Morales Bartolomé, Eva

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Morales Bartolomé, Eva

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Morales Bartolomé, Eva

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Universidad de Murcia. Departamento de Ciencias Sociosanitarias

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Urinary concentrations of non-essential and essential elements during weaning in infants from the NELA cohort in Spain
(Elsevier, 2024-09-13) Notario-Barandiaran, Leyre; Morales Bartolomé, Eva; Vioque, Jesús; Martínez Gracia, Carmen; Santaella-Pascual, Marina; Suárez Martínez, Clara; García-Marcos Álvarez, Luis Vicente; Karagas, Margaret R.; Signes-Pastor, Antonio J.; NELA Study Group; Tecnología de Alimentos, Nutrición y Bromatología; Facultad de Veterinaria
Infancy is a period of continuous growth and development, where inadequate intake of essential elements and exposure to non-essential elements may have lifelong health consequences. Thus, the aim of this study is to evaluate the urine concentration of essential and non-essential elements as a proxy for internal exposure during the weaning period, from 3 to 18 months of age. The Nutrition in Early Life and Asthma (NELA) birth cohort generated the data for this study. Sociodemographic, dietary, and urine concentration of essential (Co, Cu, Mo, I, Fe, Mn, Se, Zn, and Ni) and non-essential elements (Al, V, As, Cd, Sb, Tl, and Pb) data were available for 490 participants at 3 months of age and 216 participants at 18 months of age. Paired urine samples at both time periods were available for 175 infants. At 3 months of age, exclusively breastfed infants had lower urine concentrations of Al, V, Fe, Co, Se, Sb, and Tl. Notably, the concentration of Mo had a median (IQR) of 0.60 (0.40–2.10) μg/L compared to a median (IQR) of 39.80 (25.00–56.40) μg/L observed in infants exclusively fed with formula. When we analyzed the change in urine elements concentrations between 3 and 18 months of age, we observed increased As (0.75 vs. 18.60 μg/L), Co (0.05 vs. 0.24 μg/L), Mo (1.98 vs. 50.0 μg/L), Pb (0.15 vs. 0.69 μg/L), Se (11.3 vs. 23.1 μg/L), Tl (0.02 vs. 0.11 μg/L), and V (0.05 vs. 0.11 μg/L). For Cu, lower urine concentrations were observed at 18 months of age in comparison with concentrations at 3 months (5.77 vs. 4.41 μg/L). Among the main food items identified as driving the changes in urine concentration between 3 and 18 months of age were white fish, rice and pasta, potato chips, custard, small blue fish, and legumes. Exclusively breastfed infants showed lower exposure to non-essential elements compared to those who were fed with a mixture or formula. With the introduction of solid foods, the exposure to some non-essential elements increased drastically, as in the case of As and Pb. In addition, exposure to the essential metal Mo also increased substantially with the introduction of solid food.
Open Access
Is maternal use of Paracetamol during pregnancy associated with anogenital distance in male newborns? The results from the NELA Birth Cohort
(MDPI, 2021-06-11) Navarro Lafuente, Fuensanta; Arense Gonzalo, Julián Jesús; Adoamnei, Evdochia; Prieto Sánchez, María Teresa; Sánchez Ferrer, María Luisa; García-Marcos Álvarez, Luis Vicente; Morales Bartolomé, Eva; Mendiola Olivares, Jaime; Torres Cantero, Alberto Manuel; Ciencias Sociosanitarias
Paracetamol is the one of the most commonly used medications during pregnancy. However, its potential antiandrogenic effect has been suggested. The objective of this study was to evaluate associations between maternal paracetamol use during pregnancy and anogenital distance (AGD) in male newborns from a Spanish birth cohort. The study included two hundred and seventy-seven mother-male child pairs with self-reported paracetamol use and frequency during each trimester of pregnancy. AGD measurements were taken employing standardized methods. The associations between maternal paracetamol use and AGD measures were evaluated using linear regression models, adjusting for potential confounders and covariates. Overall, 61.7% of pregnant women consumed paracetamol at any time of pregnancy with an average of 9.43 (SD = 15.33) days throughout pregnancy. No associations between the maternal use of paracetamol or its frequency and AGD measures among different trimesters or during the whole pregnancy were found in the adjusted final models. A non-differential misclassification error may have occurred—the recall of paracetamol intake independent of AGD measurements—introducing bias towards the null hypothesis. Nevertheless, the current evidence suggests that paracetamol might have a potential antiandrogenic effect especially in the early stages of fetal development. Thus, it would be highly recommendable to pursue further studies to elucidate the potential effects of paracetamol in human perinatal health and its use among pregnant women.
