{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T11:10:08Z","timestamp":1779189008423,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Venom immunotherapy (VIT) is a crucial therapy in Hymenoptera Venom Allergy (HVA), but limited data exist on VIT during pregnancy. However, untreated HVA poses a dangerous risk of severe anaphylaxis for both the pregnant woman and her foetus. This study aimed to evaluate the safety and efficacy of maintenance VIT during pregnancy, focusing on spontaneous abortion, preterm birth and adverse events (AEs), compared with rates expected in the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective, longitudinal, multicentre study across 14 Italian allergy centres, including women who became pregnant while receiving maintenance VIT. Safety outcomes were frequencies of spontaneous abortion, preterm birth and VIT\u2010related AEs during pregnancy. Efficacy was assessed by reactions to field stings. Regression analyses evaluated factors associated with safety and efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty\u2010eight women with 86 pregnancies were included. Spontaneous abortion occurred in 11 pregnancies (12.8%) and preterm birth in 6 cases (8.1%). These figures were comparable to those in the general population. Older maternal age and previous abortions were associated with abortion in the unadjusted analysis, but no VIT\u2010related characteristics were raised as risk factors. Only one mild, self\u2010limiting AE to VIT occurred during pregnancy. Five women experienced field stings and only one large local reaction was reported, with no subsequent adverse pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Continuation of well\u2010tolerated maintenance VIT during pregnancy was safe and effective, with no increased risk of abortion, preterm birth, or significant AEs and with preserved protection against sting reactions. These findings support continuing maintenance VIT during pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/all.70386","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T10:44:42Z","timestamp":1779187482000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety of Venom Immunotherapy in Pregnancy: A Multicentre Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9873-9695","authenticated-orcid":false,"given":"Matteo","family":"Martini","sequence":"first","affiliation":[{"name":"Allergy Unit, Department of Internal Medicine University Hospital AOU Delle Marche  Ancona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2059-4470","authenticated-orcid":false,"given":"Giovanna","family":"Sfriso","sequence":"additional","affiliation":[{"name":"Allergy Unit, Azienda Ospedaliera Universitaria Integrata Verona  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerio","family":"Pravettoni","sequence":"additional","affiliation":[{"name":"SC Medicina, Immunologia e Allergologia, Fondazione IRCCS ca\u2019 Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Mauro","sequence":"additional","affiliation":[{"name":"Allergy Unit, Division of Pulmonology S. Anna Hospital  Como Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donatella","family":"Preziosi","sequence":"additional","affiliation":[{"name":"Allergy Unit, Division of Pulmonology S. Anna Hospital  Como Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Vettorato","sequence":"additional","affiliation":[{"name":"Distrettto Padova Sud, AULSS 6 Euganea  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Lucchini","sequence":"additional","affiliation":[{"name":"Biostatistic Unit, ASST Mantova, C. Poma Hospital Strada Lago Paiolo, 10  Mantua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Pagani","sequence":"additional","affiliation":[{"name":"Department of Medicine ASST Mantova, C. Poma Hospital Strada Lago Paiolo, 10  Mantua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iuliana","family":"Badiu","sequence":"additional","affiliation":[{"name":"Struttura Complessa a Direzione Universitaria (SCDU) Immunologia e Allergologia, Azienda Ospedaliera (AO) Ordine Mauriziano di Torino\u2013C.So re Umberto  Torino Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Pia","family":"Dolcher","sequence":"additional","affiliation":[{"name":"Clinical Immunology and Allergy Unit Azienda Ospedaliera Universitaria Pisana  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Gaeta","sequence":"additional","affiliation":[{"name":"Allergy Unit, ASST Valtellina e Lario  Sondrio Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Galati","sequence":"additional","affiliation":[{"name":"UOS Immunologia Clinica\u2010LUM. Diagnostica e Servizi di Supporto. Ospedale Maggiore Carlo Alberto Pizzardi  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Meucci","sequence":"additional","affiliation":[{"name":"SOS Allergologia Ed Immunologia Clinica, Azienda USL Toscana Centro, Ospedale San Giovanni di Dio  Firenze Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elide","family":"Pastorello","sequence":"additional","affiliation":[{"name":"Casa di Cura Ambrosiana, Centro