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3. Prevalence, Outcome, and Prevention of Congenital Cytomegalovirus Infection in Neonates Born to Women With Preconception Immunity (CHILd Study)

Author

Lilleri, D., Tassis, B., Pugni, L., Ronchi, A., Pietrasanta, C., Spinillo, A., Arossa, A., Achille, C., Vergani, P., Ornaghi, S., Riboni, S., Cavoretto, P., Candiani, M., Gaeta, G., Prefumo, F., Fratelli, N., Fichera, A., Vignali, M., Prun, A.B.D., Fabbri, E., Cetin, I., Locatelli, A., Consonni, S., Rutolo, S., Miotto, E., Savasi, V., Di Giminiani, M., Cromi, A., Binda, S., Fiorina, L., Furione, M., Cassinelli, G., Klersy, C., Lilleri, D, Tassis, B, Pugni, L, Ronchi, A, Pietrasanta, C, Spinillo, A, Arossa, A, Achille, C, Vergani, P, Ornaghi, S, Riboni, S, Cavoretto, P, Candiani, M, Gaeta, G, Prefumo, F, Fratelli, N, Fichera, A, Vignali, M, Prun, A, Fabbri, E, Cetin, I, Locatelli, A, Consonni, S, Rutolo, S, Miotto, E, Savasi, V, Di Giminiani, M, Cromi, A, Binda, S, Fiorina, L, Furione, M, Cassinelli, G, and Klersy, C

Subjects
Microbiology (medical), Human cytomegalovirus, congenital infection, non-primary infection, pre-conception immunity, Settore MED/17 - Malattie Infettive, preconception immunity, Settore MED/07 - Microbiologia e Microbiologia Clinica, Infectious Diseases, nonprimary infection, human cytomegalovirus, Settore MED/40 - Ginecologia e Ostetricia, human cytomegaloviru
Abstract

Background Human cytomegalovirus (HCMV) is the leading infectious cause of congenital disabilities. We designed a prospective study to investigate the rate, outcome, and risk factors of congenital CMV (cCMV) infection in neonates born to immune women, and the potential need and effectiveness of hygiene recommendations in this population. Methods The study was composed of 2 sequential parts: an epidemiology (part 1) and a prevention (part 2) study. Performance of part 2 depended upon a cCMV rate >0.4%. Women enrolled in part 1 did not receive hygiene recommendations. Newborns were screened by HCMV DNA testing in saliva and cCMV was confirmed by urine testing. Results Saliva swabs were positive for HCMV DNA in 45/9661 newborns and cCMV was confirmed in 18 cases. The rate of cCMV was .19% (95% confidence interval [CI]: .11–.29%), and 3 out of 18 infants with cCMV had symptoms of CMV at birth. Age, nationality, occupation, and contact with children were similar between mothers of infected and noninfected newborns. Twin pregnancy (odds ratio [OR]: 7.2; 95% CI: 1.7–32.2; P = .037) and maternal medical conditions (OR: 3.9; 95% CI: 1.5–10.1; P = .003) appeared associated with cCMV. Given the rate of cCMV was lower than expected, the prevention part of the study was cancelled. Conclusions Newborns from women with preconception immunity have a low rate of cCMV, which appears to be mostly due to reactivation of the latent virus. Therefore, serological screening in childbearing age would be pivotal to identify HCMV-seropositive women, whose newborns have a low risk of cCMV. Clinical trials registration www.clinicaltrials.gov (NCT03973359).

Published
2023

4. Prevalence, Outcome, and Prevention of Congenital Cytomegalovirus Infection in Neonates Born to Women With Preconception Immunity (CHILd Study)

Author

Lilleri, D, Tassis, B, Pugni, L, Ronchi, A, Pietrasanta, C, Spinillo, A, Arossa, A, Achille, C, Vergani, P, Ornaghi, S, Riboni, S, Cavoretto, P, Candiani, M, Gaeta, G, Prefumo, F, Fratelli, N, Fichera, A, Vignali, M, Prun, A, Fabbri, E, Cetin, I, Locatelli, A, Consonni, S, Rutolo, S, Miotto, E, Savasi, V, Di Giminiani, M, Cromi, A, Binda, S, Fiorina, L, Furione, M, Cassinelli, G, Klersy, C, Lilleri, Daniele, Tassis, Beatrice, Pugni, Lorenza, Ronchi, Andrea, Pietrasanta, Carlo, Spinillo, Arsenio, Arossa, Alessia, Achille, Cristian, Vergani, Patrizia, Ornaghi, Sara, Riboni, Silvia, Cavoretto, Paolo, Candiani, Massimo, Gaeta, Gerarda, Prefumo, Federico, Fratelli, Nicola, Fichera, Anna, Vignali, Michele, Prun, Allegra Barbasetti Di, Fabbri, Elisa, Cetin, Irene, Locatelli, Anna, Consonni, Sara, Rutolo, Simona, Miotto, Elena, Savasi, Valeria, Di Giminiani, Maria, Cromi, Antonella, Binda, Sandro, Fiorina, Loretta, Furione, Milena, Cassinelli, Gabriela, Klersy, Catherine, Lilleri, D, Tassis, B, Pugni, L, Ronchi, A, Pietrasanta, C, Spinillo, A, Arossa, A, Achille, C, Vergani, P, Ornaghi, S, Riboni, S, Cavoretto, P, Candiani, M, Gaeta, G, Prefumo, F, Fratelli, N, Fichera, A, Vignali, M, Prun, A, Fabbri, E, Cetin, I, Locatelli, A, Consonni, S, Rutolo, S, Miotto, E, Savasi, V, Di Giminiani, M, Cromi, A, Binda, S, Fiorina, L, Furione, M, Cassinelli, G, Klersy, C, Lilleri, Daniele, Tassis, Beatrice, Pugni, Lorenza, Ronchi, Andrea, Pietrasanta, Carlo, Spinillo, Arsenio, Arossa, Alessia, Achille, Cristian, Vergani, Patrizia, Ornaghi, Sara, Riboni, Silvia, Cavoretto, Paolo, Candiani, Massimo, Gaeta, Gerarda, Prefumo, Federico, Fratelli, Nicola, Fichera, Anna, Vignali, Michele, Prun, Allegra Barbasetti Di, Fabbri, Elisa, Cetin, Irene, Locatelli, Anna, Consonni, Sara, Rutolo, Simona, Miotto, Elena, Savasi, Valeria, Di Giminiani, Maria, Cromi, Antonella, Binda, Sandro, Fiorina, Loretta, Furione, Milena, Cassinelli, Gabriela, and Klersy, Catherine

Abstract

BACKGROUND: Human cytomegalovirus (HCMV) is the leading infectious cause of congenital disabilities. We designed a prospective study to investigate the rate, outcome, and risk factors of congenital CMV (cCMV) infection in neonates born to immune women, and the potential need and effectiveness of hygiene recommendations in this population. METHODS: The study was composed of 2 sequential parts: an epidemiology (part 1) and a prevention (part 2) study. Performance of part 2 depended upon a cCMV rate >0.4%. Women enrolled in part 1 did not receive hygiene recommendations. Newborns were screened by HCMV DNA testing in saliva and cCMV was confirmed by urine testing. RESULTS: Saliva swabs were positive for HCMV DNA in 45/9661 newborns and cCMV was confirmed in 18 cases. The rate of cCMV was .19% (95% confidence interval [CI]: .11-.29%), and 3 out of 18 infants with cCMV had symptoms of CMV at birth. Age, nationality, occupation, and contact with children were similar between mothers of infected and noninfected newborns. Twin pregnancy (odds ratio [OR]: 7.2; 95% CI: 1.7-32.2; P = .037) and maternal medical conditions (OR: 3.9; 95% CI: 1.5-10.1; P = .003) appeared associated with cCMV. Given the rate of cCMV was lower than expected, the prevention part of the study was cancelled. CONCLUSIONS: Newborns from women with preconception immunity have a low rate of cCMV, which appears to be mostly due to reactivation of the latent virus. Therefore, serological screening in childbearing age would be pivotal to identify HCMV-seropositive women, whose newborns have a low risk of cCMV. CLINICAL TRIALS REGISTRATION: www.clinicaltrials.gov (NCT03973359).

Published
2023

5. The first SARS-CoV-2 wave among pregnant women in Italy: results from a prospective population-based study

Author

Donati, S, Corsi, E, Maraschini, A, Salvatore, M, Baltaro, F, Boldrini, R, Bonassisa, S, Brunelli, R, Cagnacci, A, Casucci, P, Cataneo, I, Cetin, I, de Ambrosi, E, Manso, M, Fabiani, M, Fieni, S, Franchi, M, Iurlaro, E, Leo, L, Liberati, M, Sacchi, L, Livio, S, Locci, M, Marozio, L, Martini, C, Maso, G, Mecacci, F, Meloni, A, Mignuoli, A, Moresi, S, Patane, L, Perotti, F, Perrone, E, Prefumo, F, Ramenghi, L, Rusciani, R, Savasi, V, Schettini, S, Simeone, D, Soligo, M, Steinkasserer, M, Tateo, S, Ternelli, G, Tironi, R, Trojano, V, Vergani, P, Donati S., Corsi E., Maraschini A., Salvatore M. A., Baltaro F., Boldrini R., Bonassisa S., Brunelli R., Cagnacci A., Casucci P., Cataneo I., Cetin I., de Ambrosi E., Manso M. D., Fabiani M., Fieni S., Franchi M. P., Iurlaro E., Leo L., Liberati M., Sacchi L. L., Livio S., Locci M., Marozio L., Martini C., Maso G., Mecacci F., Meloni A., Mignuoli A. D., Moresi S., Patane L., Perotti F., Perrone E., Prefumo F., Ramenghi L., Rusciani R., Savasi V., Schettini S. C. A., Simeone D., Soligo M., Steinkasserer M., Tateo S., Ternelli G., Tironi R., Trojano V., Vergani P., Donati, S, Corsi, E, Maraschini, A, Salvatore, M, Baltaro, F, Boldrini, R, Bonassisa, S, Brunelli, R, Cagnacci, A, Casucci, P, Cataneo, I, Cetin, I, de Ambrosi, E, Manso, M, Fabiani, M, Fieni, S, Franchi, M, Iurlaro, E, Leo, L, Liberati, M, Sacchi, L, Livio, S, Locci, M, Marozio, L, Martini, C, Maso, G, Mecacci, F, Meloni, A, Mignuoli, A, Moresi, S, Patane, L, Perotti, F, Perrone, E, Prefumo, F, Ramenghi, L, Rusciani, R, Savasi, V, Schettini, S, Simeone, D, Soligo, M, Steinkasserer, M, Tateo, S, Ternelli, G, Tironi, R, Trojano, V, Vergani, P, Donati S., Corsi E., Maraschini A., Salvatore M. A., Baltaro F., Boldrini R., Bonassisa S., Brunelli R., Cagnacci A., Casucci P., Cataneo I., Cetin I., de Ambrosi E., Manso M. D., Fabiani M., Fieni S., Franchi M. P., Iurlaro E., Leo L., Liberati M., Sacchi L. L., Livio S., Locci M., Marozio L., Martini C., Maso G., Mecacci F., Meloni A., Mignuoli A. D., Moresi S., Patane L., Perotti F., Perrone E., Prefumo F., Ramenghi L., Rusciani R., Savasi V., Schettini S. C. A., Simeone D., Soligo M., Steinkasserer M., Tateo S., Ternelli G., Tironi R., Trojano V., and Vergani P.

