[Effects of folic acid supplementation on pregnancy outcomes: a review of randomized clinical trials]. / Revisione narrativa dei risultati degli studi clinici controllati sull'efficacia della supplementazione con folati nel migliorare l'esito della gravidanza.

Despite the causal association between defects of the metabolism of the folate (hyperhomocysteinemia) and risk of neural tube defects are both well documented, the association between folate deficiency and other pregnancy pathologies is still not entirely clear. The present article aims to gather the data published about the relationship between serum folate and pregnancy pathologies, distinguishing between the evidences emerged from the observational studies and the results of the clinical trials. We carried out a brief examination of the relationships between folate metabolism and homocysteine. Observational studies have suggested that a good level of folate in pregnancy is associated with higher birthweight, increased placental weight and fewer preterm birth. These results were not entirely consistent with findings from clinical trials. We have identified 12 randomized clinical studies with folate supplementation versus placebo. In the clinical studies where folic acid (FA) could improve pregnancy outcomes, its effect was not statistically significant, except for three studies where FA showed a significant decrease of low birthweight. With regard to preterm birth, pre-eclampsia and abruptio placentae, although in some observational studies AF was found to be associated with a reduction of these adverse outcomes, in currently available controlled clinical trials, FA supplementation had no statistically significant effects.

[Vesicular mole. Epidemiological considerations]. / La mola vescicolare. Considerazioni epidemiologiche.

A full and detailed review of trophoblast disease at Rome University's Obstetrics and Gynecology Clinic led to a re-examination of some of the classical epidemiological factors in this pathology: age, parity and blood group. The precise incidence of this condition is difficult to establish from hospital series alone. In spite of numerous clinical studies, its aetiology has not yet been fully clarified. The various environmental socio-economic, racial, genetic and other factors, which are sometimes quoted, are too heterogeneous and contradictory to provide significant results. Of evaluated risk parameters, only pregnancy at an advanced age appears to carry increased risk. For these reasons, and given the low incidence of trophoblast pathology, it is recommended that a register of the disease be instituted, at least at Regional level.