Ambulatoriale di Allergologia  Cesano Boscone Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Patella","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine ASL Salerno Santa Maria Della Speranza Hospital  Salerno Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Pucci","sequence":"additional","affiliation":[{"name":"Allergy Unit, Hospital of Civitanova Marche  Civitanova Marche Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Roncallo","sequence":"additional","affiliation":[{"name":"Specialista Ambulatoriale ASST Lariana  Como Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Savi","sequence":"additional","affiliation":[{"name":"Allergy Unit Ospedale G.Da Saliceto  Piacenza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livio","family":"Simioni","sequence":"additional","affiliation":[{"name":"Allergy Unit, Aulss 1 Dolomiti\u2013Regione Veneto, Medical Department Ospedale Santa Maria del Prato  Feltre Belluno Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9324-6039","authenticated-orcid":false,"given":"Maria Beatrice","family":"Bil\u00f2","sequence":"additional","affiliation":[{"name":"Allergy Unit, Department of Internal Medicine University Hospital AOU Delle Marche  Ancona Italy"},{"name":"Department of Clinical and Molecular Sciences Marche Polytechnic University  Ancona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrizia","family":"Bonadonna","sequence":"additional","affiliation":[{"name":"Allergy Unit, Verona University Hospital  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1080\/08830185.2020.1777292","article-title":"Pregnancy Immune Tolerance at the Maternal\u2010Fetal Interface","volume":"39","author":"Li X.","year":"2020","journal-title":"International Reviews of Immunology"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1002\/cbin.11955","article-title":"Dominant Immune Cells in Pregnancy and Pregnancy Complications: T Helper Cells (TH1\/TH2, TH17\/Treg Cells), NK Cells, MDSCs, and the Immune Checkpoints","volume":"47","author":"Esparvarinha M.","year":"2023","journal-title":"Cell Biology International"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1016\/j.jaip.2021.03.029","article-title":"Immunological Responses and Biomarkers for Allergen\u2010Specific Immunotherapy Against Inhaled Allergens","volume":"9","author":"Shamji M. H.","year":"2021","journal-title":"Journal of Allergy and Clinical Immunology. In Practice"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"327","DOI":"10.2131\/jts.47.327","article-title":"Fetal Loss due to Th1\u2010Skewed Th1\/Th2 Balance With Increase (Not Decrease) of Regulatory T Cells in Abortion\u2010Prone Mouse Model","volume":"47","author":"Sakakibara M.","year":"2022","journal-title":"Journal of Toxicological Sciences"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1056\/NEJMra1409760","article-title":"Mast Cells, Mastocytosis, and Related Disorders","volume":"373","author":"Theoharides T. C.","year":"2015","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/j.jaci.2012.06.035","article-title":"Anaphylaxis During Pregnancy","volume":"130","author":"Simons F. E. R.","year":"2012","journal-title":"Journal of Allergy and Clinical Immunology"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1111\/all.13262","article-title":"EAACI Guidelines on Allergen Immunotherapy: Hymenoptera Venom Allergy","volume":"73","author":"Sturm G. J.","year":"2018","journal-title":"Allergy"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.anai.2016.10.031","article-title":"Stinging Insect Hypersensitivity: A Practice Parameter Update 2016","volume":"118","author":"Golden D. B. K.","year":"2017","journal-title":"Annals of Allergy, Asthma & Immunology"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.l869","article-title":"Role of Maternal Age and Pregnancy History in Risk of Miscarriage: Prospective Register Based Study","volume":"364","author":"Magnus M. C.","year":"2019","journal-title":"BMJ"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1177\/03008916241298810","article-title":"Fertility and Abortion: A Population\u2010Based Comparison Between Women With Cancer and Those in Childbearing Age","volume":"111","author":"Maraschini A.","year":"2025","journal-title":"Tumori Journal"},{"key":"e_1_2_9_12_1","volume-title":"The Johns Hopkins Manual of Gynecology and Obstetrics","author":"Hurt K. J.","year":"2012"},{"key":"e_1_2_9_13_1","first-page":"e178","article-title":"External Cephalic Version and Reducing the Incidence of Term Breech Presentation: Green\u2010Top Guideline No. 20a","volume":"124","author":"Impey L. W.","year":"2017","journal-title":"BJOG: An International Journal of Obstetrics & Gynaecology"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1126\/science.1251816","article-title":"Preterm Labor: One Syndrome, Many Causes","volume":"345","author":"Romero R.","year":"2014","journal-title":"Science"},{"key":"e_1_2_9_15_1","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1111\/1471-0528.12281","article-title":"Preterm Birth Time Trends in Europe: A Study of 