Abstract

Introduction. This study aimed to estimate the incidence of SARS-CoV-2 infection among pregnant women during the first pandemic wave in Italy, and to describe CO-VID-19 disease characteristics and maternal and perinatal outcomes. Materials and methods. National population-based prospective cohort study collecting information on women with SARS-CoV-2 diagnosis, confirmed within 7 days from hospital admission. Results. The national SARS-CoV-2 rate was 6.04 per 1,000 births (95% CI 5.62-6.49) among pregnant women and 7.54 (95% CI 7.47-7.61) among women in reproductive age. 72.1% of the cohort developed mild COVID-19 disease without pneumonia nor need for ventilatory support. Severe disease was significantly associated with women’s previous comorbidities (OR 2.55; 95% CI 0.98-6.90), obesity (OR 4.76; 95% CI 1.79-12.66) and citizenship from High Migration Pressure Countries (OR 3.43; 95% CI 1.27-9.25). Conclusions. During the first pandemic wave in Italy, the SARS-CoV-2 rate among pregnant women was lower compared to that detected among women of reproductive age, and risks of severe COVID-19 disease and adverse maternal and perinatal outcomes were rare.

Published
2021

6. Placental pathology in COVID-19 affected pregnant women: A prospective case-control study

Author

Tasca, C, Rossi, R, Corti, S, Anelli, G, Savasi, V, Brunetti, F, Cardellicchio, M, Caselli, E, Tonello, C, Vergani, P, Nebuloni, M, Cetin, I, Tasca C., Rossi R. S., Corti S., Anelli G. M., Savasi V., Brunetti F., Cardellicchio M., Caselli E., Tonello C., Vergani P., Nebuloni M., Cetin I., Tasca, C, Rossi, R, Corti, S, Anelli, G, Savasi, V, Brunetti, F, Cardellicchio, M, Caselli, E, Tonello, C, Vergani, P, Nebuloni, M, Cetin, I, Tasca C., Rossi R. S., Corti S., Anelli G. M., Savasi V., Brunetti F., Cardellicchio M., Caselli E., Tonello C., Vergani P., Nebuloni M., and Cetin I.

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

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

Author

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, Zullino, S, Donati S., Corsi E., Salvatore M. A., Maraschini A., Bonassisa S., Casucci P., Cataneo I., Cetin I., D'aloja P., Dardanoni G., De Ambrosi E., Ferrazzi E., Fieni S., Franchi M. P., Gargantini G., Iurlaro E., Leo L., Liberati M., Livio S., Locci M., Marozio L., Martini C., Maso G., Mecacci F., Meloni A., Mignuoli A. D., Patane L., Pellegrini E., Perotti F., Perrone E., Prefumo F., Ramenghi L., Rusciani R., Savasi V., Schettini S. C. A., Simeone D., Simeone S., Spinillo A., Steinkasserer M., Tateo S., Ternelli G., Tironi R., Trojano V., Vergani P., Zullino S., 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, Zullino, S, Donati S., Corsi E., Salvatore M. A., Maraschini A., Bonassisa S., Casucci P., Cataneo I., Cetin I., D'aloja P., Dardanoni G., De Ambrosi E., Ferrazzi E., Fieni S., Franchi M. P., Gargantini G., Iurlaro E., Leo L., Liberati M., Livio S., Locci M., Marozio L., Martini C., Maso G., Mecacci F., Meloni A., Mignuoli A. D., Patane L., Pellegrini E., Perotti F., Perrone E., Prefumo F., Ramenghi L., Rusciani R., Savasi V., Schettini S. C. A., Simeone D., Simeone S., Spinillo A., Steinkasserer M., Tateo S., Ternelli G., Tironi R., Trojano V., Vergani P., and Zullino S.

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

8. The first SARS-CoV-2 wave among pregnant women in Italy: results from a prospective population-based study

Author

Donati S., Corsi E., Maraschini A., Salvatore M. A., Baltaro F., Boldrini R., Bonassisa S., Brunelli R., Cagnacci A., Casucci P., Cataneo I., Cetin I., de Ambrosi E., Manso M. D., Fabiani M., Fieni S., Franchi M. P., Iurlaro E., Leo L., Liberati M., Sacchi L. L., Livio S., Locci M., Marozio L., Martini C., Maso G., Mecacci F., Meloni A., Mignuoli A. D., Moresi S., Patane L., Perotti F., Perrone E., Prefumo F., Ramenghi L., Rusciani R., Savasi V., Schettini S. C. A., Simeone D., Soligo M., Steinkasserer M., Tateo S., Ternelli G., Tironi R., Trojano V., Vergani P., Donati, S., Corsi, E., Maraschini, A., Salvatore, M. A., Baltaro, F., Boldrini, R., Bonassisa, S., Brunelli, R., Cagnacci, A., Casucci, P., Cataneo, I., Cetin, I., de Ambrosi, E., Manso, M. D., Fabiani, M., Fieni, S., Franchi, M. P., Iurlaro, E., Leo, L., Liberati, M., Sacchi, L. L., Livio, S., Locci, M., Marozio, L., Martini, C., Maso, G., Mecacci, F., Meloni, A., Mignuoli, A. D., Moresi, S., Patane, L., Perotti, F., Perrone, E., Prefumo, F., Ramenghi, L., Rusciani, R., Savasi, V., Schettini, S. C. A., Simeone, D., Soligo, M., Steinkasserer, M., Tateo, S., Ternelli, G., Tironi, R., Trojano, V., Vergani, P., Donati, S, Corsi, E, Maraschini, A, Salvatore, M, Baltaro, F, Boldrini, R, Bonassisa, S, Brunelli, R, Cagnacci, A, Casucci, P, Cataneo, I, Cetin, I, de Ambrosi, E, Manso, M, Fabiani, M, Fieni, S, Franchi, M, Iurlaro, E, Leo, L, Liberati, M, Sacchi, L, Livio, S, Locci, M, Marozio, L, Martini, C, Maso, G, Mecacci, F, Meloni, A, Mignuoli, A, Moresi, S, Patane, L, Perotti, F, Perrone, E, Prefumo, F, Ramenghi, L, Rusciani, R, Savasi, V, Schettini, S, Simeone, D, Soligo, M, Steinkasserer, M, Tateo, S, Ternelli, G, Tironi, R, Trojano, V, and Vergani, P

Subjects
SARS-CoV-2, Infectious, Cohort studies, Italy, Pregnancy outcome, COVID-19 Testing, Citizenship, Female, Humans, Pregnancy, Pregnant Women, Prospective Studies, COVID-19, Pregnancy Complications, Infectious, Pregnancy Complications, Cohort studie
Abstract

Introduction. This study aimed to estimate the incidence of SARS-CoV-2 infection among pregnant women during the first pandemic wave in Italy, and to describe CO-VID-19 disease characteristics and maternal and perinatal outcomes. Materials and methods. National population-based prospective cohort study collecting information on women with SARS-CoV-2 diagnosis, confirmed within 7 days from hospital admission. Results. The national SARS-CoV-2 rate was 6.04 per 1,000 births (95% CI 5.62-6.49) among pregnant women and 7.54 (95% CI 7.47-7.61) among women in reproductive age. 72.1% of the cohort developed mild COVID-19 disease without pneumonia nor need for ventilatory support. Severe disease was significantly associated with women’s previous comorbidities (OR 2.55; 95% CI 0.98-6.90), obesity (OR 4.76; 95% CI 1.79-12.66) and citizenship from High Migration Pressure Countries (OR 3.43; 95% CI 1.27-9.25). Conclusions. During the first pandemic wave in Italy, the SARS-CoV-2 rate among pregnant women was lower compared to that detected among women of reproductive age, and risks of severe COVID-19 disease and adverse maternal and perinatal outcomes were rare.

Published
2021

9. CD4/CD8 ratio in pregnant women with HIV and its association with pregnancy outcome: data from a national study in Italy

Author

Floridia, M., Pinnetti, C., Masuelli, G., Spinillo, A., Savasi, V. M., Liuzzi, G., Degli Antoni, A. M., Sansone, M., Guaraldi, G., Dalzero, S., Maso, G., Francisci, D., Sterrantino, G., Ravizza, M., Tamburrini, E., Di Lorenzo, F., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Zanaboni, D., Nardini, G., Stentarelli, C., Beghetto, B., Molinari, A., Crisalli, M. P., Donisi, A., Ruggieri, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Paradiso, L., Forlanini, F., Longoni, E., Placido, G., Milini, P., Savalli, F., Sabbatini, F., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Portelli, V., Bernardon, M., Bussolaro, S., Della Pieta, I., Sorz, A., Meloni, A., Chiodo, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Vimercati, A., Calabretti, D., Gigante, S., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Savasi, V., Cardellicchio, E., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Forleo, M. A., Tassis, B., Ruggiero, M., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., Ierardi, M., Simonetti, S. C., Alfieri, N., Agrati, S., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Cerioli, A., De Martino, M., Parazzini, F., Vella, S., Floridia M., Pinnetti C., Masuelli G., Spinillo A., Savasi V.M., Liuzzi G., Degli Antoni A.M., Sansone M., Guaraldi G., Dalzero S., Maso G., Francisci D., Sterrantino G., Ravizza M., Tamburrini E., Di Lorenzo F., Meli M., Campolmi I., Vichi F., Del Pin B., Marocco R., Mastroianni C., Mercurio V.S., Zanaboni D., Nardini G., Stentarelli C., Beghetto B., Molinari A., Crisalli M.P., Donisi A., Ruggieri A., Piepoli M., Cerri V., Zuccotti G., Giacomet V., Paradiso L., Forlanini F., Longoni E., Placido G., Milini P., Savalli F., Sabbatini F., Papalini C., Bernini L., Grossi P., Rizzi L., Portelli V., Bernardon M., Bussolaro S., Della Pieta I., Sorz A., Meloni A., Chiodo A., Dedoni M., Ortu F., Piano P., Citernesi A., Bordoni Vicini I., Luzi K., Roccio M., Vimercati A., Calabretti D., Gigante S., Guerra B., Cervi F., Simonazzi G., Margarito E., Capretti M.G., Marsico C., Faldella G., Martinelli P., Agangi A., Capone A., Maruotti G.M., Tibaldi C., Trentini L., Todros T., Frisina V., Savasi V., Cardellicchio E., Giaquinto C., Fiscon M., Rubino E., Franceschetti L., Badolato R., Forleo M.A., Tassis B., Ruggiero M., Genovese O., Cafforio C., Casadei A.M., Cavaliere A.F., Cellini M., Marconi A.M., Ierardi M., Simonetti S.C., Alfieri N., Agrati S., Polizzi C., Mattei A., Pirillo M.F., Amici R., Galluzzo C.M., Donnini S., Baroncelli S., Cerioli A., De Martino M., Parazzini F., and Vella S.

