[Prenatal screening and the prevalence of hepatitis B infection in pregnant women in the Marche Region (Central Italy): differences between ethnic groups]. / Lo screening prenatale e la prevalenza dell'infezione da epatite B nelle donne in gravidanza nelle Marche: differenze tra gruppi etnici.

OBJECTIVES: to evaluate the epidemiology of hepatitis B infection in pregnant women living in the Marche Region (Central Italy), according to the Country of origin. DESIGN: cross sectional observational study conducted from May 2011 to April 2012, which involved 13 of the 15 birthing centres in the Marche region. SETTING AND PARTICIPANTS: serological data of hepatitis B infection were obtained during the execution of mandatory prenatal screening. The total number of pregnant women was of 10,232 of which 7,669 were Italian (74.9%) and 2,563 were foreign (25.1%). MAIN OUTCOME MEASURES: rate of adherence to prenatal serologic screening and prevalence of hepatitis B infection in Italian and foreign pregnant women. The 95% confidence intervals were calculated using the exact method for proportions. The test for proportions was applied to make comparisons between groups (significance level: 0.05). RESULTS: the rate of adherence to prenatal serologic screening and the overall prevalence of hepatitis B infection in pregnancy ware 98.6% and 0.8%, respectively. In foreign women, compared to native ones, differences of adherence to screening and the prevalence of infection were significant (96.7% vs. 99.3% and 2.7% vs. 0.2%). The highest prevalence was observed in pregnant women who came from the Western Pacific Region, Eastern Europe, and Africa (7.0%, 4.0%, and 3.3%, respectively). More than half of the cases of pregnant women, positive for hepatitis B surface antigen, were originating in Albania and China (60.6%). The prevalence of hepatitis B infection was significantly higher in pregnant women from China (8.1%), Albania (7.7%), Ukraine (7.2%), and Senegal (6.1%). CONCLUSIONS: the study emphasises the need to organise targeted interventions to facilitate access to prenatal screening programmes to foreign women for better control of hepatitis B infection in the Marche Region.

[Congenital and perinatal infections in the Marche region (Italy): an epidemiological study and differences between ethnic groups]. / Le infezioni congenite e perinatali nella regione Marche (Italia). Studio epidemiologico e differenze tra gruppi etnici.

The purpose of this study was to evaluate the epidemiological data regarding congenital and perinatal infections in the Marche region to verify the existence of differences in relation to maternal country of origin. This prospective study was conducted from May 2001 to April 2012, and it involved all the maternity units of the Marche region. A total of 10232 pregnant women were included, 25.1% of whom were of foreign nationality while the number of births totalled 10371. Estimated uptake of antenatal screening was 80.5% for CMV infection, 98.6% for HBV infection, 97.5% for HCV infection, 97.4% for HIV infection, 93.1% for syphilis and 98.5% for toxoplasmosis. For group B streptococcus vaginal and perianal swabs were performed in 81.2% of all women (78.4% in immigrant and 90.4% in Italian women; the difference was statistically significant [p 0.001]) and 13.6% were positive. The overall prevalence for CMV infection was 72.3% (91.9% in immigrant women) while for toxoplasmosis it was 27.5% (28.8% in immigrant women). The rate of seroconversion in pregnant women investigated for CMV infection was 0.28%, while that for toxoplasmosis was 0.09%. The overall prevalence for HBV infection was 0.79% (4.3% in immigrant and 0.4% in Italian pregnant women; the difference was statistically significant [p 0.001]), 0.4% for HCV infection (1% in immigrant and 0.48% in Italian pregnant women; the difference was not statistically significant [p 0.413]), 0.22% for syphilis (0.8% in immigrant and 0.08% in Italian pregnant women; the difference was not statistically significant [p 0.062]), 0.09% for HIV infection, and 0.03% for tuberculosis. The prevalence of congenital CMV infection was 0.04% and that of congenital toxoplasmosis 0.01%. The prevalence of early-onset infection from Group B streptococcus was 0.029%. No cases were observed of congenital syphilis, congenital tuberculosis or maternal and neonatal HSV infections. The study proves that in the Marche region there is a high percentage of women who undergo prenatal screening, including screening for infections, not offered by the National Health Service, such as CMV and HCV. The data also demonstrate that some infections, such as tuberculosis, HIV and HBV, almost exclusively affect immigrant women. Regarding neonatal infections, the data presented are in line with those in the literature, with the exception of congenital CMV infection, in which the low prevalence observed could be linked to the recent and massive migration of already immunized women.