19 Countries","volume":"120","author":"Zeitlin J.","year":"2013","journal-title":"BJOG: An International Journal of Obstetrics & Gynaecology"},{"key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/S0140-6736(11)61577-8","article-title":"Long\u2010Term Neurodevelopmental Outcomes After Intrauterine and Neonatal Insults: A Systematic Review","volume":"379","author":"Mwaniki M. K.","year":"2012","journal-title":"Lancet"},{"key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"180","DOI":"10.18176\/jiaci.0310","article-title":"Hymenoptera Venom Allergy: Management of Children and Adults in Clinical Practice","volume":"29","author":"Bil\u00f2 M. B.","year":"2019","journal-title":"Journal of Investigational Allergology & Clinical Immunology"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1111\/all.12638","article-title":"Clinical Contraindications to Allergen Immunotherapy: An EAACI Position Paper","volume":"70","author":"Pitsios C.","year":"2015","journal-title":"Allergy"},{"key":"e_1_2_9_19_1","first-page":"331","article-title":"Diagnosis and Treatment of Insect Sensitivity","volume":"3","author":"Mueller H. L.","year":"1966","journal-title":"Journal of Asthma"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/0091-6749(90)90188-A","article-title":"Venom Immunotherapy in the Hymenoptera\u2010Allergic Pregnant Patient","volume":"85","author":"Schwartz H. J.","year":"1990","journal-title":"Journal of Allergy and Clinical Immunology"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008838.pub2"},{"key":"e_1_2_9_22_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0126971","article-title":"Risk Associated With Bee Venom Therapy: A Systematic Review and Meta\u2010Analysis","volume":"10","author":"Park J. H.","year":"2015","journal-title":"PLoS One"},{"key":"e_1_2_9_23_1","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1034\/j.1398-9995.2000.00587.x","article-title":"Side\u2010Effects of Insect Venom Immunotherapy: Results From an EAACI Multicenter Study","volume":"55","author":"Mosbech H.","year":"2000","journal-title":"Allergy"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.70278"},{"key":"e_1_2_9_25_1","doi-asserted-by":"crossref","first-page":"154","DOI":"10.5414\/ALX02430E","article-title":"Diagnosis and Treatment of Hymenoptera Venom Allergy","volume":"7","author":"Ru\u00ebff F.","year":"2023","journal-title":"Allergologie Select"},{"key":"e_1_2_9_26_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12905-023-02685-6","article-title":"Spontaneous and Induced Abortions in Women With a Diagnosis of Gestational Related Neoplasm: A Population\u2010Based Linkage Study in Lombardy, 2010\u20102020","volume":"23","author":"Esposito G.","year":"2023","journal-title":"BMC Women's Health"},{"key":"e_1_2_9_27_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jogoh.2024.102780","article-title":"Population\u2010Based Surveillance of Congenital Anomalies Over 40\u2009Years (1981\u20132020): Results From the Paris Registry of Congenital Malformations (remaPAR)","volume":"53","author":"Monier I.","year":"2024","journal-title":"Journal of Gynecology Obstetrics and Human Reproduction"},{"key":"e_1_2_9_28_1","unstructured":"National Congenital Anomaly and Rare Disease Registration Service \u201cNCARDRS Congenital Condition Statistics Report 2022\u2014Birth Prevalence of Babies With Congenital Conditions in England \u201d(2025) https:\/\/digital.nhs.uk\/data\u2010and\u2010information\/publications\/statistical\/ncardrs\u2010congenital\u2010anomaly\u2010statistics\u2010annual\u2010data\/ncardrs\u2010congenital\u2010condition\u2010statistics\u2010report\u20102022\/total\u2010birth\u2010prevalence\u2010of\u2010congenital\u2010anomalies."},{"key":"e_1_2_9_29_1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.5114\/ada.2018.73168","article-title":"Venom Immunotherapy and Pregnancy","volume":"35","author":"Pa\u0142gan K.","year":"2018","journal-title":"Postepy Dermatologii I Alergologii"},{"key":"e_1_2_9_30_1","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1097\/ACI.0000000000000681","article-title":"Pregnancy and Hymenoptera Venom Allergy","volume":"20","author":"Bonadonna P.","year":"2020","journal-title":"Current Opinion in Allergy and Clinical Immunology"}],"container-title":["Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/all.70386","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/all.70386","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/all.70386","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T10:44:47Z","timestamp":1779187487000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/all.70386"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":29,"alternative-id":["10.1111\/all.70386"],"URL":"https:\/\/doi.org\/10.1111\/all.70386","archive":["Portico"],"relation":{},"ISSN":["0105-4538","1398-9995"],"issn-type":[{"value":"0105-4538","type":"print"},{"value":"1398-9995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]},"assertion":[{"value":"2026-02-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"all.70386"}}