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51. Exposure to antiretroviral therapy in utero or early life: the health of uninfected children born to HIV-infected women

Author

Newell, ML, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Mok, J, Johnstone, F, de Jose, I, Bates, I, Salas, S, de Guevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, Garcia-Rodriguez, MC, Asensi-Botet, F, Otero, MC, Perez-Tamarit, D, Ridaura, S, GREGORI, PIETRO, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Belfrage, E, Naver, L, LEVY, JOHANNA, Barlow, P, Hainaut, M, Peltier, A, Wibaut, S, Ferrazin, A, Bassetti, D, DE MARIA, ANTONELLA, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Rovira, MA, Carreras, R, Valerius, NH, Coll, O, Vidal, R, PEREZ, JESUS MARIA, Boguna, J, Fortuny, C, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Savasi, V, Vigano, A, Ferrazzi, E, BRAMBILLA, TERESA, Bianchi, L, Maccabruni, A, Taylor, GP, Lyall, EGH, Penn, Z, Buffolano, W, Martinelli, P, Sansone, M, Tibaldi, C, Marini, C, Masuelli, G, Benedetto, C, Niemiec, T, Marczynska, M, Newell, ML, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Mok, J, Johnstone, F, de Jose, I, Bates, I, Salas, S, de Guevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, Garcia-Rodriguez, MC, Asensi-Botet, F, Otero, MC, Perez-Tamarit, D, Ridaura, S, Gregori, P, de la Torre, R, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, AB, Lindgren, S, Ehrnst, A, Belfrage, E, Naver, L, Levy, J, Barlow, P, Hainaut, M, Peltier, A, Wibaut, S, Ferrazin, A, Bassetti, D, De Maria, A, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Rovira, MA, Carreras, R, Valerius, NH, Coll, O, Vidal, R, Perez, JM, Boguna, J, Fortuny, C, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Savasi, V, Vigano, A, Ferrazzi, E, Brambilla, T, Bianchi, L, Maccabruni, A, Taylor, GP, Lyall, EGH, Penn, Z, Buffolano, W, Martinelli, P, Sansone, M, Tibaldi, C, Marini, C, Masuelli, G, Benedetto, C, Niemiec, T, and Marczynska, M

Subjects
Europe, antiretroviral therapy, HIV, uninfected children, abnormalities
Abstract

Concerns have been raised over possible adverse effects of prophylactic antiretroviral therapy (ART) on the fetus and newborn. We analyzed data relating to uninfected children enrolled in the European Collaborative Study and investigated the association between ART exposure, perinatal problems, and major adverse health events later in life. Median length of follow-up was 2.2 (0-15.9) years. Of the 2414 uninfected children, 687 (28%) were exposed to ART in all three periods (antenatal, intrapartum, and neonatal). Of the 1008 infants exposed to ART at any time, 906 (90%) were exposed antenatally, 840 (83%) neonatally, and 750 (74%) both antenatally and neonatally. ART exposure was not significantly associated with pattern or prevalence of congenital abnormalities or low birth weight. In multivariate analysis, prematurity was associated with exposure to combination therapy without a protease inhibitor (PI) (OR = 2.66; 95% CI: 1.52-4.67) and with a PI (OR = 4.14; 95% CI: 2.36-7.23). ART exposure was associated with anemia in early life (P < .001). There was no evidence of an association with clinical manifestations suggestive of mitochondrial abnormalities. The absence of serious adverse events in this large cohort of uninfected children exposed to prophylactic ART in the short to medium term is reassuring.

Published
2004

52. Missed opportunities among HIV-positive women to control viral replication during pregnancy and to have a vaginal delivery

Author

Aebi Popp, K, Mulcahy, F, Glass, Tr, Rudin, C, Martinez de Tejada, B, Bertisch, B, Fehr, J, Grawe, C, Scheibner, K, Rickenbach, M, Hoesli, I, Thorne, C, European Collaborative Study in EuroCoord, Swiss, Mother, Child HIV Cohort Study Collaborators: Thorne, C, Bailey, H, Giaquinto, C, Rampon, O, Mazza, A, De Rossi, A, Wörner, I, Mok, J, de José MI, Martínez, B, Peña, J, Garcia, J, Lopez, Jr, Rodriguez, Mc, Asensi Botet, F, Otero, Mc, Pérez Tamarit, D, Scherpbier, Hj, Kreyenbroek, M, Godfried, Mh, Nellen, Fj, Boer, K, Navér, L, Bohlin, Ab, Lindgren, S, Kaldma, A, Belfrage, E, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Brichard, B, De Camps, J, Thiry, N, Deboone, G, Waterloos, H, Viscoli, C, De Maria, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mûr, A, Payà, A, López Vilchez MA, Carreras, R, Valerius, Nh, Rosenfeldt, V, Coll, O, Suy, A, Perez, J, Fortuny, C, Boguña, J, Savasi, V, Fiore, S, Crivelli, M, Viganò, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Alberico, S, Maso, G, Tropea, M, Barresi, V, Taylor, G, Lyall, Eg, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Sansone, M, Maruotti, G, Agangi, A, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, Chiara, Niemieç, T, Marczynska, M, Dobosz, S, Popielska, J, Oldakowska, A, Aubert, V, Barth, J, Battegay, M, Bernasconi, E, Böni, J, Brazzola, P, Bucher, Hc, Burton Jeangros, C, Calmy, A, Cavassini, M, Cheseaux, Jj, Drack, G, Duppenthaler, A, Egger, M, Elzi, L, Fellay, J, Francini, K, Furrer, H, Fux, Ca, Gorgievski, M, Günthard, H, Haerry, D, Hasse, B, Hirsch, Hh, Hösli, I, Kahlert, C, Kaiser, L, Keiser, O, Klimkait, T, Kovari, H, Ledergerber, B, Martinetti, G, de Tejada, B, Metzner, K, Müller, N, Nadal, D, Pantaleo, G, Polli, Ch, Posfay Barbe, K, Rauch, A, Regenass, S, Schmid, P, Schultze, D, Schöni Affolter, F, Schüpbach, J, Speck, R, Taffé, P, Tarr, P, Telenti, A, Trkola, A, Vernazza, P, Weber, R, Wyler, Ca, Yerly, S., Posfay Barbe, Klara, Wyler, Claire-Anne, University of Zurich, Aebi-Popp, Karoline, Aebi Popp, K, Mulcahy, F, Glass, Tr, Rudin, C, Martinez de Tejada, B, Bertisch, B, Fehr, J, Grawe, C, Scheibner, K, Rickenbach, M, Hoesli, I, Buffolano, Wilma, Thorne, C, European Collaborative Study in, Eurocoord, Swiss, Mother, and Child HIV Cohort, S. t. u. d. y.

Subjects
mode of delivery, medicine.medical_treatment, HIV Infections, Delivery, Obstetric/statistics & numerical data, Virus Replication, 10234 Clinic for Infectious Diseases, Cohort Studies, HIV Infections/drug therapy/prevention & control/transmission, Pregnancy, Antiretroviral Therapy, Highly Active, 2736 Pharmacology (medical), Pharmacology (medical), Surgical Procedures, Elective/statistics & numerical data, Pregnancy Complications, Infectious, Europe, HIV, Mode of delivery, Adult, Anti-HIV Agents, Cesarean Section, Delivery, Obstetric, Drug Therapy, Combination, Elective Surgical Procedures, Female, Guidelines as Topic, Health Policy, Humans, Infant, Newborn, Infectious Disease Transmission, Vertical, Viral Load, Infectious Diseases, ddc:618, Obstetrics, Vaginal delivery, Transmission (medicine), Cesarean Section/statistics & numerical data, Meta-analysis, provvedimento amministrativo - nullità - domanda riconvenzionale, Viral load, Cohort study, medicine.medical_specialty, Pregnancy Complications, Infectious/drug therapy/epidemiology/prevention & control, 610 Medicine & health, Europe/epidemiology, Pharmacotherapy, medicine, Caesarean section, business.industry, 2725 Infectious Diseases, medicine.disease, Viral Load/drug effects, HIV, pregnancy, mode of delivery, Anti-HIV Agents/therapeutic use, Settore MED/40 - Ginecologia e Ostetricia, business, Infectious Disease Transmission, Vertical/prevention & control/statistics & numerical data
Abstract

INTRODUCTION: Most national guidelines for the prevention of mother-to-child transmission of HIV in Europe updated between 2001 and 2010 recommend vaginal deliveries for women with undetectable or very low viral load (VL). Our aim was to explore the impact of these new guidelines on the rates of vaginal deliveries among HIV-positive women in Europe. METHODS: In a pooled analysis of data on HIV-positive pregnant women enrolled in the Swiss Mother & Child HIV Cohort Study and the European Collaborative Study 2000 to 2010, deliveries were classified as occurring pre- or postpublication of national guidelines recommending vaginal delivery. RESULTS: Overall, 2663 women with 3013 deliveries were included from 10 countries; 28% women were diagnosed with HIV during pregnancy. Combination antiretroviral therapy was used in most pregnancies (2020, 73%), starting during the first or second trimester in 78% and during the third trimester in 22%; in 25% pregnancies, the woman conceived on combination antiretroviral therapy. Overall, in 86% pregnancies, a VL < 400 copies per milliliter was achieved before delivery. The proportion of vaginal deliveries increased from 17% (414/2377) before the change in guidelines to 52% (313/600) after; elective Caesarean section rates decreased from 65% to 27%. The proportion of women with undetectable VL having a Caesarean section was 55% after implementation of new guidelines. We observed a decrease of late preterm deliveries from 16% (377/2354) before to 7% (42/599) after the change in guidelines (P < 0.001). CONCLUSION: There are still missed opportunities for women with HIV to fully suppress their VL and to deliver vaginally in Europe.

Published
2013

53. Body Mass Index and Weight Gain in Pregnant Women With HIV: A National Study in Italy

Author

Floridia, M., Ravizza, M., Masuelli, G., Dalzero, S., Pinnetti, C., Cetin, I., Meloni, A., Spinillo, A., Rubino, E., Francisci, D., Tamburrini, E., Mori, F., Ortolani, P., Dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, Claudio Maria, Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Luzi, K., Nardini, G., Stentarelli, C., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Fabiano, V., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Bernini, L., Alberico, S., Maso, G., Tropea, M., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Vicini, I., Roccio, M., Vimercati, A., Miccolis, A., Bassi, E., Guerra, B., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Tibaldi, C., Trentini, L., Todros, T., Garetto, S., Brambilla, T., Savasi, V., Crepaldi, A., Giaquinto, C., Fiscon, M., Rinaldi, R., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Liuzzi, G., Tozzi, V., Massetti, Anna Paola, Anceschi, M., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Marconi, A. M., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Ravizza, M, Masuelli, G, Dalzero, S, Pinnetti, C, Cetin, I, Meloni, A, Spinillo, A, Rubino, E, Francisci, D, Tamburrini, E, Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy, Martinelli, Pasquale, Floridia M, Ravizza M, Masuelli G, Dalzero S, Pinnetti C, Cetin I, Meloni A, Spinillo A, Rubino E, Francisci D, Tamburrini E, Faldella G, Guerra B, and for the Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy

Subjects
Microbiology (medical), medicine.medical_specialty, antiretroviral therapy, MEDLINE, Human immunodeficiency virus (HIV), HIV Infections, body mass index, medicine.disease_cause, Settore MED/17 - MALATTIE INFETTIVE, Body Mass Index, BMI, weight gain, HIV-1, Pregnancy, Medicine, Humans, HIV infection, pregnancy, Pregnancy Complications, Infectious, business.industry, Obstetrics, Cesarean Section, Infectious, Pregnancy Outcome, HIV, medicine.disease, Pregnancy Complications, Infectious Diseases, Italy, National study, Female, medicine.symptom, business, Weight gain, Body mass index
Abstract

Although most of the women (69.4%) had a normal BMI at start of pregnancy, only 37% had an adequate weight gain during pregnancy. Inadequate body weight gain was more common (44.8%) than excessive weight gain (18.2%), but 40% of overweight women and 50% of obese women had an excessive weight gain in pregnancy, with about 9% of the women in these categories gaining >18 kg during pregnancy (Table 1). Only 1.9% of the women had a vaginal delivery; elective and nonelective cesarean deliveries accounted for 81.3% and 16.7% of deliveries, respectively. Compared to underweight/normal women, overweight/obese women had similar occurrences of preterm delivery (23.4% vs 22.7%, P = .871), significantly lower rates of low birthweight (14.2% vs 24.2%, P = .007) and nonelective cesarean deliveries (11.7% vs 18.3%, P = .042), and a significantly higher occurrence of fasting plasma glucose >92 mg/dL at 20–28 weeks (12.1% vs 6.6%, P = .027), hypertension during pregnancy (6.4% vs 2.7%, P = .019), and gestational age–adjusted birthweight >90th percentile (15.5% vs 5.0%, P < .001). Complications of delivery, major birth defects, and HIV transmission were similar between the 2 groups (7.3% vs 7.6%, P = .881; 2.6% vs 3.5%, P = .589; and 0.8% vs 0.5%, P = .661, respectively). An inadequate weight gain during pregnancy was associated with an increased risk of nonelective cesarean delivery (OR, 1.589 [95% CI, 1.077–2.346], P = .020). Excessive weight gain during pregnancy was not associated with either hypertension (OR, 1.364 [95% CI, .537–3.465], P = .514) or 20–28 week glucose level of >92 mg/dL (OR, 0.841 [95% CI, .399–1.772], P = .648), but was significantly associated with birthweight >90th percentile (OR, 2.271 [95% CI, 1.229–4.195], P = .009), and appeared to be protective against low birthweight (OR, 0.544 [95% CI, .323–.918], P = .023) and birthweight

Published
2013

54. Body Mass Index and Weight Gain in Pregnant Women With HIV: A National Study in Italy

Author

Floridia, M, Ravizza, M, Masuelli, G, Dalzero, S, Pinnetti, C, Cetin, I, Meloni, A, Spinillo, A, Rubino, E, Francisci Dtamburrini, E, Mori, F, Ortolani, P, Dalle Nogare Er, Di Lorenzo, F, Sterrantino, G, Meli, M, Polemi, S, Nocentini, J, Baldini, M, Montorzi, G, Mazzetti, M, Rogasi, P, Borchi, B, Vichi, F, Pinter, E, Anzalone, E, Marocco, R, Mastroianni, C, Mercurio, Vs, Carocci, A, Grilli, E, Maccabruni, A, Zaramella, M, Mariani, B, Natalini Raponi, G, Guaraldi, G, Luzi, K, Nardini, G, Stentarelli, C, Degli Antoni Am, Molinari, A, Crisalli, Mp, Donisi, A, Piepoli, M, Cerri, V, Zuccotti, G, Giacomet, V, Fabiano, V, Placido, G, Vivarelli, A, Castelli, P, Savalli, F, Portelli, V, Sabbatini, F, Francisci, D, Bernini, L, Alberico, S, Maso, G, Tropea, M, Dedoni, M, Cuboni, C, Ortu, F, Piano, P, Citernesi, A, Vicini, I, Roccio, M, Vimercati, A, Miccolis, A, Bassi, E, Guerra, B, Cervi, F, Puccetti, C, Murano, P, Contoli, M, Capretti, Mg, Marsico, C, Faldella, G, Sansone, M, Martinelli, P, Agangi, A, Tibaldi, C, Trentini, L, Todros, T, Garetto, S, Brambilla, T, Savasi, V, Crepaldi, A, Giaquinto, C, Fiscon, M, Rinaldi, R, Bucceri, A, Matrone, R, Scaravelli, G, Fundarò, C, Genovese, O, Cafforio, C, Liuzzi, G, Tozzi, V, Massetti, P, Anceschi, M, Casadei, Am, Cavaliere, Af, Finelli, V, Cellini, M, Castelli Gattinara, G, Marconi, Am, Sacchi, V, De Pirro, A, Polizzi, C, Mattei, A, Pirillo, Mf, Amici, R, Galluzzo, Cm, Donnini, S, Baroncelli, S, Villani, P, Cusato, M, Cerioli, A, De Martino, Maurizio, Mastroiacovo, P, Moroni, M, Parazzini, F, Tamburrini, E, Vella, S, and Martinelli, P.

