Antonella Cromi, Roberta Granese, Antonio Simone Laganà, Maria Giulia Lombana Marino, Silvia Visentin, Beatrice Bianchi, Roberta Venturella, Federica Laraud, Amanda Bermejo, Reyhan Gündüz, Marina Moucho, Zita Maria Gambacorti-Passerini, Danila Morano, Pedro Arango, Francesca Della Sala, Gaetana Di Donna, Jesús S Jimenez Lopez, Mariano Catello Di Donna, Giuliana Simonazzi, Snezana Zdjelar, Vedran Stefanovic, Cecilia Villalain, Antonio Coviello, Lars Hellmeyer, Antonella Giancotti, Elisa Bevilacqua, Igor Samardjiski, Riccardo Buscemi, Arianna Ramone, Marco Cerbone, Lorenza Driul, Danilo Buca, Tiziana Frusca, Elisa Done, Marco Liberati, José Morales Roselló, Fabio Ghezzi, Lorenzo Vasciaveo, Bernd Froessler, Alejandro Pittaro, Yolanda Cuñarro López, Andrew Carlin, Sakine Rahimli Ocakouglu, Giorgia Gattei, I. Cataneo, María José Suárez, Giada Ameli, Lamberto Manzoli, Kaisa Nelskylä, Ludovico Muzii, Peter Palm, Olus Api, Elisa Cueto, Martina Leombroni, Ksenia A. Gorina, HUS Gynecology and Obstetrics, Department of Obstetrics and Gynecology, Children's Hospital, HUS Children and Adolescents, HUS Perioperative, Intensive Care and Pain Medicine, Anestesiologian yksikkö, Department of Diagnostics and Therapeutics, Dicle Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve Doğum Ana Bilim Dalı, Gündüz, Reyhan, Di Mascio D., Sen C., Saccone G., Galindo A., Grunebaum A., Yoshimatsu J., Stanojevic M., Kurjak A., Chervenak F., Suarez M.J.R., Gambacorti-Passerini Z.M., De Los Angeles Anaya Baz M., Galan E.V.A., Lopez Y.C., De Leon Luis J.A., Hernandez I.C., Herraiz I., Villalain C., Venturella R., Rizzo G., Mappa I., Gerosolima G., Hellmeyer L., Konigbauer J., Ameli G., Frusca T., Volpe N., Schera G.B.L., Fieni S., Esposito E., Simonazzi G., Di Donna G., Youssef A., Della Gatta A.N., Di Donna M.C., Chiantera V., Buono N., Sozzi G., Greco P., Morano D., Bianchi B., Marino M.G.L., Laraud F., Ramone A., Cagnacci A., Barra F., Gustavino C., Ferrero S., Ghezzi F., Cromi A., Lagana A.S., Longo V.L., Stollagli F., Sirico A., Lanzone A., Driul L., Fabiana Cecchini D., Xodo S., Rodriguez B., Mercado-Olivares F., Elkafrawi D., Sisti G., Esposito R., Coviello A., Cerbone M., Morlando M., Schiattarella A., Colacurci N., De Franciscis P., Cataneo I., Lenzi M., Sandri F., Buscemi R., Gattei G., Della Sala F., Valori E., Rovellotti M.C., Done E., Faron G., Gucciardo L., Esposito V., Vena F., Giancotti A., Brunelli R., Muzii L., Nappi L., Sorrentino F., Vasciaveo L., Liberati M., Buca D., Leombroni M., Di Sebastiano F., Di Tizio L., Gazzolo D., Franchi M., Ianniciello Q.C., Garzon S., Petriglia G., Borrello L., Nieto-Calvache A.J., Burgos-Luna J.M., Kadji C., Carlin A., Bevilacqua E., Moucho M., Pinto P.V., Figueiredo R., Rosello J.M., Loscalzo G., Martinez-Varea A., Diago V., Lopez J.S.J., Aykanat A.Y., Cosma S., Carosso A., Benedetto C., Bermejo A., Feuerschuette O.H.M., Uyaniklar O., Ocakouglu S.R., Atak Z., Gunduz R., Haberal E.T., Froessler B., Parange A., Palm P., Samardjiski I., Taccaliti C., Okuyan E., Daskalakis G., De Sa R.A.M., Pittaro A., Gonzalez-Duran M.L., Guisan A.C., Genc S.O., Zlatohlavkova B., Piqueras A.L., Oliva D.E., Cil A.P., Api O., Antsaklis P., Ples L., Kyvernitakis I., Maul H., Malan M., Lila A., Granese R., Ercoli A., Zoccali G., Villasco A., Biglia N., Madalina C., Costa E., Daelemans C., Pintiaux A., Cueto E., Hadar E., Dollinger S., Sinai N.A.B., Huertas E., Arango P., Sanchez A., Schvartzman J.A., Cojocaru L., Turan S., Turan O., Di Dedda M.C., Molpeceres R.G., Zdjelar S., Premru-Srsen T., Cerar L.K., Druskovie M., De Robertis V., Stefanovic V., Nupponen I., Nelskyla K., Khodjaeva Z., Gorina K.A., Sukhikh G.T., Maruotti G.M., Visentin S., Cosmi E., Ferrari J., Gatti A., Luvero D., Angioli R., Puri L., Palumbo M., D'Urso G., Colaleo F., Rapisarda A.M.C., Carbone I.F., Mollo A., Nazzaro G., Locci M., Guida M., Di Spiezio Sardo A., Panici P.B., Berghella V., Flacco M.E., Manzoli L., Bifulco G., Scambia G., Zullo F., D'Antonio F., Di Mascio D, Sen C, Saccone G, Galindo A, Grünebaum A, Yoshimatsu J, Stanojevic M, Kurjak A, Chervenak F, Rodríguez Suárez MJ, Gambacorti-Passerini ZM, Baz MLAA, Aguilar Galán EV, López YC, De León Luis JA, Hernández IC, Herraiz I, Villalain C, Venturella R, Rizzo G, Mappa I, Gerosolima G, Hellmeyer L, Königbauer J, Ameli G, Frusca T, Volpe N, Luca Schera GB, Fieni S, Esposito E, Simonazzi G, Di Donna G, Youssef A, Della Gatta AN, Di Donna MC, Chiantera V, Buono N, Sozzi G, Greco P, Morano D, Bianchi B, Lombana Marino MG, Laraud F, Ramone A, Cagnacci A, Barra F, Gustavino C, Ferrero S, Ghezzi F, Cromi A, Laganà AS, Laurita Longo V, Stollagli F, Sirico A, Lanzone A, Driul L, Cecchini D F, Xodo S, Rodriguez B, Mercado-Olivares F, Elkafrawi D, Sisti G, Esposito R, Coviello A, Cerbone M, Morlando M, Schiattarella A, Colacurci N, De Franciscis P, Cataneo I, Lenzi M, Sandri F, Buscemi R, Gattei G, Sala FD, Valori E, Rovellotti MC, Done E, Faron G, Gucciardo L, Esposito V, Vena F, Giancotti A, Brunelli R, Muzii L, Nappi L, Sorrentino F, Vasciaveo L, Liberati M, Buca D, Leombroni M, Di Sebastiano F, Di Tizio L, Gazzolo D, Franchi M, Ianniciello QC, Garzon S, Petriglia G, Borrello L, Nieto-Calvache AJ, Burgos-Luna JM, Kadji C, Carlin A, Bevilacqua E, Moucho M, Pinto PV, Figueiredo R, Roselló JM, Loscalzo G, Martinez-Varea A, Diago V, Jimenez Lopez JS, Aykanat AY, Cosma S, Carosso A, Benedetto C, Bermejo A, May Feuerschuette OH, Uyaniklar O, Ocakouglu SR, Atak Z, Gündüz R, Haberal ET, Froessler B, Parange A, Palm P, Samardjiski I, Taccaliti C, Okuyan E, Daskalakis G, Moreira de Sa RA, Pittaro A, Gonzalez-Duran ML, Guisan AC, Genç ŞÖ, Zlatohlávková B, Piqueras AL, Oliva DE, Cil AP, Api O, Antsaklis P, Ples L, Kyvernitakis I, Maul H, Malan M, Lila A, Granese R, Ercoli A, Zoccali G, Villasco A, Biglia N, Madalina C, Costa E, Daelemans C, Pintiaux A, Cueto E, Hadar E, Dollinger S, Brzezinski Sinai NA, Huertas E, Arango P, Sanchez A, Schvartzman JA, Cojocaru L, Turan S, Turan O, Di Dedda MC, Molpeceres RG, Zdjelar S, Premru-Srsen T, Cerar LK, Druškovič M, De Robertis V, Stefanovic V, Nupponen I, Nelskylä K, Khodjaeva Z, Gorina KA, Sukhikh GT, Maruotti GM, Visentin S, Cosmi E, Ferrari J, Gatti A, Luvero D, Angioli R, Puri L, Palumbo M, D'Urso G, Colaleo F, Chiara Rapisarda AM, Carbone IF, Mollo A, Nazzaro G, Locci M, Guida M, Di Spiezio Sardo A, Panici PB, Berghella V, Flacco ME, Manzoli L, Bifulco G, Scambia G, Zullo F, D'Antonio F, Di Mascio, D., Sen, C., Saccone, G., Galindo, A., Grunebaum, A., Yoshimatsu, J., Stanojevic, M., Kurjak, A., Chervenak, F., Suarez, M. J. R., Gambacorti-Passerini, Z. M., De Los Angeles Anaya Baz, M., Galan, E. V. A., Lopez, Y. C., De Leon