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Hospital de Órbigo, Spain

Comas M.,Servei de Ginecologia i Obstetricia | Crispi F.,University of Barcelona
Fetal Diagnosis and Therapy | Year: 2012

Objective: Tissue Doppler echocardiography is being increasingly used in fetal medicine as a clinical and research tool. The objective of this study was to review the current status of tissue Doppler imaging (TDI) techniques applied to the fetus. Methods: Fetal cardiac function was evaluated using spectral and color TDI modes in normal fetuses and in several clinical conditions. Results: Annular peak velocities and their ratios as well as the myocardial performance index were evaluated using spectral TDI, and changes throughout gestation were described. Color TDI has several limitations in fetal life, particularly the use of low frame rates with current methods of acquisition and the lack of normal references for deformation parameters. Conclusions: Despite its limitations, TDI is a sensitive and promising method to evaluate fetal cardiac function. Copyright © 2012 S. Karger AG, Basel. Source


Aguilera I.,Center for Research in Environmental Epidemiology | Aguilera I.,Municipal Institute of Medical Research IMIM Hospital Del Mar | Aguilera I.,Research Center Biomedica En Red Of Epidemiologia lud Publica | Aguilera I.,University Pompeu Fabra | And 16 more authors.
Environmental Health Perspectives | Year: 2010

Background: Few studies have used longitudinal ultrasound measurements to assess the effect of traffic-related air pollution on fetal growth. Objective: We examined the relationship between exposure to nitrogen dioxide (NO2) and aromatic hydrocarbons [benzene, toluene, ethylbenzene, m/p-xylene, and o-xylene (BTEX)] on fetal growth assessed by 1,692 ultrasound measurements among 562 pregnant women from the Sabadell cohort of the Spanish INMA (Environment and Childhood) study. Methods: We used temporally adjusted land-use regression models to estimate exposures to NO2 and BTEX. We fitted mixed-effects models to estimate longitudinal growth curves for femur length (FL), head circumference (HC), abdominal circumference (AC), biparietal diameter (BPD), and estimated fetal weight (EFW). Unconditional and conditional SD scores were calculated at 12, 20, and 32 weeks of gestation. Sensitivity analyses were performed considering time-activity patterns during pregnancy. Results: Exposure to BTEX from early pregnancy was negatively associated with growth in BPD during weeks 20-32. None of the other fetal growth parameters were associated with exposure to air pollution during pregnancy. When considering only women who spent < 2 hr/day in nonresidential outdoor locations, effect estimates were stronger and statistically significant for the association between NO2 and growth in HC during weeks 12-20 and growth in AC, BPD, and EFW during weeks 20-32. Conclusions: Our results lend some support to an effect of exposure to traffic-related air pollutants from early pregnancy on fetal growth during mid-pregnancy. Source


Garcia-Patterson A.,Servei dEndocrinologia i Nutricio | Aulinas A.,Servei dEndocrinologia i Nutricio | Sojo L.,Servei dEndocrinologia i Nutricio | Ginovart G.,Servei de Pediatria | And 3 more authors.
Diabetic Medicine | Year: 2011

Aims To assess perinatal outcome in women with pregestational diabetes mellitus according to the sex of the fetus. Methods A retrospective review of all singleton pregnancies of women with pregestational diabetes progressing to a gestational age of 22weeks or more who attended the diabetes and pregnancy clinic from 1981 to 2006 (n=455). We compared maternal characteristics and perinatal outcomes (perinatal mortality, major congenital malformations, small and large for gestational age newborns, preterm birth and a composite of the former) according to the sex of the fetus. A logistic regression analysis was performed using the composite perinatal outcome as the dependent variable and all maternal variables and sex of fetus as potential predictors. Results Maternal characteristics did not differ in mothers of male and female newborns. In the whole cohort, the composite perinatal outcome was significantly higher in male fetuses; adjusted OR 1.61 (95%CI1.04-2.50). Conclusions In women with pregestational diabetes, perinatal outcome was poorer in male newborns despite similar maternal characteristics. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK. Source