Open Access
Impact of environmental exposures on exhaled breath and lung function: NELA Birth Cohort
(ERS publications, 2025) Sola-Martínez, Rosa A.; Jiménez Guerrero, Pedro; Sánchez-Solís de Querol, Manuel; Lozano Terol, Gema; Gallego Jara, Julia; Martínez Vivancos, Adrián; Morales Bartolomé, Eva; García-Marcos Álvarez, Luis Vicente; Diego Puente, Teresa de; NELA Study Group; Cirugía, Pediatría y Obstetricia y Ginecología; Facultad de Medicina
Introduction: Exposure to environmental factors (i.e. air pollution and second-hand tobacco smoke) have been associated with impaired lung function. However, the impact of environmental factors on lung health is usually evaluated separately and not with an exposomic framework. In this regard, breath analysis could be a noninvasive tool for biomonitoring of global human environmental exposure. Methods: Data come from 337 mother-child pairs from the Nutrition in Early Childhood Asthma (NELA) birth cohort. Levels of BTEX (benzene, toluene, ethylbenzene and xylenes) in exhaled breath from mothers and children at 3 months after birth were estimated using gas hromatography-mass spectrometry. Short-term residential exposures (breath sampling day and 15 days before breath sampling) to nitrogen dioxide, particulate matter (PM2.5) and ozone were determined by chemical dispersion/transport modelling. Forced vital capacity, forced expiratory volume in 0.5 s (FEV0.5) and forced expiratory flow at 75% of FVC and at 25%-75% of FVC were measured in infants according to the raised-volume rapid thoracoabdominal compression technique. Results: The results showed significant associations between short-term exposure to external agents and levels of benzene and toluene in exhaled breath. It was observed that exhaled levels of benzene and toluene were influenced by smoking status and outdoor air pollution in mothers, and by air pollution in infants (3 months of age). No significant relationship was observed between exposure to maternal tobacco smoking and/or short-term air pollution and lung function in healthy infants. However, there was a significant relationship between FEV0.5 and exhaled toluene in children. Discussion: These findings indicated a significant relationship between environmental exposures and exhaled levels of benzene and toluene, suggesting that breath analysis could be a helpful exposure biomonitoring tool.
Open Access
Maternal urinary concentrations of bisphenol A during pregnancy are associated with global DNA methylation in cord blood of newborns in the “NELA” birth cohort
(Elsevier, 2022-06-03) Navarro Lafuente, Fuensanta; Adoamnei, Evdochia; Arense Gonzalo, Julián Jesús; Prieto Sánchez, María Teresa; Sánchez Ferrer, María Luisa; Parrado, Antonio; Fernández, Mariana F.; Suarez, Beatriz; López Acosta, Antonia; Sánchez Guillamón, Antonio; García-Marcos Álvarez, Luis Vicente; Morales Bartolomé, Eva; Mendiola Olivares, Jaime; Torres Cantero, Alberto Manuel; NELA Study group; Ciencias Sociosanitarias
Endocrine disrupting chemicals (EDCs) set a public health risk through disruption of normal physiological processes. The toxicoepigenetic mechanisms of developmental exposure to common EDCs, such as bisphenol A (BPA), are poorly known. The present study aimed to evaluate associations between perinatal maternal urinary concentrations of BPA, bisphenol S (BPS) and bisphenol F (BPF) and LINE-1 (long interspersed nuclear elements) and Alu (short interspersed nuclear elements, SINEs) DNA methylation levels in newborns, as surrogate markers of global DNA methylation. Data come from 318 mother-child pairs of the `Nutrition in Early Life and Asthma´ (NELA) birth cohort. Urinary bisphenol concentration was measured by dispersive liquid–liquid microextraction and ultrahigh performance liquid chromatography with tandem mass spectrometry detection. DNA methylation was quantitatively assessed by bisulphite pyrosequencing on 3 LINEs and 5 SINEs. Unadjusted linear regression analyses showed that higher concentration of maternal urinary BPA in 24th week's pregnancy was associated with an increase in LINE-1 methylation in all newborns (p = 0.01) and, particularly, in male newborns (p = 0.03). These associations remained in full adjusted models [beta = 0.09 (95 % CI = 0.03; 0.14) for all newborns; and beta = 0.10 (95 % CI = 0.03; 0.17) for males], including a non-linear association for female newborns as well (p-trend = 0.003). No associations were found between maternal concentrations of bisphenol and Alu sequences. Our results suggest that exposure to environmental levels of BPA may be associated with a modest increase in LINE-1 methylation -as a relevant marker of epigenomic stability- during human fetal development. However, any effects on global DNA methylation are likely to be small, and of uncertain biological significance.