Subjects
HIV
Published
2013

55. Birth defects in a national cohort of pregnant women with HIV infection in Italy, 2001-2011

Author

Floridia, M., Mastroiacovo, P., Tamburrini, E., Tibaldi, C., Todros, T., Crepaldi, A., Sansone, M., Fiscon, M., Liuzzi, G., Guerra, B., Vimercati, A., Vichi, F., Vicini, I., Pinnetti, C., Marconi, A. M., Ravizza, M., Mori, F., Ortolani, P., dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Pinter, E., Anzalone, E., Marocco, R., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Luzi, K., Nardini, G., Stentarelli, C., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Fabiano, V., Coletto, S., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Alberico, S., Maso, G., Tropea, M., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Spinillo, A., Roccio, M., Miccolis, A., Bassi, E., Cervi, F., Puccetti, C., Murano, P., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Trentini, L., Masuelli, G., Garetto, S., Cetin, I., Brambilla, T., Savasi, V., Giaquinto, C., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Anceschi, M., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Castelli Gattinara, G., Dalzero, S., Sacchi, V., De Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Regazzi, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Mastroiacovo, P, Tamburrini, E, Tibaldi, C, Todros, T, Crepaldi, A, Sansone, M, Fiscon, M, Liuzzi, G, Guerra, B, Vimercati, A, Vichi, F, Vicini, I, Pinnetti, C, Marconi, A, Ravizza, M, Martinelli, Pasquale, and The Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy

Subjects
Male, HIV Infections, transcriptase inhibitors, Cohort Studies, chemistry.chemical_compound, Pregnancy, Prevalence, Birth Weight, Young adult, Pregnancy Complications, Infectious, education.field_of_study, Obstetrics, Coinfection, Antiretroviral therapy, birth defects, efavirenz, HIV, non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, pregnancy, protease inhibitors, women, Obstetrics and Gynecology, Abnormalities, Drug-Induced, Middle Aged, Italy, Maternal Exposure, Reverse Transcriptase Inhibitors, Female, Cohort study, Adult, medicine.medical_specialty, Efavirenz, Adolescent, Anti-HIV Agents, Birth weight, Population, Antiretroviral Therapy, Birth defects, HIV-1, Young Adult, Hepatitis B, Chronic, medicine, Humans, education, business.industry, Infant, Newborn, Odds ratio, Hepatitis C, Chronic, medicine.disease, Infectious Disease Transmission, Vertical, Surgery, Pregnancy Trimester, First, chemistry, business
Abstract

Objective We used data from a national study of pregnant women with HIV to evaluate the prevalence of congenital abnormalities in newborns from women with HIV infection. Design Observational study. Setting University and hospital clinics. Population Pregnant women with HIV exposed to antiretroviral treatment at any time during pregnancy. Methods The total prevalence of birth defects was assessed on live births, stillbirths, and elective terminations for fetal anomaly. The associations between potentially predictive variables and the occurrence of birth defects were expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs) for exposed versus unexposed cases, calculated in univariate and multivariate logistic regression analyses. Main outcome measures Birth defects, defined according to the Antiretroviral Pregnancy Registry criteria. Results A total of 1257 pregnancies with exposure at any time to antiretroviral therapy were evaluated. Forty-two cases with major defects were observed. The total prevalence was 3.2% (95% CI 1.9–4.5) for exposure to any antiretroviral drug during the first trimester (23 cases with defects) and 3.4% (95% CI 1.9–4.9) for no antiretroviral exposure during the first trimester (19 cases). No associations were found between major birth defects and first-trimester exposure to any antiretroviral treatment (OR 0.94, 95% CI 0.51–1.75), main drug classes (nucleoside reverse transcriptase inhibitors, OR 0.95, 95% CI 0.51–1.76; non-nucleoside reverse transcriptase inhibitors, OR 1.20, 95% CI 0.56–2.55; protease inhibitors, OR 0.92, 95% CI 0.43–1.95), and individual drugs, including efavirenz (prevalence for efavirenz, 2.5%). Conclusions This study adds further support to the assumption that first-trimester exposure to antiretroviral treatment does not increase the risk of congenital abnormalities.

Published
2013

56. Insufficient antiretroviral therapy in pregnancy: missed opportunities for prevention of mother-to-child transmission of HIV in Europe

Author

Bayley, H, Townsend, C, Cortina Borja, M, Thorne, C, Newell, Ml, Giaquinto, Carlo, Rampon, O, Mazza, A, DE ROSSI, Anita, Grosch Wörner, I, Mok, J, de José MI, Larrú Martínez, B, Ma Peña, J, Gonzalez Garcia, J, Arribas Lopez JR, Garcia Rodriguez MC, Asensi Botet, F, Otero, Mc, Pérez Tamarit, D, Scherpbier, Hj, Kreyenbroek, M, Godfried, Mh, Nellen, Fj, Boer, K, Navér, L, Bohlin, Ab, Belfrage, E, Lindgren, S, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Brichard, B, De Camps, J, Thiry, N, Deboone, G, Waterloos, H, Viscoli, C, De Maria, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mûr, A, Pàya, A, López Vilchez MA, Carreras, R, Valerius, Nh, Rosenfeldt, V, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguña, J, Savasi, V, Fiore, S, Crivelli, M, Viganò, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Alberico, S, Tropea, M, Businelli, C, Taylor, Gp, Lyall, Eg, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Sansone, M, Maruotti, G, Agangi, A, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, C, Niemieç, T, Marczynska, M, Dobosz, S, Popielska, J, Oldakowska, A, Malyuta, R, Semenenko, I, Pilipenko, T., European Collaborative Study in, Eurocoord, Buffolano, Wilma, Bailey, H, Townsend, C, Cortina Borja, M, Thorne, C., European Collaborative, Study, Martinelli, Pasquale, AII - Amsterdam institute for Infection and Immunity, Paediatric Infectious Diseases / Rheumatology / Immunology, General Internal Medicine, Infectious diseases, Other Research, and Obstetrics and Gynaecology

Subjects
Adult, medicine.medical_specialty, Acquired Immunodeficiency Syndrome, HIV, Pregnancy, Antiviral Agents, antiretroviral therapy, Human immunodeficiency virus (HIV), HIV-1 infected women, mother-to-child transmission, risk factors, HIV Infections, medicine.disease_cause, Medical care, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Antiretroviral Therapy, Highly Active, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Disengagement theory, Pregnancy Complications, Infectious, Pharmacology, 030219 obstetrics & reproductive medicine, business.industry, mother-to-child transmission, Prevention of mother to child transmission, medicine.disease, Antiretroviral therapy, Infectious Disease Transmission, Vertical, 3. Good health, Europe, Infectious Diseases, Family medicine, Immunology, HIV-1, Female, business, HIV-1 infected women, Viral load
Abstract

Background Although mother-to-child transmission (MTCT) rates are at an all-time low in Western Europe, potentially preventable transmissions continue to occur. Duration of antenatal combination antiretroviral therapy (ART) is strongly associated with MTCT risk. Methods Data on pregnant HIV-infected women enrolled in the Western and Central European sites of the European Collaborative Study between January 2000 and July 2009 were analysed. The proportion of women receiving no antenatal ART or 1–13 days of treatment was investigated, and associated factors explored using logistic regression models. Results Of 2,148 women, 142 (7%) received no antenatal ART, decreasing from 8% in 2000–2003 to 5% in 2004– 2009 (χ2=8.73; PConclusions Over the last 10 years, around one in 11 women in this study received insufficient antenatal ART, accounting for 40% of MTCTs. One-half of these women were diagnosed before conception, suggesting disengagement from care.

Published
2011

57. Mode of delivery in HIV-infected pregnant women and prevention of mother-to-child transmission: changing practices in Western Europe

Author

Boer, K, England, K, Godfried, Mh, Thorne, C, Newell, Ml, Mahdavi, S, Giaquinto, Carlo, Rampon, O, Mazza, A, DE ROSSI, Anita, Worner, Ig, Mok, J, DE JOSE MI, Martinez, Bl, Pena, Jm, Garcia, Jg, Lopez, Jra, Rodriguez, Mcg, ASENSI BOTET, F, Otero, Mc, PEREZ TAMARIT, D, Scherpbier, Hj, Kreyenbroek, M, Nellen, Fjb, Naver, L, Bohlin, Ab, Lindgren, S, Kaldma, A, Belfrage, E, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Brichard, B, DE BRUYCKER JJ, Thiry, N, Waterloos, H, Viscoli, C, DE MARIA, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mur, A, Paya, A, LOPEZ VILCHEZ MA, Carreras, R, Valerius, Nh, Rosenfeldt, V, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguna, J, Savasi, V, Fiore, S, Crivelli, M, Vigano, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Alberico, S, Tropea, M, Businelli, C, Taylor, Gp, Lyall, Egh, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Sansone, M, Maruotti, G, Agangi, A, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, C, Niemiec, T, Marczynska, M, Dobosz, S, Popielska, J, Oldakowska, A, Malyuta, R, Semenenko, I, Pilipenko, T., Other Research, Obstetrics and Gynaecology, AII - Amsterdam institute for Infection and Immunity, General Internal Medicine, and Martinelli, Pasquale

Subjects
mode of delivery, HIV Infections, 0302 clinical medicine, prevention, Pregnancy, Antiretroviral Therapy, Highly Active, Pharmacology (medical), 030212 general & internal medicine, Young adult, Pregnancy Complications, Infectious, Substance Abuse, Intravenous, elective caesarean section, mode of delivery, mother-to-child transmission, prevention, 030219 obstetrics & reproductive medicine, pregnancy mother-to-child transmission, Vaginal delivery, Obstetrics, Health Policy, Prenatal Care, Viral Load, 3. Good health, Substance abuse, Europe, Infectious Diseases, Premature birth, Premature Birth, Reverse Transcriptase Inhibitors, Female, medicine.symptom, delivery, Viral load, Zidovudine, Adult, medicine.medical_specialty, elective caesarean section, Prenatal care, Article, 03 medical and health sciences, Young Adult, medicine, Humans, business.industry, Cesarean Section, mother-to-child transmission, HIV, Infant, Newborn, Infant, medicine.disease, Delivery, Obstetric, Infectious Disease Transmission, Vertical, Low birth weight, business, Epidemiologic Methods
Abstract

Objectives The aim of the study was to examine temporal and geographical patterns of mode of delivery in the European Collaborative Study (ECS), identify factors associated with elective caesarean section (CS) delivery in the highly active antiretroviral therapy (HAART) era and explore associations between mode of delivery and mother-to-child transmission (MTCT). Methods The ECS is a cohort study in which HIV-infected pregnant women are enrolled and their infants prospectively followed. Data on 5238 mother-child pairs (MCPs) enrolled in Western European ECS sites between 1985 and 2007 were analysed. Results The elective CS rate increased from 16% in 1985-1993 to 67% in 1999-2001, declining to 51% by 2005-2007. In 2002-2004, 10% of infants were delivered vaginally, increasing to 34% by 2005-2007. During the HAART era, women in Belgium, the United Kingdom and the Netherlands were less likely to deliver by elective CS than those in Italy and Spain [adjusted odds ratio (AOR) 0.07; 95% confidence interval (CI) 0.04-0.12]. The MTCT rate in 2005-2007 was 1%. Among MCPs with maternal HIV RNA

Published
2010

58. Use of neonatal antiretroviral prophylaxis for prevention of mother-to-child transmission of HIV is decreasing in Western Europe

Author

England, K., Thorne, C., Giaquinto, C., Rampon, O., D’Elia, R., De Rossi, A., Grosch Wörner, I., Mok, J., de José, I., Laaru ́, A., Bates, I., Salas, A., Ma Peña, J., Gonzalez Garcia, J., Arribas Lo pez, J. R., Garcia Rodriguez, M. C., Asensi Botet, F., Otero, M. C., Pérez Tamarit, D., Scherpbier, H. J., Kreyenbroek, M., Godfried, M. H., Nellen, F. J. B., Boer, K., Bohlin, A. B., Lindgren, S., Anzén, B., Lidman, K., Elfgren, K., Gyllensten, K., Pehrson, P. O., Levy, J., Barlow, P., Manigart, Y., Hainaut, M., Peltier, A., Goetghebuer, T., Ferrazin, A., DE MARIA, Andrea, Bentivoglio, Giorgio, Ferrero, Simone, Gotta, C., Mur, A., Paya, A., López Vilchez, M. A., Carreras, R., Valerius, N. H., Rosenfeldt, V., Jimenez, J., Coll, O., Suy, A., Perez, J. M., Fortuny, C., Boguña, J., Canet, Y., Pardi, G., Ravizza, M., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Prati, E., Duse, M., Scaravelli, G., Stegagno, M., De Santis, M., Savasi, V., Fiore, S., Cri velli, M., Ferrazzi, E., Vigano`, A., Giacomet, V., Frasca, D., Zuccotti, G., Ravagni Probizer, F., Maccabruni, A., Bucceri, A., Rancilio, L., Alberico, S., Rabusin, M., Bernardon, M., Taylor, G. P., Lyall, E. G. H., Penn, Z., Buffolano, W., Tiseo, R., Martinelli, P., Sansone, M., Maruotti, G., Agangi, A., Tibaldi, C., Marini, S., Masuelli, G., Benedetto, C., Marczynska, T. Niemiec ̧ M., Dobosz, S., Popielska, J., and Oldakowska, A.

