Prieto Sánchez, María Teresa

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Prieto Sánchez, María Teresa

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Prieto Sánchez, María Teresa

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Universidad de Murcia. Departamento de Cirugía, Pediatría, Obstetriciay Ginecología

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Open Access
Self-reported DHA supplementation during pregnancy and its association with obesity or gestational diabetes in relation to DHA concentration in cord and maternal plasma: results from NELA, a prospective mother-offspring cohort.
(2021-03) Gázquez, Antonio; Giménez-Bañón, María J.; Martínez-Graciá, Carmen; Suárez, Clara; Larqué, Elvira; Galdo-Castiñeira, Lina; Ballesteros-Meseguer, Carmen; Vioque, Jesús; Santaella-Pascual, Marina; Avilés Plaza, Francisco Valeriano; Martínez Villanueva, Miriam; Noguera Velasco, José Antonio; Morales Bartolomé, Eva; García-Marcos Álvarez, Luis Vicente; Prieto Sánchez, María Teresa; Cirugía, Pediatría y Obstetricia y Ginecología; Fisiología; Tecnología de Alimentos, Nutrición y Bromatología
Maternal supplementation of docosahexaenoic acid (DHA) during pregnancy has been recommended due to its role in infant development, but its effect on materno-fetal DHA status is not well established. We evaluated the associations between DHA supplementation in pregnant women with obesity or gestational diabetes mellitus (GDM) and maternal and neonatal DHA status. Serum fatty acids (FA) were analyzed in 641 pregnant women (24 weeks of gestation) and in 345 venous and 166 arterial cord blood samples of participants of the NELA cohort. Obese women (n = 47) presented lower DHA in serum than those lean (n = 397) or overweight (n = 116) before pregnancy. Linoleic acid in arterial cord was elevated in obese women, which indicates lower fetal retention. Maternal DHA supplementation (200 mg/d) during pregnancy was associated with enhanced maternal and fetal DHA levels regardless of pre-pregnancy body mass index (BMI), although higher arterial DHA in overweight women indicated an attenuated response. Maternal DHA supplementation was not associated with cord venous DHA in neonates of mothers with GDM. The cord arteriovenous difference was similar for DHA between GDM and controls. In conclusion, maternal DHA supplementation during pregnancy enhanced fetal DHA status regardless of the pre-pregnancy BMI while GDM may reduce the effect of DHA supplementation in newborns.
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Are there differences in basal thrombophilias and C-reactive protein between women with or without PCOS?
(2009-02) Sánchez-Ferrer, María L.; Corbalán-Biyang, , Shiana; Adoamnei, Evdochia; Hernández-Peñalver, Ana L.; Carmona-Barnosi, Ana; Salido-Fiérrez, Eduardo J.; Mendiola Olivares, Jaime; Torres Cantero, Alberto Manuel; Prieto Sánchez, María Teresa; Cirugía, Pediatría y Obstetricia y Ginecología
Polycystic ovary syndrome (PCOS) women have increased cardiovascular risks, although it is unclear whether the haemostatic system and coagulation contribute to that increased risk. Women attending the Gynecology Unit of the 'Virgen de la Arrixaca' University Hospital (Murcia, Spain) for routine gynaecological examinations between September 2014 and May 2016 were assessed for PCOS using the Rotterdam criteria (hyperandrogenism [H], oligo/amenorrhoea [O] and polycystic ovarian morphology [POM]) and were classified into four phenotypic. In total, 126 cases were identified and 159 control women were selected. All women underwent physical and gynaecological examinations, and blood tests between the second and fifth day of the menstrual cycle. Differences in hormonal, basal thrombophilia and metabolic parameters, and C-reactive protein (CRP) between PCOS and controls were analysed. After adjusting by BMI and age, PCOS women had higher LH (P < 0.001), testosterone (P < 0.001), free testosterone (P = 0.01) and anti-Müllerian hormone (P < 0.001) and lower FSH (P = 0.03) compared with controls, whereas sex hormone-binding globulin was no different. Cases showed significantly higher protein S, glucose, insulin and insulin resistance (HOMA-IR) compared with controls (P < 0.05). There were no differences in protein C levels, antithrombin III, prothrombin time, homocysteine, D-dimer, factor V Leyden, prothrombin G20210A polymorphism or CRP. The H+O phenotype showed the poorest results for insulin and HOMA-IR (P = 0.04 and 0.05). The results suggest that there are no differences in the basal thrombophilias between women with and without PCOS. However, PCOS with H+O shows the poorest metabolic profile.