Open Access
Exhaled volatilome analysis as a useful tool to discriminate asthma with other coexisting atopic diseases in women of childbearing age
(Springer Nature, 2021-07-05) Sola Martínez, Rosa Alba; Lozano Terol, Gema; Gallego Jara, Julia; Morales Bartolomé, Eva; Cantero-Cano, Esther; Sánchez-Solís de Querol, Manuel; García-Marcos Álvarez, Luis Vicente; Jiménez Guerrero, Pedro; Noguera Velasco, José Antonio; Cánovas Díaz, Manuel; Diego Puente, Teresa de; NELA study group; Bioquímica y Biología Molecular B e Inmunología; Cirugía, Pediatría y Obstetricia y Ginecología
The prevalence of asthma is considerably high among women of childbearing age. Most asthmatic women also often have other atopic disorders. Therefore, the diferentiation between patients with atopic diseases without asthma and asthmatics with coexisting diseases is essential to avoid underdiagnosis of asthma and to design strategies to reduce symptom severity and improve quality of life of patients. Hence, we aimed for the frst time to conduct an analysis of volatile organic compounds in exhaled breath of women of childbearing age as a new approach to discriminate between asthmatics with other coexisting atopic diseases and non-asthmatics (with or without atopic diseases), which could be a helpful tool for more accurate asthma detection and monitoring using a noninvasive technique in the near future. In this study, exhaled air samples of 336 women (training set (n= 211) and validation set (n= 125)) were collected and analyzed by thermal desorption coupled with gas chromatography-mass spectrometry. ASCA (ANOVA (analysis of variance) simultaneous component analysis) and LASSO+LS (least absolute shrinkage and selection operator+ logistic regression) were employed for data analysis. Fifteen statistically signifcant models (p-value< 0.05 in permutation tests) that discriminated asthma with other coexisting atopic diseases in women of childbearing age were generated. Acetone, 2-ethyl-1-hexanol and a tetrahydroisoquinoline derivative were selected as discriminants of asthma with other coexisting atopic diseases. In addition, carbon disulfde, a tetrahydroisoquinoline derivative, 2-ethyl-1-hexanol and decane discriminated asthma disease among patients with other atopic disorders. Results of this study indicate that refned metabolomic analysis of exhaled breath allows asthma with other coexisting atopic diseases discrimination in women of reproductive age.
Open Access
Maternal non-compliance with recommended folic acid supplement use alters global DNA methylation in cord blood of newborns: a cohort study
(Elsevier, 2024) Morales Bartolomé, Eva; Prieto Sánchez, María Teresa; Mendiola Olivares, Jaime; Cutillas Tolín, Ana; Adoamnei, Evdochia; Valera-Gran, Desiree; Santaella-Pascual, Marina; Suárez Martínez, Clara; Vioque, Jesús; Castaños, María Jesús; Castillo, Eva del; García-Marcos Álvarez, Luis Vicente; Tecnología de Alimentos, Nutrición y Bromatología; Facultad de Veterinaria
Background & aims: Prenatal folate exposure may alter epigenetic marks in the offspring. We aimed to evaluate associations between prenatal exposure to folic acid (FA) in preconception and in utero with cord blood DNA methylation in long interspersed nuclear element 1 (LINE-1) and Alu short interspersed nuclear elements (SINEs) as markers of global DNA methylation levels. Methods: Data come from 325 motherechild pairs participating in the Nutrition in Early Life and Asthma (NELA) birth cohort (2015e2018). Pregnant women were asked about supplement use, including brand name and dose, one month before pregnancy (preconception) and through the trimesters of pregnancy. Maternal dietary folate intake was assessed using a validated food frequency questionnaire with additional questions for FA supplement use. Folate serum levels were measured in mothers at 24 weeks of gestation and in cord blood of newborns. DNA methylation was quantitatively assessed by bisulfite pyrosequencing on 5 LINE-1 and 3 Alu different elements. Associations were estimated using multivariable linear regression models. Results: A reduction in methylation levels of LINE-1 in newborns was associated with the use of FA supplements below the recommended doses (<400 ug/day) during preconception ( 0.50; 95% CI: 0.91, 0.09; P ¼ 0.016), and from preconception up to 12 weeks of gestation ( 0.48; 95% CI: 0.88, 0.08; P ¼ 0.018). Maternal use of FA supplements above the tolerable upper intake level of 1000 ug/day from preconception until 12 weeks of gestation was also related to lower methylation in LINE-1 at birth ( 0.77; 95% CI: 1.52, 0.02; P ¼ 0.044). Neither FA supplement use after 12 weeks of gestation nor maternal total folate intake (diet plus supplements) were associated with global DNA methylation levels at birth.