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Multivariate analysis, 030106 microbiology, CD4-CD8 Ratio, Human immunodeficiency virus (HIV), HIV Infections, CD8-Positive T-Lymphocytes, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, CD4/CD8 ratio, Pregnancy, CD4, CD8, HIV suppression, Preterm delivery, Female, Humans, Infant, Newborn, Pregnancy Outcome, Pregnant Women, Viral Load, Pregnancy Complications, Infectious, medicine, 030212 general & internal medicine, business.industry, Obstetrics, Infectious, Infant, General Medicine, Newborn, medicine.disease, Pregnancy Complications, Infectious Diseases, Increased risk, National study, Outcome data, business
Abstract

Purpose: To evaluate associations between CD4/CD8 ratio and pregnancy outcomes in women with HIV. Methods: We evaluated, in a national study of pregnant women with HIV receiving antiretroviral treatment (ART), values of CD4/CD8 ratio at entry in pregnancy, changes between first and third trimester, and possible associations with preterm delivery, low birthweight, and HIV-RNA < 50 copies/ml at third trimester in univariate and multivariate analyses. Results: Among 934 women, 536 (57.4%) were already on ART at conception. CD4/CD8 ratio (baseline value 0.570) increased significantly between the first and third trimesters, particularly in women who started ART in pregnancy (+ 0.163, vs. + 0.036 in women already on treatment). The rate of CD4/CD8 ratio normalization, defined by achieving a ratio ≥ 1 at the third trimester, was 13.2%. In multivariable analyses, women who entered pregnancy with a CD4/CD8 ratio < 0.3, compared to women with ratio ≥ 1, were almost four-times less likely to have third-trimester HIV-RNA < 50 copies/ml (AOR 0.258, 95%CI 0.111–0.601), and more than twice as likely to have preterm delivery (AOR 2.379, 95%CI 1.082–5.232). For preterm delivery, also a baseline CD4/CD8 ratio between 0.3 and 0.45 was significantly associated with an increased risk (AOR: 3.415, 95%CI 1.690–6.900). Conclusion: We described for the first time independent associations of low CD4/CD8 ratio with preterm delivery and HIV-RNA suppression.

Published
2021

10. Coronavirus and birth in Italy: Results of a national population-based cohort study

Author

Donati, S, Maraschini, A, Lega, I, D'Aloja, P, Sampaolo, L, Salvatore, M, Corsi, E, Alberico, S, Casucci, P, Cetin, I, Dardanoni, G, Doganiero, F, Franchi, M, Ferrazzi, E, Leo, L, Liberati, M, Locci, M, Martini, C, Mecacci, F, Meloni, A, Mignuoli, A, Mondo, L, Patane, L, Perrone, E, Prefumo, F, Ramenghi, L, Savasi, V, Schettini, S, Steinkasserer, M, Tateo, S, Trojano, V, Vergani, P, Donati S., Maraschini A., Lega I., D'Aloja P., Sampaolo L., Salvatore M. A., Corsi E., Alberico S., Casucci P., Cetin I., Dardanoni G., Doganiero F., Franchi M. P., Ferrazzi E., Leo L., Liberati M., Locci M., Martini C., Mecacci F., Meloni A., Mignuoli A. D., Mondo L., Patane L., Perrone E., Prefumo F., Ramenghi L., Savasi V., Schettini S., Steinkasserer M., Tateo S., Trojano V., Vergani P., Donati, S, Maraschini, A, Lega, I, D'Aloja, P, Sampaolo, L, Salvatore, M, Corsi, E, Alberico, S, Casucci, P, Cetin, I, Dardanoni, G, Doganiero, F, Franchi, M, Ferrazzi, E, Leo, L, Liberati, M, Locci, M, Martini, C, Mecacci, F, Meloni, A, Mignuoli, A, Mondo, L, Patane, L, Perrone, E, Prefumo, F, Ramenghi, L, Savasi, V, Schettini, S, Steinkasserer, M, Tateo, S, Trojano, V, Vergani, P, Donati S., Maraschini A., Lega I., D'Aloja P., Sampaolo L., Salvatore M. A., Corsi E., Alberico S., Casucci P., Cetin I., Dardanoni G., Doganiero F., Franchi M. P., Ferrazzi E., Leo L., Liberati M., Locci M., Martini C., Mecacci F., Meloni A., Mignuoli A. D., Mondo L., Patane L., Perrone E., Prefumo F., Ramenghi L., Savasi V., Schettini S., Steinkasserer M., Tateo S., Trojano V., and Vergani P.

Abstract

Introduction. The study was implemented to provide guidance to decision-makers and clinicians by describing hospital care offered to women who gave birth with confirmed SARS-CoV-2 infection. Materials and methods. National population‐based prospective cohort study involving all women with confirmed SARS-CoV-2 infection who gave birth between February 25 and April 22, 2020 in any Italian hospital. Results. The incidence rate of confirmed SARS-CoV-2 infection in women who gave birth was 2.1 per 1000 maternities at a national level and 6.9/1000 in the Lombardy Region. Overall one third of the women developed a pneumonia and 49.7% assumed at least one drug against SARS-CoV-2 infection. Caesarean rate was 32.9%, no mothers nor newborns died. Six percent of the infants tested positive for SARS-CoV-2 at birth. Conclusions. Clinical features and outcomes of COVID-19 in women who gave birth are similar to those described for the general population, most women developing mild to moderate illness.

Published
2020

11. SARS-CoV-2 infection testing at delivery: a clinical and epidemiological priority

Author

Ferrazzi, E, Beretta, P, Bianchi, S, Cetin, I, Guarnerio, P, Locatelli, A, Marconi, A, Meroni, M, Pavone, G, Pintucci, A, Prefumo, F, Savasi, V, Spinillo, A, Tassis, B, Vergani, P, Vignali, M, Parazzini, F, La Vecchia, C, Ferrazzi E., Beretta P., Bianchi S., Cetin I., Guarnerio P., Locatelli A., Marconi A. M., Meroni M. G., Pavone G., Pintucci A., Prefumo F., Savasi V., Spinillo A., Tassis B., Vergani P., Vignali M., Parazzini F., La Vecchia C., Ferrazzi, E, Beretta, P, Bianchi, S, Cetin, I, Guarnerio, P, Locatelli, A, Marconi, A, Meroni, M, Pavone, G, Pintucci, A, Prefumo, F, Savasi, V, Spinillo, A, Tassis, B, Vergani, P, Vignali, M, Parazzini, F, La Vecchia, C, Ferrazzi E., Beretta P., Bianchi S., Cetin I., Guarnerio P., Locatelli A., Marconi A. M., Meroni M. G., Pavone G., Pintucci A., Prefumo F., Savasi V., Spinillo A., Tassis B., Vergani P., Vignali M., Parazzini F., and La Vecchia C.

Abstract

Background: Universal testing has been suggested as a useful strategy for a safe exit from the total lockdown, without recurrence of COVID-19 epidemic, delivering women being considered a sentinel population. Further universal testing for pregnant women may be useful in order to define appropriate access to COVID19 areas, dedicated neonatal care, and personal protective equipment. Methods: During the period 10–26 April, all consecutive women admitted for delivery at the Maternity Hospitals of the city of Milan and in six provinces of Lombardy: Brescia, Como, Lecco Monza, Pavia, and Sondrio. areas were tested with nasopharyngeal swabs. Results and conclusion: Out of 1566 women, 49 were tested positive for SARS-Cov-2 (3.1%, 95% Confidence Interval (CI) 2.3–4.0). This value is largely higher than Heath Authorities estimate. Of tested positive women, 22 (44.9%) had symptoms or reported close contacts with positive patients, that is were found at risk by the itemized questionnaire. In conclusion, routine estimate of frequency of positivity among delivering women can be consider a useful methods to monitor positivity at least in females in their fertile ages.

Published
2020

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

Author

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, Cetin, I, Ferrazzi E., Frigerio L., Savasi V., Vergani P., Prefumo F., Barresi S., Bianchi S., Ciriello E., Facchinetti F., Gervasi M. T., Iurlaro E., Kustermann A., Mangili G., Mosca F., Patane L., Spazzini D., Spinillo A., Trojano G., Vignali M., Villa A., Zuccotti G., Parazzini F., Cetin I., 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, Cetin, I, Ferrazzi E., Frigerio L., Savasi V., Vergani P., Prefumo F., Barresi S., Bianchi S., Ciriello E., Facchinetti F., Gervasi M. T., 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.

Abstract

Objective: To report mode of delivery and immediate neonatal outcome in COVID-19 infected women. Design: This is a 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 during the period 1-20 march 2020 were eligible. Data were collected from the clinical records using a standardized 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 Measure: Data on mode of delivery and neonatal outcome. Results: 42 women with COVID-19 delivered at the participating centres: 24(57,1%, 95% CI= 41,0-72,3) delivered vaginally. An elective cesarean section was performed in 18/42 (42,9%, 95%CI 27,7-59,0) cases: in 8 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%,95CI 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 post-partum period: their new-borns tested positive for SARS-Cov-2 infection. In one case a new-born had a positive test after a vaginal operative delivery. Conclusions: Although post-partum 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 new-born.

Published
2020

13. Coronavirus and birth in Italy: Results of a national population-based cohort study

Author

Donati S., Maraschini A., Lega I., D'Aloja P., Sampaolo L., Salvatore M. A., Corsi E., Alberico S., Casucci P., Cetin I., Dardanoni G., Doganiero F., Franchi M. P., Ferrazzi E., Leo L., Liberati M., Locci M., Martini C., Mecacci F., Meloni A., Mignuoli A. D., Mondo L., Patane L., Perrone E., Prefumo F., Ramenghi L., Savasi V., Schettini S., Steinkasserer M., Tateo S., Trojano V., Vergani P., Donati, S, Maraschini, A, Lega, I, D'Aloja, P, Sampaolo, L, Salvatore, M, Corsi, E, Alberico, S, Casucci, P, Cetin, I, Dardanoni, G, Doganiero, F, Franchi, M, Ferrazzi, E, Leo, L, Liberati, M, Locci, M, Martini, C, Mecacci, F, Meloni, A, Mignuoli, A, Mondo, L, Patane, L, Perrone, E, Prefumo, F, Ramenghi, L, Savasi, V, Schettini, S, Steinkasserer, M, Tateo, S, Trojano, V, Vergani, P, Donati S., Maraschini A., Lega I., D'Aloja P., Sampaolo L., Salvatore M.A., Corsi E., Alberico S., Casucci P., Cetin I., Dardanoni G., Doganiero F., Franchi M.P., Ferrazzi E., Leo L., Liberati M., Locci M., Martini C., Mecacci F., Meloni A., Mignuoli A.D., Mondo L., Patane L., Perrone E., Prefumo F., Ramenghi L., Savasi V., Schettini S., Steinkasserer M., Tateo S., Trojano V., and Vergani P.

Subjects
Pediatrics, medicine.medical_treatment, Infectious Disease Transmission, medicine.disease_cause, Adrenal Cortex Hormone, Population based cohort, Pregnancy, Adrenal Cortex Hormones, Cohort studies, COVID-19, Pregnancy outcome, SARS-CoV-2, Adult, Cesarean Section, Coronavirus Infections, Emigrants and Immigrants, Female, Fetal Organ Maturity, Humans, Incidence, Infant, Newborn, Infectious Disease Transmission, Vertical, Italy, Lung, Pneumonia, Viral, Pregnancy Complications, Infectious, Pregnancy Outcome, Premature Birth, Procedures and Techniques Utilization, Prospective Studies, Stillbirth, Betacoronavirus, Pandemics, Vertical, Viral, Prospective cohort study, pregnancy, pregnancy outcome, cohort studies, Coronavirus, education.field_of_study, Infectious, Human, medicine.medical_specialty, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Population, NO, medicine, Caesarean section, National level, education, Betacoronaviru, Pandemic, business.industry, Coronavirus Infection, Infant, Emigrants and Immigrant, Pneumonia, medicine.disease, Newborn, COVID-19 Drug Treatment, Pregnancy Complications, Prospective Studie, Pregnancy Complications, Infectiou, business, Cohort studie
Abstract

IntroductionThe study was implemented to provide guidance to decision-makers and clinicians by describing hospital care offered to women who gave birth with confirmed COVID-19 infection.Materials and methodsNational population-based prospective cohort study involving all women with confirmed COVID-19 who gave birth between February 25 and April 22, 2020 in any Italian hospital.ResultsThe incidence rate of confirmed SARS-CoV-2 infection in women who gave birth was 2.1 per 1000 maternities at a national level and 6.9/1000 in the Lombardy Region. Overall one third of the women developed a pneumonia and 49.7% assumed at least one drug. Caesarean section rate was 32.9%, no mothers nor newborns died. Six percent of the infants tested positive for SARS – CoV-2 at birth.ConclusionsClinical features and outcomes of COVID-19 in women who gave birth are similar to those described for the general population, most women developing mild to moderate illness.