Luis, J. A., Hernandez, I. C., Herraiz, I., Villalain, C., Venturella, R., Rizzo, G., Mappa, I., Gerosolima, G., Hellmeyer, L., Konigbauer, J., Ameli, G., Frusca, T., Volpe, N., Schera, G. B. L., Fieni, S., Esposito, E., Simonazzi, G., Di Donna, G., Youssef, A., Della Gatta, A. N., Di Donna, M. C., Chiantera, V., Buono, N., Sozzi, G., Greco, P., Morano, D., Bianchi, B., Marino, M. G. L., Laraud, F., Ramone, A., Cagnacci, A., Barra, F., Gustavino, C., Ferrero, S., Ghezzi, F., Cromi, A., Lagana, A. S., Longo, V. L., Stollagli, F., Sirico, A., Lanzone, A., Driul, L., Fabiana Cecchini, D., Xodo, S., Rodriguez, B., Mercado-Olivares, F., Elkafrawi, D., Sisti, G., Esposito, R., Coviello, A., Cerbone, M., Morlando, M., Schiattarella, A., Colacurci, N., De Franciscis, P., Cataneo, I., Lenzi, M., Sandri, F., Buscemi, R., Gattei, G., Della Sala, F., Valori, E., Rovellotti, M. C., Done, E., Faron, G., Gucciardo, L., Esposito, V., Vena, F., Giancotti, A., Brunelli, R., Muzii, L., Nappi, L., Sorrentino, F., Vasciaveo, L., Liberati, M., Buca, D., Leombroni, M., Di Sebastiano, F., Di Tizio, L., Gazzolo, D., Franchi, M., Ianniciello, Q. C., Garzon, S., Petriglia, G., Borrello, L., Nieto-Calvache, A. J., Burgos-Luna, J. M., Kadji, C., Carlin, A., Bevilacqua, E., Moucho, M., Pinto, P. V., Figueiredo, R., Rosello, J. M., Loscalzo, G., Martinez-Varea, A., Diago, V., Lopez, J. S. J., Aykanat, A. Y., Cosma, S., Carosso, A., Benedetto, C., Bermejo, A., Feuerschuette, O. H. M., Uyaniklar, O., Ocakouglu, S. R., Atak, Z., Gunduz, R., Haberal, E. T., Froessler, B., Parange, A., Palm, P., Samardjiski, I., Taccaliti, C., Okuyan, E., Daskalakis, G., De Sa, R. A. M., Pittaro, A., Gonzalez-Duran, M. L., Guisan, A. C., Genc, S. O., Zlatohlavkova, B., Piqueras, A. L., Oliva, D. E., Cil, A. P., Api, O., Antsaklis, P., Ples, L., Kyvernitakis, I., Maul, H., Malan, M., Lila, A., Granese, R., Ercoli, A., Zoccali, G., Villasco, A., Biglia, N., Madalina, C., Costa, E., Daelemans, C., Pintiaux, A., Cueto, E., Hadar, E., Dollinger, S., Sinai, N. A. B., Huertas, E., Arango, P., Sanchez, A., Schvartzman, J. A., Cojocaru, L., Turan, S., Turan, O., Di Dedda, M. C., Molpeceres, R. G., Zdjelar, S., Premru-Srsen, T., Cerar, L. K., Druskovie, M., De Robertis, V., Stefanovic, V., Nupponen, I., Nelskyla, K., Khodjaeva, Z., Gorina, K. A., Sukhikh, G. T., Maruotti, G. M., Visentin, S., Cosmi, E., Ferrari, J., Gatti, A., Luvero, D., Angioli, R., Puri, L., Palumbo, M., D'Urso, G., Colaleo, F., Rapisarda, A. M. C., Carbone, I. F., Mollo, A., Nazzaro, G., Locci, M., Guida, M., Di Spiezio Sardo, A., Panici, P. B., Berghella, V., Flacco, M. E., Manzoli, L., Bifulco, G., Scambia, G., Zullo, F., D'Antonio, F., Di Mascio, Daniele, Sen, Cihat, Saccone, Gabriele, Galindo, Alberto, Grünebaum, Amo, Yoshimatsu, Jun, Stanojevic, Milan, Kurjak, Asım, Chervenak, Frank, Rodríguez Suárez, María José, Gambacorti-Passerini, Zita Maria, Baz, María de Los Angeles Anaya, Aguilar Galán, Esther Vanessa, López, Yolanda Cuñarro, De León Luis, Juan Antonio, Hernández, Ignacio Cueto, Herraiz, Ignacio, Villalain, Cecilia, Venturella, Roberta, Rizzo, Giuseppe, Mappa, Ilenia, Gerosolima, Giovanni, Hellmeyer, Lar, Königbauer, Josefine, Ameli, Giada, Frusca, Tiziana, Volpe, Nicola, Luca Schera, Giovanni Battista, Fieni, Stefania, Esposito, Eutalia, Simonazzi, Giuliana, Di Donna, Gaetana, Youssef, Aly, Della Gatta, Anna Nunzia, Di Donna, Mariano Catello, Chiantera, Vito, Buono, Natalina, Sozzi, Giulio, Greco, Pantaleo, Morano, Danila, Bianchi, Beatrice, Lombana Marino, Maria Giulia, Laraud, Federica, Ramone, Arianna, Cagnacci, Angelo, Barra, Fabio, Gustavino, Claudio, Ferrero, Simone, Ghezzi, Fabio, Cromi, Antonella, Laganà, Antonio Simone, Longo, Valentina Laurita, Stollagli, Francesca, Sirico, Angelo, Lanzone, Antonio, Driul, Lorenza, Cecchini D, Fabiana, Xodo, Serena, Rodriguez, Brian, Mercado-Olivares, Felipe, Elkafrawi, Deena, Sisti, Giovanni, Esposito, Rosanna, Coviello, Antonio, Cerbone, Marco, Morlando, Maddalena, Schiattarella, Antonio, Colacurci, Nicola, De Franciscis, Pasquale, Cataneo, Ilaria, Lenzi, Marinella, Sandri, Fabrizio, Buscemi, Riccardo, Gattei, Giorgia, Sala, Francesca Della, Valori, Eleonora, Rovellotti, Maria Cristina, Done, Elisa, Faron, Gille, Gucciardo, Leonardo, Esposito, Valentina, Vena, Flaminia, Giancotti, Antonella, Brunelli, Roberto, Muzii, Ludovico, Nappi, Luigi, Sorrentino, Felice, Vasciaveo, Lorenzo, Liberati, Marco, Buca, Danilo, Leombroni, Martina, Di Sebastiano, Francesca, Di Tizio, Luciano, Gazzolo, Diego, Franchi, Massimo, Ianniciello, Quintino Cesare, Garzon, Simone, Petriglia, Giuliano, Borrello, Leonardo, Nieto-Calvache, Albaro Josè, Burgos-Luna, Juan Manuel, Kadji, Caroline, Carlin, Andrew, Bevilacqua, Elisa, Moucho, Marina, Pinto, Pedro Viana, Figueiredo, Rita, Roselló, José Morale, Loscalzo, Gabriela, Martinez-Varea, Alicia, Diago, Vincente, Jimenez Lopez, Jesús S, Aykanat, Alicia Yeliz, Cosma, Stefano, Carosso, Andrea, Benedetto, Chiara, Bermejo, Amanda, May Feuerschuette, Otto Henrique, Uyaniklar, Ozlem, Ocakouglu, Sakine Rahimli, Atak, Zeliha, Haberal, Esra Tusta, Froessler, Bernd, Parange, Anupam, Palm, Peter, Samardjiski, Igor, Taccaliti, Chiara, Okuyan, Erhan, Daskalakis, George, Moreira de Sa, Renato Augusto, Pittaro, Alejandro, Gonzalez-Duran, Maria Luisa, Guisan, Ana Concheiro, Genç, Şerife Özlem, Zlatohlávková, Blanka, Piqueras, Anna Luengo, Oliva, Dolores Esteban, Cil, Aylin Pelin, Api, Olu, Antsaklis, Pano, Ples, Liana, Kyvernitakis, Ioanni, Maul, Holger, Malan, Marcel, Lila, Albert, Granese, Roberta, Ercoli, Alfredo, Zoccali, Giuseppe, Villasco, Andrea, Biglia, Nicoletta, Madalina, Ciuhodaru, Costa, Elena, Daelemans, Caroline, Pintiaux, Axelle, Yapar Eyi, Elif Gül, Cueto, Elisa, Hadar, Eran, Dollinger, Sarah, Brzezinski Sinai, Noa A, Huertas, Erasmo, Arango, Pedro, Sanchez, Amadeo, Schvartzman, Javier Alfonso, Cojocaru, Liviu, Turan, Sifa, Turan, Ozhan, Di Dedda, Maria Carmela, Molpeceres, Rebeca Garrote, Zdjelar, Snezana, Premru-Srsen, Tanja, Cerar, Lilijana Kornhauser, Druškovič, Mirjam, De Robertis, Valentina, Stefanovic, Vedran, Nupponen, Irmeli, Nelskylä, Kaisa, Khodjaeva, Zulfiya, Gorina, Ksenia A, Sukhikh, Gennady T, Maruotti, Giuseppe Maria, Visentin, Silvia, Cosmi, Erich, Ferrari, Jacopo, Gatti, Alessandra, Luvero, Daniela, Angioli, Roberto, Puri, Ludovica, Palumbo, Marco, D'Urso, Giusella, Colaleo, Francesco, Chiara Rapisarda, Agnese Maria, Carbone, Ilma Floriana, Mollo, Antonio, Nazzaro, Giovanni, Locci, Mariavittoria, Guida, Maurizio, Di Spiezio Sardo, Attilio, Panici, Pierluigi Benedetti, Berghella, Vincenzo, Flacco, Maria Elena, Manzoli, Lamberto, Bifulco, Giuseppe, Scambia, Giovanni, Zullo, Fulvio, and D'Antonio, Francesco