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Role of body mass index in unbalanced (dysanaptic) lung growth of healthy infants
(Wiley, 2024-07-05) Sánchez-Solís de Querol, Manuel; Forno, Erick; Morales Bartolomé, Eva; García-Marcos Álvarez, Luis Vicente; The NELA Study Group; Cirugía, Pediatría y Obstetricia y Ginecología; Facultad de Medicina
Rationale: Imbalance between forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) (dysanapsis) has been reported in children who are obese. This dysanaptic growth might begin at an early age, although there are no data on children younger than 6 years. Objetives: To assess whether body mass index (BMI) and early weight gain, in healthy infants born at term, plays a significant role in the imbalance between FEV1 and FVC, even in the absence of obesity. Methods: Lung function was measured by means of raised volume rapid thoracic compression in 69 healthy infants born at term from the Nutrition in Early Life and Asthma cohort. Dysanapsis was defined as zFVC >0.674, zFEV0 .5 ≥-1.645, and FEV0 .5/FVC ≤-1.645. Weight gain (g/day) and growth rate (cm/year) were calculated as the difference between weight and length on the test date and those at birth. To assess the relationship between zBMI and dysanapsis, a receiver operating characteristic curve was performed. Multivariable analysis was carried out by means of linear regressions (one for each lung function index) and by logistic regression for dysanapsis (yes/no). Results: Higher zBMI was associated with risk of dysanapsis (odds ratio: 3.53, [95% confidence interval: 1.30; 9.66]; p = .014): Each additional zBMI unit was associated with ~10 mL higher FVC and with ~3.5% lower FEV0.5/FVC. Weight gain was associated with lower FEV0.5/FVC ratio. Conclusion: Dysanaptic development of lung function begins very early in infancy and is related with weight gain and body mass index, even in the absence of obesity.
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Serum vitamins A and E at mid-pregnancy and their relationships with both maternal and cord blood antioxidant status and perinatal conditions: The NELA Cohort
(2023-06-02) Sánchez-Campillo, María; Gázquez García, Antonio; Serrano-Munuera, Ana; Bañón Arnao, Marino; Avilés Plaza, Francisco Valeriano; Garcia-Serna, Azahara M.; Noguera Velasco, José Antonio; Martínez López de Castro, Ana María; Martínez Gracia, Carmen; Suárez Martínez, Clara; Santaella-Pascual, Marina; Vioque, Jesús; Montoya-Hernández, Carmen; Ballesteros Meseguer, Carmen; Sánchez Ferrer, María Luisa; Pérez Fernández, Virginia; Morales Bartolomé, Eva; García-Marcos Álvarez, Luis Vicente; Larqué Daza, Elvira; Nela Study Group; Tecnología de Alimentos, Nutrición y Bromatología; Facultad de Veterinaria
Introduction: Most of the pregnant women do not achieve the recommended dietary intake of vitamins A and E. These vitamins may counteract oxidative stress involved in some adverse perinatal outcomes. We aimed to assess the associations between maternal vitamin A and E at mid-pregnancy with both maternal and fetal outcomes and to identify possible early biomarkers during pregnancy to predict and prevent oxidative stress in the offspring. Methods: Data on dietary and serum levels of vitamins A and E were collected from 544 pregnant women from the Nutrition in Early Life and Asthma (NELA) study, a prospective mother-child cohort set up in Spain. Results: There were large discrepancies between low dietary vitamin E intake (78% of the mothers) and low serum vitamin E levels (3%) at 24 weeks of gestation. Maternal serum vitamins A and E at mid-pregnancy were associated with higher antioxidant status not only in the mother at this time point (lower hydroperoxides and higher total antioxidant activity [TAA]) but also with the newborn at birth (higher TAA). Gestational diabetes mellitus (GDM) was negatively associated with maternal serum vitamin A (OR: 0.95 CI: 0.91–0.99, p = 0.009) at mid-pregnancy. Nevertheless, we could not detect any association between GDM and oxidative stress parameters. Conclusions: In conclusion, maternal vitamin A and E serum levels may be used as an early potential biomarker of antioxidant status of the neonate at birth. Control of these vitamins during pregnancy could help avoid morbid conditions in the newborn caused by oxidative stress in GDM pregnancies.