Published
2020

15. Atazanavir and darunavir in pregnant women with HIV: evaluation of laboratory and clinical outcomes from an observational national study

Author

Floridia, M., Masuelli, G., Ravizza, M., Tassis, B., Cetin, I., Sansone, M., Antoni, A. D., Simonazzi, G., Maccabruni, A., Francisci, D., Frisina, V., Liuzzi, G., Dalzero, S., Tamburrini, E., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., S. Mercurio V., Zanaboni, D., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A. M. D., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Maso, G., Rizzante, E., Belcaro, C., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Bordonivicini, I., Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Crupano, F. M., Calabretti, D., Cervi, F., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Tiso, G. C., Genovese, O., Cafforio, C., Pinnetti, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., Sacchi, V., Ierardi, M., 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., Parazzini, F., Vella, S., Floridia, M., Masuelli, G., Ravizza, M., Tassis, B., Cetin, I., Sansone, M., Antoni, A. Degli, Simonazzi, G., Maccabruni, A., Francisci, D., Frisina, V., Liuzzi, G., Dalzero, S., Tamburrini, E., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., S.Mercurio, V., Zanaboni, D., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A.M. Degli, Molinari, A., Crisalli, M.P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Maso, G., Rizzante, E., Belcaro, C., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., BordoniVicini, I., Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Crupano, F.M., Calabretti, D., Cervi, F., Margarito, E., Capretti, M.G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G.M., Tibaldi, C., Trentini, L., Todros, T., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Tiso, G.C., Genovese, O., Cafforio, C., Pinnetti, C., Casadei, A.M., Cavaliere, A.F., Cellini, M., Marconi, A.M., Sacchi, V., Ierardi, M., 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., Parazzini, F., and Vella, S.

Subjects
Male, 0301 basic medicine, medicine.medical_treatment, HIV Infections, 0302 clinical medicine, Pregnancy, Pharmacology (medical), 030212 general & internal medicine, Pregnancy Complications, Infectious, Darunavir, medicine.diagnostic_test, Obstetrics, Pregnancy Outcome, virus diseases, Alanine Transaminase, Viral Load, Cholesterol, Treatment Outcome, Infectious Diseases, Premature birth, Gestation, Female, Drugs in pregnancy, medicine.drug, Adult, Microbiology (medical), medicine.medical_specialty, Drug-Related Side Effects and Adverse Reactions, Anti-HIV Agents, Atazanavir Sulfate, Settore MED/17 - MALATTIE INFETTIVE, 03 medical and health sciences, pharmacology, pharmacology (medical), infectious diseases, medicine, Humans, Caesarean section, Triglycerides, Pharmacology, business.industry, Infant, Newborn, Infant, Bilirubin, medicine.disease, 030112 virology, Atazanavir, azatanavir sulfate, Lipid profile, business
Abstract

Background Atazanavir and darunavir represent the main HIV PIs recommended in pregnancy, but comparative data in pregnant women are limited. We assessed the safety and activity profile of these two drugs in pregnancy using data from a national observational study. Methods Women with atazanavir or darunavir exposure in pregnancy were evaluated for laboratory measures and main pregnancy outcomes (e.g. preterm delivery, low birthweight, non-elective caesarean section and neonatal gestational age-adjusted birthweight Z-score). Results Final analysis included 500 pregnancies with either atazanavir (n = 409) or darunavir (n = 91) exposure. No differences in pregnancy outcomes, weight gain in pregnancy, drug discontinuations, undetectable HIV-RNA, haemoglobin, ALT, total cholesterol, HDL cholesterol and LDL cholesterol were observed between the two groups. At third trimester, exposure to darunavir was associated with higher levels of plasma triglycerides (median 235.5 versus 179 mg/dL; P = 0.032) and a higher total cholesterol/HDL cholesterol ratio (median 4.03 versus 3.27; P = 0.028) and exposure to atazanavir was associated with higher levels of plasma bilirubin (1.54 versus 0.32 mg/dL; P

Published
2017
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16. Weight Gain during Pregnancy in Women with HIV Receiving Different Antiretroviral Regimens

Author

Floridia, M., Masuelli, G., Tassis, B., Franceschetti, L., Savasi, V. M., Spinillo, A., Tamburrini, E., Guaraldi, G., Dalzero, S., Sansone, M., Chiodo, A., Degli Antoni, A. M., Pinnetti, C., Liuzzi, G., Ravizza, M., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Zanaboni, D., Nardini, G., Stentarelli, C., Beghetto, B., Molinari, A., Crisalli, M. P., Donisi, A., Ruggieri, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Paradiso, L., Forlanini, F., Longoni, E., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Maso, G., Bernardon, M., Bussolaro, S., della Pieta, I., Sorz, A., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Vicini, I. B., Luzi, K., Roccio, M., Vimercati, A., Calabretti, D., Gigante, S., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Cardellicchio, E., Giaquinto, C., Fiscon, M., Rubino, E., Badolato, R., Forleo, M. A., Ruggiero, M., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., Ierardi, M., Simonetti, S. C., Alfieri, N., Agrati, S., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Cerioli, A., de Martino, M., Parazzini, F., and Vella, S.

Subjects
medicine.medical_specialty, Multivariate analysis, Anti-HIV Agents, Integrase inhibitor, HIV Infections, Overweight, Weight Gain, Cohort Studies, Pregnancy, Internal medicine, medicine, Humans, Pharmacology (medical), Settore MED/38 - Pediatria Generale e Specialistica, Pharmacology, business.industry, Weight change, Odds ratio, medicine.disease, Obesity, Infectious Diseases, Reverse Transcriptase Inhibitors, Female, medicine.symptom, business, Weight gain
Abstract

Background No published studies have evaluated in pregnant women with HIV weight gain with different antiretroviral drug classes. Methods Data from a national cohort study were used. We compared absolute weight gain and occurrence of excessive weight gain in women with HIV who received during pregnancy integrase inhibitors (INSTI), protease inhibitors (PI), or non-nucleoside reverse transcriptase inhibitors (NNRTI). Excessive weight gain was defined according to the Institute of Medicine recommendations. Possible predictors of weight gain were assessed using univariate and multivariate analyses. Results Among 273 cases (PI: 191, NNRTI: 43, INSTI: 39), the mean weight increase was 11.3 kg, and 25.4% of the mothers had an excessive weight increase. No significant differences were found among the three treatment groups for absolute weight increase, occurrence of excessive weight gain, infant birthweight, and other pregnancy and laboratory outcomes. The comparisons of individual drugs, although based on a limited number of cases, suggested no major differences. A significant positive correlation was found between weight gain and CD4+ T-cell increase during pregnancy. In multivariate analyses, drug class and nucleoside backbone were not associated with absolute or excessive weight increase. Excessive weight increase was significantly associated with week of delivery (adjusted odds ratio: 1.74, 95% CI 1.15, 2.63), obesity (5.21, 95% CI 1.85, 14.64), overweight (7.95, 95% CI 3.26, 19.39), recent substance use (5.96, 95% CI 1.13, 31.40) and fasting 2nd trimester hyperglycaemia (3.94, 95% CI 1.14, 13.65). Conclusions No significant differences in absolute weight change or occurrence of excessive weight gain were found among women with HIV who received during pregnancy different classes of antiretroviral drugs.

Published
2021

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

Author

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

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

Published
2021

20. Vaginal Delivery in SARS-CoV-2-infected Pregnant Women in Northern Italy: A Retrospective Analysis

Author

Ferrazzi, E., primary, Frigerio, L., additional, Savasi, V., additional, Vergani, P., additional, Prefumo, F., additional, Barresi, S., additional, Bianchi, S., additional, Ciriello, E., additional, Facchinetti, F., additional, Gervasi, M.T., additional, Iurlaro, E., additional, Kustermann, A., additional, Mangili, G., additional, Mosca, F., additional, Patane, L., additional, Spazzini, D., additional, Spinillo, A., additional, Trojano, G., additional, Vignali, M., additional, Villa, A., additional, Zuccotti, G.V., additional, Parazzini, F., additional, and Cetine, L., additional

Published
2021
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21. Monochorionic Triplet Gestation after Single Blastocyst Transfer Using Donor Oocytes: Case Report and Review

Author

Ferri, G., Musto, M., Colombo, G., and Savasi, V. M.

Subjects
Article Subject
Abstract

We report a case of a 43-year-old patient with a monochorionic triamniotic triplet pregnancy after IVF with donor oocytes. After failed IVF attempts, the patient chose to undergo treatment with donor oocytes. Her 22-year-old oocyte donor underwent standard controlled ovarian hyperstimulation. The retrieved oocytes were fertilized in vitro, and one embryo was transferred at the blastocyst stage. At 6 weeks and 5 days of gestation, an ultrasound revealed monochorionic triamniotic (MCTA) triplets. The risk of monozygotic twinning in women undergoing in vitro fertilization (IVF) is reported to be higher than that in natural conception, although the causes of the phenomenon have not yet been clarified. Efforts still must be made in order to prevent monozygotic multiple pregnancies, associated with much greater chances of obstetric and perinatal morbidity and mortality.

Published
2020
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22. 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

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

Abstract

Objectives 1. To assess the performance of an extended questionnaire in identifying cases of SARSCoV- 2 infection among obstetric patients. 2. To evaluate the rate of infection among healthcare workers involved in women’s care. Study design A 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. Results There 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 SARSCoV- 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%. Conclusions An exhaustive triage questionnaire can effectively discriminate women at low risk of SARSCoV- 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 pe

Published
2020

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

Author

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

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.