Subjects
Microbiology (medical), Cart, Pediatrics, medicine.medical_specialty, antiretroviral therapy, HIV Infections, Chemoprevention, Article, Zidovudine, Pregnancy, Medicine, Humans, HIV, pregnancy, Maternal Transmission, business.industry, Infant, Newborn, medicine.disease, Infectious Disease Transmission, Vertical, Europe, Infectious Diseases, Chemoprophylaxis, Cohort, Observational study, Female, business, Viral load, medicine.drug
Abstract

To the Editor: Since the ACTG076 trial results were published in 1994 [1], antiretroviral prophylaxis for the neonate as well as during pregnancy and delivery has been the cornerstone of prevention of mother-to-child transmission (MTCT) of HIV. In the second decade of the combination antiretroviral therapy (cART) era, around 90% of pregnant HIV-infected women in Western Europe receive antenatal cART, for their own health and/or for prevention of MTCT (PMTCT) [2-4]. The rationale for including neonatal prophylaxis in the ACTG076 trial included uncertainty regarding timing of MTCT and the desire to boost the infant’s in utero and intrapartum antiretroviral drug exposure with 6 weeks zidovudine prophylaxis, as a post-exposure prophylaxis (PEP) for newborns not infected with HIV in utero. Observational studies and trials subsequently demonstrated effectiveness of neonatal PEP for infants whose mothers received no antiretroviral drugs [5-7]. No trial data exist comparing the efficacy of different neonatal prophylaxis regimens for infants of women on cART. We investigated trends in neonatal prophylaxis use in the cART era in Western European sites of the European Collaborative Study, a cohort of HIV-infected pregnant women and their children; full methods are described elsewhere [4]. Logistic regression was used to investigate factors associated with receipt of neonatal prophylaxis. Variables considered in the multivariable model were antenatal antiretroviral use, mode of delivery, country and year of delivery, prematurity (

Published
2009

60. The mother-to-child HIV transmission epidemic in Europe: evolving in the East and established in the West

Author

Giaquinto, C, Rampon, O, D'Elia, R, De Rossi, A, Grosch Worner, I, Feiterna Sperling, C, Schmitz, T, Casteleyn, S, Mok, J., de Jose, I, Bates, I, Larru, B, Pena, Jm, Garcia, Jg, Lopez, Jra, Garcia Rodriguez MC, Asensi Botet, F, Otero, Mc, Perez Tamarit, D, Suarez, G, Scherpbier, H, Kreyenbroek, M, Godfried, Mh, Nellen, Fj, Boer, K, Bohlin, Ab, Lindgren, S, Belfrage, E, Naver, L, Anzen, B, Lidman, K, Levy, J, Hainaut, M, Goetghebuer, T, Manigart, Y, Barlow, P, Ferrazin, A, Bassetti, D, De Maria, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mur, A, Paya, A, Lopez Vilchez MA, Carreras, R, Valerius, Nh, Jimenez, J, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguna, J, Caro, Mc, Canet, Y, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Prati, E, Duse, Marzia, Scaravelli, G, Stegagno, M, De Santis, M, Savasi, V, Ferrazzi, E, Vigano, A, Giacomet, V, Probizer, Fr, Maccabruni, A, Bucceri, A, Rancilio, L, Alberico, S, Rabusin, M, Bernardon, M, Taylor, Gp, Lyall, Egh, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Sansone, M, Agangi, A, Tibaldi, C, and Marini, S.

Published
2006

61. Increasing likelihood of further live births in HIV-infected women in recent years

Author

Giaquinto, Carlo, Ruga, EZIA MARIA, DE ROSSI, Anita, GROSCH WORNER, I, Mok, J, DE JOSE, I, Bates, I, Hawkins, F, DE GUEVARA CL, Pena, Jm, Garcia, Jg, Lopez, Jra, GARCIA RODRIGUEZ MC, ASENSI BOTET, F, Otero, Mc, PEREZ TAMARIT, D, Suarez, G, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, Ab, Lindgren, S, Belfrage, E, Naver, L, Anzen, B, Lidman, K, Levy, J, Barlow, P, Hainaut, M, Peltier, A, Goetghebuer, T, Ferrazin, A, Bassetti, D, DE MARIA, A, Gotta, C, Mur, A, Paya, A, LOPEZ VILCHEZ MA, Carreras, R, Valerius, Nh, Jimenez, J, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguna, J, Caro, Mc, Canet, Y, Pardi, G, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Prati, E, Duse, M, Scaravelli, G, Stegagno, M, DE SANTIS, M, Semprini, Ae, Savasi, V, Vigano, A, Probizer, Fr, Maccabruni, A, Bucceri, A, Rancilio, L, Alberico, S, Rabusin, M, Bernardon, M, Taylor, Gp, Lyall, Egh, Penn, Z, Buffolano, Dw, Tiseo, R, Martinelli, P, Sansone, M, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, C, Niemiec, T, Marczynska, M, Horban, A., Agangi, A., theEUROPEAN COLLABORATIVE, Study, and Martinelli, Pasquale

Subjects
medicine.medical_specialty, Time Factors, Population, HIV Infections, Logistic regression, ANTIRETROVIRAL THERAPY, Pregnancy, Antiretroviral Therapy, Highly Active, Hiv infected, medicine, Humans, Pregnancy Complications, Infectious, Prospective cohort study, education, Reproductive History, VERTICAL TRANSMISSION, Gynecology, education.field_of_study, business.industry, Obstetrics and Gynecology, Odds ratio, IMMUNODEFICIENCY-VIRUS TYPE-1, IMMUNODEFICIENCY-VIRUS TYPE-1, ANTIRETROVIRAL THERAPY, VERTICAL TRANSMISSION, Confidence interval, Parity, Female, Epidemiologic Methods, business, Live birth, Parity (mathematics), Maternal Age, Demography
Abstract

OBJECTIVE To examine how the subsequent childbearing of HIV-infected mothers enrolled in the European Collaborative Study (ECS) has changed over time and identify factors predictive of further childbearing. DESIGN Prospective cohort study. SETTING Centres in nine European countries included in the ECS, enrolled between end 1986 and November 2003. POPULATION HIV-infected women (3911): 3693 with only one and 218 with subsequent live births. METHODS Univariable and multivariable logistic regression analyses to obtain odds ratios (OR) and 95% confidence intervals (CI). Kaplan-Meier (KM) analyses to estimate cumulative proportions of women having a subsequent live birth. MAIN OUTCOME MEASURES Subsequent live birth. RESULTS In multivariable analysis adjusting for time period, ethnicity, maternal age and parity, black women were more likely [adjusted odds ratio (AOR) 2.45; 95% CI, 1.75-3.43], and women >30 years less likely (AOR 0.54, 0.37-0.80), to have a subsequent live birth. Time to subsequent live birth significantly shortened over time, with an estimated 2% of women having a subsequent live birth within 24 months of enrollment pre-1989 versus 14% in 2000-2003 (P < 0.001). Estimated time to subsequent live birth was shorter for black than for white women (P < 0.001). CONCLUSIONS The likelihood of subsequent live births substantially increased after 1995 and birth intervals were shorter in women on HAART and among black women. Numbers are currently too small to address the issue of advantages and disadvantages in the management of subsequent deliveries.

Published
2005

62. Mother-to-child transmission of HIV infection in the era of highly active antiretroviral therapy

Author

Giaquinto, Carlo, Ruga, EZIA MARIA, DE ROSSI, Anita, GROSCH WORNER, I, Mok, J, DE JOSE, I, Bates, I, Hawkins, F, DE GUEVARA CL, Pena, Jm, Garcia, Jg, Lopez, Jra, GARCIA RODRIGUEZ MC, ASENSI BOTET, F, Otero, Mc, PEREZ TAMARIT DP, Suarez, G, Scherpbier, H, Kreyenbroek, M, Boer, K, Bohlin, Ab, Lindgren, S, Ehrnst, A, Belfrage, E, Naver, L, Lidman, K, Anzen, B, Levy, J, Barlow, P, Hainaut, M, Peltier, A, Goetghebuer, T, Ferrazin, A, Bassetti, D, DE MARIA, A, Gotta, C, Mur, A, Paya, A, Vinolas, M, LOPEZ VILCHEZ MA, Rovira, Carreras, R, Valerius, Nh, Jimenez, J, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Caro, Mc, Canet, Y, Savasi, V, Vigano, A, Ferrazi, E, Alberico, S, Rabusin, M, Bernardon, M, Taylor, Gp, Lyall, Egh, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, P, Agangi, A, Sansone, M, Tibaldi, C, and Et, Al

Subjects
PERINATAL TRANSMISSION, HUMAN-IMMUNODEFICIENCY-VIRUS, RNA LEVELS, VERTICAL TRANSMISSION, CESAREAN DELIVERY, PREGNANT-WOMEN, PERINATAL TRANSMISSION, HUMAN-IMMUNODEFICIENCY-VIRUS, CESAREAN DELIVERY, RNA LEVELS, VERTICAL TRANSMISSION, PREGNANT-WOMEN
Published
2005

63. Women Facing HIV. Key Question on Women with HIV Infection: Italian Consensus Workshop

Author

Carosi, G, Nasta, P, Fiore, S, Matteelli, A, Cauda, Roberto, Ferrazzi, E, Tamburrini, Enrica, Savasi, V, Bini, T, Ravizza, M, Bucceri, A, Vichi, F, Murri, Rita, Mazzotta, F, D'Arminio Monforte, A., Cauda, Roberto (ORCID:0000-0002-1498-4229), Tamburrini, Enrica (ORCID:0000-0003-4930-426X), Murri, Rita (ORCID:0000-0003-4263-7854), Carosi, G, Nasta, P, Fiore, S, Matteelli, A, Cauda, Roberto, Ferrazzi, E, Tamburrini, Enrica, Savasi, V, Bini, T, Ravizza, M, Bucceri, A, Vichi, F, Murri, Rita, Mazzotta, F, D'Arminio Monforte, A., Cauda, Roberto (ORCID:0000-0002-1498-4229), Tamburrini, Enrica (ORCID:0000-0003-4930-426X), and Murri, Rita (ORCID:0000-0003-4263-7854)

Abstract

A panel of leading Italian specialists in infectious diseases, obstetrics and gynaecology met in a national consensus workshop on women facing HIV to review critical aspects and discuss recommendations for selected key questions on four issues: (1) women and highly active antiretroviral therapy (HAART): access to care and adherence to therapy, side effects and drug-drug interaction; (2) HIV-infected pregnant women: prevention of mother to child transmission; (3) desire for children among women living with HIV: assisted reproduction; (4) sexually transmitted diseases and genital disturbances. The method of a nominal group meeting was used, and recommendations were graded for their strength and quality of evidence using a system based on the one adopted by the Infectious Diseases Society of America. Main conclusions are summarized and critically discussed, and some of the most recent data supporting recommendations are provided.

Published
2009

64. Andrology

Author

Carchenilla, M. S. C., primary, Agudo, D., additional, Rubio, S., additional, Becerra, D., additional, Bronet, F., additional, Garcia-Velasco, J. A., additional, Pacheco, A., additional, Lardone, M., additional, Piottante, A., additional, Parada-Bustamante, A., additional, Argandona, F., additional, Florez, M., additional, Espinoza, A., additional, Ebensperger, M., additional, Castro, A., additional, Cohen-Bacrie, M., additional, Belloc, S., additional, Dalleac, A., additional, Amar, E., additional, Izard, V., additional, Hazout, A., additional, Cohen-Bacrie, P., additional, de Mouzon, J., additional, Muzzonigro, F., additional, Crivello, A. M., additional, Stanghellini, I., additional, Bernardini, L., additional, Ferraretti, A. P., additional, Magli, C., additional, Gianaroli, L., additional, Martin, P. S., additional, Duvison, M. H., additional, Silva, M. D., additional, Gosalvez, J., additional, Martin, F. S., additional, Pomante, A., additional, Colombo, F., additional, Mattioli, M., additional, Barboni, B., additional, Magli, M. C., additional, Hacifazlioglu, O., additional, Findikli, N., additional, Goktolga, U., additional, Bahceci, M., additional, Jakab, A., additional, Mokanszki, A., additional, Varga, A., additional, Benyo, M., additional, Kassai, Z., additional, Olah, E., additional, Molnar, Z., additional, Gundogan, G. I., additional, Bozkurt, H. H., additional, Irez, T., additional, Domingo, A., additional, Anarte, C., additional, Presilla, N., additional, Calvo, I., additional, Aguirre, O., additional, Oroquieta, A., additional, Agirregoikoa, J. A., additional, De Pablo, J. L., additional, Barrenetxea, G., additional, Moragues, I., additional, Medrano, M. L., additional, Montoya, A., additional, Ramos, B., additional, Torres, M. J. G., additional, Aizpurua, J., additional, Ibala, S. R., additional, Ghedir, H., additional, Mehri, A., additional, Zidi, I., additional, Brahem, S., additional, Mehdi, M., additional, Ajina, M., additional, Saad, A., additional, Gomez-Torres, M. J., additional, Cavaco, J. E., additional, Rato, L., additional, Alves, M. G., additional, Dias, T. R., additional, Lopes, G., additional, Socorro, S., additional, Oliveira, P. F., additional, Lobascio, A. M., additional, Minasi, M. G., additional, Greco, E., additional, Bungum, M., additional, Bungum, A., additional, Silver, N., additional, Zahiri, M., additional, Movahedin, M., additional, Mowla, S. J., additional, Noruzinia, M., additional, Huleihel, M., additional, Abarbanel, Y., additional, Haber, E. P., additional, Azab, M., additional, Lan, D., additional, Lunenfeld, E., additional, Smith, M. J., additional, Neri, Q. V., additional, Harvey, L., additional, Rosenwaks, Z., additional, Palermo, G. D., additional, Alhalabi, M., additional, Samawi, S., additional, Droubi, H., additional, Khalaf, M., additional, Taha, A., additional, Khatib, R., additional, Bednarowska-flisiak, A., additional, Wcislo, M., additional, Liss, J., additional, Swider, A., additional, Szczyglinska, J., additional, Grzymkowska, M., additional, Bruszczynska, A., additional, Glowacka, J., additional, Kitowska-Marszalkowska, K., additional, Krapchev, M., additional, Mirecka, A., additional, Wisniewska, K., additional, Lukaszuk, K., additional, Natali, I., additional, Tamburrino, L., additional, Cambi, M., additional, Marchiani, S., additional, Noci, I., additional, Maggi, M., additional, Forti, G., additional, Baldi, E., additional, Muratori, M., additional, Ferraretto, X., additional, Pasquet, B., additional, Damond, F., additional, Matheron, S., additional, Epelboin, S., additional, Yahi, S., additional, Demailly, P., additional, Rougier, N., additional, Yazbeck, C., additional, Delaroche, L., additional, Longuet, P., additional, Llabador, M., additional, Estellat, C., additional, Patrat, C., additional, Askarijahromi, M., additional, Amanlu, M., additional, Mowla, S. j., additional, Mazaheri, Z., additional, Christensen, P., additional, Sills, E. S., additional, Fischer, R., additional, Naether, O. G. J., additional, Walsh, D., additional, Rudolf, K., additional, Coull, G., additional, Baukloh, V., additional, Labouriau, R., additional, Birck, A., additional, Parisi, F., additional, Parrilla, B., additional, Oneta, M., additional, Savasi, V., additional, Veleva, L., additional, Milachich, T., additional, Bochev, I., additional, Antonova, I., additional, Shterev, A., additional, Vlaisavljevic, V., additional, Breznik, B. P., additional, Kovacic, B., additional, Serrano, M., additional, Gonzalvo, M. C., additional, Clavero, A., additional, Fernandez, M. F., additional, Mozas, J., additional, Martinez, L., additional, Fontes, J., additional, Carrillo, S., additional, Lopez-Regalado, M. L., additional, Lopez-Leria, B., additional, Orozco, I., additional, Mantilla, A., additional, Castilla, J. A., additional, Mskhalaya, G., additional, Zakharova, E., additional, Zaletova, V., additional, Kasatonova, E., additional, Melnik, Y., additional, Efremov, E., additional, Schiewe, M. C., additional, Verheyen, G., additional, Tournaye, H., additional, Phletincx, I., additional, Sims, C. A., additional, Rothman, C., additional, Borges, E., additional, Setti, A. S., additional, Braga, D. P. A. F., additional, Vingris, L., additional, Iaconelli, A., additional, Dupont, C., additional, Faure, C., additional, Sermondade, N., additional, Gautier, B., additional, Herbemont, C., additional, Aknin, I., additional, Klein, J. P., additional, Cedrin-Durnerin, I., additional, Wolf, J. P., additional, Czernichow, S., additional, Levy, R., additional, Rondanino, C., additional, Chauffour, C., additional, Ouchchane, L., additional, Artonne, C., additional, Janny, L., additional, Lobaccaro, J. M., additional, Volle, D. H., additional, Brugnon, F., additional, Colacurci, N., additional, Piomboni, P., additional, Ruvolo, G., additional, Lombardo, F., additional, Verde, E. L., additional, De Leo, V., additional, Lispi, M., additional, Papaleo, E., additional, De Palo, R., additional, Gandini, L., additional, Longobardi, S., additional, Yokota, Y., additional, Yokota, M., additional, Yokota, H., additional, Araki, Y., additional, Alshahrani, S., additional, Durairajanayagam, D., additional, Sharma, R., additional, Sabanegh, E., additional, Agarwal, A., additional, Hattori, H., additional, Nakajo, Y., additional, Ikeno, T., additional, Sato, Y., additional, Kyoya, T., additional, Kyono, K., additional, Li, B., additional, Li, J. B., additional, Xiao, X. F., additional, Ma, Y. F., additional, Wang, J., additional, Liang, X. X., additional, Zhao, H. X., additional, Jiang, F., additional, Yao, Y. Q., additional, Wang, X. H., additional, Roan, N. R., additional, Liu, H., additional, Muller, J., additional, Avila-Herrera, A., additional, Pollard, K. S., additional, Lishko, P., additional, Kirchhoff, F., additional, Munch, J., additional, Witkowska, H. E., additional, Greene, W. C., additional, Mangiarini, A., additional, Paffoni, A., additional, Restelli, L., additional, Guarneri, C., additional, Somigliana, E., additional, Ragni, G., additional, Bou, R., additional, Aleman, M., additional, Guardiola, F., additional, Camargo, C., additional, Oliveira, J. B. A., additional, Petersen, C. G., additional, Mauri, A. L., additional, Massaro, F. C., additional, Nicoletti, A., additional, Nascimento, A. M., additional, Vagnini, L. D., additional, Martins, A. M. V. C., additional, Cavagna, M., additional, Baruffi, R. L. R., additional, and Franco, J. G., additional

