Background: Congenital cytomegalovirus (cCMV) infection is a leading cause of neonatal morbidity. This retrospective study aimed to evaluate the efficacy of valacyclovir in reducing vertical transmission after primary maternal CMV infection and to assess the diagnostic performance of amniocentesis and prenatal imaging. Methods: Eighty-two pregnant women with confirmed primary CMV infection were included. Maternal CMV serology and viral DNA were assessed in blood and urine, with standardized prenatal care including serial ultrasound examinations and fetal MRI when indicated. Amniocentesis was offered to confirm fetal infection. Valacyclovir (8 g/day) was administered before 24 weeks’ gestation, and neonatal infection was diagnosed by CMV DNA detection in urine at birth. Statistical analyses were performed using SPSS version 27.0. Results: Most infections (62.2%) were diagnosed in the first trimester. Valacyclovir was administered in 97.6% of cases, and amniocentesis was performed in 81.7%, with CMV DNA detected in 19.4%. Among 74 live births, 23% of neonates were CMV-positive and 6.8% symptomatic. Seven infected neonates had negative amniocentesis (false-negative rate, 13.2%). Prenatal ultrasound and MRI failed to detect abnormalities in symptomatic cases. Conclusions: Valacyclovir may reduce, but does not eliminate, the risk of cCMV transmission. Negative amniocentesis does not fully exclude fetal infection, highlighting postnatal follow-up.

Background: Gestational diabetes mellitus (GDM) and periodontitis (PD) are chronic inflammatory conditions that may share metabolic and immune pathways. Evidence suggests an association between them, although results across studies remain inconsistent. This systematic review and meta-analysis evaluated the relationship between GDM and PD and examined whether GDM influences key periodontal parameters. Methods: A systematic search of PubMed/MEDLINE, Scopus, Web of Science, and Embase was conducted up to August 2025 following PRISMA guidelines. Observational studies comparing periodontal status in pregnant women with and without GDM were included. Periodontal status was assessed using probing pocket depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP). Study quality was evaluated with the Newcastle–Ottawa Scale, and random-effects models were applied to estimate pooled associations. Results: Fifteen studies involving about 3800 pregnant women met the criteria. A significant association was found between GDM and PD (Odds Ratio [OR] 2.10; 95% Confidence Interval [CI] 1.64–2.69). No significant association emerged between GDM and gingivitis. Women with GDM showed increased BOP and higher PPD, indicating greater periodontal inflammation, while CAL did not significantly differ between groups. Conclusions: The findings support a significant association between GDM and periodontitis, suggesting that gestational hyperglycemia may enhance periodontal inflammation and early tissue changes. Incorporating periodontal screening into prenatal care may benefit maternal oral and metabolic health. Further longitudinal and interventional studies are needed to clarify causality and to explore whether periodontal therapy may help reduce risks linked to GDM.

Background: Congenital toxoplasmosis remains a significant cause of fetal morbidity worldwide. This case–control study aimed to identify sociodemographic, dietary, and behavioral factors associated with Toxoplasma gondii infection during pregnancy in Italy by comparing infected women with seronegative controls, and to evaluate modifiable risk behaviors and treatment-related outcomes among affected patients. Methods: This case–control study included 201 pregnant women (100 with T. gondii infection and 101 seronegative controls). Participants completed a structured questionnaire on sociodemographic factors, diet, environmental exposures, and preventive behaviors. Clinical data were collected for infected women and analyzed using SPSS v27.0. Results: Sociodemographic and obstetric characteristics did not differ between groups. Infected women were more likely to live in rural areas (p < 0.001), have a lower educational level (p = 0.009), consume unpasteurized dairy products and cured meats (p < 0.05), purchase food from farmers or butchers (p = 0.01), and do not check food preparation practices when eating outside the home. High-risk animal-related behaviors were also more common among cases (p < 0.001). Despite similar baseline awareness, adherence to preventive measures was lower among cases; most infections were diagnosed in the first trimester and treated with spiramycin with good tolerability. Conclusions: Maternal toxoplasmosis is mainly associated with modifiable behavioral and environmental factors, underscoring the need for targeted, preconception counseling to reduce the risk of congenital infection.

Background/Objectives: Maternal valaciclovir therapy is increasingly used to reduce fetal viral replication in cases of primary cytomegalovirus (CMV) infection during pregnancy. However, data on its impact on early neurodevelopmental outcomes remain limited. This study aimed to evaluate the association between prenatal valaciclovir exposure and early neurodevelopment in infants with confirmed congenital CMV infection (cCMV). Methods: In this retrospective monocentric cohort study, 30 infants with PCR-confirmed cCMV infection were assessed at 4–8 months of age using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Infants were stratified according to prenatal exposure to maternal valaciclovir. Univariate analyses and multivariable linear regression models were performed to evaluate the association between prenatal antiviral exposure and cognitive outcome, adjusting for brain MRI findings and selected clinical variables. Results: Fifteen infants (50%) were exposed to prenatal valaciclovir. Exposed infants demonstrated higher cognitive composite scores compared with unexposed infants (median 105 [IQR 100–110] vs. 90 [85–110]; p = 0.030). In multivariable analysis, prenatal valaciclovir exposure remained significantly associated with higher cognitive scores (β = 11.89, 95% CI 2.86–20.92; p = 0.012), while neonatal MRI abnormalities were not independently associated with outcome. No significant differences were observed in language or motor domains. The final model explained 30% of the variance in cognitive scores (R² = 0.30). Conclusions: Prenatal valaciclovir exposure was associated with higher cognitive composite scores after adjustment for selected covariates. Although causality cannot be inferred, these findings suggest a potential association with early neurodevelopmental outcomes and support the inclusion of functional neurodevelopmental endpoints in future prospective studies. These results should be considered exploratory and hypothesis-generating

Objective: To describe a prenatal case of congenital diaphragmatic eventration, describe prenatal presentation and summarize available postnatal outcomes of previously reported cases. Methods: We present a prenatally diagnosed case of congenital diaphragmatic eventration managed at our institution and a structured literature review to identify previously reported prenatal cases published between 1984 and 2025. Results: Congenital diaphragmatic eventration was diagnosed at 20 + 2 weeks’ gestation following suspicion of fetal dextrocardia. Fetal magnetic resonance imaging confirmed diaphragmatic continuity and excluded congenital diaphragmatic hernia. Mild neonatal respiratory distress required only transient continuous positive airway pressure. Nineteen prenatally suspected cases were identified from the literature, most of which were initially misdiagnosed as congenital diaphragmatic hernia (89.5%). Correct prenatal characterization was reported in 57% of cases evaluated with fetal MRI and 25% with ultrasound alone; however, these findings should be interpreted as a descriptive observation due to the limited number and heterogeneity of available reports. Conclusions: Congenital diaphragmatic eventration is a rare but important mimic of congenital diaphragmatic hernia. Fetal magnetic resonance imaging may provide additional anatomical information in selected cases and facilitate counselling and perinatal management.