Older Pregnancies & Prevention: Italy’s Maternal Health Focus

Italy is experiencing a shift in maternal health, marked by rising maternal age, increasing anxiety among expectant mothers and concerningly low vaccination rates. These trends were highlighted at a recent event, “The protection of maternal and child health: the value of primary prevention in pregnancy,” hosted by Fondazione Onda ETS at the Ministry of Health, bringing together institutions and the scientific community to strengthen integrated prevention strategies.

The average age of a first-time mother in Italy is now 34. While not inherently problematic, this demographic reality necessitates a recalibration of prenatal care, as older mothers face statistically higher risks during pregnancy, and childbirth. Alongside this, over one in five pregnant women are experiencing anxiety, and less than half (47%) connect preventative measures with vaccinations, creating a significant gap in protective healthcare.

Francesca Merzagora, president of Fondazione Onda ETS, emphasized the importance of primary prevention. “Primary prevention in pregnancy protects both mother and baby: healthy lifestyles and recommended vaccinations protect women from complications and defend the newborn in the first months, when they are most vulnerable,” she stated. “The Ministry of Health and obstetric-gynecological scientific societies agree on this. Even in Europe, the message is clear: we must vaccinate, but coverage rates (as in Italy) are unfortunately low. Fondazione Onda ETS, through the ‘Bollino Rosa’ initiative, can play an important role by integrating preventative care for women during pregnancy and acting as a bridge between scientific recommendations and clinical practice, as well as through targeted national campaigns dedicated to these issues.”

Vito Trojano, president of the Italian Society of Gynecology and Obstetrics (SIGO), underscored the fundamental value of prevention. “The value of prevention in pregnancy is crucial to ensuring the health of the mother and child. Many complications are preventable through accurate and periodic monitoring of the pregnant woman,” he explained. “Preventing means reducing the risk of complications during pregnancy and childbirth, improving the health of the mother and child through screening for diseases such as pre-eclampsia, gestational diabetes, and infections. Regular prenatal visits, healthy lifestyles, vaccinations, prenatal screenings, and psychological support are important. Preparing for childbirth, both physically and psychologically, is also essential. The new role of the gynecologist, must be that of educator, clinician, coordinator, and empathetic guide, always working together with other professionals in the sector, with institutions, and with associations, realizing correct prenatal education that guarantees a healthy and happy pregnancy.”

The psychological well-being of expectant mothers is also a key concern. Claudio Mencacci, co-president of the Italian Society of Neuropsychopharmacology (SINPF) and president of the scientific technical committee of Fondazione Onda ETS, differentiated between pregnancy-related anxiety – which can affect up to 14.4% of pregnant women – and pre-existing anxiety disorders that may emerge or recur during pregnancy, affecting between 5% and 37% of women. He noted that concerns about vaccinations can also contribute to psychological stress, highlighting the need for clear communication and integrated psychological and preventative care for a safer and more serene maternity experience.

An investigation by Fondazione Onda ETS, titled “Primary prevention and vaccinations in pregnancy” (Elma Research, 2024), revealed that the experience of pregnancy is increasingly influenced by age, personal and work responsibilities, and difficulty navigating fragmented health information. The study also found that one in three women report practical difficulties coordinating visits, exams, and preventative recommendations, emphasizing the need for more streamlined and patient-centered care pathways.

Massimo Agosti, president of the Italian Society of Neonatology (SIN), highlighted the importance of the first 1,000 days of life for preventing chronic diseases. “Scientific evidence demonstrates that unhealthy lifestyles during pregnancy and early childhood increase the risk of obesity and diabetes. Early intervention is a public health priority.”

Michela Patruno, representing the Italian Society of General Medicine and Primary Care (SIMG), emphasized the central role of general practitioners in managing women throughout pregnancy, from the preconception phase to postpartum care. They are key in managing chronic conditions and minor symptoms, promoting healthy lifestyles, and providing essential support.

Vaccinations during pregnancy are crucial for protecting both the mother and the baby. Currently recommended and available vaccines in Italy include those against pertussis (DTPa), influenza, and COVID-19, all considered safe for both mother and fetus and recommended with each pregnancy. A new opportunity for prevention is also available with vaccination against Respiratory Syncytial Virus (RSV), which causes tens of thousands of outpatient visits and approximately 15,000 hospitalizations annually in Italy, particularly affecting infants.

Maternal RSV vaccination, administered in the third trimester, provides early protection to the newborn, significantly reducing the risk of severe respiratory infections and hospitalization in the first months of life. However, a significant gap remains between scientific recommendations and clinical practice, underscoring the need to strengthen information, active offering, and uniform access across the country.

Enrico Di Rosa, president of the Italian Society of Hygiene (SITI), added, “Vaccination during pregnancy is a safe and effective preventative measure that protects the health of the mother and child. Vaccinating a pregnant woman reduces the risk of illness in the mother and provides early protection to the newborn through antibody transfer. Promoting these vaccinations means protecting the most vulnerable and strengthening public health.”