Published
2013
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66. POSTER VIEWING SESSION - ANDROLOGY

Author

Dul, E. C., primary, van Ravenswaaij-Arts, C. M. A., additional, Groen, H., additional, van Echten-Arends, J., additional, Land, J. A., additional, Tyulenev, Y., additional, Naumenko, V., additional, Kurilo, L., additional, Shileiko, L., additional, Segal, A., additional, Klimova, R., additional, Kushch, A., additional, Ribas-Maynou, J., additional, Garcia-Peiro, A., additional, Abad, C., additional, Amengual, M. J., additional, Benet, J., additional, Navarro, J., additional, Colasante, A., additional, Lobascio, A. M., additional, Scarselli, F., additional, Minasi, M. G., additional, Alviggi, E., additional, Rubino, P., additional, Casciani, V., additional, Pena, R., additional, Varricchio, M. T., additional, Litwicka, K., additional, Ferrero, S., additional, Zavaglia, D., additional, Franco, G., additional, Nagy, Z. P., additional, Greco, E., additional, Romany, L., additional, Meseguer, M., additional, Garcia-Herrero, S., additional, Pellicer, A., additional, Garrido, N., additional, Dam, A., additional, Pijnenburg, A., additional, Hendriks, J. C., additional, Westphal, J. R., additional, Ramos, L., additional, Kremer, J. A. M., additional, Eertmans, F., additional, Bogaert, V., additional, Puype, B., additional, Geisler, W., additional, Clusmann, C., additional, Klopsch, I., additional, Strowitzki, T., additional, Eggert-Kruse, W., additional, Maettner, R., additional, Isachenko, E., additional, Isachenko, V., additional, Strehler, E., additional, Sterzik, K., additional, Band, G., additional, Madgar, I., additional, Brietbart, H., additional, Naor, Z., additional, Cunha-Filho, J. S., additional, Souza, C. A., additional, Krebs, V. G., additional, Santos, K. D., additional, Koff, W. J., additional, Stein, A., additional, Hammoud, I., additional, Albert, M., additional, Bergere, M., additional, Bailly, M., additional, Boitrelle, F., additional, Vialard, F., additional, Wainer, R., additional, Izard, V., additional, Selva, J., additional, Cohen - Bacrie, P., additional, Belloc, S., additional, de mouzon, J., additional, Cohen-Bacrie, M., additional, Alvarez, S., additional, Junca, A. M., additional, Dumont, M., additional, Douard, S., additional, Prisant, N., additional, Tomita, K., additional, Hashimoto, S., additional, Akamatsu, Y., additional, Satoh, M., additional, Mori, R., additional, Inoue, T., additional, Ohnishi, Y., additional, Ito, K., additional, Nakaoka, Y., additional, Morimoto, Y., additional, Smith, V. J. H., additional, Ahuja, K. K., additional, Atig, F., additional, Raffa, M., additional, Sfar, M. T., additional, Saad, A., additional, Ajina, M., additional, Braga, D. P. A. F., additional, Halpern, G., additional, Figueira, R. C. S., additional, Setti, A. S., additional, Iaconelli Jr., A., additional, Borges Jr., E., additional, Medeiros, G. S., additional, Pasqualotto, E. B., additional, Pasqualotto, F. F., additional, Nadalini, M., additional, Tarozzi, N., additional, Di Santo, M., additional, Borini, A., additional, Lopez-Fernandez, C., additional, Arroyo, F., additional, Caballero, P., additional, Nunez-Calonge, R., additional, Fernandez, J. L., additional, Gosalvez, J., additional, Gosalbez, A., additional, Cortes, S., additional, Zikopoulos, K., additional, Lazaros, L., additional, Vartholomatos, G., additional, Kaponis, A., additional, Makrydimas, G., additional, Plachouras, N., additional, Sofikitis, N., additional, Kalantaridou, S., additional, Hatzi, E., additional, Georgiou, I., additional, de Mouzon, J., additional, Amar, E., additional, Cohen-Bacrie, P., additional, Vuillaume, M. L., additional, Brugnon, F., additional, Artonne, C., additional, Janny, L., additional, Pons-Rejraji, H., additional, Fedder, J., additional, Bosco, L., additional, Ruvolo, G., additional, Bruccoleri, A. M., additional, Manno, M., additional, Roccheri, M. C., additional, Cittadini, E., additional, Bochev, I., additional, Gavrilov, P., additional, Kyurkchiev, S., additional, Shterev, A., additional, Carlomagno, G., additional, Colone, M., additional, Condorelli, R. A., additional, Stringaro, A., additional, Calogero, A. E., additional, Zakova, J., additional, Kralikova, M., additional, Crha, I., additional, Ventruba, P., additional, Melounova, J., additional, Matejovicova, M., additional, Vodova, M., additional, Lousova, E., additional, Sanchez Toledo, M., additional, Alvarez LLeo, C., additional, Garcia Garrido, C., additional, Resta Serra, M., additional, Belmonte Andujar, L. L., additional, Gonzalez de Merlo, G., additional, Pohanka, M., additional, Huser, M., additional, Amiri, I., additional, Karimi, J., additional, Goodarzi, M. T., additional, Tavilani, H., additional, Filannino, A., additional, Magli, M. C., additional, Boudjema, E., additional, Crippa, A., additional, Ferraretti, A. P., additional, Gianaroli, L., additional, Robles, F., additional, Huang, H., additional, Yao, D. J., additional, Huang, H. J., additional, Li, J. R., additional, Fan, S. K., additional, Wang, M. L., additional, Yung-Kuei, S., additional, Amer, S., additional, Mahran, A., additional, Darne, J., additional, Shaw, R., additional, Borghi, E., additional, Cetera, C., additional, Shukla, U., additional, Ogutu, D., additional, Deval, B., additional, Jansa, M., additional, Savvas, M., additional, Narvekar, N., additional, Houska, P., additional, Dackland, A. 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A., additional, Carreras, R., additional, Brassesco, M., additional, Oneta, M., additional, Savasi, V., additional, Parrilla, B., additional, Guarneri, D., additional, Laureti, A., additional, Pagano, F., additional, Cetin, I., additional, Ekwurtzel, E., additional, Morgante, G., additional, Piomboni, P., additional, Stendardi, A., additional, Serafini, F., additional, De Leo, V., additional, Focarelli, R., additional, Benkhalifa, M., additional, De Mouzon, J., additional, Entezami, F., additional, Junca, A., additional, De Mouzon, J. J., additional, Mangiarini, A., additional, Capitanio, E., additional, Paffoni, A., additional, Restelli, L., additional, Guarneri, C., additional, Scarduelli, C., additional, Ragni, G., additional, Harrison, K., additional, Irving, J., additional, Martin, N., additional, Sherrin, D., additional, Yazdani, A., additional, Almeida, C., additional, Correia, S., additional, Rocha, E., additional, Alves, A., additional, Cunha, M., additional, Ferraz, L., additional, Silva, S., additional, Sousa, M., additional, Barros, A., additional, Perdrix, A., additional, Travers, A., additional, Milazzo, J. P., additional, Clatot, F., additional, Mousset-Simeon, N., additional, Mace, B., additional, Rives, N., additional, Clarke, H. S., additional, Callow, A., additional, Saxton, D., additional, Pacey, A. A., additional, Sapir, O., additional, Oron, G., additional, Ben-Haroush, A., additional, Garor, R., additional, Feldberg, D., additional, Pinkas, H., additional, Wertheimer, A., additional, Fisch, B., additional, Palacios, E., additional, Gonzalvo, M. C., additional, Clavero, A., additional, Ramirez, J. P., additional, Rosales, A., additional, Mozas, J., additional, Castilla, J. A., additional, Mugica, J., additional, Ramon, O., additional, Valdivia, A., additional, Exposito, A., additional, Casis, L., additional, Matorras, R., additional, Bongers, R., additional, Gottardo, F., additional, Zitzmann, M., additional, Kliesch, S., additional, Cordes, T., additional, Kamischke, A., additional, Schultze-Mosgau, A., additional, Buendgen, N., additional, Diedrich, K., additional, Griesinger, G., additional, Crisol, L., additional, Aspichueta, F., additional, Hernandez, M. L., additional, Ruiz-Sanz, J. I., additional, Mendoza, R., additional, Sanchez-Tusie, A. A., additional, Bermudez, A., additional, Lopez, P., additional, Churchill, G. C., additional, Trevino, C. L., additional, Maldonado, I., additional, and Dabbah, J., additional

Published
2011
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67. SELECTED ORAL COMMUNICATION SESSION, SESSION 35: ENDOMETRIOSIS, Tuesday 5 July 2011 10:00 - 11:30

Author

Moulin, J., primary, Marszalek, A., additional, Gayet, V., additional, Blanchet, V., additional, Streuli, I., additional, Lafay, M., additional, Pont, J. C., additional, Chapron, C., additional, De Ziegler, D., additional, Moolenaar, L. M., additional, Verhoeve, H. R., additional, van der Veen, F., additional, Hompes, P., additional, Mol, B. W. J., additional, Savasi, V., additional, Oneta, M., additional, Elli, M., additional, Parilla, B., additional, Loareti, A., additional, Cetin, I., additional, Shapiro, B. S., additional, Daneshmand, S. T., additional, Garner, F. C., additional, Aguirre, M., additional, Hudson, C., additional, Thomas, S., additional, Simsek, Y., additional, Celik, O., additional, Yilmaz, E., additional, Karaer, A., additional, Koc, O., additional, Aydin, N. E., additional, Rodriguez, S., additional, Agudo, D., additional, Pacheco, A., additional, Garcia-Cerrudo, E., additional, Schneider, J., additional, and Garcia-Velasco, J. A., additional

Published
2011
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78. Assisted reproductive technologies and uterine factors influencing their success.

Author

SAVASI, V., LEONE, F. P. G., FUSÈ, F., PARISI, F., and CETIN, I.

Subjects
REPRODUCTIVE technology research, UTERUS physiology, HYSTEROSCOPIC sterilization, HUMAN fertility, MYOMECTOMY
Abstract

The article discusses a study on the role of uterus and its anomalies in influencing reproductive and assisted reproductive technology (ART) outcomes. Topics discussed include congenital uterine anomalies, acquired uterine factors, and factors affecting the potential influence of myomectomy on fertility outcomes. Also mentioned are the positive effects of hysteroscopic polipectomy on fertility and the importance of detailed evaluation of uterine cavity in infertile women.

