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Rial-Crestelo M, Garcia-Otero L, Cancemi A, Giannone M, Escazzocchio E, Biterna A, Ferriols E, Hernandez JL, Lubusky M, Kolarova V, Krofta L, Vojtêch J, Zohav E, Krajden K, Cruz-Martinez R, Cruz-Lemini M, Parra-Cordero M, Socias P, Crispi F, Lopez M, Gratacós E, Figueras F. Prescriptive Reference Standards of Third-Trimester Cerebroplacental Ratio and Its Physiological Determinants. Fetal Diagn Ther 2020; 47:1-8. [PMID: 32663828 DOI: 10.1159/000508366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 04/26/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To construct valid reference standards reflecting optimal cerebroplacental ratio and to explore its physiological determinants. METHODS A cohort of 391 low-risk pregnancies of singleton pregnancies of nonmalformed fetuses without maternal medical conditions and with normal perinatal outcomes was created. Doppler measurements of the middle cerebral artery and umbilical artery were performed at 24-42 weeks. Reference standards were produced, and the influence of physiological determinants was explored by nonparametric quantile regression. The derived standards were validated in a cohort of 200 low-risk pregnancies. RESULTS Maternal body mass index was significantly associated with the 5th centile of the cerebroplacental ratio. For each additional unit of body mass index, the 5th centile was on average 0.014 lower. The derived 5th, 10th, and 50th centiles selected in the validation cohort were 5, 9.5, and 51% of the measurements. CONCLUSIONS This study provides methodologically sound prescriptive standards and suggests that maternal body mass index is a determinant of a cutoff commonly used for decision-making.
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Affiliation(s)
- Marta Rial-Crestelo
- Hospital Clinic Barcelona, Fetal Medicine Unit, Fetal Medicine Research Center, BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital San Joan de Deu), Barcelona, Spain
| | - Laura Garcia-Otero
- Fetal Medicine Unit Fetal Medicine Research Center, BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital San Joan de Deu), Barcelona, Spain
| | - Annalisa Cancemi
- Fetal Medicine Unit Fetal Medicine Research Center, BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital San Joan de Deu), Barcelona, Spain
| | - Mariella Giannone
- Fetal Medicine Unit Fetal Medicine Research Center, BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital San Joan de Deu), Barcelona, Spain
| | - Elena Escazzocchio
- Atenció a la Salut Sexual i Reproductiva (ASSIR) de Barcelona ciutat, Institut Catala de la Salut, Barcelona, Spain
| | - Alex Biterna
- Obstetrics and Gynecology Institut Catala de la Salut, Atencio Primaria Barcelona Ciutat, Barcelona, Spain
| | - Elena Ferriols
- Obstetrics and Gynecology Consorci Parc de Salut Mar, Hospital del Mar, Barcelona, Spain
| | - Jose Luis Hernandez
- Obstetrics and Gynecology Consorci Parc de Salut Mar, Hospital del Mar, Barcelona, Spain
| | - Marek Lubusky
- Department of Obstetrics and Gynecology, Palacky University Olomouc, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, Czechia
| | - Veronika Kolarova
- Department of Obstetrics and Gynecology, Palacky University Olomouc, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, Czechia
| | - Ladislav Krofta
- Obstetrics and Gynecology, Institute for the Care of Mother and Child, Prague, Czechia
| | - Jiri Vojtêch
- Center of Fetal Medicine, Institute for the Care of Mother and Child, Prague, Czechia
| | - Eyal Zohav
- Department of Obstetrics and Gynecology, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Karina Krajden
- Wolfson Medical Center, Ultrasound Unit, Fetal Neurology Clinic, Holon, Israel
| | | | - Monica Cruz-Lemini
- Fetal Medicine Research Center, Fetal Medicine Mexico, Querétaro, Mexico
| | - Mauro Parra-Cordero
- Fetal Medicine Unit, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - Pamela Socias
- Obstetrics and Gynecology Fetal Medicine Unit, University of Chile Hospital, Santiago de Chile, Chile
| | - Fàtima Crispi
- Maternal-Fetal Medicine BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospitals Clínic and Sant Joan de Déu), IDIBAPS, Barcelona University, Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - Marta Lopez
- Hospital Clinic Barcelona, Fetal Medicine Unit, Fetal Medicine Research Center, BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital San Joan de Deu), Barcelona, Spain
| | - Eduard Gratacós
- Hospital Clinic Barcelona, Fetal Medicine Unit, Fetal Medicine Research Center, BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital San Joan de Deu), Barcelona, Spain
| | - Francesc Figueras
- Hospital Clinic Barcelona, Fetal Medicine Unit, Fetal Medicine Research Center, BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital San Joan de Deu), Barcelona, Spain,
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Ferriols E, Rueda C, Gamero R, Vidal M, Payá A, Carreras R, Flores-le Roux JA, Pedro-Botet J. [Relationship between lipid alterations during pregnancy and adverse pregnancy outcomes]. Clin Investig Arterioscler 2016; 28:232-244. [PMID: 26088001 DOI: 10.1016/j.arteri.2015.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 04/13/2015] [Accepted: 04/14/2015] [Indexed: 06/04/2023]
Abstract
Lipids play an important role during pregnancy, and in this period major changes occur in lipoprotein metabolism. During the third trimester plasma cholesterol and triglyceride levels are substantially increased, returning to normal after delivery. Described associations between increased morbidity during pregnancy and excessive increases in plasma cholesterol and triglycerides. For this reason we have reviewed the relationship between lipid alterations, preeclampsia, gestational diabetes and preterm birth. The overall metabolic control can improve pregnancy outcomes, and the assessment of supraphysiological changes in lipid profile will classify pregnancy risk at a higher level, which would entail a stricter control.
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Affiliation(s)
- Elena Ferriols
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España.
| | - Carolina Rueda
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España
| | - Rocío Gamero
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España
| | - Mar Vidal
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España
| | - Antonio Payá
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España; Departament de Pediatria, d'Obstetrícia i Ginecologia, i de Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España
| | - Ramón Carreras
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España; Departament de Pediatria, d'Obstetrícia i Ginecologia, i de Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España
| | - Juana A Flores-le Roux
- Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Juan Pedro-Botet
- Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
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Martorell A, Sanz J, Ortiz M, Julve N, Cerdá JC, Ferriols E, Alvarez V. Prevalence of dermographism in children. J Investig Allergol Clin Immunol 2000; 10:166-9. [PMID: 10923592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
The prevalence of dermographism in our pediatric population was studied in 238 children of both sexes (128 boys and 110 girls) aged 2-14 years, randomly selected from a health care center. Skin reaction was evaluated after 5 min pressure (3,200 g/cm2) applied with a dermatographometer on a 5-cm length of dorsal skin. The reaction was considered positive when a wheal of more than 2 mm was observed. The prevalence of dermographism was found to be 24%, with a significant female predominance (33%) over males (16%). Forty-one percent of the children with dermographism reported exanthema in response to friction and pressure, which was compatible with symptomatic dermographism, compared with only 5% of those who yielded negative reactions. In order to assess the prevalence of dermographism in the atopic population, 100 patients in the 4-14 age range with respiratory disease (perennial allergic rhinitis and/or bronchial asthma) involving sensitization to aeroallergens (house dust mites and/or Alternaria) were studied. A positive response to the application of pressure (3,200 g/cm2) was observed in 47% of cases, this figure being significantly higher than in the general pediatric population.
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Affiliation(s)
- A Martorell
- Allergy Section, Pediatric Service, Valencia University General Hospital, Valencia, Spain
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