Subjects
COVID-19 Vaccine, Infectious Disease Transmission, Perinatal Death, Abortion, Clinical Laboratory Technique, Miscarriage, Cohort Studies, 0302 clinical medicine, COVID-19 Testing, Pregnancy, Risk Factors, 3123 Gynaecology and paediatrics, Secondary analysis, Perinatal medicine, Abortion, Spontaneou, Medicine, Vertical, 030212 general & internal medicine, Viral, Pregnancy Complications, Infectious, coronavirus, perinatal morbidity, perinatal mortality, covid-19, Coronavirus, Abortion, Spontaneous, COVID-19, COVID-19 Vaccines, Clinical Laboratory Techniques, Coronavirus Infections, Female, Gestational Age, Humans, Infant, Newborn, Infant, Premature, Infectious Disease Transmission, Vertical, Pandemics, Pneumonia, Viral, Pregnancy Outcome, Reverse Transcriptase Polymerase Chain Reaction, SARS-CoV-2, Betacoronavirus, Fetal Death, 030219 obstetrics & reproductive medicine, Obstetrics, Infectious, Gestational age, Obstetrics and Gynecology, 3. Good health, Settore MED/40, Gestation, Human, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Coronaviru, Socio-culturale, Intrauterine device, 03 medical and health sciences, PARVOVIRUS B19 INFECTION, Coronavirus, perinatal morbidity, perinatal mortality, Adverse effect, Premature, Fetus, Betacoronaviru, Pandemic, Coronavirus Infection, business.industry, Risk Factor, Spontaneous, MORTALITY, Infant, Odds ratio, Pneumonia, medicine.disease, Newborn, Pregnancy Complications, Pediatrics, Perinatology and Child Health, Pregnancy Complications, Infectiou, Cohort Studie, business
Abstract

Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6±9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8–0.9 per week increase; p Conclusions Early gestational age at infection, maternal ventilatory supports and low birthweight are the main determinants of adverse perinatal outcomes in fetuses with maternal COVID-19 infection. Conversely, the risk of vertical transmission seems negligible.

Published
2021

44. Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection

Author

Di Mascio Daniele, Gabriele, Saccone, Cihat, Sen, Daniele Di Mascio, Alberto, Galindo, Amos, Grünebaum, Jun, Yoshimatsu, Milan, Stanojevic, Asım, Kurjak, Frank, Chervenak, María José Rodríguez Suárez, Zita Maria Gambacorti-Passerini, María de Los Angeles Anaya Baz, Esther Vanessa Aguilar Galán, Yolanda Cuñarro López, Juan Antonio De León Luis, Ignacio Cueto Hernández, Ignacio, Herraiz, Cecilia, Villalain, Roberta, Venturella, Rizzo, GIUSEPPE DAVIDE, Ilenia, Mappa, Giovanni, Gerosolima, Lars, Hellmeyer, Josefine, Königbauer, Giada, Ameli, Tiziana, Frusca, Nicola, Volpe, Giovanni Battista Luca Schera, Stefania, Fieni, Eutalia, Esposito, Giuliana, Simonazzi, Gaetana Di Donna, Aly, Youssef, Anna Nunzia Della Gatta, Mariano Catello Di Donna, Vito, Chiantera, Natalina, Buono, Giulio, Sozzi, Pantaleo, Greco, Danila, Morano, Beatrice, Bianchi, Maria Giulia Lombana Marino, Federica, Laraud, Arianna, Ramone, Angelo, Cagnacci, Fabio, Barra, Claudio, Gustavino, Ferrero, Simone, Fabio, Ghezzi, Antonella, Cromi, Antonio Simone Laganà, Valentina Laurita Longo, Francesca, Stollagli, Angelo, Sirico, Antonio, Lanzone, Lorenza, Driul, Fabiana, Cecchini, Serena, Xodo, Brian, Rodriguez, Felipe, Mercado-Olivares, Deena, Elkafrawi, Giovanni, Sisti, Rosanna, Esposito, Antonio, Coviello, Marco, Cerbone, Maddalena, Morlando, Antonio, Schiattarella, Nicola, Colacurci, Pasquale De Franciscis, Ilaria, Cataneo, Marinella, Lenzi, Fabrizio, Sandri, Riccardo, Buscemi, Giorgia, Gattei, Francesca Della Sala, Eleonora, Valori, Maria Cristina Rovellotti, Elisa, Done, Gilles, Faron, Leonardo, Gucciardo, Esposito, Valentina, Flaminia, Vena, Antonella, Giancotti, Roberto, Brunelli, Ludovico, Muzii, Luigi, Nappi, Felice, Sorrentino, Marco, Liberati, Danilo, Buca, Martina, Leombroni, Francesca Di Sebastiano, Massimo, Franchi, Quintino Cesare Ianniciello, Simone, Garzon, Giuliano, Petriglia, Leonardo, Borrello, Albaro Josè Nieto-Calvache, Juan Manuel Burgos-Luna, Caroline, Kadji, Andrew, Carlin, Elisa, Bevilacqua, Marina, Moucho, Pedro, Viana, Rita, Figueiredo, José Morales Roselló, Gabriela, Loscalzo, Alicia, Martinez-Varea, Vincente, Diago, Jesús, S Jimenez Lopez, Alicia Yeliz Aykanat, Cosma, Stefano Domenico, Carosso, ANDREA ROBERTO, Benedetto, Chiara, Amanda, Bermejo, Otto Henrique May Feuerschuette, Ozlem, Uyaniklar, Sakine Rahimli Ocakouglu, Zeliha, Atak, Reyhan, Gündüz, Esra Tustas Haberal, Bernd, Froessler, Anupam, Parange, Peter, Palm, Igor, Samardjiski, Chiara, Taccaliti, Erhan, Okuyan, George, Daskalakis, Renato Augusto Moreira de Sa, Alejandro, Pittaro, Maria Luisa Gonzalez-Duran, Ana Concheiro Guisan, Şerife Özlem Genç, Blanka, Zlatohlávková, Anna Luengo Piqueras, Dolores Esteban Oliva, Aylin Pelin Cil, Olus, Api, Panos, Antsaklis, Liana, Ples, Ioannis, Kyvernitakis, Holger, Maul, Marcel, Malan, Albert, Lila, Roberta, Granese, Alfredo, Ercoli, Giuseppe, Zoccali, Villasco, Andrea, Biglia, Nicoletta, Ciuhodaru, Madalina, Costa, Elena, Caroline, Daelemans, Axelle, Pintiaux, Elif Gül Yapar Eyi, Elisa, Cueto, Eran, Hadar, Sarah, Dollinger, Noa, A Brzezinski-Sinai, Erasmo, Huertas, Pedro, Arango, Amadeo, Sanchez, Javier Alfonso Schvartzman, Liviu, Cojocaru, Sifa, Turan, Ozhan, Turan, Maria Carmela Di Dedda, Rebeca Garrote Molpeceres, Snezana, Zdjelar, Tanja, Premru-Srsen, Lilijana, Kornhauser-Cerar, Mirjam, Druškovič, Valentina De Robertis, Vedran, Stefanovic, Irmeli, Nupponen, Kaisa, Nelskylä, Zulfiya, Khodjaeva, Ksenia, A Gorina, Gennady, T Sukhikh, Giuseppe Maria Maruotti, Silvia, Visentin, Erich, Cosmi, Jacopo, Ferrari, Alessandra, Gatti, Daniela, Luvero, Roberto, Angioli, Ludovica, Puri, Marco, Palumbo, Giusella, D'Urso, Francesco, Colaleo, Agnese Maria Chiara Rapisarda, Ilma Floriana Carbone, Manzoli, Lamberto, Maria Elena Flacco, Giovanni, Nazzaro, Mariavittoria, Locci, Maurizio, Guida, Attilio Di Spiezio Sardo, Pierluigi Benedetti Panici, Asma, Khalil, Vincenzo, Berghella, Giuseppe, Bifulco, Giovanni, Scambia, Fulvio, Zullo, Francesco, D'Antonio, Saccone, Gabriele, Sen, Cihat, Di Mascio, Daniele, Galindo, Alberto, Grünebaum, Amo, Yoshimatsu, Jun, Stanojevic, Milan, Kurjak, Asım, Chervenak, Frank, Suárez, María José Rodríguez, Gambacorti‐Passerini, Zita Maria, de los Angeles Anaya Baz, María, Galán, Esther Vanessa Aguilar, López, Yolanda Cuñarro, Luis, Juan Antonio De León, Hernández, Ignacio Cueto, Herraiz, Ignacio, Villalain, Cecilia, Venturella, Roberta, Rizzo, Giuseppe, Mappa, Ilenia, Gerosolima, Giovanni, Hellmeyer, Lar, Königbauer, Josefine, Ameli, Giada, Frusca, Tiziana, Volpe, Nicola, Schera, Giovanni Battista Luca, Fieni, Stefania, Esposito, Eutalia, Simonazzi, Giuliana, Di Donna, Gaetana, Youssef, Aly, Gatta, Anna Nunzia Della, Di Donna, Mariano