Published
2013

81. Levels and patterns of HIV RNA viral load in untreated pregnant women

Author

Patel, D, Thorne, C, Newell, Ml, CORTINA BORJA, M, Giaquinto, Carlo, Rampon, O, D'Elia, R, DE ROSSI, Anita, GROSCH WORNER, I, Mok, J, DE JOSE MI, Martinez, Bl, Pena, Jm, Garcia, Jg, Lopez, Jra, GARCIA RODRIGUEZ, J, ASENSI BOTET, F, Otero, Mc, PEREZ TAMARIT, D, Scherpbier, Hj, Kreyenbroek, M, Godfried, Mh, Nellen, Fjb, Boer, K, Ehrnst, A, Bohlin, Ab, Lindgren, S, Anzen, B, Lidman, K, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Ferrazin, A, Viscoli, C, DE MARIA, A, Bentivoglio, G, Ferrero, S, Gotta, C, Mur, A, Paya, A, LOPEZ VILCHEZ MA, Carreras, R, Valerius, Nh, Rosenfeldt, V, Jimenez, J, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguna, J, Caro, Mc, Canet, Y, Ravizza, M, Guerra, B, Lanari, M, Bianchi, S, Bovicelli, L, Prati, E, Duse, M, Scaravelli, G, Stegagno, M, DE SANTIS, M, Savasi, V, Fiore, S, Crivelli, M, Ferrazzi, E, Vigano, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Probizer, Fr, Maccabruni, A, Bucceri, A, Rancilio, L, Alberico, S, Rabusin, M, Bernardon, M, Taylor, Gp, Lyall, Egh, Penn, Z, Buffolano, W, Tiseo, R, Martinelli, A, Sansone, M, Maruotti, G, Agangi, A, Tibaldi, C, Marini, S, Masuelli, G, Benedetto, C, Niemiec, T, Marczynska, M, Dobosz, S, Popielska, J, Oldakowska, A, Malyuta, R, Semenenko, I, Pilipenko, T, Posokhova, S, Kaleeva, T, Stelmah, A, Kiseleva, G., European Collaborative Study, Patel D, Thorne C, Newell ML, Cortina-Borja M [, Guerra B, Lanari M ], Amsterdam institute for Infection and Immunity, Paediatric Infectious Diseases / Rheumatology / Immunology, General Internal Medicine, Infectious diseases, Other Research, and Obstetrics and Gynaecology

Subjects
Microbiology (medical), Adult, medicine.medical_specialty, Race, Adolescent, Black People, Gestational Age, HIV Infections, Disease, White People, HIV, Pregnancy, HIV RNA viral load, ART-naïve, Young Adult, Asian People, pregnancy, Medicine, Humans, Young adult, Pregnancy Complications, Infectious, business.industry, Obstetrics, Confounding, RNA, Gestational age, General Medicine, Viral Load, medicine.disease, CD4 Lymphocyte Count, hiv, art-naïve, hiv rna viral load, race, art-naive, Infectious Diseases, Immunology, HIV-1, RNA, Viral, Female, Sample collection, business, Viral load
Abstract

Objective: To assess pregnancy levels and patterns of HIV RNA in the absence of antiretroviral therapy, while appropriately adjusting for potential confounders, including maternal immune status and race. Methods: Data on >= 1 antenatal HIV RNA measurements were available for 333 untreated HIV-infected pregnant women enrolled in the European Collaborative Study. CD4 counts and HIV RNA measurements were routinely collected from 1992 and 1998, respectively. Linear mixed effects models based on 246 women for whom complete data were available examined changes in HIV RNA levels over pregnancy, with a nested random effects term accounting for measurement variability within women and period of sample collection. Results: The change in HIV RNA over pregnancy varied significantly by race (p = 0.005): from the second trimester until delivery, HIV RNA decreased significantly by an estimated 0.019 log(10) copies/ml/week in white women (95% Cl -0.03, -0.007); in black women the estimated 0.016 log(10) copies/ml/week increase (95% Cl -0.005, 0.037) was not statistically significant. At delivery, HIV RNA levels in black women were 0.45 log(10) copies/ml higher (95% Cl 0.08, 0.83) than in white women. Conclusions: Our findings suggest that HIV RNA dynamics over pregnancy differ by race, although other interpretations cannot be excluded, due to potential for unmeasured confounding. (C) 2008 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved

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82. Mother-to-child transmission of HIV infection in the era of highly active antiretroviral therapy

Author

Giaquinto, C., Ruga, E., Anita De Rossi, Grosch-Worner, I., Mok, J., Jose, I., Bates, I., Hawkins, F., Guevara, C. L., Pena, J. M., Garcia, J. G., Lopez, J. R. A., Garcia-Rodriguez, M. C., Asensi-Botet, F., Otero, M. C., Perez-Tamarit, D. P., Suarez, G., Scherpbier, H., Kreyenbroek, M., Boer, K., Bohlin, A. B., Lindgren, S., Ehrnst, A., Belfrage, E., Naver, L., Lidman, K., Anzen, B., Levy, J., Barlow, P., Hainaut, M., Peltier, A., Goetghebuer, T., Ferrazin, A., Bassetti, D., Maria, A., Gotta, C., Mur, A., Paya, A., Vinolas, M., Lopez-Vilchez, M. A., Rovira, Carreras, R., Valerius, N. H., Jimenez, J., Coll, O., Suy, A., Perez, J. M., Fortuny, C., Caro, M. C., Canet, Y., Savasi, V., Vigano, A., Ferrazi, E., Alberico, S., Rabusin, M., Bernardon, M., Taylor, G. P., Lyall, E. G. H., Penn, Z., Buffolano, W., Tiseo, R., Martinelli, P., Agangi, A., Sansone, M., Tibaldi, C., Marini, S., Masuelli, G., Benedetto, C., Niemiec, T., Marczynska, M., Horban, A., and European Collaborative, Study

84. Consequences of presentation with advanced HIV disease in pregnancy: Data from a national study in Italy

Author

Floridia, M., Tamburrini, E., Masuelli, G., Guaraldi, G., Molinari, A., Cetin, I., Dalzero, S., Spinillo, A., Liuzzi, G., Pinnetti, C., Vicini, I., Castelli, P., Sacchi, V., Ravizza, M., Mori, F., Ortolani, P., Dalle Nogare, E. R., Di Lorenzo, F., Sterrantino, G., Meli, M., Polemi, S., Nocentini, J., Baldini, M., Montorzi, G., Mazzetti, M., Rogasi, P., Borchi, B., Vichi, F., Del Pin, B., Pinter, E., Anzalone, E., Marocco, R., Claudio Maria MASTROIANNI, Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Raponi, G. N., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Fabiano, V., Coletto, S., Di Nello, F., Placido, G., Vivarelli, A., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Grossi, P., Rizzi, L., Alberico, S., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Vicini, I. B., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., Gennaro, A., Guerra, B., Cervi, F., Puccetti, C., Margarito, E., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundarò, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Finelli, V., Cellini, M., Gattinara, G. C., Marconi, A. M., Pirro, A., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Cerioli, A., Martino, M., Mastroiacovo, P., Moroni, M., Parazzini, F., and Vella, S.

85. The mother-to-child HIV transmission epidemic in Europe: evolving in the East and established in the West

Author

Giaquinto, C., Rampon, O., D Elia, R., Anita De Rossi, Grosch-Woerner, I., Feiterna-Sperling, C., Schmitz, T., Casteleyn, S., Mok, J., Jose, I., Bates, I., Larru, B., Pena, J. M., Garcia, J. Gonzalez, Lopez, J. R. Arribas, Garcia-Rodriguez, M. C., Asensi-Botet, F., Otero, M. C., Perez-Tamarit, D., Suarez, G., Scherpbier, H., Kreyenbroek, M., Godfried, M. H., Nellen, F. J., Boer, K., Bohlin, A. B., Lindgren, S., Belfrage, E., Naver, L., Anzen, B., Lidman, K., Levy, J., Hainaut, M., Goetghebuer, T., Manigart, Y., Barlow, P., Ferrazin, A., Bassetti, D., Maria, A., Bentivoglio, G., Ferrero, S., Gotta, C., Mur, A., Paya, A., Lopez-Vilchez, M. A., Carreras, R., Valerius, N. H., Jimenez, J., Coll, O., Suy, A., Perez, J. M., Fortuny, C., Boguna, J., Caro, M. Casellas, Canet, Y., Pardi, G., Ravizza, M., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Prati, E., Duse, M., Scaravelli, G., Stegagno, M., Santis, M., Savasi, V., Ferrazzi, E., Vigano, A., Giacomet, V., Probizer, F. Ravagni, Maccabruni, A., Bucceri, A., Rancilio, L., Alberico, S., Rabusin, M., Bernardon, M., Taylor, G. P., Lyall, E. G. H., Penn, Z., Buffolano, W., Tiseo, R., Martinelli, P., Sansone, M., Agangi, A., Tibaldi, C., Marini, S., Masuelli, G., Benedetto, C., Niemiec, T., Marczynska, M., Oldakowska, A., Kaflik, M., Posokhova, S., Kaleeva, T., Stelmah, A., Kiseleva, G., and European Collaborative, Study

86. Assisted reproductive technologies and uterine factors influencing their success

Author

Savasi, V., Leone, F. P. G., Fusè, F., Parisi, F., and IRENE CETIN

Subjects
Uterine Diseases, Pregnancy Rate, Reproductive Techniques, Assisted, Pregnancy, Uterine Myomectomy, Uterus, Humans, Female, Embryo Implantation, Hysteroscopy, Infertility, Female
Abstract

Congenital and acquired uterine factors are known to influence the success of assisted reproductive technologies (ARTs). Several studies analyzed the role of uterine septa, adenomyosis, myomas, endometrial polyps and intrauterine adhesions in female infertility. All of them might cause defective endometrial receptivity and consequently decreased embryo implantation and pregnancy rate. In particular, septate uterus represents the most frequent Müllerian anomaly leading to an increased risk of abortion. Many studies evaluated the role of hysteroscopic metroplasty on fertility outcomes, but this topic remains controversial. The role of adenomyosis in infertility is still debated and, even if different mechanisms have been described to explain implantation failure, there are still conflicting findings on the impact of adenomyosis on ART. The effects of myomas on fertility mainly depend on their type, so that submucous have a detrimental impact on fertility, subserous seem to have no effect, while there is no clear consensus regarding the effect of intramural. Consequently, the potential influence of myomectomy on fertility outcomes depends on the type, being mandatory only the hysteroscopic treatment of submucous myomas. The effect of endometrial polyps on endometrial receptivity and fertility is not clear, even if some studies identified improvement in pregnancy rates after hysteroscopic polipectomy. In presence of intrauterine adhesions, infertility represents the most common manifestation and the restoring of normal uterine cavity should be always pursued when possible.

87. Exposure to antiretroviral therapy in utero or early life: the health of uninfected children born to HIV-infected women

Author

European Collaborative Study, Newell, Ml, Giaquinto, C., Ruga, E., Rossi, A., Grosch-Worner, I., Mok, J., Johnstone, F., Jose, I., Bates, I., Salas, S., Guevara, Cl, Pena, Jm, Garcia, Jg, Lopez, Jra, Garcia-Rodriguez, Mc, Asensi-Botet, F., Otero, Mc, Perez-Tamarit, D., Ridaura, S., Gregori, P., La Torre, R., Scherpbier, H., Kreyenbroek, M., Boer, K., Bohlin, Ab, Lindgren, S., Ehrnst, A., Belfrage, E., Lars Naver, Levy, J., Barlow, P., Hainaut, M., Peltier, A., Wibaut, S., Ferrazin, A., Bassetti, D., Maria, A., Gotta, C., Mur, A., Paya, A., Vinolas, M., Lopez-Vilchez, Ma, Rovira, Ma, Carreras, R., Valerius, Nh, Coll, O., Vidal, R., Perez, Jm, Boguna, J., Fortuny, C., Pardi, G., Ravizza, M., Guerra, B., Lanari, M., Bianchi, S., Bovicelli, L., Savasi, V., Vigano, A., Ferrazzi, E., Brambilla, T., Bianchi, L., Maccabruni, A., Taylor, Gp, Lyall, Egh, Penn, Z., Buffolano, W., Martinelli, P., Sansone, M., Tibaldi, C., Marini, C., Masuelli, G., Benedetto, C., Niemiec, T., and Marczynska, M.

88. Evolving treatment implementation among HIV- infected pregnant women and their partners: Results from a national surveillance study in Italy, 2001-2015

Author

Floridia, M., Frisina, V. b., Ravizza, M., Marconi, A. M., Pinnetti, C., Cetin, I., Sansone, M., Molinari, A., Cervi, F., Meloni, A., Luzi, K., Masuelli, G., Tamburrini, E., Ensoli, B., Moroni, M., Lazzarin, A., Sagnelli, E., Antinori, A., Carosi, G., Marcotullio, S., Mazzotta, F., Vella, S., Ammassari, A., Antonucci, G., Andreoni, M., Angarano, G., Armignacco, O., Babudieri, S., Baldelli, F., Bini, T., Bonfanti, Bonora, P., Borderi, S., Bruno, M., Bucciardini, R., Castagna, R, Cattelan, A., Cauda, A. M., Cerioli, R., Chirianni, A., Cingolani, A., Cinque, A., D'Arminio, Monforte, Carli, De, Luca, De, Perri, Di, Pietro, Di, Hamad, El, Errico, I., Ferrazzi, M., Gabrielli, E., Galli, E., Giaquinto, M., Girardi, C., Gori, E., Grossi, A., Guaraldi, P., Liuzzi, G., Caputo, Lo, Maggiolo, S., Malena, F., Maserati, M., Mastroianni, R., Matteelli, C., Morrone, A., Murri, A., Mussini, R., Nasta, C., Oldrini, P., Oleari, M., Orlando, F., Palù, G., Pempinello, G., Perno, R., Prestileo, C., Pompa, T., Puoti, M. G., Puro, M., Rancilio, V., Rasi, L., Rizzardini, G., Savasi, G., Signorini, V. M., Sighinolfi, L., Stagnitta, L., Starace, M., Starnini, F., Sterrantino, G., Suter, G., Tambussi, F., Tavio, G., Torti, M., Tozzi, C., Trotta, V., Vaccher, M. P., Viganò, E., Visintini, A., Vullo, R., Zuccotti, V., Dell'Isola, G. V., Manfredini, S., Parisi, V., Pezzoli, S., M. C., Floridia, M, Frisina, V, Ravizza, M, Marconi, A, Pinnetti, C, Cetin, I, Sansone, M, Molinari, A, Cervi, F, Meloni, A, Luzi, K, Masuelli, G, Tamburrini, E, Ensoli, B, Moroni, M, Lazzarin, A, Sagnelli, E, Antinori, A, Carosi, G, Marcotullio, S, Mazzotta, F, Vella, S, Ammassari, A, Antonucci, G, Andreoni, M, Angarano, G, Armignacco, O, Babudieri, S, Baldelli, F, Bini, T, Bonfanti, P, Bonora, S, Borderi, M, Bruno, R, Bucciardini, R, Castagna, A, Cattelan, A, Cauda, R, Cerioli, A, Chirianni, A, Cingolani, A, Cinque, P, d'Arminio Monforte, A, De Carli, G, De Luca, A, Di Perri, G, Di Pietro, M, El Hamad, I, Errico, M, Ferrazzi, E, Gabrielli, E, Galli, M, Giaquinto, C, Girardi, E, Gori, A, Grossi, P, Guaraldi, G, Liuzzi, G, Lo Caputo, S, Maggiolo, F, Malena, M, Maserati, R, Mastroianni, C, Matteelli, A, Morrone, A, Murri, R, Mussini, C, Nasta, P, Oldrini, M, Oleari, F, Orlando, G, Palu, G, Pempinello, R, Perno, C, Prestileo, T, Pompa, M, Puoti, M, Puro, V, Rancilio, L, Rasi, G, Rizzardini, G, Savasi, V, Signorini, L, Sighinolfi, L, Stagnitta, M, Starace, F, Starnini, G, Sterrantino, G, Suter, F, Tambussi, G, Tavio, M, Torti, C, Tozzi, V, Trotta, M, Vaccher, E, Vigano, A, Visintini, R, Vullo, V, Zuccotti, G, Dell'Isola, S, Manfredini, V, Parisi, S, Pezzoli, M, Zona, S, Floridia, M., Frisina, V., Ravizza, M., Marconi, A. M., Pinnetti, C., Cetin, I., Sansone, M., Molinari, A., Cervi, F., Meloni, A., Luzi, K., Masuelli, G., Tamburrini, E., Ensoli, B., Moroni, M., Lazzarin, A., Sagnelli, E., Antinori, A., Carosi, G., Marcotullio, S., Mazzotta, F., Vella, S., Ammassari, A., Antonucci, G., Andreoni, M., Angarano, G., Armignacco, O., Babudieri, S., Baldelli, F., Bini, T., Bonfanti, P., Bonora, S., Borderi, M., Bruno, R., Bucciardini, R., Castagna, A., Cattelan, A. M., Cauda, R., Cerioli, A., Chirianni, A., Cingolani, A., Cinque, P., d'Arminio Monforte, A., De Carli, G., De Luca, A., Di Perri, G., Di Pietro, M., El Hamad, I., Errico, M., Ferrazzi, E., Gabrielli, E., Galli, M., Giaquinto, C., Girardi, E., Gori, A., Grossi, P., Guaraldi, G., Liuzzi, G., Lo Caputo, S., Maggiolo, F., Malena, M., Maserati, R., Mastroianni, C., Matteelli, A., Morrone, A., Murri, R., Mussini, C., Nasta, P., Oldrini, M., Oleari, F., Orlando, G., Palu, G., Pempinello, R., Perno, C. -F., Prestileo, T., Pompa, M. G., Puoti, M., Puro, V., Rancilio, L., Rasi, G., Rizzardini, G., Savasi, V. M., Signorini, L., Sighinolfi, L., Stagnitta, M., Starace, F., Starnini, G., Sterrantino, G., Suter, F., Tambussi, G., Tavio, M., Torti, C., Tozzi, V., Trotta, M. P., Vaccher, E., Vigano, A., Visintini, R., Vullo, V., Zuccotti, G. V., Dell'Isola, S., Manfredini, V., Parisi, S., Pezzoli, M. C., and Zona, S.

