In this study, we analyzed the estimated frequency of monozygotic (MZ) and dizygotic (DZ) spontan... more In this study, we analyzed the estimated frequency of monozygotic (MZ) and dizygotic (DZ) spontaneous twins in Lombardy during the period 2007−2017. This is a population-based study using the regional healthcare utilization databases of the Lombardy Region. The total number of spontaneous twin deliveries, in separate strata of like and unlike sex, was obtained. Moreover, estimates of DZ and MZ twin births were calculated using Weinberg’s method. The standardized rates (SRs), adjusted for maternal age, of DZ and MZ twin births were computed according to calendar period. The twinning rates were calculated among strata of parity and maternal age. Finally, DZ:MZ ratio was calculated. Among the 734,278 spontaneous deliveries, 9176 (12.5 out of 1000 births) couples of twins were identified. In the three periods considered (i.e. 2007−2010, 2011−2014 and 2015−2017), no trend in the SRs of MZ twins was observed, respectively 0.41 (95% CI [0.40, 0.43]), 0.43 (95% CI [0.42, 0.45]) and 0.43 (95...
BackgroundInfertility involves 15% of couples in Italy and approximately 10-12% worldwide.Focusin... more BackgroundInfertility involves 15% of couples in Italy and approximately 10-12% worldwide.Focusing on female fertility, it can underline multiple causes, among them the diet has a great influence. Methods We investigated whether the consumption of some fatty acids affects four outcomes of the assisted reproduction techniques. From September 2014 to December 2016, women referring to our Italian fertility unit, eligible for assisted reproduction techniques, were invited to participate. Information on dietwere recorded through a validated food frequency questionnaire. Results494 women were included, of whom95% achieved good quality oocytes, 87% resulted in embryo transfer, 32.0%in clinical pregnancies, and 24.5% in pregnancy at term.The fourth quartile of saturated fatty acids consumption, compared to the first one, showed an association with clinical pregnancy (adjusted relative risk 0.67, 95% confidence interval 0.45 to 1.00, p=0.0491). Some associations emerge accounting for confounders. Age was associated with clinical pregnancy and pregnancy at term in the models considering all fatty intakes and food groups variables but was not associated with oocytes quality and embryo transfer. Physical activity was associated with clinical pregnancy. ConclusionsThere is biologic plausibility of the effect of omega-3 and omega-6 polyunsaturated fatty acids on oocyte development via eicosanoids synthesis, even if our results showed limited associations.Future research is aimed to measure serum levels of fatty acids and investigate the assisted reproduction techniques' outcomes. This article is protected by copyright. All rights reserved.
Objectives The purpose of this cross-sectional study was to prepare a reliable and easy-to-use ar... more Objectives The purpose of this cross-sectional study was to prepare a reliable and easy-to-use architectural classification for vulvar lichen sclerosus (VLS) aimed at defining the morphological patterns of this condition. Materials and Methods An expert panel composed by 7 physicians with expertise in clinical care of vulvar conditions outlined the architectural criteria for the definition of VLS severity (phimosis of the clitoris, involvement of the interlabial sulci, narrowing of the vulvar introitus), identifying 5 grades to build up a classification. Thirteen physicians with 2–30 years expertise in vulvar diseases (nonexpert group) were asked to evaluate 3–5 pictures from 137 patients. Each physician individually assigned a grade to each case, according to the previously mentioned criteria. Interrater reliability was analyzed by means of intraclass correlation coefficient (ICC). The reliability concerning the 2 classifications of each rater was analyzed by means of κ statistic. Intraobserver and interobserver reliability in vivo was analyzed by means of κ index. Results This study provides a new classification of VLS, based on defined anatomical criteria and graded into mutually exclusive progressive classes. The ICC analysis showed a substantial interrater reliability of the classification, ICC = 0.89 (0.87–0.91), both in the expert panel and in the nonexpert group (ICC = 0.92 and 0.87, respectively). An “almost perfect” intraobserver and interobserver reliability was achieved among physicians in vivo (κ = 0.93). Conclusions Our classification showed a high reliability. It is easy to use, and it can be applied in clinical practice and eventually, in the evaluation of regenerative and cosmetic surgery.
