Maternal and perinatal outcomes following pre-Delta, Delta, and Omicron SARS-CoV-2 variants infection among unvaccinated pregnant women in France and Switzerland: a prospective cohort study using the COVI-PREG registry.

BACKGROUND SARS-CoV-2 positive pregnant women are at higher risk of adverse outcomes, but little evidence is available on how variants impact that risk. We aim to evaluate maternal and perinatal outcomes among unvaccinated pregnant women that tested positive for SARS-CoV-2, stratified by pre-Delta, Delta, and Omicron periods. METHODS This prospective study enrolled women from March 2020 to September 2022. Exposure to the different SARS-CoV-2 variants was defined by their periods of predominance. The primary outcome was severe maternal adverse outcome defined as either intensive care unit admission, acute respiratory distress syndrome, advanced oxygen supplementation, or maternal death. The secondary outcomes were preterm birth and other perinatal outcomes. FINDINGS Overall, 1402, 262, and 391 SARS-CoV-2 positive pregnant women were enrolled during the pre-Delta, Delta, and Omicron periods respectively. Severe maternal adverse outcome was reported in 3.4% (n = 947/1402; 95% confidence intervals (95%CI) 2.5-4.5), 6.5% (n = 7/262; 95%CI 3.8-10.2), and 1.0% (n = 4/391; 95%CI 0.3-2.6) of women during the pre-Delta, Delta, and Omicron periods. The risk of severe maternal adverse outcome was higher during the Delta vs pre-Delta period (adjusted risk ratio (aRR) = 1.8; 95%CI 1.1-3.2) and lower during the Omicron vs pre-Delta period (aRR = 0.3; 95%CI, 0.1-0.8). The risks of hospitalization for COVID-19 were 12.6% (n = 176/1402; 95%CI 10.9-14.4), 17.2% (n = 45/262; 95%CI 12.8-22.3), and 12.5% (n = 49/391; 95%CI 9.4-16.2), during the pre-Delta, Delta, and Omicron period, respectively. Pregnancy complications occurred after SARS-CoV-2 exposure in 30.0% (n = 363/1212; 95%CI 27.4-32.6), 35.2% (n = 83/236; 95%CI 29.1-41.6), and 30.3% (n = 105/347; 95%CI 25.5-35.4) of patients during the pre-Delta, Delta, and Omicron periods, respectively. Stillbirths were reported in 0.5% (n = 6/1159; 95%CI 0.2-1.1), 2.8% (n = 6/210; 95%CI 1.0-6.0), and 0.9% (n = 2/213; 95%CI 0.1-3.4) or patients during the pre-Delta, Delta, and Omicron periods respectively. INTERPRETATION The Delta period was associated with a higher risk of severe maternal adverse outcome and the Omicron period with a lower risk of severe adverse outcome compared to pre-Delta era. The reported risk of hospitalization was high during the Omicron period and should not be trivialized. FUNDING Swiss Federal Office of Public Health, Fondation CHUV

Usages de la pierre dans la construction du port romain de Saint-Lupien à Rezé/Ratiatum (Loire-Atlantique) : extraire, transformer, bâtir

Les recherches menées sur le site portuaire antique de Saint-Lupien à Rezé/Ratiatum (Loire-Atlantique) ont livré de nombreux renseignements quant aux modes de construction de caissons mêlant bois et pierre, utilisés comme quais en bordure d’un bras de la Loire et découverts dans un état de conservation exceptionnel. Au sein de ce programme monumental de construction, réalisé entre la fin du ier s. et le début du iie s. apr. J.-C., puis de diverses réfections ultérieures, la pierre, élément indispensable à l’ensemble, a fait l’objet d’une étude tracéologique et architecturale intégrant des questionnements liés à l’acquisition, à la transformation et à la mise en œuvre des produits lithiques.Research carried out into the Roman port site of Saint-Lupien at Rezé/Ratiatum (Loire-Atlantique) has made it possible to examine the construction methods of port facilities established in the upper part of the Loire estuary as early as the end of the 1st c. AD. Discovered in a remarkable state of preservation, they take the form of monumental quays, built on the caisson principle and characterised by a mixed architecture combining timber and stone. This latter material, which was later favoured during the various transformations the quays underwent from the mid-2nd c. AD on, is at the heart of a traceological analysis and an architectural study with the aim of better understanding the construction and restructuring logics of the artificial platforms that have been uncovered, by integrating questions related to the acquisition, transformation and use of stone materials. It draws attention to the use of mica-schist for these developments, a local metamorphic rock that is not very suitable for quarrying. This material, abundant in the subsoil of Rezé, was the main material used for the construction of the quays of the port of Rezé/Ratiatum. The traceological analysis also highlighted the various processes used by the builders, who were able to take advantage of the physical characteristics of mica-schist, associated with timber. The shaping and perfect interweaving in the structural network of the quays reveals an ingenious and reasoned design

Risk of congenital malformation following first trimester mRNA COVID-19 vaccine exposure in pregnancy: the COVI-PREG prospective cohort.