Subjects
0301 basic medicine, Male, Infectious Disease Transmission, HIV Infections, Pre-Exposure Prophylaxi, Miscarriage, Cohort Studies, Pre-exposure prophylaxis, 0302 clinical medicine, Pregnancy, Prevalence, Medicine, Vertical, HIV Infection, 030212 general & internal medicine, Pregnancy Complications, Infectious, Treatment implementation, Obstetrics, Health Policy, Medicine (all), Infectious, Pregnancy Outcome, Articles, 3. Good health, Sexual Partner, Sexual Partners, Italy, Serodiscordant, Chemoprophylaxis, Female, Live birth, Adolescent, Adult, Anti-HIV Agents, Fertilization, Humans, Infectious Disease Transmission, Vertical, Pre-Exposure Prophylaxis, Cohort study, Human, medicine.medical_specialty, 03 medical and health sciences, Environmental health, business.industry, Public Health, Environmental and Occupational Health, Anti-HIV Agent, medicine.disease, 030112 virology, Pregnancy Complications, Pregnancy Complications, Infectiou, Cohort Studie, business
Abstract

Background The current global and national indications for antiretroviral treatment (ART, usually triple combination therapy) in adolescent and adults, including pregnant women, recommend early ART before immunologic decline, pre-exposure chemoprophylaxis (PrEP), and treatment of HIV-negative partners in serodiscordant couples. There is limited information on the implementation of these recommendations among pregnant women with HIV and their partners. Methods The present analysis was performed in 2016, using data from clinical records of pregnant women with HIV, followed between 2001 and 2015 at hospital or university clinics within a large, nationally representative Italian cohort study. The study period was divided in three intervals of five years each (2001-2005, 2006-2010, 2011-2015), and the analysis evaluated temporal trends in rates of HIV diagnosis in pregnancy, maternal antiretroviral treatment at conception, prevalence of HIV infection among partners of pregnant women with HIV, and proportion of seronegative and seropositive male partners receiving antiretroviral treatment. Results The analysis included 2755 pregnancies in women with HIV. During the three time intervals considered the rate of HIV diagnosis in pregnancy (overall 23.3%), and the distribution of HIV status among male partners (overall 48.7% HIV- negative, 28.6% HIV-positive and 22.8% unknown) remained substantially unchanged. Significant increases were observed in the proportion of women with HIV diagnosed before pregnancy who were on antiretroviral treatment at conception (from 62.0% in 2001-2005 to 81.3% in 2011-2015, P < 0.001), and in the proportion of HIV-positive partners on antiretroviral treatment (from 73.3% in 2001-2005 to 95.8% in 2011-2015, P = 0.002). Antiretroviral treatment was administered in 99.1% of the pregnancies that did not end early because of miscarriage, termination, or intrauterine death, and in 75.3% of those not ending in a live birth. No implementation of antiretroviral treatment was introduced among male HIV-negative partners. Conclusions The results suggest good implementation of antiretroviral treatment among HIV-positive women and their HIV-positive partners, but no implementation, even in recent years, of Pre-Exposure Prophylaxis (PrEP) among uninfected male partners. Further studies should assess the determinants of this occurrence and clarify the attitudes and the potential barriers to PrEP use.

Published
2017

89. SARS‐CoV‐2 infection among hospitalised pregnant women and impact of different viral strains on COVID‐19 severity in Italy: a national prospective population‐based cohort study

Author

Donati, S, Corsi, E, Maraschini, A, Salvatore, M A, Maria Grazia Arena, Rosaria, Boldrini, Roberto, Brunelli, Angelo, Cagnacci, Paola, Casucci, Irene, Cetin, Luigi, Cobellis, Gabriella, Dardanoni, Elena De Ambrosi, Martina Del Manso, Sara, D'Eusanio, Lorenza, Driul, Giorgio, Epicoco, Massimo, Fabiani, Franchi, Massimo Piergiuseppe, Livio, Leo, Marco, Liberati, Mariavittoria, Locci, Antonino Lo Re, Claudio, Martini, Gianpaolo, Maso, Federico, Mecacci, Alessandra, Meloni, Anna Domenica Mignuoli, Luisa, Mondo, Enrica, Perrone, Lucia, Porcino, Luca, Ramenghi, Valeria, Savasi, Sergio Crescenzo Antonio Schettini, Gabriella, Scorpio, Daniela, Simeone, Serena, Simeone, Martin, Steinkasserer, Fabrizio, Taddei, Saverio, Tateo, Vito, Trojano, Caterina, Tronci, Antonella, Vimercati, Donati, S., Corsi, E., Maraschini, A., Salvatore, M. A., Arena, M. G., Boldrini, R., Brunelli, R., Cagnacci, A., Casucci, P., Cetin, I., Cobellis, L., Dardanoni, G., De Ambrosi, E., Del Manso, M., D'Eusanio, S., Driul, L., Epicoco, G., Fabiani, M., Franchi, M. P., Leo, L., Liberati, M., Locci, M., Lo Re, A., Martini, C., Maso, G., Mecacci, F., Meloni, A., Mignuoli, A. D., Mondo, L., Perrone, E., Porcino, L., Ramenghi, L., Savasi, V., Schettini, S. C. A., Scorpio, G., Simeone, D., Simeone, S., Steinkasserer, M., Taddei, F., Tateo, S., Trojano, V., Tronci, C., Vimercati, A., S., Donati, E., Corsi, A., Maraschini, M. A., Salvatore, and Cobellis, Luigi

Subjects
Pediatrics, Comorbidity, Severity of Illness Index, SARS‐CoV‐2, law.invention, COVID-19 Testing, Risk Factors, Pregnancy, law, Pregnancy Complications, Infectious, Prospective cohort study, Research Articles, education.field_of_study, Infectious, Pregnancy Outcome, Obstetrics and Gynecology, Intensive care unit, Hospitals, Hospitalization, Intensive Care Units, Italy, Cohort, Premature Birth, Cohort studies, Female, medicine.symptom, Human, Research Article, Cohort study, Adult, medicine.medical_specialty, Maternity, Intensive Care Unit, Population, Hospitals, Maternity, Risk Assessment, Asymptomatic, medicine, Humans, COVID-19 pneumonia, education, SARS-CoV-2, business.industry, Risk Factor, COVID-19, medicine.disease, Pregnancy Complications, pregnancy, Cohort Studies, Pneumonia, Pregnancy Complications, Infectiou, Mini Commentary, Pregnant Women, Cohort Studie, business, COVID‐19 pneumonia
Abstract

Objective The primary aim of this article was to describe SARS‐CoV‐2 infection among pregnant women during the wild‐type and Alpha‐variant periods in Italy. The secondary aim was to compare the impact of the virus variants on the severity of maternal and perinatal outcomes. Design National population‐based prospective cohort study. Setting A total of 315 Italian maternity hospitals. Sample A cohort of 3306 women with SARS‐CoV‐2 infection confirmed within 7 days of hospital admission. Methods Cases were prospectively reported by trained clinicians for each participating maternity unit. Data were described by univariate and multivariate analyses. Main outcome measures COVID‐19 pneumonia, ventilatory support, intensive care unit (ICU) admission, mode of delivery, preterm birth, stillbirth, and maternal and neonatal mortality. Results We found that 64.3% of the cohort was asymptomatic, 12.8% developed COVID‐19 pneumonia and 3.3% required ventilatory support and/or ICU admission. Maternal age of 30–34 years (OR 1.43, 95% CI 1.09–1.87) and ≥35 years (OR 1.62, 95% CI 1.23–2.13), citizenship of countries with high migration pressure (OR 1.75, 95% CI 1.36–2.25), previous comorbidities (OR 1.49, 95% CI 1.13–1.98) and obesity (OR 1.72, 95% CI 1.29–2.27) were all associated with a higher occurrence of pneumonia. The preterm birth rate was 11.1%. In comparison with the pre‐pandemic period, stillbirths and maternal and neonatal deaths remained stable. The need for ventilatory support and/or ICU admission among women with pneumonia increased during the Alpha‐variant period compared with the wild‐type period (OR 3.24, 95% CI 1.99–5.28). Conclusions Our results are consistent with a low risk of severe COVID‐19 disease among pregnant women and with rare adverse perinatal outcomes. During the Alpha‐variant period there was a significant increase of severe COVID‐19 illness. Further research is needed to describe the impact of different SARS‐CoV‐2 viral strains on maternal and perinatal outcomes., Tweetable abstract The rate of severe COVID‐19 disease increased during the Alpha‐variant period compared with the wild‐type period.

Published
2021
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90. Placental Pathology in COVID-19 Affected Pregnant Women: a Prospective Case-Control Study

Author

Irene Cetin, Valeria Savasi, Chiara Tasca, Emilio Caselli, Manuela Nebuloni, Roberta Simona Rossi, Patrizia Vergani, G.M. Anelli, Federica Brunetti, Manuela Cardellicchio, Silvia Corti, Cristina Tonello, Tasca, C, Rossi, R, Corti, S, Anelli, G, Savasi, V, Brunetti, F, Cardellicchio, M, Caselli, E, Tonello, C, Vergani, P, Nebuloni, M, and Cetin, I

Subjects
0301 basic medicine, placental histological lesions, MVM, maternal vascular malperfusion, Placenta, BMI, body mass index, Physiology, Umbilical cord, 0302 clinical medicine, Medicine, Prospective Studies, PTL, pre-term labor, Pregnancy Complications, Infectious, Prospective cohort study, Asymptomatic Infections, NICU, neonatal intensive care unit, 030219 obstetrics & reproductive medicine, Obstetrics and Gynecology, PPH, post-partum hemorrhage, COVID-19, SARS-CoV-2 disease 19, medicine.anatomical_structure, IUGR, intrauterine growth restriction, Female, pregnancy, Adult, FVM, fetal vascular malperfusion, Article, PaO₂/FiO₂, arterial oxygen partial pressure / fraction of inspired oxygen, 03 medical and health sciences, Humans, Placental histological lesion, ICP, intrahepatic cholestasis of pregnancy, Fetus, Pregnancy, business.industry, SARS-CoV-2, GDM, gestational diabetes mellitus, SARS-CoV-2 infection, SaO₂, oxygen saturation, Case-control study, Infant, Newborn, COVID-19, Histology, medicine.disease, COVID-19 Drug Treatment, LMWH, low molecular weight heparin, 030104 developmental biology, Reproductive Medicine, Case-Control Studies, business, Body mass index, Developmental Biology
Abstract

Introduction During pregnancy, SARS-CoV-2 infection may cause an abnormal development of the placenta, thus influencing maternal and fetal outcomes. Few studies have reported data on placental morphology and histology in infected pregnant patients, although not compared with carefully matched controls. The aim of this study is to compare placental morphology and histology of pregnant women affected by SARS-CoV-2 to non-infected controls. Methods This is a prospective multicenter case-control study on 64 pregnant women affected by SARS-CoV-2 who delivered at term or late-preterm. Data were collected about pregnancy course, maternal and fetal outcomes, placental biometry and macro- and microscopical morphology. 64 not-infected women were identified as controls, matched by age, body mass index and ethnicity. Results Cases and controls had similar fetal and maternal outcomes. No significant differences were observed in placental macro- or microscopical morphology between the two groups. In the cases treated with antivirals, chloroquine, LMWH or antibiotics, placentas were heavier but not more efficient than the non-treated, since the fetal/placental weight ratio did not differ. Moreover, delayed villous maturation was more frequent in treated women, although not significantly. The newborns whose mothers received oxygen therapy as treatment had higher levels of umbilical cord pO₂ at birth. Discussion In this prospective case-control study, SARS-CoV-2 infection during the third trimester did not influence placental histological pattern. Pharmacological and oxygen therapy administered to women affected by this viral infection could impact maternal and fetal outcomes and be associated to placental histological alterations.

