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Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, Bianchi S, Ciriello E, Facchinetti F, Gervasi MT, Iurlaro E, Kustermann A, Mangili G, Mosca F, Patanè L, Spazzini D, Spinillo A, Trojano G, Vignali M, Villa A, Zuccotti GV, Parazzini F, Cetin I. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG 2020; 127:1116-1121. [PMID: 32339382 PMCID: PMC7267664 DOI: 10.1111/1471-0528.16278] [Citation(s) in RCA: 190] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To report mode of delivery and immediate neonatal outcome in women infected with COVID-19. DESIGN Retrospective study. SETTING Twelve hospitals in northern Italy. PARTICIPANTS Pregnant women with COVID-19-confirmed infection who delivered. EXPOSURE COVID 19 infection in pregnancy. METHODS SARS-CoV-2-infected women who were admitted and delivered from 1 to 20 March 2020 were eligible. Data were collected from the clinical records using a standardised questionnaire on maternal general characteristics, any medical or obstetric co-morbidity, course of pregnancy, clinical signs and symptoms, treatment of COVID 19 infection, mode of delivery, neonatal data and breastfeeding. MAIN OUTCOME AND MEASURES Data on mode of delivery and neonatal outcome. RESULTS In all, 42 women with COVID-19 delivered at the participating centres; 24 (57.1%, 95% CI 41.0-72.3) delivered vaginally. An elective caesarean section was performed in 18/42 (42.9%, 95% CI 27.7-59.0) cases: in eight cases the indication was unrelated to COVID-19 infection. Pneumonia was diagnosed in 19/42 (45.2%, 95% CI 29.8-61.3) cases: of these, 7/19 (36.8%, 95% CI 16.3-61.6) required oxygen support and 4/19 (21.1%, 95% CI 6.1-45.6) were admitted to a critical care unit. Two women with COVID-19 breastfed without a mask because infection was diagnosed in the postpartum period: their newborns tested positive for SARS-Cov-2 infection. In one case, a newborn had a positive test after a vaginal operative delivery. CONCLUSIONS Although postpartum infection cannot be excluded with 100% certainty, these findings suggest that vaginal delivery is associated with a low risk of intrapartum SARS-Cov-2 transmission to the newborn. TWEETABLE ABSTRACT This study suggests that vaginal delivery may be associated with a low risk of intrapartum SARS-Cov-2 transmission to the newborn.
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Affiliation(s)
- E Ferrazzi
- Department of Woman, Child and Neonate, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - L Frigerio
- Dept of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - V Savasi
- Department of Woman, Mother and Neonate, Sacco Hospital-ASST Fatebenefratelli-Sacco, Milan, Italy.,Dept of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - P Vergani
- Department of Maternal Fetal Medicine, Fondazione MBBM, San Gerardo Hospital, Monza, Italy.,University of Milano Bicocca, Monza, Italy
| | - F Prefumo
- Department of Obstetrics and Gynecology, Spedali Civili di Brescia, Brescia, Italy.,University of Brescia, Brescia, Italy
| | - S Barresi
- Dept of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - S Bianchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - E Ciriello
- Dept of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - F Facchinetti
- Obstetrics Unit, Mother Infant Department, AOU of Modena, Modena, Italy
| | - M T Gervasi
- Obstetrics and Gynecology Unit, Department of Woman's and Child's, Health University Hospital of Padua, Padua, Italy
| | - E Iurlaro
- Department of Woman, Child and Neonate, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A Kustermann
- Department of Woman, Child and Neonate, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Mangili
- Department of Neonatology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - F Mosca
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore, Milano, Italy
| | - L Patanè
- Dept of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - D Spazzini
- Obstetrics and Gynecology Unit, Azienda Ospedaliera Bolognini, Seriate, Italy
| | - A Spinillo
- Department of Obstetrics and Gynecology, University of Pavia, Pavia, Italy.,IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - G Trojano
- Obstetrics and Gynecology Department "Madonna delle Grazie" Hospital, Matera, Italy
| | - M Vignali
- Obstetrics and Gynecology Unit, P.O. Macedonio Melloni-ASST Fatebenefratelli-Sacco, Milan, Italy.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - A Villa
- Obstetrics and Gynecology Unit, Hospital of Treviglio-Caravaggio, Bergamo, Italy
| | - G V Zuccotti
- Dept of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.,Department of Pediatrics, Ospedale dei Bambini V. Buzzi, Milan, Italy
| | - F Parazzini