Garcia-Patterson A.,Servei dEndocrinologia i Nutricio | Aulinas A.,Servei dEndocrinologia i Nutricio | Maria M.A.,Servei dEndocrinologia i Nutricio | Ubeda J.,Servei dEndocrinologia i Nutricio | And 10 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2012

Context: In diabetic pregnancy, neonatal hypoglycemia (NH) is usually attributed to insufficient regulation of maternal glycemic control. Recent data suggest that maternal body mass index (BMI) could have an influence. Objective: Our objective was to determine whether an association exists between maternal prepregnancy BMI category and occurrence of NH among infants born to women with gestational diabetes mellitus (GDM). Design and Setting: This was a retrospective study including all GDM pregnancies delivered between 1986 and 2006 at a tertiary care center (Hospital de la Santa Creu i Sant Pau, Barcelona). Patients and Outcomes: GDM was diagnosed using universal screening and National Diabetes Data Group criteria. Two thousand ninety-two newborns (1925 singletons, 85% of total GDM offspring) were studied. NH was defined according to Cornblath criteria. In addition to maternal BMI, we considered other variables such as glucose values at diagnosis or third-trimester glycated hemoglobin as potential predictors of NH. We explored whether the association between maternal BMI and NH could be due to intermediate steps such as cesarean section or abnormal birth weight. Results: The rate of NH was 3%. In the bivariate analysis, prepregnancy BMI was higher in the NH group (24.45 vs. 23.19 kg/m2, P < 0.02). In the logistic regression analysis, prepregnancy BMI of at least 25 kg/m2 was independently associated with NH whetherthe analysis included intermediate variables (odds ratio = 2.11; 95% confidence interval = 1.10-4.03) or not (odds ratio = 2.66; 95% confidence interval = 1.44-4.92). Conclusions: Pregestational BMI should be considered among the predictors of NH in offspring of women with GDM. Copyright © 2012 by The Endocrine Society. Source


Garcia-Cruz R.,University of Barcelona | Casanovas A.,University of Barcelona | Brieno-Enriquez M.,University of Barcelona | Robles P.,University of Barcelona | And 5 more authors.
Human Reproduction | Year: 2010

Background: Nowadays, oocyte donation is an extended practise in IVF programmes. However, to date, little information on aneuploidy frequency in oocytes from donors is available. Aneuploidy is one of the major causes of embryo and fetal wastage as well as of congenital mental and developmental disabilities. It is known that most aneuploidies are due to non-disjunction events occurring in the maternal germ line. Linkage studies have associated abnormal patterns of meiotic recombination to the origin of the non-disjunction event in many aneuploid conditions. methods and results: In the present study, we analyse the frequency of chromosome imbalances in a series of metaphase I (MI; n 44) and metaphase II (MII; n 103) oocytes from 140 young donors (aged from 18 to 35 years, mean age 26.6) after hormone-induced superovulation. The aneuploidy frequency found in MII oocytes was 12.6%, and both whole-chromosome non-disjunction (1.94%) and premature separation of sister chromatids (PSSC) (12.6%) have been found. The chromosomes involved have been identified by multiplex fluorescent in situ hybridization (FISH). Achiasmate chromosomes have been identified in MI oocytes (9.1%), with most of them corresponding to chromosome 16 (6.8%). For this reason, the meiotic recombination pattern of chromosome 16 has been analysed in prophase I oocytes (n 81) by immunofluorescence staining against MLH1 protein and subsequent FISH with specific probes. Our results show a percentage of oocytes with non-crossover bivalent 16 (2.5%) and a high percentage of bivalents 16 with a single exchange (19.8%). conclusions: In the present study, we report the finding of a considerable frequency of aneuploidy in oocytes from young donors, with the frequency of PSSC being higher than the frequency of whole-chromosome non-disjunction. In addition, we report vulnerable patterns of meiotic recombination in chromosome 16 that may be at risk of leading to a non-disjunction event. This gives new data on the susceptibility of the control population to conceive a trisomic 16 embryo. Source

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