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In vivo kinetic study of materno-fetal fatty acid transfer in obese and normal weight pregnant women
(2019-10) Gázquez, Antonio; Van Harskamp, Dewin; Perazzolo, Simone; Oosterink, J. Efraim; Demmelmair, Hans; Schierbeek, Henk; Sengers, Bram G.; Lewis, Rohan M.; Van Goudoever, Johannes B.; Koletzko, Berthold; Larqué, Elvira; Blanco Carnero, José Eliseo; Prieto Sánchez, María Teresa; Cirugía, Pediatría y Obstetricia y Ginecología; Fisiología
Placental structure and function can be modified as a result of maternal obesity affecting materno-fetal fatty acids (FA) transport. We report for the first time, in humans and in vivo, the kinetics of placental FA transfer in normo-weight and in normolipemic obese pregnant women using stable isotopes. The administration of different tracer FA with similar behaviour to the mother at different time points allows the collection of kinetic information on materno-fetal transfer of FA despite only one sample of placenta and cord can be collected per subject. Computational modelling showed a good fit to the data when considering all maternal plasma lipid classes but not when based only on non-esterified FA. The novel approach using multiple tracer FA administration combined with computational modelling shows a consistent time course of placental tracer FA and predicted total FA accumulation.
Open Access
Accuracy of anogenital distance and anti-Müllerian hormone in the diagnosis of endometriosis without surgery
(Wiley, 2019) Sánchez-Ferrer María L.; Jiménez-Velázquez, Raquel; Carmona-Barnosi, Ana; Corbalán-Biyang, Shiana; Hernández-Peñalver, Ana I.; Adoamnei, Evdochia; Mendiola Olivares, Jaime; Torres Cantero, Alberto Manuel; Cánovas López, Laura; Nieto Díaz, Anibal; Prieto Sánchez, María Teresa; Cirugía, Pediatría y Obstetricia y Ginecología; Ciencias Sociosanitarias
Objective: To assess the predictive ability of a combination of anogenital distance (AGD) and anti-Müllerian hormone (AMH) to diagnosis the presence of endometriosis without surgery. Methods: The present study included women diagnosed with endometriosis and a control group who attended the "Virgen de la Arrixaca" University Hospital, Murcia, Spain, between September 1, 2014, and May 31, 2015. Serum concentrations of AMH were measured, and two AGD measurements were obtained: from the anterior clitoral surface to the upper verge of the anus (AGDAC ), and from the posterior fourchette to the upper verge of the anus (AGDAF ). Data were assessed by receiver operator characteristic (ROC) curves. Results: Women in the endometriosis group (n=57) had significantly shorter AGDAF (22.8 ± 4.6 vs 27.2 ± 5.7 mm; P<0.001) and lower AMH (2.2 ± 2.5 vs 3.3 ± 1.9 ng/mL; P<0.003) compared with the control group (n=93). Women with serum AMH below the clinical cut-off (1 ng/mL) were 17.40-times more likely to have endometriosis (95% confidence interval [CI] 5.64-53.82). The area under the ROC curve of combined AMH and AGDAF was 0.77 (95% CI 0.70-0.85). Conclusion: The model for predicting endometriosis on the basis of AMH and AGD could be useful for clinicians and epidemiologists to improve diagnosis and prognosis of this condition.
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Does the anogenital distance change across pregnancy?
(Elsevier, 2020-05-25) Sánchez Ferrer, María Luisa; Arense Gonzalo, Julián Jesús; Prieto Sánchez, María Teresa; Alfosea-Marhuenda, Emilia; Gómez-Carrascosa, Inmaculada; Iniesta, Miguel A.; Mendiola Olivares, Jaime; Torres Cantero, Alberto Manuel; Ciencias Sociosanitarias; Facultad de Farmacia
Research question: Does the length of the anogenital distance (AGD), an anthropometric biomarker of fetal androgen exposure, change across pregnancy? It has been suggested that AGD remains stable during adulthood with no changes across the menstrual cycle. No studies, however, have been carried out during pregnancy, during which women are exposed to important hormonal and anthropometric variations. Design: A cohort study of 186 singleton pregnant women recruited in the first trimester of pregnancy. Measurements from the anterior clitoral surface to the upper verge of the anus (AGDAC), and from the posterior fourchette to the upper verge of the anus (AGDAF) and body mass index (BMI) were obtained in each trimester. Generalized linear model for repeated measures was carried out to assess differences in AGDs and BMI across the three trimesters of the pregnancy. Results: In crude analyses, AGDAC was progressively and significantly longer as the pregnancy developed (first trimester: 87.69 ± 13.14mm; second trimester: 89.69 ± 13.47mm; third trimester: 91.95 ± 13.25 mm; P < 0.001), whereas AGDAF did not significantly change throughout pregnancy (first trimester: 28.37 ± 6.94 mm; second trimester: 28.09 ± 7.66 mm; third trimester: 28.94 ± 6.7 mm). In the multivariable mixed-effect models for fixed effect (trimester) and time-covariate (BMI), AGDs did not show significant associations with trimesters of pregnancy when BMI was included in the model. Conclusions: Our results suggest that AGDAF and AGDAC, when adjusted by BMI, do not change throughout gestation despite maternal anthropometric variations during pregnancy. AGDAF may be a meaningful measurement at any time during pregnancy without considering BMI. Therefore, maternal AGDAF may be used as a prenatal biomarker of the mother's in-uteru hormonal exposure even during pregnancy.