American Journal of Obstetrics and Gynecology, 2013
To offer a general figure of the available data on the relation between alcohol intake and risk o... more To offer a general figure of the available data on the relation between alcohol intake and risk of endometriosis, we conducted a systematic review and a metaanalysis of studies published up to May 2012. We carried out a literature search of all case-control and cohort studies published as original articles in English up to May 2012. Only those papers that were published as full-length articles were considered. Pooled estimates of the relative risks (RRs) and the corresponding 95% confidence intervals (CIs) were calculated using fixed or, when significant heterogeneity among estimates emerged, random effects models. A total of 15 studies were identified for the review. The summary estimate was 1.24 (95% CI, 1.12-1.36) for any alcohol intake vs no alcohol intake. Considering the results of the analyses of infrequent, moderate/regular, and heavy alcohol intake vs no alcohol intake, the summary RR estimates were, respectively, 1.14 (95% CI, 0.86-1.52), 1.23 (95% CI, 1.08-1.40), and 1.19 (95% CI, 0.99-1.43). Three studies reported separate results for current and former drinkers, and the summary RR were 1.42 (95% CI, 1.14-1.76) and 1.09 (95% CI, 0.83-1.43), respectively. The present metaanalysis provides evidence for an association between alcohol consumption and endometriosis risk. Further studies are needed to clarify whether alcohol consumption may exacerbate an existing disease or could be related to the severity of the disease.
To examine the degree of agreement between the paediatrician's assessment and parental re... more To examine the degree of agreement between the paediatrician's assessment and parental reporting of infants' development using a postal questionnaire. The developmental status of 241 infants in the charge of 9 community paediatricians or discharged from one Neonatal Intensive Care Unit (NICU) was assessed by their parents 18 mo after delivery, using a postal questionnaire regarding child's height, weight. respiratory, hearing and vision problems, and items taken mainly from the Griffiths' Developmental Scales. At this age, infants were seen by the community or NICU paediatricians, for a complete physical and neurodevelopmental examination. The mean agreement on items regarding developmental areas between parents and paediatricians was 93.0%. In general, parents and professionals agreed on items describing gross motor behaviour (k from 0.39 to 0.83) and disagreed on individual questions describing language/relational behaviour (k from 0 to 0.38). A 97.9% level of agreement was found for hearing status (k = 0), and 96.2% for assessment of vision (k = 0.29), whereas the level of agreement ranged from 43.2% to 86.2% (k from 0 to 0.15) for the three questions describing respiratory problems. The mean weight and height assessments by paediatricians and parents of infants at 18 mo of age were similar. Further improvement of the questionnaire is needed, but our findings suggest that this methodology can be considered for use in comparing large cohorts of infants included in randomized clinical trials.
Folic acid (FA) supplementation prevents neural tube defects (NTDs), but the effects on other rep... more Folic acid (FA) supplementation prevents neural tube defects (NTDs), but the effects on other reproductive outcomes are unclear. While common recommendation is 0.4 mg/day in addition to regular nutrition, the most appropriate dose of FA is still under debate. We investigated the effects of a higher dose of periconception FA on reducing adverse reproductive outcomes. In this multicenter double-blind randomized controlled trial (RCT), 1060 women (aged 18–44 years and planning a pregnancy) were randomly assigned to receive 4.0 mg or 0.4 mg of FA daily. The primary outcome was the occurrence of congenital malformations (CMs). A composite outcome including one or more adverse pregnancy outcomes was also evaluated. A total of 431 women had a natural conception within 1 year. The primary outcome occurred in 8/227 (3.5%) women receiving 4.0 mg FA and 9/204 (4.4%) women receiving 0.4 mg FA (RR 0.80; 95%CI 0.31 to 2.03). The composite outcome occurred in 43/227 (18.9%) women receiving 4.0 mg ...