Catello, Chiantera, Vito, Buono, Natalina, Sozzi, Giulio, Greco, Pantaleo, Morano, Danila, Bianchi, Beatrice, Marino, Maria Giulia Lombana, Laraud, Federica, Ramone, Arianna, Cagnacci, Angelo, Barra, Fabio, Gustavino, Claudio, Ferrero, Simone, Ghezzi, Fabio, Cromi, Antonella, Laganà, Antonio Simone, Longo, Valentina Laurita, Stollagli, Francesca, Sirico, Angelo, Lanzone, Antonio, Driul, Lorenza, Cecchini, Fabiana, Xodo, Serena, Rodriguez, Brian, Mercado‐Olivares, Felipe, Elkafrawi, Deena, Sisti, Giovanni, Esposito, Rosanna, Coviello, Antonio, Cerbone, Marco, Morlando, Maddalena, Schiattarella, Antonio, Colacurci, Nicola, De Franciscis, Pasquale, Cataneo, Ilaria, Lenzi, Marinella, Sandri, Fabrizio, Buscemi, Riccardo, Gattei, Giorgia, Sala, Francesca Della, Valori, Eleonora, Rovellotti, Maria Cristina, Done, Elisa, Faron, Gille, Gucciardo, Leonardo, Esposito, Valentina, Vena, Flaminia, Giancotti, Antonella, Brunelli, Roberto, Muzii, Ludovico, Nappi, Luigi, Sorrentino, Felice, Liberati, Marco, Buca, Danilo, Leombroni, Martina, Di Sebastiano, Francesca, Franchi, Massimo, Ianniciello, Quintino Cesare, Garzon, Simone, Petriglia, Giuliano, Borrello, Leonardo, Nieto‐Calvache, Albaro Josè, Burgos‐Luna, Juan Manuel, Kadji, Caroline, Carlin, Andrew, Bevilacqua, Elisa, Moucho, Marina, Viana Pinto, Pedro, Figueiredo, Rita, Morales Roselló, José, Loscalzo, Gabriela, Martinez‐Varea, Alicia, Diago, Vincente, Jimenez Lopez, Jesús S, Aykanat, Alicia Yeliz, Cosma, Stefano, Carosso, Andrea, Benedetto, Chiara, Bermejo, Amanda, Feuerschuette, Otto Henrique May, Uyaniklar, Ozlem, Ocakouglu, Sakine Rahimli, Atak, Zeliha, Gündüz, Reyhan, Haberal, Esra Tusta, Froessler, Bernd, Parange, Anupam, Palm, Peter, Samardjiski, Igor, Taccaliti, Chiara, Okuyan, Erhan, Daskalakis, George, de Sa, Renato Augusto Moreira, Pittaro, Alejandro, Gonzalez‐Duran, Maria Luisa, Guisan, Ana Concheiro, Genç, Şerife Özlem, Zlatohlávková, Blanka, Piqueras, Anna Luengo, Oliva, Dolores Esteban, Cil, Aylin Pelin, Api, Olu, Antsaklis, Pano, Ples, Liana, Kyvernitakis, Ioanni, Maul, Holger, Malan, Marcel, Lila, Albert, Granese, Roberta, Ercoli, Alfredo, Zoccali, Giuseppe, Villasco, Andrea, Biglia, Nicoletta, Madalina, Ciuhodaru, Costa, Elena, Daelemans, Caroline, Pintiaux, Axelle, Eyi, Elif Gül Yapar, Cueto, Elisa, Hadar, Eran, Dollinger, Sarah, Brzezinski‐Sinai, Noa A., Huertas, Erasmo, Arango, Pedro, Sanchez, Amadeo, Schvartzman, Javier Alfonso, Cojocaru, Liviu, Turan, Sifa, Turan, Ozhan, Di Dedda, Maria Carmela, Molpeceres, Rebeca Garrote, Zdjelar, Snezana, Premru‐Srsen, Tanja, Kornhauser‐Cerar, Lilijana, Druškovič, Mirjam, De Robertis, Valentina, Stefanovic, Vedran, Nupponen, Irmeli, Nelskylä, Kaisa, Khodjaeva, Zulfiya, Gorina, Ksenia A., Sukhikh, Gennady T., Maruotti, Giuseppe Maria, Visentin, Silvia, Cosmi, Erich, Ferrari, Jacopo, Gatti, Alessandra, Luvero, Daniela, Angioli, Roberto, Puri, Ludovica, Palumbo, Marco, D'Urso, Giusella, Colaleo, Francesco, Rapisarda, Agnese Maria Chiara, Carbone, Ilma Floriana, Manzoli, Lamberto, Flacco, Maria Elena, Nazzaro, Giovanni, Locci, Mariavittoria, Guida, Maurizio, Sardo, Attilio Di Spiezio, Panici, Pierluigi Benedetti, Khalil, Asma, Berghella, Vincenzo, Bifulco, Giuseppe, Scambia, Giovanni, Zullo, Fulvio, D'Antonio, Francesco, Dicle Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve DoğumAna Bilim Dalı, University of Helsinki, Department of Obstetrics and Gynecology, HUS Gynecology and Obstetrics, HUS Children and Adolescents, Children's Hospital, HUS Perioperative, Intensive Care and Pain Medicine, Anestesiologian yksikkö, Department of Diagnostics and Therapeutics, Saccone, G., Sen, C., Di Mascio, D., Galindo, A., Grunebaum, A., Yoshimatsu, J., Stanojevic, M., Kurjak, A., Chervenak, F., Suarez, M. J. R., Gambacorti-Passerini, Z. M., de los Angeles Anaya Baz, M., Galan, E. V. A., Lopez, Y. C., Luis, J. A. D. L., Hernandez, I. C., Herraiz, I., Villalain, C., Venturella, R., Rizzo, G., Mappa, I., Gerosolima, G., Hellmeyer, L., Konigbauer, J., Ameli, G., Frusca, T., Volpe, N., Schera, G. B. L., Fieni, S., Esposito, E., Simonazzi, G., Di Donna, G., Youssef, A., Gatta, A. N. D., Di Donna, M. C., Chiantera, V., Buono, N., Sozzi, G., Greco, P., Morano, D., Bianchi, B., Marino, M. G. L., Laraud, F., Ramone, A., Cagnacci, A., Barra, F., Gustavino, C., Ferrero, S., Ghezzi, F., Cromi, A., Lagana, A. S., Longo, V. L., Stollagli, F., Sirico, A., Lanzone, A., Driul, L., Cecchini, F., Xodo, S., Rodriguez, B., Mercado-Olivares, F., Elkafrawi, D., Sisti, G., Esposito, R., Coviello, A., Cerbone, M., Morlando, M., Schiattarella, A., Colacurci, N., De Franciscis, P., Cataneo, I., Lenzi, M., Sandri, F., Buscemi, R., Gattei, G., Sala, F. D., Valori, E., Rovellotti, M. C., Done, E., Faron, G., Gucciardo, L., Esposito, V., Vena, F., Giancotti, A., Brunelli, R., Muzii, L., Nappi, L., Sorrentino, F., Liberati, M., Buca, D., Leombroni, M., Di Sebastiano, F., Franchi, M., Ianniciello, Q. C., Garzon, S., Petriglia, G., Borrello, L., Nieto-Calvache, A. J., Burgos-Luna, J. M., Kadji, C., Carlin, A., Bevilacqua, E., Moucho, M., Viana Pinto, P., Figueiredo, R., Morales Rosello, J., Loscalzo, G., Martinez-Varea, A., Diago, V., Jimenez