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There has been concern about the impact of the COVID-19 outbreak on women’s mental health during the perinatal period. We conducted a cross-sectional web-based study aimed at evaluating the psychological impact (BSI-18) of the COVID-19 pandemic on this population and collecting information on the perinatal experiences (COPE-IS) during the second Italian wave. Overall, 1168 pregnant women, and 940 within the first six months after childbirth, were recruited in selected Italian Family Care Centers from October 2020 to May 2021. The prevalence of psychological distress symptoms during pregnancy was 12.1% and 9.3% in the postnatal group. Financial difficulties, a previous mood or anxiety disorder and lack of perceived social support and of support provided by health professionals were associated to psychological distress symptoms in both groups. A third of the women felt unsupported by their social network; 61.7% of the pregnant women experienced changes in antenatal care; 21.2% of those in the postnatal period gave birth alone; more than 80% of the participants identified access to medical and mental health care and self-help as important resources in the present context. Health services should assure enhanced support to the most vulnerable women who face the perinatal period during the pandemic.

Introduction Distance learning efficacy on physician performances and patient health outcomes has been demonstrated. This study explored the participation and evaluation of CME e-learning courses for Italian health care professionals addressing leading causes of maternal mortality identified by the Italian Obstetric Surveillance System (ItOSS) at the Italian National Health Institute, namely postpartum hemorrhage and pregnancy hypertensive disorders. Methods A model for two online free 12-hour case-based training courses was used. Data on participants were collected, anonymized, and transferred to the Italian National Health Institute for later analysis. Participants were requested to sign an online informed consent form. Results Twenty-one thousand five hundred thirty-two health care professionals enrolled to the courses from 2014 to 2017 as follows: midwives (14,187, 65.9%); obstetricians (3,716, 17.2%); anesthesiologists (1,896, 8.8%); and other medical specialists (1,733, 8.0%). Overall, 85% of participants acquired CME credits. Participants' satisfaction on quality, efficacy, and relevance was very high. Discussion ItOSS courses were able to reach a substantial number of different professional profiles involved in perinatal care all over the country; ItOSS courses can be considered an effective way to spread evidence-based good clinical practices. Nevertheless, further studies are needed to verify the improvement in professional health care skills and patient outcomes.

Suicide has been identified as one of the most common causes of death among women within 1 year after the end of pregnancy in several high-income countries. The aim of this study was to provide the first estimate of the maternal suicide ratio and a description of the characteristics of women who died by suicide during pregnancy or within 1 year after giving birth, induced abortion or miscarriage (i.e., maternal suicide) in 10 Italian regions, covering 77% of total national births. Maternal suicides were identified through the linkage between regional death registries and hospital discharge databases. Background population data was collected from the national hospital discharge, abortion and mortality databases. The previous psychiatric history of the women who died by maternal suicide was retrieved from the regionally available data sources. A total of 67 cases of maternal suicide were identified, corresponding to a maternal suicide ratio of 2.30 per 100,000 live births in 2006–2012. The suicide rate was 1.18 per 100,000 after giving birth (n = 2,876,193), 2.77 after an induced abortion (n = 650,549) and 2.90 after a miscarriage (n = 379,583). The majority of the women who died by maternal suicide (34/57) had a previous psychiatric history; 15/18 previously diagnosed mental disorders were not registered along with the index pregnancy obstetric records. Suicide is a relevant cause of maternal death in Italy. The continuity of care between primary, mental health and maternity care were found to be critical. Clinicians should be aware of the issue, as they may play an important role in preventing suicide in their patients.

A research line in architecture and interior design has been focused for years on the selection of materials with properties specifically tailored for light, thermal and acoustic comforts. An adaptive origami-based structure is here proposed in order to overcome the limited capability of a single material to adjust its response to environmental changes. Such structure is highly flexible, with applications ranging from indoor to outdoor environments. We focus on building facades, to show some results relevant to a small-scale prototype aimed to provide shading to the sunlight.

We propose the design of an environment-responsive, deployable origami-inspired structure to be used as a smart building skin. The folding structure is composed by rigid panels connected to each other through hinge-like connectors. The overall degree of openness of the whole structure is adjusted in response to variations of environmental parameters like lighting and temperature, recorded by a network of embedded sensors. The geometry and kinematics of the origami are selected so as the deployment of each module can be induced at some key points that only slide along a linear axis; in this way, electric motors with a positional control logic can prove efficient. By properly tuning the properties of each panel mounted on the frames, the proposed solution can be adopted as a shading or light refraction system, thus improving the comfort of the building interiors. Through digital prototyping and small-scale models, the effectiveness of the proposed solution is assessed. Some site-specific applications are finally discussed from the self-sensing, self-actuation and self-powering viewpoints.

This study reports the results of an Italian sampling survey carried out in 1999 on the evaluation of the support and the information activities offered to women who delivered with specific regard to breast-feeding. 1986 women have been interviewed. The response rate was 95%. Ninety-four percent of the sample reported a positive attitude among breast-feeding, but only 80% breastfed her baby during hospital stay. Moreover only 31% had the opportunity to start breast-feeding immediately after birth. Around 50% of women reported the quality of the hospital support as inadequate. The authors conclude that, even in the light of the present Italian law, much more could and should be done in order to promote and support women in breast-feeding.

Background: In Italy the proportion of births by cesarean section rose from 11.2 percent in 1980 to 27.9 percent in 1996 and 33.2 percent in 2000. The aim of this study was to identify factors, other than medical and obstetrical risk, that may influence the method of delivery and to analyze mother's preference for vaginal versus cesarean delivery among women after the birth of their first baby in university hospitals in Italy. Methods: Primiparous women were selected from 100 consecutive deliveries in 23 university hospitals in 1999. To determine antenatal, delivery, and postnatal history, and women's preference for method of delivery, trained health personnel interviewed 1986 women. Results: Of the 1986 women who were interviewed (response rate 95%), 1023 primiparas comprised the study sample. The cesarean section rate was 36 percent. Ninety-one percent of the women who delivered spontaneously and 73 percent of those who underwent a cesarean section would have preferred a vaginal delivery. Conclusions: Most of the interviewed women in this study preferred, or were satisfied with, vaginal birth. (BIRTH 30:2 June 2003)