European Journal of Obstetrics & Gynecology and Reproductive Biology
INTRODUCTION We investigated the role of body mass index (BMI) and maternal age on the risk of la... more INTRODUCTION We investigated the role of body mass index (BMI) and maternal age on the risk of late-term induction, prolonged induction time and caesarean section (CS) after induction. MATERIAL AND METHODS This is a retrospective, observational study. All women without any fetal or maternal pathological condition, uterine scars or any other indication for an elective caesarean birth and had a singleton foetus in the cephalic position at term were included. RESULTS A total of 4006 women had a spontaneous onset of labour and 612 were induced for a late-term pregnancy. Labour induction was significantly more common in overweight (Adj Odds Ratio (OR) 1.48 95%CI 1.22-1.78) and obese (Adj OR 1.63 95%CI 1.24-2.14) women. Among induced women, a BMI ≥ 30 was a risk factor for a prolonged induction time in both nulliparous (AdjOR 2.4, 95%CI 1.02-5.67) and multiparous women (AdjOR 4.24, 95%CI 1.02-17.6). A BMI > 25-29.9 was significantly associated with a prolonged induction time only in nulliparous women (AdjOR 1.86 95%CI 1.05-3.30). A CS was more frequent in overweight (AdjOR 1.74, 95% CI 1.052.89) and obese women (AdjOR 2.72, 95%CI 1.42-5.25). Nulliparous women ageed 30-34 years had an induction time longer than women <30 years (OR 2.04 95%CI 1.07-3.91). CONCLUSIONS The results of this study suggest that a BMI > 25 kg/m2 at term of pregnancy is a risk factor for the induction of labour during a late-term pregnancy, a prolonged induction time and higher caesarean section rate.
Elective caesarean section (CS) before 39 completed weeks of gestation increases likelihood of re... more Elective caesarean section (CS) before 39 completed weeks of gestation increases likelihood of respiratory morbidity in newborns and admissions in neonatal intensive care. Thus, guidelines have recommended that planned caesarean section should not be routinely carried out before 39 completed weeks of gestation. In this paper, we have analyzed the timing of elective CS after 37th completed weeks of gestation in 2010 and 2014 in Lombardy, a region of the North of Italy, in order to evaluate whether there was a measurable change in clinical practice during the last years in the timing of the elective CS. We analyzed data of all deliveries Lombardy, in period of time between 1st January31th December 2010 and 1st January-31th December 2014. From all deliveries, we identified all elective CS deliveries at term.The frequency of elective CS in 37th and 38th week of gestation decreased respectively from 14,2% and 46,7% in 2010 to 13,7% and 44,6% in 2014 (chi square test 37-38 vs 39 or more p...
Clinical reports suggested that the use of oral contraceptives (OC) after a molar pregnancy may i... more Clinical reports suggested that the use of oral contraceptives (OC) after a molar pregnancy may increase the risk of persistent throphoblastic disease. However, few epidemiologic studies have analyzed the effect of OC use on the risk of developing gestational trophoblastic disease (GTD). To give further information, we have analyzed data from a case-control study on risk factors for GTD. Cases were 268 women with a histologically confirmed diagnosis of complete or partial mole referred to the participating Trophoblastic Disease Centers. A total of 268 subjects were interviewed; 79 cases were classified as partial and 159 as complete mole. Controls were randomly selected women who gave birth to healthy infants at term on randomly selected days in the same network of hospitals in which cases had been identified. A total of 104 cases and 130 controls reported ever OC use, and the corresponding odds ratio (OR) was 1.5 (95% CI, 1.1‐2.1). The risk of GTD increases with duration of OC use:...
Among preterm births, different clinical conditions are included: mainly spontaneous and medical ... more Among preterm births, different clinical conditions are included: mainly spontaneous and medical induced. In fact, about 30% of preterm (particularly late preterm) births are medically indicated and the birth weight of these cases may differ from spontaneous preterm birth. In this paper, we have analyzed separately the percentiles of weight at birth in preterm births according to spontaneous and induced births using data of all deliveries in Lombardy, in the period of time between 1st January 2010 and 31th December 2013. The centiles of weight were lower among medically induced births in all the considered week of gestation and among males and females. This descriptive analysis of centiles of weight at birth in Lombardy provides Italian obstetricians and neonatologist with curves of fetal growth more closely representing the population under cure, in particular offer information at our knowledge not available before on the distribution of centiles of weight at birth on babies born p...