Published
2020

24. Clinical findings and disease severity in hospitalized pregnant women with coronavirus disease 2019 (COVID-19)

Author

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

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

26. Amniocentesis and chorionic villus sampling in HIV-infected pregnant women: a multicentre case series

Author

Floridia M, Masuelli G, Meloni A, Cetin I, Tamburrini E, Cavaliere AF, Dalzero S, Sansone M, Alberico S, Guerra B, Spinillo A, Chiadò Fiorio Tin M, Ravizza M, 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, Del Pin B, 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, Nardini G, Stentarelli C, Beghetto B, Degli Antoni AM, Molinari A, Crisalli MP, Donisi A, Piepoli M, Cerri V, Zuccotti G, Giacomet V, Coletto S, Di Nello F, Madia C, Placido G, Vivarelli A, Castelli P, Savalli F, Portelli V, Sabbatini F, Francisci D, Bernini L, Grossi P, Rizzi L, Maso G, Airoud M, Soppelsa G, Dedoni M, Cuboni C, Ortu F, Piano P, Citernesi A, Bordoni Vicini I, Luzi K, Roccio M, Vimercati A, Miccolis A, De Gennaro A, Cervi F, Simonazzi G, Margarito E, Capretti MG, Marsico C, Faldella G, Martinelli P, Agangi A, Capone A, Maruotti GM, Tibaldi C, Trentini L, Todros T, Frisina V, Brambilla T, Savasi V, Personeni C, Giaquinto C, Fiscon M, Rubino E, Bucceri A, Matrone R, Scaravelli G, Genovese O, Cafforio C, Pinnetti C, Liuzzi G, Tozzi V, Massetti P, Casadei AM, Cellini M, Castelli Gattinara G, Marconi AM, Sacchi V, Ierardi M, Polizzi C, Mattei A, Pirillo MF, Amici R, Galluzzo CM, Donnini S, Baroncelli S, Villani P, Cusato M, Cerioli A, De Martino M, Mastroiacovo P, Parazzini F, Vella S., Floridia M, Masuelli G, Meloni A, Cetin I, Tamburrini E, Cavaliere AF, Dalzero S, Sansone M, Alberico S, Guerra B, Spinillo A, Chiadò Fiorio Tin M, Ravizza M, and 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, Del Pin B, 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, Nardini G, Stentarelli C, Beghetto B, Degli Antoni AM, Molinari A, Crisalli MP, Donisi A, Piepoli M, Cerri V, Zuccotti G, Giacomet V, Coletto S, Di Nello F, Madia C, Placido G, Vivarelli A, Castelli P, Savalli F, Portelli V, Sabbatini F, Francisci D, Bernini L, Grossi P, Rizzi L, Maso G, Airoud M, Soppelsa G, Dedoni M, Cuboni C, Ortu F, Piano P, Citernesi A, Bordoni Vicini I, Luzi K, Roccio M, Vimercati A, Miccolis A, De Gennaro A, Cervi F, Simonazzi G, Margarito E, Capretti MG, Marsico C, Faldella G, Martinelli P, Agangi A, Capone A, Maruotti GM, Tibaldi C, Trentini L, Todros T, Frisina V, Brambilla T, Savasi V, Personeni C, Giaquinto C, Fiscon M, Rubino E, Bucceri A, Matrone R, Scaravelli G, Genovese O, Cafforio C, Pinnetti C, Liuzzi G, Tozzi V, Massetti P, Casadei AM, Cellini M, Castelli Gattinara G, Marconi AM, Sacchi V, Ierardi M, Polizzi C, Mattei A, Pirillo MF, Amici R, Galluzzo CM, Donnini S, Baroncelli S, Villani P, Cusato M, Cerioli A, De Martino M, Mastroiacovo P, Parazzini F, Vella S.

Subjects
Infectious Disease Transmission, Prenatal diagnosis, HIV Infections, 0302 clinical medicine, Birth defect, Pregnancy, Odds Ratio, Vertical, Medicine, 030212 general & internal medicine, Pregnancy Complications, Infectious, education.field_of_study, Amniocentesi, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, Obstetrics, Infectious, Obstetrics and Gynecology, Amniocentesis, birth defects, chorionic villus sampling, HIV, invasive testing, mother-to child HIV transmission, pregnancy, prenatal diagnosis, Birth defects, Chorionic villus sampling, Invasive testing, Mother-to child HIV transmission, Anti-Retroviral Agents, Chorionic Villi Sampling, Female, Adult, medicine.medical_specialty, Prenatal diagnosi, Population, Settore MED/17 - MALATTIE INFETTIVE, 03 medical and health sciences, Humans, education, Fetal Death, Analysis of Variance, Chi-Square Distribution, business.industry, Infectious Disease Transmission, Vertical, Odds ratio, medicine.disease, Confidence interval, Pregnancy Complications, business, Chi-squared distribution
Abstract

Objectives To assess in pregnant women with HIV the rates of amniocentesis and chorionic villus sampling (CVS), and the outcomes associated with such procedures. Design Observational study. Data from the Italian National Program on Surveillance on Antiretroviral Treatment in Pregnancy were used. Setting University and hospital clinics. Population Pregnant women with HIV. Methods Temporal trends were analysed by analysis of variance and by the Chi-square test for trend. Quantitative variables were compared by Student's t-test and categorical data by the Chi-square test, with odds ratios and 95% confidence intervals calculated. Main outcome measures Rate of invasive testing, intrauterine death, HIV transmission. Results Between 2001 and 2015, among 2065 pregnancies in women with HIV, 113 (5.5%) had invasive tests performed. The procedures were conducted under antiretroviral treatment in 99 cases (87.6%), with a significant increase over time in the proportion of tests performed under highly active antiretroviral therapy (HAART) (100% in 2011–2015). Three intrauterine deaths were observed (2.6%), and 14 pregnancies were terminated because of fetal anomalies. Among 96 live newborns, eight had no information available on HIV status. Among the remaining 88 cases with either amniocentesis (n = 75), CVS (n = 12), or both (n = 1), two HIV transmissions occurred (2.3%). No HIV transmission occurred among the women who were on HAART at the time of invasive testing, and none after 2005. Conclusions The findings reinforce the assumption that invasive prenatal testing does not increase the risk of HIV vertical transmission among pregnant women under suppressive antiretroviral treatment. Tweetable abstract No HIV transmission occurred among women who underwent amniocentesis or CVS under effective anti-HIV regimens.

Published
2016
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30. Vaginal delivery in SARS‐CoV‐2‐infected pregnant women in Northern Italy: a retrospective analysis

Author

Ferrazzi, E, primary, Frigerio, L, additional, Savasi, V, additional, Vergani, P, additional, Prefumo, F, additional, Barresi, S, additional, Bianchi, S, additional, Ciriello, E, additional, Facchinetti, F, additional, Gervasi, MT, additional, Iurlaro, E, additional, Kustermann, A, additional, Mangili, G, additional, Mosca, F, additional, Patanè, L, additional, Spazzini, D, additional, Spinillo, A, additional, Trojano, G, additional, Vignali, M, additional, Villa, A, additional, Zuccotti, GV, additional, Parazzini, F, additional, and Cetin, I, additional

Published
2020
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31. 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, 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., Zona S., 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.

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 antir

Published
2017

33. Vaginal delivery in women with HIV in Italy: results of 5 years of implementation of the national SIGO-HIV protocol

Author

Tibaldi, C., Masuelli, G., Sansone, M., Tassis, B., Cetin, I., Franceschetti, L., Spinillo, A., Simonazzi, G., Vimercati, A., Dalzero, S., Meloni, A., Bernardon, M., Frisina, V., Polizzi, C., Todros, T., Martinelli, P., Floridia, M., Ravizza, M., Trentini, L., Tiso, G., Brambilla, T., Savasi, V., Personeni, C., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Forleo, M. A., Badolato, R., Roccio, M., Zanaboni, D., Sirico, A., Maruotti, G. M., Capone, A., Guerra, B., Cervi, F., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Crupano, F. M., Calabretti, D., Ravizz, M., Marconi, A. M., Galiano, V., Ierardi, S. C. S. M., Chiodo, A., Ortu, F., Piano, P., Dedoni, I. M., Maso, G., Belcaro, C., Rizzante, E., Alberico, S., Citernesi, A., Vicini, I. B., Luzi, K., Tibaldi C, Masuelli G, Sansone M, Tassis B, Cetin I, Franceschetti L, Spinillo A, Simonazzi G, Vimercati A, Dalzero S, Meloni A, Bernardon M, Frisina V, Polizzi C, Todros T, Martinelli P, Floridia M, Ravizza M, and for SIGO-HIV Study Group.

Subjects
0301 basic medicine, Microbiology (medical), Adult, medicine.medical_specialty, 030106 microbiology, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Pregnancy, medicine, Humans, 030212 general & internal medicine, Young adult, Hiv transmission, Delivery complications, Vaginal delivery, business.industry, Obstetrics, Cesarean Section, HIV, Mode of delivery, Delivery, Obstetric, Female, Italy, Viral Load, Obstetric, General Medicine, medicine.disease, Infectious Diseases, Delivery complication, business, Viral load, Delivery
Abstract

PURPOSE: To evaluate the maternal and neonatal safety of vaginal delivery in women with HIV following the implementation of a national protocol in Italy. METHODS: Vaginal delivery was offered to all eligible women who presented antenatally at twelve participating clinical sites. Data collection and definition of outcomes followed the procedures of the National Program on Surveillance on Antiretroviral Treatment in Pregnancy. Pregnancy outcomes were compared according to the mode of delivery, classified as vaginal, elective cesarean (ECS) and non-elective cesarean section (NECS). RESULTS: Among 580 women who delivered between January 2012 and September 2017, 142 (24.5%) had a vaginal delivery, 323 (55.7%) had an ECS and 115 (19.8%) had an NECS. The proportion of vaginal deliveries increased significantly over time, from 18.9% in 2012 to 35.3% in 2017 (p

Published
2019

37. Abacavir/Lamivudine and Tenofovir/Emtricitabine in Pregnant Women with Hiv: Laboratory and Clinical Outcomes in an Observational National Study

Author

Floridia, M., Pinnetti, C., Ravizza, M., Masuelli, G., Personeni, C., Sansone, M., Antoni, A. D., Guaraldi, G., Spinillo, A., Tassis, B., Dalzero, S., Liuzzi, G., Tamburrini, E., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Maccabruni, A., Zaramella, M., Mariani, B., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Maso, G., Rizzante, E., Belcaro, C., Meloni, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Vicini, I. B., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Martinelli, P., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Cetin, I., Brambilla, T., Savasi, V., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Tiso, G. C., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, M., Marconi, A. M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., and Baroncelli, S.

Subjects
0301 basic medicine, HIV Infections, Hemoglobins, 0302 clinical medicine, Abacavir, Anemia, Cholesterol, Emtricitabine, HIV-RNA, Lamivudine, Low birthweight, Pregnancy, Preterm delivery, Tenofovir, immune system diseases, Antiretroviral Therapy, Highly Active, Pharmacology (medical), 030212 general & internal medicine, Pregnancy Outcome, virus diseases, Lipoproteins, LDL, Drug Combinations, Infectious Diseases, Hypertension, RNA, Viral, Female, medicine.drug, Adult, medicine.medical_specialty, Anti-HIV Agents, Pregnancy Trimester, Third, 03 medical and health sciences, Internal medicine, medicine, Humans, AIDS-Associated Nephropathy, Cesarean Section, business.industry, Abacavir/Lamivudine, medicine.disease, 030112 virology, Dideoxynucleosides, CD4 Lymphocyte Count, Pregnancy Complications, HIV-1, Observational study, business
Abstract

Abacavir-lamivudine (ABC/3TC) and tenofovir-emtricitabine (TDF/FTC) represent in the guidelines of several countries, including Italy and United States, the preferred nucleoside/nucleotide backbones of antiretroviral regimens. We assessed their profile in pregnancy using data from a national observational study.Laboratory measures (CD4, HIV-RNA, lipid profile, glucose, hemoglobin, and alanine transferase) and pregnancy outcomes (preterm delivery, low birthweight, nonelective cesarean section, birthweight Z-score, congenital defects, HIV transmission, maternal weight gain, and pregnancy complications) were compared after prenatal exposure to ABC/3TC or TDF/FTC.The study evaluated 913 pregnancies (ABC/3TC: 252; TDF/FTC: 661). At entry in pregnancy, women on TDF/FTC were older (33.6 vs. 32.4 years, P = 0.005), less frequently on treatment (66.9% vs. 80.2%, P0.001), and had lower CD4 counts (475/mm vs. 533/mm, P = 0.003) and higher plasma HIV-RNA levels (2.48 vs. 2.22 log10 copies/mL, P = 0.003). Women on ABC/3TC had more commonly hypertension/nephropathy (5.2% vs. 2.0%, P = 0.013). No major differences were observed in the main pregnancy outcomes and in rates of undetectable HIV-RNA at third trimester. In a subgroup analysis that evaluated at third trimester only cases with regular 3-drug treatment during pregnancy, women on TDF/FTC had lower hemoglobin levels (median: 11.1 vs. 11.8 g/dL, P = 0.002) and women on ABC/3TC had higher levels of total cholesterol (median: 230 vs. 216 mg/dL, P = 0.023) and low-density lipoprotein-cholesterol (133 vs. 111 mg/dL, P = 0.030).In this study, use of TDF/FTC and ABC/3TC in pregnancy was associated with similar pregnancy outcomes and with some differences in laboratory measures that might guide physicians' prescriptions in mothers with hematologic or metabolic risk factors.