Published
2021

91. Childbirth care among sars-cov-2 positive women in Italy

Author

Donati, Serena, Corsi, Edoardo, Salvatore, Michele, Maraschini, Alice, Bonassisa, Silvia, Casucci, Paola, Cataneo, Ilaria, Cetin, Irene, D’Aloja, Paola, Dardanoni, Gabriella, Ambrosi, Elena De, Ferrazzi, Enrico, Fieni, Stefania, Franchi, Massimo, Gargantini, Gianluigi, Iurlaro, Enrico, Leo, Livio, Liberati, Marco, Livio, Stefania, Locci, Mariavittoria, Marozio, Luca, Martini, Claudio, Maso, Gianpaolo, Mecacci, Federico, Meloni, Alessandra, Mignuoli, Anna, Patanè, Luisa, Pellegrini, Edda, Perotti, Francesca, Perrone, Enrica, Prefumo, Federico, Ramenghi, Luca, Rusciani, Raffaella, Savasi, Valeria, Schettini, Sergio, Simeone, Daniela, Simeone, Serena, Spinillo, Arsenio, Steinkasserer, Martin, Tateo, Saverio, Ternelli, Giliana, Tironi, Roberta, Trojano, Vito, Vergani, Patrizia, Zullino, Sara, Group, on behalf of the ItOSS COVID-19 Working, Donati, Serena, Corsi, Edoardo, Salvatore, Michele Antonio, Maraschini, Alice, Bonassisa, Silvia, Casucci, Paola, Cataneo, Ilaria, Cetin, Irene, D'Aloja, Paola, Dardanoni, Gabriella, De Ambrosi, Elena, Ferrazzi, Enrico, Fieni, Stefania, Franchi, Massimo Piergiuseppe, Gargantini, Gianluigi, Iurlaro, Enrico, Leo, Livio, Liberati, Marco, Livio, Stefania, Locci, Mariavittoria, Marozio, Luca, Martini, Claudio, Maso, Gianpaolo, Mecacci, Federico, Meloni, Alessandra, Mignuoli, Anna Domenica, Patanè, Luisa, Pellegrini, Edda, Perotti, Francesca, Perrone, Enrica, Prefumo, Federico, Ramenghi, Luca, Rusciani, Raffaella, Savasi, Valeria, Schettini, Sergio Crescenzo Antonio, Simeone, Daniela, Simeone, Serena, Spinillo, Arsenio, Steinkasserer, Martin, Tateo, Saverio, Ternelli, Giliana, Tironi, Roberta, Trojano, Vito, Vergani, Patrizia, Zullino, Sara, Donati, S, Corsi, E, Salvatore, M, Maraschini, A, Bonassisa, S, Casucci, P, Cataneo, I, Cetin, I, D'Aloja, P, Dardanoni, G, De Ambrosi, E, Ferrazzi, E, Fieni, S, Franchi, M, Gargantini, G, Iurlaro, E, Leo, L, Liberati, M, Livio, S, Locci, M, Marozio, L, Martini, C, Maso, G, Mecacci, F, Meloni, A, Mignuoli, A, Patane, L, Pellegrini, E, Perotti, F, Perrone, E, Prefumo, F, Ramenghi, L, Rusciani, R, Savasi, V, Schettini, S, Simeone, D, Simeone, S, Spinillo, A, Steinkasserer, M, Tateo, S, Ternelli, G, Tironi, R, Trojano, V, Vergani, P, and Zullino, S

Subjects
Perinatal care, Health, Toxicology and Mutagenesis, medicine.medical_treatment, Infectious Disease Transmission, Breastfeeding, 0302 clinical medicine, Pregnancy, Health care, Childbirth, Vertical, 030212 general & internal medicine, Prospective Studies, Pregnancy Complications, Infectious, Prospective cohort study, Child, education.field_of_study, 030219 obstetrics & reproductive medicine, Obstetrics, Infectious, Italy, Cohort, Medicine, Female, Human, medicine.medical_specialty, Population, Article, 03 medical and health sciences, medicine, Humans, Caesarean section, education, business.industry, SARS-CoV-2, Cesarean Section, Public Health, Environmental and Occupational Health, Infant, Newborn, COVID-19, Infant, medicine.disease, Newborn, Infectious Disease Transmission, Vertical, Pregnancy Complications, Prospective Studie, Birth, business
Abstract

The new coronavirus emergency spread to Italy when little was known about the infection’s impact on mothers and newborns. This study aims to describe the extent to which clinical practice has protected childbirth physiology and preserved the mother–child bond during the first wave of the pandemic in Italy. A national population-based prospective cohort study was performed enrolling women with confirmed SARS-CoV-2 infection admitted for childbirth to any Italian hospital from 25 February to 31 July 2020. All cases were prospectively notified, and information on peripartum care (mother–newborn separation, skin-to-skin contact, breastfeeding, and rooming-in) and maternal and perinatal outcomes were collected in a structured form and entered in a web-based secure system. The paper describes a cohort of 525 SARS-CoV-2 positive women who gave birth. At hospital admission, 44.8% of the cohort was asymptomatic. At delivery, 51.9% of the mothers had a birth support person in the delivery room, the average caesarean section rate of 33.7% remained stable compared to the national figure. On average, 39.0% of mothers were separated from their newborns at birth, 26.6% practised skin-to-skin, 72.1% roomed in with their babies, and 79.6% of the infants received their mother’s milk. The infants separated and not separated from their SARS-CoV-2 positive mothers both had good outcomes. At the beginning of the pandemic, childbirth raised awareness and concern due to limited available evidence and led to “better safe than sorry” care choices. An improvement of the peripartum care indicators was observed over time.

Published
2021

92. Assessing risk factors for severe forms of COVID-19 in a pregnant population: A clinical series from Lombardy, Italy

Author

Daniela Di Martino, Patrizia Vergani, Arsenio Spinillo, Antonella Cromi, Federico Prefumo, Enrico Ferrazzi, Enrico Iurlaro, Valeria Savasi, Fabio Parazzini, Luisa Patanè, Francesco D'Ambrosi, Francesca Chiaffarino, Beatrice Tassis, Sara Ornaghi, Di Martino, D, Chiaffarino, F, Patanè, L, Prefumo, F, Vergani, P, Ornaghi, S, Savasi, V, Spinillo, A, Cromi, A, D'Ambrosi, F, Tassis, B, Iurlaro, E, Parazzini, F, and Ferrazzi, E

Subjects
medicine.medical_specialty, viruses, Population, Severity of Illness Index, COVID-19, SARS-CoV-2, pregnancy, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Pregnancy, Risk Factors, Environmental health, Epidemiology, Severity of illness, Obstetrics and Gynaecology, medicine, Global health, Humans, 030212 general & internal medicine, Risk factor, Pregnancy Complications, Infectious, education, education.field_of_study, 030219 obstetrics & reproductive medicine, business.industry, Female, Italy, Pregnant Women, Infectious, virus diseases, Obstetrics and Gynecology, Outbreak, General Medicine, Intensive care unit, Pregnancy Complications, business, Risk assessment
Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global health emergency [1, 2], with Lombardy being the epicenter of this outbreak in Italy [3].

Published
2020

93. Vaginal delivery in SARS‐CoV‐2‐infected pregnant women in Northern Italy: a retrospective analysis

Author

Stefano Bianchi, Santa Barresi, Luigi Frigerio, Arsenio Spinillo, Enrico Ferrazzi, Donata Spazzini, Michele Vignali, Gian Vincenzo Zuccotti, Luisa Patanè, Alessandra Kustermann, Irene Cetin, Fabio Facchinetti, Giuseppe Trojano, Federico Prefumo, Enrico Iurlaro, A. Villa, Fabio Mosca, Maria Teresa Gervasi, G. Mangili, Elena Ciriello, Patrizia Vergani, Valeria Savasi, Fabio Parazzini, Ferrazzi, E, Frigerio, L, Savasi, V, Vergani, P, Prefumo, F, Barresi, S, Bianchi, S, Ciriello, E, Facchinetti, F, Gervasi, M, Iurlaro, E, Kustermann, A, Mangili, G, Mosca, F, Patane, L, Spazzini, D, Spinillo, A, Trojano, G, Vignali, M, Villa, A, Zuccotti, G, Parazzini, F, and Cetin, I

Subjects
Adult, Male, medicine.medical_specialty, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, Breastfeeding, law.invention, COVID-19, delivery, transmission, Betacoronavirus, Pregnancy, COVID‐19, law, Obstetrics and Gynaecology, Retrospective analysis, medicine, Humans, Pregnancy Complications, Infectious, Pandemics, Retrospective Studies, SARS-CoV-2, Vaginal delivery, Obstetrics, business.industry, Infant, Newborn, Obstetrics and Gynecology, Retrospective cohort study, Original Articles, Delivery, Obstetric, medicine.disease, Intensive care unit, Infectious Disease Transmission, Vertical, Northern italy, Pneumonia, medicine.anatomical_structure, Italy, Vagina, Female, Original Article, Coronavirus Infections, business, Postpartum period
Abstract

Objective To report mode of delivery and immediate neonatal outcome in women infected with COVID‐19. Design Retrospective study. Setting Twelve hospitals in northern Italy. Participants Pregnant women with COVID‐19‐confirmed infection who delivered. Exposure COVID 19 infection in pregnancy. Methods SARS‐CoV‐2‐infected women who were admitted and delivered from 1 to 20 March 2020 were eligible. Data were collected from the clinical records using a standardised questionnaire on maternal general characteristics, any medical or obstetric co‐morbidity, course of pregnancy, clinical signs and symptoms, treatment of COVID 19 infection, mode of delivery, neonatal data and breastfeeding. Main outcome and measures Data on mode of delivery and neonatal outcome. Results In all, 42 women with COVID‐19 delivered at the participating centres; 24 (57.1%, 95% CI 41.0–72.3) delivered vaginally. An elective caesarean section was performed in 18/42 (42.9%, 95% CI 27.7–59.0) cases: in eight cases the indication was unrelated to COVID‐19 infection. Pneumonia was diagnosed in 19/42 (45.2%, 95% CI 29.8–61.3) cases: of these, 7/19 (36.8%, 95% CI 16.3–61.6) required oxygen support and 4/19 (21.1%, 95% CI 6.1–45.6) were admitted to a critical care unit. Two women with COVID‐19 breastfed without a mask because infection was diagnosed in the postpartum period: their newborns tested positive for SARS‐Cov‐2 infection. In one case, a newborn had a positive test after a vaginal operative delivery. Conclusions Although postpartum infection cannot be excluded with 100% certainty, these findings suggest that vaginal delivery is associated with a low risk of intrapartum SARS‐Cov‐2 transmission to the newborn. Tweetable abstract This study suggests that vaginal delivery may be associated with a low risk of intrapartum SARS‐Cov‐2 transmission to the newborn., Tweetable abstract This study suggests that vaginal delivery may be associated with a low risk of intrapartum SARS‐Cov‐2 transmission to the newborn. This article includes Author Insights, a video abstract available at https://vimeo.com/rcog/authorinsights16278

Published
2020
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94. COVID-19 and ART: the view of the Italian Society of Fertility and Sterility and Reproductive Medicine

Author

Roberto Palermo, Valeria Savasi, Paola Anserini, Antonio Pellicer, Maurizio Guido, Andrea Borini, Danilo Cimadomo, Paolo E. Levi-Setti, Antonio Palagiano, Alberto Vaiarelli, Silvia Ajossa, Laura Rienzi, Filippo Maria Ubaldi, Carlo Bulletti, Carlo Alviggi, Gianluca Gennarelli, Vaiarelli, A., Bulletti, C., Cimadomo, D., Borini, A., Alviggi, C., Ajossa, S., Anserini, P., Gennarelli, G., Guido, M., Levi-Setti, P. E., Palagiano, A., Palermo, R., Savasi, V., Pellicer, A., Rienzi, L., and Ubaldi, F. M.

Subjects
0301 basic medicine, medicine.medical_treatment, Advanced maternal age, 0302 clinical medicine, Reduced ovarian reserve, Pregnancy, Obstetrics and Gynaecology, Viral, media_common, Oncology patient, 030219 obstetrics & reproductive medicine, Obstetrics and Gynecology, Poor-prognosis patient, Poor-prognosis patients, Italy, Female, Coronavirus Infections, COVID-19, Oncology patients, SARS-CoV-2, Humans, Infertility, Pandemics, Pneumonia, Viral, Reproductive Techniques, Assisted, Human, medicine.medical_specialty, Sterility, media_common.quotation_subject, Reproductive medicine, Fertility, 03 medical and health sciences, Reproductive Techniques, medicine, Ovarian reserve, Assisted reproductive technology, Pandemic, business.industry, Coronavirus Infection, Pneumonia, medicine.disease, 030104 developmental biology, Reproductive Medicine, Assisted, Family medicine, business, Developmental Biology
Abstract

The COVID-19 pandemic is an unprecedented global situation. As assisted reproductive technology (ART) specialists, we should be cautious, carefully monitoring the situation while contributing by sharing novel evidence to counsel our patients, both pregnant women and would-be mothers. Time to egg collection and drop-out rates are critical parameters for scheduling treatments once the curve of infections has peaked and plateaued in each country. In order to reduce the values for these two parameters, infertile patients now require even more support from their IVF team: urgent oocyte collection for oncology patients must be guaranteed, and oocyte retrievals for women of advanced maternal age and/or reduced ovarian reserve cannot be postponed indefinitely. This document represents the position of the Italian Society of Fertility and Sterility and Reproductive Medicine (SIFES-MR) in outlining ART priorities during and after this emergency.

Published
2020

95. Analysis of SARS-CoV-2 vertical transmission during pregnancy

Author

Valeria Savasi, Patrizia Vergani, Maria Rita Gismondo, Arsenio Spinillo, Mara Biasin, Clelia Callegari, Francesca Perotti, Daria Trabattoni, Irene Cetin, Selene Cammarata, Alessandro Mancon, Ilaria Beretta, Manuela Nebuloni, Davide Mileto, Mario Clerici, Claudio Fenizia, Fenizia, C, Biasin, M, Cetin, I, Vergani, P, Mileto, D, Spinillo, A, Gismondo, M, Perotti, F, Callegari, C, Mancon, A, Cammarata, S, Beretta, I, Nebuloni, M, Trabattoni, D, Clerici, M, and Savasi, V

Subjects
Amniotic fluid, viruses, Physiology, General Physics and Astronomy, Antibodies, Viral, Umbilical cord, 0302 clinical medicine, 030212 general & internal medicine, Pregnancy Complications, Infectious, lcsh:Science, skin and connective tissue diseases, 030219 obstetrics & reproductive medicine, Multidisciplinary, biology, Transmission (medicine), Middle Aged, medicine.anatomical_structure, In utero, Gestation, Female, pregnancy, Antibody, Coronavirus Infections, Adult, Adolescent, Science, Pneumonia, Viral, Genome, Viral, Article, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Betacoronavirus, Young Adult, Placenta, medicine, Humans, Pandemics, Inflammation, Pregnancy, business.industry, SARS-CoV-2, fungi, Infant, Newborn, COVID-19, General Chemistry, medicine.disease, Infectious Disease Transmission, Vertical, respiratory tract diseases, body regions, Viral infection, biology.protein, lcsh:Q, vertical transmission, business
Abstract

The impact of SARS-CoV-2 infection during gestation remains unclear. Here, we analyse the viral genome on maternal and newborns nasopharyngeal swabs, vaginal swabs, maternal and umbilical cord plasma, placenta and umbilical cord biopsies, amniotic fluids and milk from 31 mothers with SARS-CoV-2 infection. In addition, we also test specific anti-SARS-CoV-2 antibodies and expression of genes involved in inflammatory responses in placentas, and in maternal and umbilical cord plasma. We detect SARS-CoV-2 genome in one umbilical cord blood and in two at-term placentas, in one vaginal mucosa and in one milk specimen. Furthermore, we report the presence of specific anti-SARS-CoV-2 IgM and IgG antibodies in one umbilical cord blood and in one milk specimen. Finally, in the three documented cases of vertical transmission, SARS-CoV-2 infection was accompanied by a strong inflammatory response. Together, these data support the hypothesis that in utero SARS-CoV-2 vertical transmission, while low, is possible. These results might help defining proper obstetric management of COVID-19 pregnant women, or putative indications for mode and timing of delivery., The impact of SARS-CoV-2 infection in pregnancy remains underexplored. Here, the authors provide a comprehensive characterization of virus and immunological parameters in 31 SARS-CoV-2-infected pregnant women, finding evidence of vertical transmission in two of the mother-child pairs.