Objective We investigated whether lifestyle affects assisted reproduction technology (ART) outcom... more Objective We investigated whether lifestyle affects assisted reproduction technology (ART) outcomes. Design Cohort study. Setting Italian fertility unit. Participants From September 2014 to December 2016, women from couples presenting for evaluation and eligible for ART were invited to participate. Information on alcohol intake, current smoking and leisure physical activity (PA) during the year before the interview was collected, using a structured questionnaire. We considered the ART outcomes of the cycle immediately following the interview. Primary and secondary outcome measures The primary outcome measure was cumulative pregnancy rate per retrieval. Secondary measures were number of retrieved oocytes, embryo transfer and live birth. Results In 492 women undergoing an ART cycle, 427 (86.8%) underwent embryo transfer, 157 (31.9%) had at least one clinical pregnancy and 121 (24.6%) had live birth. The cumulative pregnancy rate per retrieval was 33.3% (95% CI 28.5% to 38.7%). In wome...
In recent decades, increasing attention has been paid to the influence of diet on reproductive he... more In recent decades, increasing attention has been paid to the influence of diet on reproductive health. Carbohydrates in diet affect glucose metabolism and multiple evidences showed the key role of insulin sensitivity in regulating female fertility. We designed a prospective cohort study to investigate the relation between dietary carbohydrate intake, glycemic load (GL) and the outcomes of assisted reproduction. A population of 494 female partners of couples referring to an Italian Fertility Center and eligible for in vitro fertilization (IVF) were enrolled in the study. On the day of the oocyte retrieval, information on their diet was obtained using a validated food frequency questionnaire (FFQ). We calculated the relative risk and 95% confidence interval of embryo transfer, clinical pregnancy and live birth according to the following dietary exposures: GL, glycemic index (GI) as well as the daily carbohydrate and fiber intake. A multiple regression model was used to account for the...
In this study, we analyzed the estimated frequency of monozygotic (MZ) and dizygotic (DZ) spontan... more In this study, we analyzed the estimated frequency of monozygotic (MZ) and dizygotic (DZ) spontaneous twins in Lombardy during the period 2007−2017. This is a population-based study using the regional healthcare utilization databases of the Lombardy Region. The total number of spontaneous twin deliveries, in separate strata of like and unlike sex, was obtained. Moreover, estimates of DZ and MZ twin births were calculated using Weinberg’s method. The standardized rates (SRs), adjusted for maternal age, of DZ and MZ twin births were computed according to calendar period. The twinning rates were calculated among strata of parity and maternal age. Finally, DZ:MZ ratio was calculated. Among the 734,278 spontaneous deliveries, 9176 (12.5 out of 1000 births) couples of twins were identified. In the three periods considered (i.e. 2007−2010, 2011−2014 and 2015−2017), no trend in the SRs of MZ twins was observed, respectively 0.41 (95% CI [0.40, 0.43]), 0.43 (95% CI [0.42, 0.45]) and 0.43 (95...
BackgroundInfertility involves 15% of couples in Italy and approximately 10-12% worldwide.Focusin... more BackgroundInfertility involves 15% of couples in Italy and approximately 10-12% worldwide.Focusing on female fertility, it can underline multiple causes, among them the diet has a great influence. Methods We investigated whether the consumption of some fatty acids affects four outcomes of the assisted reproduction techniques. From September 2014 to December 2016, women referring to our Italian fertility unit, eligible for assisted reproduction techniques, were invited to participate. Information on dietwere recorded through a validated food frequency questionnaire. Results494 women were included, of whom95% achieved good quality oocytes, 87% resulted in embryo transfer, 32.0%in clinical pregnancies, and 24.5% in pregnancy at term.The fourth quartile of saturated fatty acids consumption, compared to the first one, showed an association with clinical pregnancy (adjusted relative risk 0.67, 95% confidence interval 0.45 to 1.00, p=0.0491). Some associations emerge accounting for confounders. Age was associated with clinical pregnancy and pregnancy at term in the models considering all fatty intakes and food groups variables but was not associated with oocytes quality and embryo transfer. Physical activity was associated with clinical pregnancy. ConclusionsThere is biologic plausibility of the effect of omega-3 and omega-6 polyunsaturated fatty acids on oocyte development via eicosanoids synthesis, even if our results showed limited associations.Future research is aimed to measure serum levels of fatty acids and investigate the assisted reproduction techniques' outcomes. This article is protected by copyright. All rights reserved.