Lopez, J. S., Aykanat, A. Y., Cosma, S., Carosso, A., Benedetto, C., Bermejo, A., Feuerschuette, O. H. M., Uyaniklar, O., Ocakouglu, S. R., Atak, Z., Gunduz, R., Haberal, E. T., Froessler, B., Parange, A., Palm, P., Samardjiski, I., Taccaliti, C., Okuyan, E., Daskalakis, G., de Sa, R. A. M., Pittaro, A., Gonzalez-Duran, M. L., Guisan, A. C., Genc, S. O., Zlatohlavkova, B., Piqueras, A. L., Oliva, D. E., Cil, A. P., Api, O., Antsaklis, P., Ples, L., Kyvernitakis, I., Maul, H., Malan, M., Lila, A., Granese, R., Ercoli, A., Zoccali, G., Villasco, A., Biglia, N., Madalina, C., Costa, E., Daelemans, C., Pintiaux, A., Cueto, E., Hadar, E., Dollinger, S., Brzezinski-Sinai, N. A., Huertas, E., Arango, P., Sanchez, A., Schvartzman, J. A., Cojocaru, L., Turan, S., Turan, O., Di Dedda, M. C., Molpeceres, R. G., Zdjelar, S., Premru-Srsen, T., Kornhauser-Cerar, L., Druskovic, M., De Robertis, V., Stefanovic, V., Nupponen, I., Nelskyla, K., Khodjaeva, Z., Gorina, K. A., Sukhikh, G. T., Maruotti, G. M., Visentin, S., Cosmi, E., Ferrari, J., Gatti, A., Luvero, D., Angioli, R., Puri, L., Palumbo, M., D'Urso, G., Colaleo, F., Rapisarda, A. M. C., Carbone, I. F., Manzoli, L., Flacco, M. E., Nazzaro, G., Locci, M., Guida, M., Sardo, A. D. S., Panici, P. B., Khalil, A., Berghella, V., Bifulco, G., Scambia, G., Zullo, F., D'Antonio, F., José Rodríguez Suárez, María, Maria Gambacorti-Passerini, Zita, de Los Angeles Anaya Baz, María, Vanessa Aguilar Galán, Esther, Cuñarro López, Yolanda, Antonio De León Luis, Juan, Cueto Hernández, Ignacio, Battista Luca Schera, Giovanni, Nunzia Della Gatta, Anna, Catello Di Donna, Mariano, Giulia Lombana Marino, Maria, Simone Laganà, Antonio, Laurita Longo, Valentina, Mercado-Olivares, Felipe, Della Sala, Francesca, Cristina Rovellotti, Maria, Cesare Ianniciello, Quintino, Josè Nieto-Calvache, Albaro, Manuel Burgos-Luna, Juan, Viana, Pedro, Martinez-Varea, Alicia, S Jimenez Lopez, Jesú, Yeliz Aykanat, Alicia, DI BENEDETTO, Chiara, Henrique May Feuerschuette, Otto, Rahimli Ocakouglu, Sakine, Tustas Haberal, Esra, Augusto Moreira de Sa, Renato, Luisa Gonzalez-Duran, Maria, Concheiro Guisan, Ana, Özlem Genç, Şerife, Luengo Piqueras, Anna, Esteban Oliva, Dolore, Pelin Cil, Aylin, Gül Yapar Eyi, Elif, A Brzezinski-Sinai, Noa, Alfonso Schvartzman, Javier, Carmela Di Dedda, Maria, Garrote Molpeceres, Rebeca, Premru-Srsen, Tanja, Kornhauser-Cerar, Lilijana, A Gorina, Ksenia, T Sukhikh, Gennady, Maruotti, GIUSEPPE MARIA, Maria Chiara Rapisarda, Agnese, Floriana Carbone, Ilma, Elena Flacco, Maria, DI SPIEZIO SARDO, Attilio, Benedetti Panici, Pierluigi, Saccone G., Sen C., Di Mascio D., Galindo A., Grunebaum A., Yoshimatsu J., Stanojevic M., Kurjak A., Chervenak F., Suarez M.J.R., Gambacorti-Passerini Z.M., de los Angeles Anaya Baz M., Galan E.V.A., Lopez Y.C., Luis J.A.D.L., Hernandez I.C., Herraiz I., Villalain C., Venturella R., Rizzo G., Mappa I., Gerosolima G., Hellmeyer L., Konigbauer J., Ameli G., Frusca T., Volpe N., Schera G.B.L., Fieni S., Esposito E., Simonazzi G., Di Donna G., Youssef A., Gatta A.N.D., Di Donna M.C., Chiantera V., Buono N., Sozzi G., Greco P., Morano D., Bianchi B., Marino M.G.L., Laraud F., Ramone A., Cagnacci A., Barra F., Gustavino C., Ferrero S., Ghezzi F., Cromi A., Lagana A.S., Longo V.L., Stollagli F., Sirico A., Lanzone A., Driul L., Cecchini F., Xodo S., Rodriguez B., Mercado-Olivares F., Elkafrawi D., Sisti G., Esposito R., Coviello A., Cerbone M., Morlando M., Schiattarella A., Colacurci N., De Franciscis P., Cataneo I., Lenzi M., Sandri F., Buscemi R., Gattei G., Sala F.D., Valori E., Rovellotti M.C., Done E., Faron G., Gucciardo L., Esposito V., Vena F., Giancotti A., Brunelli R., Muzii L., Nappi L., Sorrentino F., Liberati M., Buca D., Leombroni M., Di Sebastiano F., Franchi M., Ianniciello Q.C., Garzon S., Petriglia G., Borrello L., Nieto-Calvache A.J., Burgos-Luna J.M., Kadji C., Carlin A., Bevilacqua E., Moucho M., Viana Pinto P., Figueiredo R., Morales Rosello J., Loscalzo G., Martinez-Varea A., Diago V., Jimenez Lopez J.S., Aykanat A.Y., Cosma S., Carosso A., Benedetto C., Bermejo A., Feuerschuette O.H.M., Uyaniklar O., Ocakouglu S.R., Atak Z., Gunduz R., Haberal E.T., Froessler B., Parange A., Palm P., Samardjiski I., Taccaliti C., Okuyan E., Daskalakis G., de Sa R.A.M., Pittaro A., Gonzalez-Duran M.L., Guisan A.C., Genc S.O., Zlatohlavkova B., Piqueras A.L., Oliva D.E., Cil A.P., Api O., Antsaklis P., Ples L., Kyvernitakis I., Maul H., Malan M., Lila A., Granese R., Ercoli A., Zoccali G., Villasco A., Biglia N., Madalina C., Costa E., Daelemans C., Pintiaux A., Cueto E., Hadar E., Dollinger S., Brzezinski-Sinai N.A., Huertas E., Arango P., Sanchez A., Schvartzman J.A., Cojocaru L., Turan S., Turan O., Di Dedda M.C., Molpeceres R.G., Zdjelar S., Premru-Srsen T., Kornhauser-Cerar L., Druskovic M., De Robertis V., Stefanovic V., Nupponen I., Nelskyla K., Khodjaeva Z., Gorina K.A., Sukhikh G.T., Maruotti G.M., Visentin S., Cosmi E., Ferrari J., Gatti A., Luvero D., Angioli R., Puri L., Palumbo M., D'Urso G., Colaleo F., Rapisarda A.M.C., Carbone I.F., Manzoli L., Flacco M.E., Nazzaro G., Locci M., Guida M., Sardo A.D.S., Panici P.B., Khalil A., Berghella V., Bifulco G., Scambia G., Zullo F., D'Antonio F., Mother and Child, Surgical clinical sciences, Obstetrics, and Clinical sciences