Published
2018

38. Pregnancy Outcomes and Vaccine Effectiveness During the Period of Omicron as the Variant of Concern, INTERCOVID-2022: A Multinational, Observational Study

Author

Villar, J., Soto Conti, C.P., Gunier, R.B., Ariff, S., Craik, R., Cavoretto, P.I., Rauch, S., Gandino, S., Nieto, R., Winsey, A., Menis, C., Rodriguez, G.B., Savasi, V., Tug, N., Deantoni, S., Fabre, M., Martinez de Tejada, B., Rodriguez-Sibaja, M.J., Livio, S., Napolitano, R., Maiz, N., Sobrero, H., Peterson, A., Deruelle, P., Giudice, C., Teji, J.S., Casale, R.A., Salomon, L.J., Prefumo, F., Cheikh Ismail, L., Gravett, M.G., Vale, M., Hernández, V., Sentilhes, L., Easter, S.R., Capelli, C., Marler, E., Cáceres, D.M., Albornoz Crespo, G., Ernawati, E., Lipschuetz, M., Takahashi, K., Vecchiarelli, C., Hubka, T., Ikenoue, S., Tavchioska, G., Bako, B., Ayede, A.I., Eskenazi, B., Thornton, J.G., Bhutta, Z.A., Kennedy, S.H., and Papageorghiou, A.T.

Abstract

(Lancet. 2023;401:447–457)In 2021, COVID-19 during pregnancy was reported to be associated with an increased risk of maternal and neonatal outcomes. The SARS-CoV-2 virus has undergone genetic mutations since then and the subsequent impact of the omicron variant on maternal and neonatal health wasunknown. This study aimed to analyze the effects on maternal and perinatal outcomes of omicron during pregnancy as well as vaccine efficacy.

Published
2023
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39. Use of zidovudine-sparing HAART in pregnant HIV-infected women in Europe: 2000-2009

Author

Tariq, S, Townsend, Cl, Cortina Borja, M, Duong, T, Elford, J, Thorne, C, Tookey, Pa, Giaquinto, C, Rampon, O, Mazza, A, De Rossi, A, Grosch Wörner, I, Mok, J, de José MI, Larrú Martínez, B, Scherpbier, Hj, Kreyenbroek, M, Godfried, Mh, Nellen, Fj, Boer, K, Navér, L, Anzén, B, Lidman, K, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Brichard, B, De Camps, J, Thiry, N, Deboone, G, Waterloos, H, De Maria, A, Mûr, A, Payà, A, López Vilchez MA, Carreras, R, Valerius, Nh, Rosenfeldt, V, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguña, J, Savasi, V, Viganò, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Alberico, S, Rabusin, M, Bernardon, M, 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, Masters, J, Haile Selassie, H, French, C, Shakes, I., National Study of HIV in Pregnancy Childhood, National Study of HIV in Pregnancy, Childhood, Martinelli, Pasquale, Amsterdam institute for Infection and Immunity, Paediatric Infectious Diseases / Rheumatology / Immunology, General Internal Medicine, Infectious diseases, Other Research, Obstetrics and Gynaecology, Tariq, S, Townsend, Cl, Cortina Borja, M, Duong, T, Elford, J, Thorne, C, Tookey, Pa, European Collaborative, Study, Giaquinto C, National Study of HIV in Pregnancy C. h. i. l. d. h. o. o. d., Rampon, O, Mazza, A, De Rossi, A, Grosch Wörner, I, Mok, J, de José, Mi, Larrú Martínez, B, Scherpbier, Hj, Kreyenbroek, M, Godfried, Mh, Nellen, Fj, Boer, K, Navér, L, Anzén, B, Lidman, K, Levy, J, Barlow, P, Manigart, Y, Hainaut, M, Goetghebuer, T, Brichard, B, De Camps, J, Thiry, N, Deboone, G, Waterloos, H, De Maria, A, Mûr, A, Payà, A, López Vilchez, Ma, Carreras, R, Valerius, Nh, Rosenfeldt, V, Coll, O, Suy, A, Perez, Jm, Fortuny, C, Boguña, J, Savasi, V, Viganò, A, Giacomet, V, Cerini, C, Raimondi, C, Zuccotti, G, Alberico, S, Rabusin, M, Bernardon, M, Buffolano, Wilma, 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, Masters, J, Haile Selassie, H, French, C, and Shakes, I.

Subjects
Adult, Pediatrics, medicine.medical_specialty, Time Factors, HAART, Anti-HIV Agents, HIV Infections, antiretroviral agents, highly active antiretroviral therapy, HIV, pregnancy outcome, viral load, congenital abnormalities, Article, Zidovudine, ANTIRETROVIRAL AGENTS, immune system diseases, Hiv infected, Antiretroviral Therapy, Highly Active, Medicine, Humans, Pharmacology (medical), Pregnancy Complications, Infectious, antiretroviral agents, highly active antiretroviral therapy, HIV, pregnancy outcome, viral load, Pregnancy outcomes, Retrospective Studies, Pregnancy, integumentary system, business.industry, Infant, virus diseases, Retrospective cohort study, medicine.disease, Infectious Disease Transmission, Vertical, CD4 Lymphocyte Count, zidovudine, Europe, Infectious Diseases, In utero, Immunology, Female, pregnancy, business, Viral load, medicine.drug
Abstract

Increasing numbers of women in resource-rich settings are prescribed zidovudine (ZDV)-sparing highly active antiretroviral therapy (HAART) in pregnancy. We compare ZDV-sparing with ZDV-containing HAART in relation to maternal viral load at delivery, mother-to-child transmission (MTCT) of HIV, and congenital abnormality. This is an analysis of data from the National Study of HIV in Pregnancy and Childhood and the European Collaborative Study. Data on 7573 singleton births to diagnosed HIV-infected women between January 2000 and June 2009 were analyzed. Logistic regression models were fitted to estimate adjusted odds ratios (AORs). Overall, 15.8% (1199 of 7573) of women received ZDV-sparing HAART, with increasing use between 2000 and 2009 (P

Published
2011
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40. Pregnant with HIV before age 25: Data from a large national study in Italy, 2001-2016

Author

Floridia, M., Masuelli, G., Tamburrini, E., Cetin, I., Liuzzi, G., Martinelli, Paolo, Guaraldi, G., Spinillo, A., Vimercati, A., Maso, G., Pinnetti, C., Frisina, V., Dalzero, S., Ravizza, M., Di Lorenzo, F., Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Del Pin, B., Marocco, R., Mastroianni, C., Mercurio, V. S., Maccabruni, A., Zaramella, M., Mariani, Bianca, Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A. M. Degli, Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Angeli, G., Bernini, L., Grossi, P., Rizzi, L., Bernardon, M., Rizzante, E., Belcaro, C., Meloni, Antonio, Dedoni, M., Ortu, F., Piano, Pierluigi, Citernesi, A., Vicini, I. Bordoni, Luzi, K., Roccio, M., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, Filippo, Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Agangi, A., Capone, A., Maruotti, G. M., Tibaldi, C., Trentini, L., Todros, T., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Tassis, B., Genovese, O., Cafforio, C., Casadei, A. M., Cavaliere, A. F., Cellini, Matteo, Marconi, A. M., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M. F., Amici, R., Galluzzo, C. M., Donnini, S., Baroncelli, S., Cerioli, A., DE MARTINO, MARIA CRISTINA, Parazzini, F., and Vella, S.

Subjects
Antiretroviral treatment, HIV diagnosis, HIV testing, pregnancy, women's health, medicine.medical_specialty, Pediatrics, Longitudinal study, Adolescent, Epidemiology, Short Report, HIV Infections, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Pregnancy, medicine, Odds Ratio, Humans, 030212 general & internal medicine, Young adult, 030219 obstetrics & reproductive medicine, business.industry, Odds ratio, medicine.disease, Female, Italy, Infectious Diseases, Confidence interval, Family planning, business, Cohort study
Abstract

SUMMARYYoung pregnant women with HIV may be at significant risk of unplanned pregnancy, lower treatment coverage, and other adverse pregnancy outcomes. In a large cohort of pregnant women with HIV in Italy, among 2979 pregnancies followed in 2001–2016, 9·0% were in women P< 0·001). Younger women had a lower rate of planned pregnancy (23·2%vs.37·7%, odds ratio (OR) 0·50, 95% confidence interval (CI) 0·36–0·69), were more frequently diagnosed with HIV in pregnancy (46·5%vs.20·9%, OR 3·29, 95% CI 2·54–4·25), and, if already diagnosed with HIV before pregnancy, were less frequently on antiretroviral treatment at conception (vs.99·3%), with no differences in rate of HIV viral suppression at third trimester and adverse pregnancy outcomes. The data show that young women represent a growing proportion of pregnant women with HIV, and are significantly more likely to have unplanned pregnancy, undiagnosed HIV infection, and lower treatment coverage at conception. During pregnancy, antiretroviral treatment, HIV suppression, and pregnancy outcomes are similar compared with older women. Earlier intervention strategies may provide additional benefits in the quality of care for women with HIV.

Published
2017

41. Pregnancy outcomes and cytomegalovirus DNAaemia in HIV-infected pregnant women with CMV

Author

Ravizza, M., 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., Del Pin, 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., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A.M., Molinari, A., Crisalli, M.P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Vivarelli, A., Castelli, P., 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., Bordoni Vicini, I., Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M.G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Capone, A., Maruotti, G.M., Tibaldi, C., Trentini, L., Todros, T., Masuelli, G., Frisina, V., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Genovese, O., Cafforio, C., Pinnetti, C., Liuzzi, G., Tozzi, V., Massetti, P., Casadei, A.M., Cavaliere, A.F., Cellini, M., Castelli Gattinara, G., Marconi, A.M., Dalzero, S., Sacchi, V., Ierardi, M., Polizzi, C., Mattei, A., Pirillo, M.F., Amici, R., Galluzzo, C.M., Donnini, S., Baroncelli, S., Floridia, M., Villani, P., Cusato, M., Cerioli, A., De Martino, M., Mastroiacovo, P., Parazzini, F., Vella, S., and Degli Antoni, A.