Objectives The purpose of this cross-sectional study was to prepare a reliable and easy-to-use ar... more Objectives The purpose of this cross-sectional study was to prepare a reliable and easy-to-use architectural classification for vulvar lichen sclerosus (VLS) aimed at defining the morphological patterns of this condition. Materials and Methods An expert panel composed by 7 physicians with expertise in clinical care of vulvar conditions outlined the architectural criteria for the definition of VLS severity (phimosis of the clitoris, involvement of the interlabial sulci, narrowing of the vulvar introitus), identifying 5 grades to build up a classification. Thirteen physicians with 2–30 years expertise in vulvar diseases (nonexpert group) were asked to evaluate 3–5 pictures from 137 patients. Each physician individually assigned a grade to each case, according to the previously mentioned criteria. Interrater reliability was analyzed by means of intraclass correlation coefficient (ICC). The reliability concerning the 2 classifications of each rater was analyzed by means of κ statistic. Intraobserver and interobserver reliability in vivo was analyzed by means of κ index. Results This study provides a new classification of VLS, based on defined anatomical criteria and graded into mutually exclusive progressive classes. The ICC analysis showed a substantial interrater reliability of the classification, ICC = 0.89 (0.87–0.91), both in the expert panel and in the nonexpert group (ICC = 0.92 and 0.87, respectively). An “almost perfect” intraobserver and interobserver reliability was achieved among physicians in vivo (κ = 0.93). Conclusions Our classification showed a high reliability. It is easy to use, and it can be applied in clinical practice and eventually, in the evaluation of regenerative and cosmetic surgery.
American Journal of Obstetrics and Gynecology, 2013
To offer a general figure of the available data on the relation between alcohol intake and risk o... more To offer a general figure of the available data on the relation between alcohol intake and risk of endometriosis, we conducted a systematic review and a metaanalysis of studies published up to May 2012. We carried out a literature search of all case-control and cohort studies published as original articles in English up to May 2012. Only those papers that were published as full-length articles were considered. Pooled estimates of the relative risks (RRs) and the corresponding 95% confidence intervals (CIs) were calculated using fixed or, when significant heterogeneity among estimates emerged, random effects models. A total of 15 studies were identified for the review. The summary estimate was 1.24 (95% CI, 1.12-1.36) for any alcohol intake vs no alcohol intake. Considering the results of the analyses of infrequent, moderate/regular, and heavy alcohol intake vs no alcohol intake, the summary RR estimates were, respectively, 1.14 (95% CI, 0.86-1.52), 1.23 (95% CI, 1.08-1.40), and 1.19 (95% CI, 0.99-1.43). Three studies reported separate results for current and former drinkers, and the summary RR were 1.42 (95% CI, 1.14-1.76) and 1.09 (95% CI, 0.83-1.43), respectively. The present metaanalysis provides evidence for an association between alcohol consumption and endometriosis risk. Further studies are needed to clarify whether alcohol consumption may exacerbate an existing disease or could be related to the severity of the disease.