OBJECTIVES This study aimed to evaluate the risk of congenital malformation among pregnant women exposed to the mRNA COVID-19 vaccines during the first trimester of pregnancy, which is a developmental period where the fetus is at risk of teratogenicity. METHODS Pregnant women were prospectively enrolled from March 2021 to March 2022, at the time of COVID-19 vaccination. Pregnant women exposed to at least one dose of mRNA COVID-19 vaccine from conception to 11 weeks of gestations and 6 days were compared to pregnant women exposed to the vaccine from 12 weeks to the end of pregnancy. The primary outcome was a confirmed congenital malformation at birth. RESULTS A total of 1450 pregnant women were enrolled including 124 in the first trimester and 1326 in the second and third trimester. The overall proportion of congenital malformation was 0.81% (n=1/124; 95%CI 0.02-4.41) and 0.83% (n=11/1326; 95% CI 0.41-1.48) among pregnant exposed to the COVID-19 vaccine during the first and second/third trimester, respectively. First trimester exposure was not associated with a higher risk of congenital malformation with a relative risk (RR) of 0.89 (95%CI 0.12-6.80) with no significant changes after adjustment through exploratory analysis. CONCLUSION Pregnant women exposed to mRNA COVID-19 vaccine before 12 weeks of gestation did not have an increased risk of congenital malformation compared to women exposed outside the teratogenic window. As vaccination is safe and effective, emphasis must be placed on promoting vaccination during pregnancy

Le port romain du quartier de Saint-Lupien à Rezé/<i>Ratiatum</i> (Loire-Atlantique) : origine et évolution

International audienceThe small town of Rezé/Ratiatum (Loire-Atlantique) is located at the end and along the south shore of the Loire estuary facing the city of Nantes/Condevicnum. Located in the Aquitaine province and Pictones territory, the town is situated at an important crossroads of land, river and sea routes. It developed along the river, spreading over at least 40 to 50 ha at its peak, toward the beginning of the 2nd c. AD. The excavations carried out between 2005 and 2016 in the neighborhood of Saint-Lupien made it possible to confirm the existence of harbor facilities in close connection with a series of warehouses, previously identified in the 1980s. Though initially relatively modest in size (primarily consisting of structures built on micro-piles), by the end of the 1st c. AD, a period during which the entire district was at the center of a vast restructuring program, these riverbank constructions became much more imposing. The later buildings can be distinguished by the use of wood and stone, following box construction guidelines, the whole was then sealed with high facades of timber frames. Throughout Antiquity, this group of platforms, upholding buildings and serving as a quay at the foot of the riverbank, would undergo numerous rehabilitation works or reconstructions, before gradually being replaced by a slipway, that would remain active until the beginning of the Middle Ages.L’agglomération de Rezé/Ratiatum (Loire-Atlantique) est localisée au fond et en rive sud de l’estuaire de la Loire face à la ville de Nantes/Condevicnum. Située en province d’Aquitaine et en territoire picton, elle occupe un important carrefour de voies terrestres, fluviales et maritimes et se développe le long du fleuve sur au moins 40 à 50 ha à son apogée, au début du IIe s. apr. J.-C. Les fouilles conduites entre 2005 et 2016 dans le quartier de Saint-Lupien ont permis de confirmer l’existence d’équipements portuaires en étroite relation avec une série d’entrepôts déjà reconnus dans les années 1980. Relativement modestes dans un premier temps (constructions sur micropieux), ces aménagements de berge deviennent bien plus imposants à partir de la fin du Ier s., époque durant laquelle l’ensemble du quartier fait alors l’objet d’un vaste programme de restructuration. Leur édification se singularise par l’emploi du bois et de la pierre, suivant le principe de construction en caisson, le tout étant fermé par des façades élevées en pan de bois. Durant toute l’Antiquité, cet ensemble de plates-formes, supportant des bâtiments et servant de quai en pied de berge, va être soumis à de nombreux travaux de réfection ou de reconstruction, avant de laisser place progressivement à l’établissement d’une cale en pente douce, encore active au début du Moyen Âge

Risk of congenital malformation following first trimester mRNA COVID-19 vaccine exposure in pregnancy: the COVI-PREG prospective cohort.