Published
2016
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43. Rate, correlates and outcomes of repeat pregnancy in HIV-infected women

Author

Floridia, M., Tamburrini, E., Masuelli, G., Martinelli, P., Spinillo, A., Liuzzi, G., Vimercati, A., Alberico, S., Maccabruni, A., Pinnetti, C., Frisina, V., Dalzero, S., 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., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Bernini, L., Grossi, P., Rizzi, L., Maso, G., Airoud, M., Soppelsa, G., Meloni, A., Dedoni, M., Cuboni, C., Ortu, F., Piano, P., Citernesi, A., Bordoni Vicini, I., Luzi, K., Roccio, M., Miccolis, A., De Gennaro, A., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Agangi, A., Capone, A., Maruotti, M., Tibaldi, C., Trentini, L., Todros, T., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Fiscon, M., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., Casadei, A. M., Cavaliere, A. F., Cellini, M., Castelli Gattinara, G., Marconi, A. M., Sacchi, V., Ierardi, M., 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., Parazzini, F., Vella, S., Floridia, M, Tamburrini, E., Masuelli, G., Martinelli, P., Spinillo, A., Liuzzi, G., Vimercati, A., Alberico, S., Maccabruni, A., Pinnetti, C., Frisina, V., Dalzero, S., Ravizza, M. [, Faldella G., and ]

Subjects
0301 basic medicine, Adult, medicine.medical_specialty, HIV RNA, Anti-HIV Agents, birth weight, HIV, pregnancy, preterm delivery, Health Policy, Infectious Diseases, Pharmacology (medical), Birth weight, Emigrants and Immigrants, HIV Infections, Settore MED/17 - MALATTIE INFETTIVE, Pregnancy, Preterm delivery, CD4 Lymphocyte Count, Female, HIV-1, Humans, Premature Birth, Viral Load, Infant, Low Birth Weight, 03 medical and health sciences, medicine, Obstetrics, business.industry, Low Birth Weight, Infant, Odds ratio, medicine.disease, 030112 virology, Confidence interval, Pregnancy rate, Low birth weight, Premature birth, medicine.symptom, business, Viral load
Abstract

Objectives The aim of the study was to assess the rate, determinants, and outcomes of repeat pregnancies in women with HIV infection. Methods Data from a national study of pregnant women with HIV infection were used. Main outcomes were preterm delivery, low birth weight, CD4 cell count and HIV plasma viral load. Results The rate of repeat pregnancy among 3007 women was 16.2%. Women with a repeat pregnancy were on average younger than those with a single pregnancy (median age 30 vs. 33 years, respectively), more recently diagnosed with HIV infection (median time since diagnosis 25 vs. 51 months, respectively), and more frequently of foreign origin [odds ratio (OR) 1.36; 95% confidence interval (CI) 1.10–1.68], diagnosed with HIV infection in the current pregnancy (OR: 1.69; 95% CI: 1.35–2.11), and at their first pregnancy (OR: 1.33; 95% CI: 1.06–1.66). In women with sequential pregnancies, compared with the first pregnancy, several outcomes showed a significant improvement in the second pregnancy, with a higher rate of antiretroviral treatment at conception (39.0 vs. 65.4%, respectively), better median maternal weight at the start of pregnancy (60 vs. 61 kg, respectively), a higher rate of end-of-pregnancy undetectable HIV RNA (60.7 vs. 71.6%, respectively), a higher median birth weight (2815 vs. 2885 g, respectively), lower rates of preterm delivery (23.0 vs. 17.7%, respectively) and of low birth weight (23.4 vs. 15.4%, respectively), and a higher median CD4 cell count (+47 cells/μL), with almost no clinical progression to Centers for Disease Control and Prevention stage C (CDC-C) HIV disease (0.3%). The second pregnancy was significantly more likely to end in voluntary termination than the first pregnancy (11.4 vs. 6.1%, respectively). Conclusions Younger and foreign women were more likely to have a repeat pregnancy; in women with sequential pregnancies, the second pregnancy was characterized by a significant improvement in several outcomes, suggesting that women with HIV infection who desire multiple children may proceed safely and confidently with subsequent pregnancies.

Published
2016

44. Good prenatal detection rate of major birth defects in HIV-infected pregnant women in Italy

Author

Floridia, M, Mastroiacovo, P., Ravizza, M., Todros, T., Chiadò Fiorio Tin, M., Marconi, A. M., Cetin, I., Maruotti, G. M., Liuzzi, G., Pinnetti, C., Degli Antoni, A., Spinillo, A., Guerra, B., Tamburrini, E., Floridia, 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., Mastroianni, C., Mercurio, V. S., Carocci, A., Grilli, E., Maccabruni, A., Zaramella, M., Mariani, B., Natalini Raponi, G., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Coletto, S., Di Nello, F., Madia, C., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, Daniela, 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., Bordoni Vicini, I., Luzi, K., Roccio, M., Vimercati, A., Miccolis, A., De Gennaro, A., Cervi, F., Puccetti, C., Margarito, E., Contoli, M., Capretti, M. G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Capone, A., Tibaldi, C., Trentini, L., Masuelli, G., 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., Castelli Gattinara, G., Dalzero, S., Sacchi, V., Ierardi, M., 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., Parazzini, F., and Vella, S.

Subjects
Adult, Infectious, Obstetrics and Gynecology, HIV Infections, Congenital Abnormalities, Pregnancy Complications, Italy, Pregnancy, Humans, Female, Pregnancy Complications, Infectious, Genetics (clinical)
Published
2015

45. Weight Gain during Pregnancy in Women with HIV Receiving Different Antiretroviral Regimens

Author

Floridia, Marco, Masuelli, Giulia, Tassis, Beatrice, Franceschetti, Laura, Savasi, Valeria Maria, Spinillo, Arsenio, Tamburrini, Enrica, Guaraldi, Giovanni, Dalzero, Serena, Sansone, Matilde, Chiodo, Antonella, Antoni, Anna Maria Degli, Pinnetti, Carmela, Liuzzi, Giuseppina, Ravizza, Marina, Floridia, M., Ravizza, M., Tamburrini, E., Ravizza, M., Tamburrini, E., Lorenzo, F. Di, Sterrantino, G., Meli, M., Campolmi, I., Vichi, F., Pin, B. Del, Marocco, R., Mastroianni, C., Mercurio, V.S., Zanaboni, D., Guaraldi, G., Nardini, G., Stentarelli, C., Beghetto, B., Antoni, A.M. Degli, Molinari, A., Crisalli, M.P., Donisi, A., Ruggieri, A., Piepoli, M., Cerri, V., Zuccotti, G., Giacomet, V., Paradiso, L., Forlanini, F., Longoni, E., Placido, G., Milini, P., Savalli, F., Portelli, V., Sabbatini, F., Francisci, D., Papalini, C., Bernini, L., Grossi, P., Rizzi, L., Maso, G., Bernardon, M., Bussolaro, S., Pietà, I. Della, Sorz, A., Meloni, A., Chiodo, A., Dedoni, M., Ortu, F., Piano, P., Citernesi, A., Vicini, I. Bordoni, Luzi, K., Spinillo, A., Roccio, M., Vimercati, A., Calabretti, D., Gigante, S., Guerra, B., Cervi, F., Simonazzi, G., Margarito, E., Capretti, M.G., Marsico, C., Faldella, G., Sansone, M., Martinelli, P., Agangi, A., Capone, A., Maruotti, G.M., Tibaldi, C., Trentini, L., Todros, T., Masuelli, G., Frisina, V., Savasi, V., Cardellicchio, E., Giaquinto, C., Fiscon, M., Rubino, E., Franceschetti, L., Badolato, R., Forleo, M.A., Tassis, B., Ruggiero, M., Genovese, O., Cafforio, C., Pinnetti, C., Liuzzi, G., Casadei, A.M., Cavaliere, A.F., Cellini, M., Marconi, A.M., Dalzero, S., Ierardi, M., Simonetti, S.C., Alfieri, N., Agrati, S., Polizzi, C., Mattei, A., Pirillo, M.F., Amici, R., Galluzzo, C.M., Donnini, S., Baroncelli, S., Floridia, M., Cerioli, A., Martino, M. De, Parazzini, F., Tamburrini, E., Vella, S., Martinelli, P., and Ravizza, M.

Abstract

Background No published studies have evaluated in pregnant women with HIV weight gain with different antiretroviral drug classes.Methods Data from a national cohort study were used. We compared absolute weight gain and occurrence of excessive weight gain in women with HIV who received during pregnancy integrase inhibitors (INSTI), protease inhibitors (PI), or non-nucleoside reverse transcriptase inhibitors (NNRTI). Excessive weight gain was defined according to the Institute of Medicine recommendations. Possible predictors of weight gain were assessed using univariate and multivariate analyses.Results Among 273 cases (PI: 191, NNRTI: 43, INSTI: 39), the mean weight increase was 11.3 kg, and 25.4% of the mothers had an excessive weight increase. No significant differences were found among the three treatment groups for absolute weight increase, occurrence of excessive weight gain, infant birthweight, and other pregnancy and laboratory outcomes. The comparisons of individual drugs, although based on a limited number of cases, suggested no major differences. A significant positive correlation was found between weight gain and CD4+T-cell increase during pregnancy. In multivariate analyses, drug class and nucleoside backbone were not associated with absolute or excessive weight increase. Excessive weight increase was significantly associated with week of delivery (adjusted odds ratio: 1.74, 95% CI 1.15, 2.63), obesity (5.21, 95% CI 1.85, 14.64), overweight (7.95, 95% CI 3.26, 19.39), recent substance use (5.96, 95% CI 1.13, 31.40) and fasting 2nd trimester hyperglycaemia (3.94, 95% CI 1.14, 13.65).Conclusions No significant differences in absolute weight change or occurrence of excessive weight gain were found among women with HIV who received during pregnancy different classes of antiretroviral drugs.

Published
2020
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46. Micronutrient supplementation in pregnancy: Who, what and how much?

Author

Parisi, F., di Bartolo, I., Savasi, V. M., and Cetin, I.