Published
2020

96. Performance of an extended triage questionnaire to detect suspected cases of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in obstetric patients: Experience from two large teaching hospitals in Lombardy, Northern Italy

Author

Irene Cetin, Clelia Callegari, Patrizia Vergani, Stefania Livio, Chiara Lubrano, Laura La Milia, Sara Ornaghi, Valeria Savasi, Federica Brunetti, Chiara Tasca, Roberta Milazzo, Ornaghi, S, Callegari, C, Milazzo, R, La Milia, L, Brunetti, F, Lubrano, C, Tasca, C, Livio, S, Savasi, V, Cetin, I, and Vergani, P

Subjects
RNA viruses, Questionnaires, Viral Diseases, Pulmonology, Coronaviruses, Artificial Gene Amplification and Extension, Polymerase Chain Reaction, Taste Disorders, Medical Conditions, 0302 clinical medicine, Nasopharynx, Surveys and Questionnaires, Pandemic, Medicine and Health Sciences, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Pathology and laboratory medicine, Virus Testing, 030219 obstetrics & reproductive medicine, Multidisciplinary, Reverse Transcriptase Polymerase Chain Reaction, Obstetrics and Gynecology, Medical microbiology, Hospitals, Infectious Diseases, Taste disorder, Italy, Research Design, Viruses, Medicine, RNA, Viral, Female, pregnancy, SARS CoV 2, Pathogens, medicine.symptom, Coronavirus Infections, Research Article, Adult, medicine.medical_specialty, SARS coronavirus, Science, Health Personnel, Pneumonia, Viral, Context (language use), Research and Analysis Methods, Microbiology, Asymptomatic, Respiratory Disorders, 03 medical and health sciences, Betacoronavirus, Diagnostic Medicine, Internal medicine, medicine, Humans, Molecular Biology Techniques, Hospitals, Teaching, Molecular Biology, Pandemics, Pregnancy, Survey Research, Biology and life sciences, business.industry, SARS-CoV-2, Organisms, Viral pathogens, COVID-19, Covid 19, Reverse Transcriptase-Polymerase Chain Reaction, medicine.disease, Triage, infection, Microbial pathogens, Health Care, Pneumonia, Health Care Facilities, Respiratory Infections, Asymptomatic Diseases, Women's Health, business
Abstract

Objectives1. To assess the performance of an extended questionnaire in identifying cases of SARS-CoV-2 infection among obstetric patients. 2. To evaluate the rate of infection among healthcare workers involved in women's care.Study designA prospective cohort study of obstetric patients admitted to MBBM Foundation and Buzzi Hospital (Lombardy, Northern Italy) from March 16th to May 22nd, 2020. Women were screened on admission by a questionnaire investigating major and minor symptoms of infection and high-risk contacts in the last 14 days. SARS-CoV-2 assessment was performed by RT-PCR on nasopharyngeal swabs. Till April 7th, a targeted SARS-CoV-2 testing triggered by a positive questionnaire was used; from April 8th, a universal testing approach was implemented.ResultsThere were 1,177 women screened by the questionnaire, which yielded a positive result in 130 (11.0%) cases. SARS-CoV-2 RT-PCR was performed in 865 (73.5%) patients, identifying 51 (5.9%) infections. During the first period, there were 29 infected mothers, 4 (13.8%) of whom had a negative questionnaire. After universal testing implementation, there were 22 (3%, 95% CI 1.94% - 4.04%) infected mothers, 13 (59.1%) of whom had a negative questionnaire; rate of infection among asymptomatic women was 1.9%. Six of the 17 SARS-CoV-2-positive women with a negative questionnaire reported symptoms more than 14 but within 30 days before admission. Isolated olfactory or taste disorders were identified in 15.7% of infected patients. Rate of infection among healthcare workers was 5.8%.ConclusionsAn exhaustive triage questionnaire can effectively discriminate women at low risk of SARS-CoV-2 infection in the context of a targeted and a universal viral testing approach. In 15.7% of infected women, correct classification as a suspected case of infection was due to investigation of olfactory and taste disorders. Extension of the assessed time-frame to 30 days may be worth considering to increase the questionnaire's performance.

Published
2020

97. Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19)

Author

Irene Cetin, Saverio Tateo, Valeria Savasi, Donata Spazzini, Luisa Patanè, Antonio Pellegrino, Paola Veronese, Patrizia Vergani, Mariacristina Ottoboni, Francesca Parisi, Fabio Facchinetti, Enrico Ferrazzi, Luigi Frigerio, Arsenio Spinillo, Felice Petraglia, Savasi, V, Parisi, F, Patanè, L, Ferrazzi, E, Frigerio, L, Pellegrino, A, Spinillo, A, Tateo, S, Ottoboni, M, Veronese, P, Petraglia, F, Vergani, P, Facchinetti, F, Spazzini, D, and Cetin, I

Subjects
Pediatrics, Neonatal intensive care unit, medicine.medical_treatment, law.invention, Body Mass Index, 0302 clinical medicine, law, Pregnancy, Risk Factors, Obstetrics and Gynaecology, 030212 general & internal medicine, Prospective Studies, Pregnancy Complications, Infectious, Prospective cohort study, 030219 obstetrics & reproductive medicine, Pregnancy Outcome, Obstetrics and Gynecology, Middle Aged, Intensive care unit, Hospitalization, Italy, Premature birth, COVID-19, pregnant women, Cohort, Premature Birth, Female, Coronavirus Infections, Cohort study, Adult, medicine.medical_specialty, Adolescent, Fever, Pregnancy Trimester, Third, Pneumonia, Viral, Hospitals, Maternity, 03 medical and health sciences, Betacoronavirus, Young Adult, medicine, Extracorporeal membrane oxygenation, Humans, Risk factor, Pandemics, business.industry, SARS-CoV-2, Infant, Newborn, COVID-19, medicine.disease, Infectious Disease Transmission, Vertical, Dyspnea, business
Abstract

Objective To investigate the clinical evolution of coronavirus disease 2019 (COVID-19) in hospitalized pregnant women and potential factors associated with severe maternal outcomes. Methods We designed a prospective multicenter cohort study of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were admitted to 12 Italian maternity hospitals between February 23 and March 28, 2020. Clinical records, laboratory and radiologic examinations, and pregnancy outcomes were collected. A subgroup of patients with severe disease was identified based on intensive care unit (ICU) admission, delivery for respiratory compromise, or both. Results Seventy-seven patients were included, 14 of whom had severe disease (18%). Two thirds of the patients in the cohort were admitted during the third trimester, and 84% were symptomatic on admission. Eleven patients underwent urgent delivery for respiratory compromise (16%), and six were admitted to the ICU (8%). One woman received extracorporeal membrane oxygenation; no deaths occurred. Preterm delivery occurred in 12% of patients, and nine newborns were admitted to the neonatal intensive care unit. Patients in the severe subgroup had significantly higher pregestational body mass indexes (BMIs) and heart and respiratory rates and a greater frequency of fever or dyspnea on admission compared with women with a nonsevere disease evolution. Conclusion In our cohort, one in five women hospitalized with COVID-19 infection delivered urgently for respiratory compromise or were admitted to the ICU. None, however, died. Increased pregestational BMI and abnormal heart and respiratory rates on admission were associated with severe disease.

Published
2020
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98. PREGNANCY LOSS IN WOMEN WITH HIV IS NOT ASSOCIATED WITH HIV MARKERS: DATA FROM A NATIONAL STUDY IN ITALY, 2001-2018

Author

Laura Franceschetti, Giuseppina Liuzzi, Marco Floridia, Beatrice Tassis, Matilde Sansone, Giuliana Simonazzi, Enrica Tamburrini, Marina Ravizza, Anna Degli Antoni, Daniela Francisci, Giulia Masuelli, Carmela Pinnetti, Arsenio Spinillo, Gianpaolo Maso, Valeria Savasi, Serena Dalzero, and Floridia M, Masuelli G, Tassis B, Tamburrini E, Savasi V, Sansone M, Spinillo A, Liuzzi G, Antoni AD, Dalzero S, Franceschetti L, Simonazzi G, Maso G, Francisci D, Pinnetti C, Ravizza M.

Subjects
medicine.medical_specialty, Multivariate analysis, CD4 cell count, Miscarriage, Pregnancy loss, medicine, Pregnancy, lcsh:RC633-647.5, Obstetrics, business.industry, HIV, lcsh:Diseases of the blood and blood-forming organs, Hematology, Odds ratio, Stillbirth, medicine.disease, miscarriage, stillbirth, pregnancy loss, Confidence interval, Pregnancy lo, Infectious Diseases, Original Article, Observational study, Parity (mathematics), business, Viral load
Abstract

Background: There is limited information on pregnancy loss in women with HIV, and it is still debate whether HIV-related markers may play a role. Objectives: To explore potential risk factors for pregnancy loss in women with HIV, with particular reference to modifiable risk factors and markers of HIV disease. Methods: Multicenter observational study of HIV-positive pregnant women. The main outcome measure was pregnancy loss, including both miscarriage (

Published
2019
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99. Reproductive experience of HIV-infected women living in Europe

Author

Claire Thorne, Isabelle Heard, Tomasz Niemiec, Oriol Coll, Marie-Louise Newell, Valeria Savasi, Simona Fiore, Ruslan Malyuta, Cecilia Tibaldi, Pasquale Martinelli, Fiore, S, Heard, I, Thorne, C, Savasi, V, Coll, O, Malyuta, R, Niemiec, T, Martinelli, Pasquale, Tibaldi, C, and Newell, M. L.

Subjects
Infertility, Adult, medicine.medical_specialty, Pregnancy Rate, medicine.medical_treatment, media_common.quotation_subject, Health Status, Sexual Behavior, Fertility, Gravidity, HIV Infections, Acquired immunodeficiency syndrome (AIDS), Pregnancy, Disease Transmission, Infectious, Medicine, Humans, Pregnancy Complications, Infectious, media_common, Gynecology, In vitro fertilisation, Marital Status, business.industry, Obstetrics, Reproduction, Rehabilitation, Obstetrics and Gynecology, HIV, medicine.disease, Infectious Disease Transmission, Vertical, Europe, Cross-Sectional Studies, Logistic Models, Reproductive Medicine, Socioeconomic Factors, Heterosexuality, Gestation, Female, Live birth, business
Abstract

BACKGROUND: The aim of this study was to describe the experience of pregnant and non-pregnant HIV-infected women regarding fertility and childbearing, with a view to inform policies and practices to improve reproductive outcome. METHODS: A cross-sectional survey collected information on socio-demographic and basic reproductive characteristics of HIV-infected women in Europe. A total of 403 women participated; 121 were pregnant. RESULTS: The median age was 29 years and 84% (228) of women were born in Europe. Overall 68% (275 of 403) had been pregnant at some time. At the time of the survey, 59% (n 5 160) of women had no HIV symptoms; severe symptoms were more frequent among non-pregnant than pregnant respondents (36% (65 of 181) versus 5% (4 of 88)). Of the women, 80% reported being in a long-standing relationship; 39% (74 of 190) reported that they became infected by their current partner and, overall, heterosexual infection was reported as the mode of acquisition in 55% (190 of 344). Maternal well-being, no previous live birth and having an uninfected partner were strongly associated with the likelihood of being pregnant. To assess the problems relating to fertility, pregnant and nonpregnant women were considered separately. Overall, 46% of pregnant women reported not using condoms to protect against infection during pregnancy. Of the 60 pregnant women who planned their pregnancies, 10 reported the need for assistance in conceiving: five monitored their ovulation period and five became pregnant through in vitro fertilization. Of 34 non-pregnant women currently trying for a baby, 15 (44%) had done so for more than 18 months. Overall 25 (27%) of 94 women who planned to become pregnant needed reproductive care. CONCLUSIONS: Our results suggest that these days knowledge of HIV infection neither influences the desire for children nor the decisions regarding pregnancy in HIV-infected women living in Europe.

Published
2008

100. Hepatitis B or hepatitis C coinfection in HIV-infected pregnant women in Europe

Author

Megan Landes, Igor Semenenko, Patricia Barlow, Valeria Savasi, Svetlana Posokhova, Claire Thorne, Pasquale Martinelli, Andrej Stelmah, Marie-Louise Newell, Ruslan Malyuta, Cecilia Tibaldi, Simona Fiore, Landes, M, Newell, Ml, Barlow, P, Fiore, S, Malyuta, R, Martinelli, Pasquale, Posokhova, S, Savasi, V, Semenenko, I, Stelmah, A, Tibaldi, C, and Thorne, C.

Subjects
Adult, medicine.medical_specialty, HBsAg, Adolescent, HIV Infections, Cohort Studies, Young Adult, Hepatitis B, Chronic, Pregnancy, Risk Factors, Internal medicine, Antiretroviral Therapy, Highly Active, Epidemiology, medicine, Prevalence, Humans, Pharmacology (medical), Young adult, Hepatitis B Surface Antigens, business.industry, Health Policy, virus diseases, Odds ratio, Hepatitis C, Hepatitis B, Hepatitis C Antibodies, Hepatitis C, Chronic, medicine.disease, digestive system diseases, CD4 Lymphocyte Count, Europe, Infectious Diseases, Logistic Models, Immunology, Coinfection, RNA, Viral, Female, Serostatus, business
Abstract

Objectives The aim of the study was to investigate the prevalence of and risk factors for hepatitis C or B virus (HCV or HBV) coinfection among HIV-infected pregnant women, and to investigate their immunological and virological characteristics and antiretroviral therapy use. Methods Information on HBV surface antigen (HBsAg) positivity and HCV antibody (anti-HCV) was collected retrospectively from the antenatal records of HIV-infected women enrolled in the European Collaborative Study and linked to prospectively collected data. Results Of 1050 women, 4.9% [95% confidence interval (CI) 3.6–6.3] were HBsAg positive and 12.3% (95% CI 10.4–14.4) had anti-HCV antibody. Women with an injecting drug use(r) (IDU) history had the highest HCV-seropositivity prevalence (28%; 95% CI 22.8–35.7). Risk factors for HCV seropositivity included IDU history [adjusted odds ratio (AOR) 2.92; 95% CI 1.86–4.58], age (for ≥35 years vs.

Published
2008

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