To examine the degree of agreement between the paediatrician&#39;s assessment and parental re... more To examine the degree of agreement between the paediatrician&#39;s assessment and parental reporting of infants&#39; development using a postal questionnaire. The developmental status of 241 infants in the charge of 9 community paediatricians or discharged from one Neonatal Intensive Care Unit (NICU) was assessed by their parents 18 mo after delivery, using a postal questionnaire regarding child&#39;s height, weight. respiratory, hearing and vision problems, and items taken mainly from the Griffiths&#39; Developmental Scales. At this age, infants were seen by the community or NICU paediatricians, for a complete physical and neurodevelopmental examination. The mean agreement on items regarding developmental areas between parents and paediatricians was 93.0%. In general, parents and professionals agreed on items describing gross motor behaviour (k from 0.39 to 0.83) and disagreed on individual questions describing language/relational behaviour (k from 0 to 0.38). A 97.9% level of agreement was found for hearing status (k = 0), and 96.2% for assessment of vision (k = 0.29), whereas the level of agreement ranged from 43.2% to 86.2% (k from 0 to 0.15) for the three questions describing respiratory problems. The mean weight and height assessments by paediatricians and parents of infants at 18 mo of age were similar. Further improvement of the questionnaire is needed, but our findings suggest that this methodology can be considered for use in comparing large cohorts of infants included in randomized clinical trials.
Folic acid (FA) supplementation prevents neural tube defects (NTDs), but the effects on other rep... more Folic acid (FA) supplementation prevents neural tube defects (NTDs), but the effects on other reproductive outcomes are unclear. While common recommendation is 0.4 mg/day in addition to regular nutrition, the most appropriate dose of FA is still under debate. We investigated the effects of a higher dose of periconception FA on reducing adverse reproductive outcomes. In this multicenter double-blind randomized controlled trial (RCT), 1060 women (aged 18–44 years and planning a pregnancy) were randomly assigned to receive 4.0 mg or 0.4 mg of FA daily. The primary outcome was the occurrence of congenital malformations (CMs). A composite outcome including one or more adverse pregnancy outcomes was also evaluated. A total of 431 women had a natural conception within 1 year. The primary outcome occurred in 8/227 (3.5%) women receiving 4.0 mg FA and 9/204 (4.4%) women receiving 0.4 mg FA (RR 0.80; 95%CI 0.31 to 2.03). The composite outcome occurred in 43/227 (18.9%) women receiving 4.0 mg ...
European Journal of Obstetrics & Gynecology and Reproductive Biology
INTRODUCTION We investigated the role of body mass index (BMI) and maternal age on the risk of la... more INTRODUCTION We investigated the role of body mass index (BMI) and maternal age on the risk of late-term induction, prolonged induction time and caesarean section (CS) after induction. MATERIAL AND METHODS This is a retrospective, observational study. All women without any fetal or maternal pathological condition, uterine scars or any other indication for an elective caesarean birth and had a singleton foetus in the cephalic position at term were included. RESULTS A total of 4006 women had a spontaneous onset of labour and 612 were induced for a late-term pregnancy. Labour induction was significantly more common in overweight (Adj Odds Ratio (OR) 1.48 95%CI 1.22-1.78) and obese (Adj OR 1.63 95%CI 1.24-2.14) women. Among induced women, a BMI ≥ 30 was a risk factor for a prolonged induction time in both nulliparous (AdjOR 2.4, 95%CI 1.02-5.67) and multiparous women (AdjOR 4.24, 95%CI 1.02-17.6). A BMI > 25-29.9 was significantly associated with a prolonged induction time only in nulliparous women (AdjOR 1.86 95%CI 1.05-3.30). A CS was more frequent in overweight (AdjOR 1.74, 95% CI 1.052.89) and obese women (AdjOR 2.72, 95%CI 1.42-5.25). Nulliparous women ageed 30-34 years had an induction time longer than women <30 years (OR 2.04 95%CI 1.07-3.91). CONCLUSIONS The results of this study suggest that a BMI > 25 kg/m2 at term of pregnancy is a risk factor for the induction of labour during a late-term pregnancy, a prolonged induction time and higher caesarean section rate.
Elective caesarean section (CS) before 39 completed weeks of gestation increases likelihood of re... more Elective caesarean section (CS) before 39 completed weeks of gestation increases likelihood of respiratory morbidity in newborns and admissions in neonatal intensive care. Thus, guidelines have recommended that planned caesarean section should not be routinely carried out before 39 completed weeks of gestation. In this paper, we have analyzed the timing of elective CS after 37th completed weeks of gestation in 2010 and 2014 in Lombardy, a region of the North of Italy, in order to evaluate whether there was a measurable change in clinical practice during the last years in the timing of the elective CS. We analyzed data of all deliveries Lombardy, in period of time between 1st January31th December 2010 and 1st January-31th December 2014. From all deliveries, we identified all elective CS deliveries at term.The frequency of elective CS in 37th and 38th week of gestation decreased respectively from 14,2% and 46,7% in 2010 to 13,7% and 44,6% in 2014 (chi square test 37-38 vs 39 or more p...