Subjects
COVID19, medicine.medical_treatment, coronavirus, COVID-19, infection, pregnancy, SARS-CoV-2, Abortion, infectious diseases, law.invention, Cohort Studies, 0302 clinical medicine, law, 3123 Gynaecology and paediatrics, Pregnancy, Obstetrics and Gynaecology, 030212 general & internal medicine, Pregnancy Complications, Infectious, 030219 obstetrics & reproductive medicine, Radiological and Ultrasound Technology, Transmission (medicine), Obstetrics, Pregnancy Outcome, Obstetrics and Gynecology, Coronavirus, SARS-COV-2, General Medicine, Disease 2019 Covid-19, Intensive care unit, 3. Good health, Hospitalization, Intensive Care Units, Maternal Mortality, Settore MED/40, Radiology Nuclear Medicine and imaging, Gestation, Female, coronavirus, Pandemics, Pregnancy, Pregnancy Complications, Infectious, Pregnancy Outcome, Respiration, Artificial, Retrospective Studies, SARS-CoV-2, COVID-19, Infant, Newborn, Intensive Care Units,Maternal Mortality, Infection, Cohort study, Adult, medicine.medical_specialty, NO, 03 medical and health sciences, medicine, Humans, Radiology, Nuclear Medicine and imaging, Pandemics, Retrospective Studies, Mechanical ventilation, business.industry, Infant, Newborn, Infant, Retrospective cohort study, medicine.disease, Respiration, Artificial, coronaviru, Reproductive Medicine, business
Abstract