- Department of Woman, Child and Neonate, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - I Cetin
- Dept of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.,Department of Woman, Mother and Neonate, Buzzi Children's Hospital-ASST Fatebenefratelli-Sacco Milan, Italy
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Barresi S, Niceta M, Alfieri P, Brankovic V, Piccini G, Bruselles A, Barone MR, Cusmai R, Tartaglia M, Bertini E, Zanni G. Mutations in the IRBIT domain of ITPR1 are a frequent cause of autosomal dominant nonprogressive congenital ataxia. Clin Genet 2016; 91:86-91. [PMID: 27062503 DOI: 10.1111/cge.12783] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/01/2016] [Accepted: 04/01/2016] [Indexed: 01/23/2023]
Abstract
Congenital ataxias are nonprogressive neurological disorders characterized by neonatal hypotonia, developmental delay and ataxia, variably associated with intellectual disability and other neurological or extraneurological features. We performed trio-based whole-exome sequencing of 12 families with congenital cerebellar and/or vermis atrophy in parallel with targeted next-generation sequencing of known ataxia genes (CACNA1A, ITPR1, KCNC3, ATP2B3 and GRM1) in 12 additional patients with a similar phenotype. Novel pathological mutations of ITPR1 (inositol 1,4,5-trisphosphate receptor, type 1) were found in seven patients from four families (4/24, ∼16.8%) all localized in the IRBIT (inositol triphosphate receptor binding protein) domain which plays an essential role in the regulation of neuronal plasticity and development. Our study expands the mutational spectrum of ITPR1-related congenital ataxia and indicates that ITPR1 gene screening should be implemented in this subgroup of ataxias.
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Affiliation(s)
- S Barresi
- Department of Neurosciences, Unit of Molecular Medicine for Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Niceta
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - P Alfieri
- Department of Neurosciences, Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - V Brankovic
- Clinic for Child Neurology and Psychiatry, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - G Piccini
- Department of Neurosciences, Child Neuropsychiatry, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A Bruselles
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - M R Barone
- Centro ambulatoriale di Riabilitazione, Fondazione Betania Onlus, Catanzaro, Italy
| | - R Cusmai
- Department of Neurosciences, Neurology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Tartaglia
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - E Bertini
- Department of Neurosciences, Unit of Molecular Medicine for Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - G Zanni
- Department of Neurosciences, Unit of Molecular Medicine for Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Abstract
This study was undertaken to investigate research and outreach priorities for Progetto Ibleo (Project Ibleo), a center created in 1990 with tripartite government funding to serve dairy producers in the Hyblean region of Sicily. Data comprised values for production and composition of milk from 1984 to 1989 from 35 herds of Modicana cows on a system based on pasture and that from 69 input-intensive herds of Holstein cows, associated lactation and reproduction measures, and yield and composition of forages from 4 of these farms in 1988. Season had a large effect on the neutral detergent fiber and crude protein composition of forages, production and composition of milk, and predicted yield of fresh Ragusano cheese manufactured from the milk of these cows. The poorest forage quality and the poorest cow performance were observed in summer and fall months (May to October). Lactation curves that were flat, without a discernible peak, or convex were observed for both systems, especially for cows calving in spring and in the dry summer seasons (March to July). These abnormalities, signifying substantial sacrifices in production potential, probably had a complex etiology that stemmed from low nutrient intake and high neutral detergent fiber and low crude protein composition of the grazed and preserved forages. Research and outreach priorities to support the Hyblean dairy industry should include chemical evaluation of forages and other feedstuffs, low moisture ensiling of high quality winter forages, better formulation of diets that are dense with nutrients, and the shifting of calving patterns to better exploit high quality winter forages.
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Affiliation(s)
- G Licitra
- Istituto de Scienze e Tecnologie delle Produzioni Animali, Università di Catania, Ragusa, Italy
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