Clinical reports suggested that the use of oral contraceptives (OC) after a molar pregnancy may i... more Clinical reports suggested that the use of oral contraceptives (OC) after a molar pregnancy may increase the risk of persistent throphoblastic disease. However, few epidemiologic studies have analyzed the effect of OC use on the risk of developing gestational trophoblastic disease (GTD). To give further information, we have analyzed data from a case-control study on risk factors for GTD. Cases were 268 women with a histologically confirmed diagnosis of complete or partial mole referred to the participating Trophoblastic Disease Centers. A total of 268 subjects were interviewed; 79 cases were classified as partial and 159 as complete mole. Controls were randomly selected women who gave birth to healthy infants at term on randomly selected days in the same network of hospitals in which cases had been identified. A total of 104 cases and 130 controls reported ever OC use, and the corresponding odds ratio (OR) was 1.5 (95% CI, 1.1‐2.1). The risk of GTD increases with duration of OC use:...
Among preterm births, different clinical conditions are included: mainly spontaneous and medical ... more Among preterm births, different clinical conditions are included: mainly spontaneous and medical induced. In fact, about 30% of preterm (particularly late preterm) births are medically indicated and the birth weight of these cases may differ from spontaneous preterm birth. In this paper, we have analyzed separately the percentiles of weight at birth in preterm births according to spontaneous and induced births using data of all deliveries in Lombardy, in the period of time between 1st January 2010 and 31th December 2013. The centiles of weight were lower among medically induced births in all the considered week of gestation and among males and females. This descriptive analysis of centiles of weight at birth in Lombardy provides Italian obstetricians and neonatologist with curves of fetal growth more closely representing the population under cure, in particular offer information at our knowledge not available before on the distribution of centiles of weight at birth on babies born p...
Objective We investigated whether lifestyle affects assisted reproduction technology (ART) outcom... more Objective We investigated whether lifestyle affects assisted reproduction technology (ART) outcomes. Design Cohort study. Setting Italian fertility unit. Participants From September 2014 to December 2016, women from couples presenting for evaluation and eligible for ART were invited to participate. Information on alcohol intake, current smoking and leisure physical activity (PA) during the year before the interview was collected, using a structured questionnaire. We considered the ART outcomes of the cycle immediately following the interview. Primary and secondary outcome measures The primary outcome measure was cumulative pregnancy rate per retrieval. Secondary measures were number of retrieved oocytes, embryo transfer and live birth. Results In 492 women undergoing an ART cycle, 427 (86.8%) underwent embryo transfer, 157 (31.9%) had at least one clinical pregnancy and 121 (24.6%) had live birth. The cumulative pregnancy rate per retrieval was 33.3% (95% CI 28.5% to 38.7%). In wome...
In recent decades, increasing attention has been paid to the influence of diet on reproductive he... more In recent decades, increasing attention has been paid to the influence of diet on reproductive health. Carbohydrates in diet affect glucose metabolism and multiple evidences showed the key role of insulin sensitivity in regulating female fertility. We designed a prospective cohort study to investigate the relation between dietary carbohydrate intake, glycemic load (GL) and the outcomes of assisted reproduction. A population of 494 female partners of couples referring to an Italian Fertility Center and eligible for in vitro fertilization (IVF) were enrolled in the study. On the day of the oocyte retrieval, information on their diet was obtained using a validated food frequency questionnaire (FFQ). We calculated the relative risk and 95% confidence interval of embryo transfer, clinical pregnancy and live birth according to the following dietary exposures: GL, glycemic index (GI) as well as the daily carbohydrate and fiber intake. A multiple regression model was used to account for the...
Uploads
Papers by sonia cipriani