WOS:000613461600006 PubMed ID: 32926494 Objectives To evaluate the maternal and perinatal outcomes of pregnancies affected by SARS-CoV-2 infection. Methods This was a multinational retrospective cohort study including women with a singleton pregnancy and laboratory-confirmed SARS-CoV-2 infection, conducted in 72 centers in 22 different countries in Europe, the USA, South America, Asia and Australia, between 1 February 2020 and 30 April 2020. Confirmed SARS-CoV-2 infection was defined as a positive result on real-time reverse-transcription polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab specimens. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit (ICU), use of mechanical ventilation and death. Results In total, 388 women with a singleton pregnancy tested positive for SARS-CoV-2 on RT-PCR of a nasopharyngeal swab and were included in the study. Composite adverse maternal outcome was observed in 47/388 (12.1%) women; 43 (11.1%) women were admitted to the ICU, 36 (9.3%) required mechanical ventilation and three (0.8%) died. Of the 388 women included in the study, 122 (31.4%) were still pregnant at the time of data analysis. Among the other 266 women, six (19.4% of the 31 women with first-trimester infection) had miscarriage, three (1.1%) had termination of pregnancy, six (2.3%) had stillbirth and 251 (94.4%) delivered a liveborn infant. The rate of preterm birth before 37 weeks' gestation was 26.3% (70/266). Of the 251 liveborn infants, 69/251(27.5%) were admitted to the neonatal ICU, and there were five (2.0%) neonatal deaths. The overall rate of perinatal death was 4.1% (11/266). Only one (1/251, 0.4%) infant, born to a mother who tested positive during the third trimester, was found to be positive for SARS-CoV-2 on RT-PCR. Conclusions SARS-CoV-2 infection in pregnant women is associated with a 0.8% rate of maternal mortality, but an 11.1% rate of admission to the ICU. The risk of vertical transmission seems to be negligible. (C) 2020 International Society of Ultrasound in Obstetrics and Gynecology.

Published
2021

46. Evaluating the best treatment for multifocal hepatocellular carcinoma: A propensity score-matched analysis

Author

Risaliti, Matteo, primary, Bartolini, Ilenia, additional, Campani, Claudia, additional, Arena, Umberto, additional, Xodo, Carlotta, additional, Adotti, Valentina, additional, Rosi, Martina, additional, Taddei, Antonio, additional, Muiesan, Paolo, additional, Amedei, Amedeo, additional, Batignani, Giacomo, additional, and Marra, Fabio, additional

Published
2022
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48. Peri-Operative Management of Patients Undergoing Fenestrated-Branched Endovascular Repair for Juxtarenal, Pararenal and Thoracoabdominal Aortic Aneurysms: Preventing, Recognizing and Treating Complications to Improve Clinical Outcomes

Author

Xodo, Andrea, primary, D’Oria, Mario, additional, Mendes, Bernardo, additional, Bertoglio, Luca, additional, Mani, Kevin, additional, Gargiulo, Mauro, additional, Budtz-Lilly, Jacob, additional, Antonello, Michele, additional, Veraldi, Gian Franco, additional, Pilon, Fabio, additional, Milite, Domenico, additional, Calvagna, Cristiano, additional, Griselli, Filippo, additional, Taglialavoro, Jacopo, additional, Bassini, Silvia, additional, Wanhainen, Anders, additional, Lindstrom, David, additional, Gallitto, Enrico, additional, Mezzetto, Luca, additional, Mastrorilli, Davide, additional, Lepidi, Sandro, additional, and DeMartino, Randall, additional

Published
2022
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50. Chapter Prodromi dell’alternanza scuola-lavoro: la Ferme École di Meleto in Val d’Elsa

Author

XODO, CARLA

Subjects
School-work alternation, Ferme école, theory-practice relationship, education-training, thema EDItEUR::J Society and Social Sciences::JN Education
Abstract

The contribution reconstructs the work of innovation carried out by Cosimo Ridolfi in the Agricultural Institute of Meleto in Val d'Elsa, as a paradigmatic example of the relationship between theory and practice and a model example of school-work alternation. Through a historical perspective, we want to highlight the educational aspects of practical and conceptual activity in practical and operational contexts, especially in agriculture, a tradition inaugurated by Ridolfi and continued by Lambruschini, which initiated a true Tuscan school of innovation in the formal learning setting of education and training that has become a European model.

Published
2022
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