Il parto extra-ospedaliero: un'indagine quanti-qualitativa presso una casa maternità di Roma

A quantitative-qualitative study was performed to describe outcomes and experiences of women who gave birth in an out-of-hospital setting in Rome, Italy, between 2016 and 2018. A retrospective observational study was carried out through the collection of clinical and healthcare data of 96 women assisted in these 3 years. Among them 9 were transferred to hospital during labour. The main outcomes of the out-of-hospital deliveries (n = 87) were: intact perineum and no third- or fourth-degree perineal tear in 44,8% of cases, delayed cord clamping in 100% of cases (of which 26.4% were lotus birth) and exclusive breastfeeding in 94.3% of cases at 7 days after delivery and 93.3% at 3 and 6 months. The qualitative phase was conducted on 15 women and involved focus groups and in-depth interviews. It emerged that the choice to give birth in an out-of-hospital setting was mainly due to either the couple's respect for birth physiology and intimacy or a previous negative experience of hospital birth

Sindrome della morte improvvisa del lattante (SIDS) in Sicilia: una valutazione dei principali determinanti di accudimento

Aim: to evaluate certain caring behaviors associated with the onset of sudden infant death syndrome (SIDS). Methods: a telephone questionnaire was administered between May and July 2017 to a sample of 1055 Sicilian mothers within 30 days of delivery. A multivariate logistic analysis was conducted considering outcome variables: the sleeping position of the children, exclusive breastfeeding and passive smoking. Results: 62% of the participants place their children in the supine position, 37.9% practice exclusive breastfeeding and 89.0% are not smokers. Being aged < 32 years, having a low level of education and limited economic resources are risk factors for the non-supine positioning of children during sleep. A low level of education, primiparity, non-participation to an antenatal course expose mothers to a greater risk of not practicing exclusive breastfeeding at one month. Postpartum smoking is positively associated with a low level of education. Conclusions: the assessment of the main caring behaviors towards newborns and infants is essential for an effective campaign for reducing the risk of SIDS

Severe asthma: One disease and multiple definitions

Introduction There is, so far, no universal definition of severe asthma. This definition usually relies on: number of exacerbations, inhaled therapy, need for oral corticosteroids, and respiratory function. The use of such parameters varies in the different definitions used. Thus, according to the parameters chosen, each patient may result in having severe asthma or not. The aim of this study was to evaluate how the choice of a specific definition of severe asthma can change the allocation of patients. Methods Data collected from the Severe Asthma Network Italy (SANI) registry were analyzed. All the patients included were then reclassified according to the definitions of U-BIOPRED, NICE, WHO, ATS/ERS, GINA, ENFUMOSA, and TENOR. Results 540 patients, were extracted from the SANI database. We observed that 462 (86%) met the ATS/ERS criteria as well as the GINA criteria, 259 (48%) the U-Biopred, 222 (41%) the NICE, 125 (23%) the WHO, 313 (58%) the Enfumosa, and 251 (46%) the TENOR criteria. The mean eosinophil value were similar in the ATS/ERS, U-Biopred, and Enfumosa (528, 532 and 516 cells/mcl), higher in WHO and Tenor (567 and 570 cells/mcl) and much higher in the NICE classification (624 cells/mcl). Lung function tests resulted similarly in all groups, with WHO (67%) and ATS/ERS-GINA (73%), respectively, showing the lower and upper mean FEV1 values. Conclusions The present observations clearly evidence the heterogeneity in the distribution of patients when different definitions of severe asthma are used. However, the recent definition of severe asthma, provided by the GINA document, is similar to that indicated in 2014 by ATS/ERS, allowing mirror reclassification of the patients examined. This lack of homogeneity could complicate the access to biological therapies. The definition provided by the GINA document, which reflects what suggested by ATS/ERS, could partially overcome the problem