This study aimed to evaluate the risk of congenital malformation among pregnant women exposed to the mRNA COVID-19 vaccines during the first trimester of pregnancy, which is a developmental period where the fetus is at risk of teratogenicity. Pregnant women were prospectively enrolled from March 2021 to March 2022, at the time of COVID-19 vaccination. Pregnant women exposed to at least one dose of mRNA COVID-19 vaccine from conception to 11 weeks of gestations and 6 days were compared to pregnant women exposed to the vaccine from 12 weeks to the end of pregnancy. The primary outcome was a confirmed congenital malformation at birth. A total of 1450 pregnant women were enrolled including 124 in the first trimester and 1326 in the second and third trimester. The overall proportion of congenital malformation was 0.81% (n=1/124; 95%CI 0.02-4.41) and 0.83% (n=11/1326; 95% CI 0.41-1.48) among pregnant exposed to the COVID-19 vaccine during the first and second/third trimester, respectively. First trimester exposure was not associated with a higher risk of congenital malformation with a relative risk (RR) of 0.89 (95%CI 0.12-6.80) with no significant changes after adjustment through exploratory analysis. Pregnant women exposed to mRNA COVID-19 vaccine before 12 weeks of gestation did not have an increased risk of congenital malformation compared to women exposed outside the teratogenic window. As vaccination is safe and effective, emphasis must be placed on promoting vaccination during pregnancy

Mass spectrometry-based proteomics in clinical practice amyloid typing: state-of-the-art from a French nationwide cohort

International audienc

Les ports romains dans les Trois Gaules

Ce dossier dresse un bilan des ports romains fouillés à ce jour dans les Trois Gaules (Lyonnaise, Aquitaine et Belgique) et plus particulièrement dans l’Arc Atlantique et les eaux intérieures. Prenant appui sur les communications présentées dans le cadre d’un colloque organisé à Nantes en 2018, il rend compte de près d’un siècle de recherches et de découvertes reflétant l’émergence de l’archéologie portuaire dans cet espace non méditerranéen, tout en offrant une image inédite de ports antiques établis en fond d’estuaire ou sur les rives de fleuves et de rivières. La préparation de ce volume a été l’occasion de mettre plus particulièrement à l’honneur les configurations, les infrastructures, les systèmes architecturaux et les choix techniques retenus pour équiper une partie du triptyque portuaire usuel, à savoir l’espace lié aux activités de (dé)chargement, en pied de berge, et à l’espace navigable. Le programme de fouilles mené entre 2005 et 2016 sur le port fluvio-maritime du quartier de Saint-Lupien à Rezé (Loire-Atlantique), en bordure d’un bras disparu de la Loire, est à l’origine du colloque de Nantes et donc de ce dossier. Il a révélé des quais remarquablement conservés et construits en caissons à pans de bois et blocages de pierres. Il a également permis de rassembler de multiples données au sein des alluvions accumulées à leur pied (faune, insectes, textiles…). C’est cet ensemble qui a en particulier servi de point de comparaison à la présentation de plusieurs autres sites portuaires mis en évidence dans les bassins de la Seine (Aizier [Eure], Incarville [Eure], Rouen [Seine-Maritime], Blainville-sur-Orne [Calvados], Reims [Marne], Pont-Sainte-Maxence [Oise], Chelles [Seine-et-Marne], Les Mureaux [Yvelines]), de la Loire (Tours [Indre-et-Loire], Orléans [Loiret], Bourges [Cher]) ou encore de la Garonne (Barzan [Charente-Maritime], Saintes [Charente-Maritime], Naintré [Vienne], Bordeaux [Gironde]). Afin d’en enrichir le propos et d’en prolonger la discussion, ce dossier s’achève par une ouverture chronologique (Vix [Côte-d’Or]), doublée d’une ouverture géographique, de l’autre côté de la ligne de partage des eaux, côté Rhin, Rhône et Méditerranée, avec une présentation de ports bâtis en contexte portuaire lacustre, fluvio-lacustre ou lagunaire (Besançon [Doubs], la Suisse, Irun [Pays basque, Espagne] et Narbonne [Aude])