Subjects
MICRONUTRIENTS, MALNUTRITION, DIETARY calcium, COST effectiveness, COUNSELING, DIETARY supplements, FOLIC acid, FOOD habits, GOAL (Psychology), INGESTION, IRON compounds, MATERNAL health services, NUTRITIONAL assessment, VITAMIN A, VITAMIN D, SOCIOECONOMIC factors, BODY mass index, FETAL development, PREGNANCY, THERAPEUTICS
Abstract

Pregnancy represents a period of major physiological and metabolic change, aiming to ensure proper fetal growth and development, as well as maternal preservation. This review focuses on maternal nutrition, and particularly on micronutrient deficiencies and supplementation during pregnancy. Nutrient deficiencies and consequences in pregnant women are presented, with an overview of current recommendations for dietary supplementation in pregnancy, even considering the risk of micronutrient overload. Appropriate universal supplementation and prophylaxis/treatment of nutritional needs currently appear to be the most cost-effective goal in low-income countries, thus ensuring adequate intake of key elements including folate, iron, calcium, vitamin D and A. In high-income countries, a proper nutritional assessment and counselling should be mandatory in obstetric care in order to normalize pregestational body mass index, choose a healthy dietary pattern and evaluate the risk of deficiencies. [ABSTRACT FROM AUTHOR]

Published
2019
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47. Atazanavir and lopinavir profile in pregnant women with HIV: tolerability, activity and pregnancy outcomes in an observational national study

Author

Floridia, M., Ravizza, M., Masuelli, G., Giacomet, V., Martinelli, P., Degli Antoni, A., Spinillo, A., Fiscon, M., Francisci, D., Liuzzi, G., Pinnetti, C., Marconi, A. M., 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., Del Pin, 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, Giovanni, Nardini, Giulia, Stentarelli, Chiara, Beghetto, Barbara, Degli Antoni, A. M., Molinari, A., Crisalli, M. P., Donisi, A., Piepoli, M., Cerri, V., Zuccotti, G., Fabiano, V., Placido, G., Vivarelli, A., Castelli, P., Savalli, F., Portelli, V., Sabbatini, F., 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., Bordoni Vicini, I., Luzi, K., 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., Agangi, A., Tibaldi, C., Trentini, L., Todros, T., Frisina, V., Cetin, I., Brambilla, T., Savasi, V., Personeni, C., Giaquinto, C., Rinaldi, R., Rubino, E., Bucceri, A., Matrone, R., Scaravelli, G., Fundaro, C., Genovese, O., Cafforio, C., Tozzi, V., Massetti, P., 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., Mastroiacovo, P., Moroni, M., Parazzini, F., Vella, S., Floridia, M, Ravizza, M, Masuelli, G, Giacomet, V, Martinelli, Pasquale, Degli Antoni, A, Spinillo, A, Fiscon, M, Francisci, D, Liuzzi, G, Pinnetti, C, Marconi, Am, Tamburrini, E, on behalf of The Italian Group on Surveillance on Antiretroviral Treatment in, Pregnancy, Floridia, M1, Italian Group on Surveillance on Antiretroviral Treatment in, P. r. e. g. n. a. n. c. y., Marco Floridia, Marina Ravizza, Giulia Masuelli, Vania Giacomet, Pasquale Martinelli, Anna Degli Antoni, Arsenio Spinillo, Marta Fiscon, Daniela Francisci, Giuseppina Liuzzi, Carmela Pinnetti, Anna Maria Marconi, Enrica Tamburrini, on behalf of The Italian Group on Surveillance on Antiretroviral Treatment in Pregnancy [.., Capretti, M.G., Marsico, C., Faldella, G., and ].

Subjects
Pyridines, Pyridine, HIV Infections, Triglyceride, Lopinavir, Liver Function Tests, Pregnancy, HIV Infection, Pharmacology (medical), Viral, Pregnancy Complications, Infectious, triglycerides, pre-term delivery, medicine.diagnostic_test, Liver Function Test, Obstetrics, Medicine (all), Pregnancy Outcome, Infectious, virus diseases, HIV, pregnancy, RNA, Lipid, Viral Load, Lipids, Infectious Diseases, Tolerability, Oligopeptide, Population study, RNA, Viral, Female, medicine.symptom, bilirubin, Viral load, Oligopeptides, Human, medicine.drug, Microbiology (medical), Adult, medicine.medical_specialty, HIV RNA, Anti-HIV Agents, Atazanavir Sulfate, Infectious Disease, Bilirubin, Cholesterol, Pre-term delivery, Triglycerides, Pharmacology, cholesterol, Settore MED/17 - MALATTIE INFETTIVE, medicine, Humans, business.industry, Anti-HIV Agent, medicine.disease, Atazanavir, CD4 Lymphocyte Count, Pregnancy Complications, Immunology, Pregnancy Complications, Infectiou, business, Liver function tests, Weight gain
Abstract

BACKGROUND: Atazanavir and lopinavir represent the main HIV protease inhibitors recommended in pregnancy, but comparative data in pregnant women are limited. METHODS: Women from a national observational study, exposed in pregnancy to either atazanavir or lopinavir, were compared for glucose and lipid profiles, liver function tests, CD4 count, HIV RNA and main pregnancy outcomes. Statistical methods included univariate and multivariable analyses. RESULTS: The study population included 428 pregnancies (lopinavir, 322; atazanavir, 106). The lopinavir group was characterized by higher rates of HIV diagnosis in pregnancy and treatment indication for maternal health, lower CD4 counts, higher HIV RNA levels, less frequent antiretroviral treatment at conception and shorter duration of drug exposure during pregnancy. No differences in pregnancy outcomes, glucose metabolism and weight gain were observed. The two groups also showed in a multivariable analysis similar odds for detectable HIV RNA in the third trimester (adjusted OR 0.85, 95% CI 0.35-2.10, P = 0.730). Total lipid levels were significantly higher in the lopinavir group (median values in the third trimester 239 versus 221 mg/dL for total cholesterol and 226 versus 181 mg/dL for triglycerides; P < 0.001 for both comparisons) and bilirubin levels were significantly higher in the atazanavir group (1.53 versus 0.46 mg/dL, P < 0.001). CONCLUSIONS: In this observational study atazanavir and lopinavir showed similar safety and activity in pregnancy, with no differences in the main pregnancy outcomes. Atazanavir use was associated with a better lipid profile and with higher bilirubin levels. Overall, the study findings confirm that these two HIV protease inhibitors represent equally valid alternative options.

Published
2014

48. Combination antiretroviral therapy and duration of pregnancy

Author

Aebi, C, Battegay, M, Bernasconi, E, Biedermann, K, Cheseaux, JJ, Drack, G, Erb, P, Flepp, M, Francioli, P, Furrer, HJ, Gianinazzi, MP, Gyr, T, Hirschel, B, Hosli, I, Hug, I, Irion, O, Keller, K, Kind, C, Laubereau, B, Lauper, U, Lorenzi, P, Matter, L, Nadal, D, Perrin, L, Rickenbach, M, Rudin, C, Schreyer, A, Schupbach, J, Telenti, A, Vernazza, P, Wolf, K, Wunder, D, Wyler, CA, Giaquinto, C, Ruga, E, De Rossi, A, Grosch-Worner, I, Seel, K, Schafer, A, Mok, J, Johnstone, F, Jimenez, J, Garcia-Rodriguez, MC, Bates, I, de Jose, I, Hawkins, F, de Gevara, CL, Pena, JM, Garcia, JG, Lopez, JRA, 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, Lidman, K, Christensson, B, Levy, J, Hainaut, M, Peltier, A, Barlow, P, Wibaut, S, Lecroart, MC, Ferrazin, A, Bassetti, D, De Maria, A, Gotta, C, Mur, A, Paya, A, Vinolas, M, Lopez-Vilchez, MA, Martinez-Gomez, P, Carreras, R, Coll, O, Fortuny-Guasch 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, Taylor, GP, Lyall, H, Penn, Z, Valerius, NH, Martinelli, P, Buffolano, W, Sansone, M, Tibaldi, C, Ziarati, N, Benedetto, C, Niemiec, T, Horban, A, Newell M.-L., Aebi C., Battegay M., Bernasconi E., Biedermann K., Cheseaux J.-J., Drack G., Erb P., Flepp M., Francioli P., Furrer H.J., Gianinazzi M.-P., Gyr T., Hirschel B., Hosli I., Hug I., Irion O., Keller K., Kind C., Laubereau B., Lauper U., Lorenzi P., Matter L., Naddal D., Perrin L., Rickenbach M., Rudin C., Schreyer A., Schupbach J., Telenti A., Vernazza P., Wolf K., Wunder D., Wyler C.-A., Giaquinto C., Ruga E., De Rossi A., Grosh-Worner I., Seel K., Schafer A., Mok J., Johnstone F., Jimenez J., Garcia-Rodriguez M.C., Bates I., De Jose I., Hawkins F., Ladron de Gevara C., Ma Pena J., Gonzalez Garcia J., Arribas Lopez J.R., Asensi-Botet F., Otero M.C., Perez-Tamarit D., Ridaura S., Gregori P., De la Torre R., Scherpbier H., Kreyenbroek M., Boer K., Bohlin A.B., Lindgren S., Ehrnst A., Belfrage E., Lidman K., Christensson B., Levy J., Hainaut M., Peltier A., Barlow P., Wibaut S., Lecroart M.C., Ferrazin A., Bassetti D., De Maria A., Gotta C., Mur A., Paya A., Vinolas M., Lopez-Vilchez M.A., Martinez-Gomez P., Carreras R., Coll O., Fortuny C., Boguna J., Casellas Caro M., 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., and Semprini A.E.

Subjects
Epidemiology, HIV Infections, Substance Abuse, Intravenou, Cohort Studies, Pregnancy, Immunology and Allergy, Medicine, HIV Infection, Prospective Studies, Pregnancy Complications, Infectious, Substance Abuse, Intravenous, Prospective cohort study, Obstetrics, Infectious, Substance Abuse, Pregnancy Outcome, Gestational age, Viral Load, Antiretroviral therapy, Reverse Transcriptase Inhibitor, Infectious Diseases, Combination, Reverse Transcriptase Inhibitors, Drug Therapy, Combination, Female, Intravenous, Prematurity, Delivery, Zidovudine, Viral load, Infant, Premature, Human, Cohort study, medicine.drug, Adult, medicine.medical_specialty, Combination therapy, Anti-HIV Agents, Immunology, CD4 Lymphocyte Count, Delivery, Obstetric, Gestational Age, HIV-1, Humans, Infant, Newborn, Drug Therapy, antiretroviral therapy, combination therapy, epidemiology, pregnancy, prematurity, Premature, business.industry, Infant, Anti-HIV Agent, Obstetric, Odds ratio, Newborn, medicine.disease, Surgery, Pregnancy Complications, Prospective Studie, Pregnancy Complications, Infectiou, Cohort Studie, business
Abstract

Objective: To assess the association between type and timing of initiation of antiretroviral therapy in pregnancy and duration of pregnancy. Design: Prospective study. Methods: Data on 3920 mother child pairs were examined (3015 mother-child pairs from the European Collaborative Study and 905 from the Swiss Mother + Child HIV Cohort Study). Factors examined included gestational age, antiretroviral therapy during pregnancy, maternal CD4 count, viral load, illicit drug use (IDU) and mode of delivery. Deliveries at less than 37 weeks were defined as premature. Results: The prematurity rate was 17% and median gestational age 39 weeks. Twenty-three per cent (896 of 3920) of women received antiretroviral therapy during pregnancy: 64% (573 of 896) zidovudine monotherapy, 24% (215) combination therapy without protease inhibitors (PI) and 12% (108) combination therapy with PI. In multivariate analysis, adjusted for maternal CD4 count and IDU, odds ratio (OR) of prematurity was 2.60 195% confidence interval (CI), 1.43-4.751 and 1.82 (95% CI, 1.13-2.92) for infants exposed to combination therapy with and without a Pl, respectively, compared to no treatment. Exposure to monotherapy was not associated with prematurity, but severe immunosuppression and IDU in pregnancy were. Women on combination therapy from before pregnancy were twice as likely to deliver prematurely as those starting therapy in the third trimester (OR, 2.17 95% CI, 1.03-4.58). Conclusions: Pregnancy issues should be discussed when making decisions about initiation of combination antiretroviral therapy for HIV-infected women. Elective caesarean section to reduce vertical transmission at 36 weeks rather than 38 weeks may be advisable in women on combination therapy with PI. © 2000 Lippincott Williams & Wilkins.

Published
2000
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50. Pregnancy outcomes and cytomegalovirus DNAaemia in HIV-infected pregnant women with CMV

Author

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

Published
2016
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