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
Child head circumference and placental MFSD2a expression are associated to the level of MFSD2a in maternal blood during pregnancy
(Frontiers Media, 2020-02-05) Sánchez-Campillo, María; Ruiz-Palacios, María; Ruiz Alcaraz, Antonio José; Blanco Carnero, José Eliseo; Prieto Sánchez, María Teresa; Zornoza, Matilde; Ruiz-Pastor, María José; Demmelmair, Hans; Sánchez-Solís de Querol, Manuel; Koletzko, Berthold; Larqué Daza, Elvira; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Gestational diabetes mellitus (GDM) is a world-wide health challenge, which prevalence is expected to increase in parallel to the epidemic of obesity. Children born from GDM mothers have lower levels of docosahexaenoic acid (DHA) in cord blood, which might influence their neurodevelopment. Recently, the membrane transporter Major Family Super Domain 2a (MFSD2a) was associated with the selective transportation of DHA as lysophospholipids. The expression of the DHA membrane transporter MFSD2a is lower in GDM placentas, which could affect materno-fetal DHA transport. Humans with homozygous inactivating mutations in the MFSD2a gene present severe microcephalyand intellectual impairments. Herein, we intended to identify early blood biomarkers that maybeofuse during pregnancy to monitor the offspring development and the adequate nutritional interventions, such as nutritional supplementation, that may be selected to improve it. We evaluated MFSD2a expression in maternal blood at the third trimester of pregnancy, and its potential relationship with the expression of placental MFSD2a at delivery and child outcomes. Three groups of pregnant women were recruited: 25 controls, 23 GDM with dietary treatment, and 20 GDM with insulin treatment. Maternal and neonatal anthropometric and biochemical parameters were evaluated. MFSD2a was analyzed in placenta, blood and serum. MFSD2a protein expression in maternal blood was significantly lower in GDM groups and correlated with placental MFSD2a and Z-score neonatal head circumference during the first 6 months of life. The cord/maternal serum ratio of DHA, a solid indicator of materno-fetal DHA transport, was reduced in GDMgroups and correlated with MFSD2a in maternal blood at the third trimester and in placenta at delivery. This indicates that altered MFSD2a levels in maternal blood during pregnancy might influence placental nutrient transport and fetal neurodevelopment. Furthermore, MFSD2a levels in maternal blood on the third trimester were inversely correlated to DHA in maternal serum lyso-PL. Thus, the level of MFSD2a in maternal blood could be used as a potential biomarker for the early detection of disturbances of MFSD2a expression during pregnancy and the subsequent consequences for the neurodevelopment of the child, as well as it may help to choose the optimal treatment approach for the affected subjects.
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
Child Head Circumference and Placental MFSD2a Expression Are Associated to the Level of MFSD2a in Maternal Blood During Pregnancy
Sanchez-campillo Muñoz, M.; Ruiz Palacios, M.; Zornoza Moreno, M.; Ruiz Pastor, M. J.; Demmelmair, H.; Sánchez-Solís de Querol, Manuel; Koletzko, B.; Larqué Daza, Elvira; Ruiz Alcaraz, Antonio José; Blanco Carnero, José Eliseo; Prieto Sánchez, María Teresa; Cirugía, Pediatría y Obstetricia y Ginecología
Open Access
Assessment of anogenital distance as a diagnostic tool in polycystic ovary syndrome
(Elsevier, 2018) Hernández-Peñalver, Ana I.; Sánchez-Ferrer, María L.; AdoamneI, Evdochia; Corbalán-Biyang, Shiana; Carmona-Barnosi, Ana; Mendiola Olivares, Jaime; Torres Cantero, Alberto Manuel; Nieto Díaz, Anibal; Prieto Sánchez, María Teresa; Cirugía, Pediatría y Obstetricia y Ginecología
Is anogenital distance (AGD) a useful clinical tool for predicting polycystic ovarian syndrome (PCOS) and its main National Institutes of Health (NIH) phenotypes? Case-control study conducted between September 2014 and May 2016 at the Department of Obstetrics and Gynecology of the University Clinical Hospital 'Virgen de la Arrixaca' in the Murcia region (south-eastern Spain). One hundred and twenty-six cases of PCOS and 159 controls without PCOS were included. AGD measurements were taken from the anterior clitoral surface to the upper verge of the anus (AGDAC), and from the posterior fourchette to the upper verge of the anus (AGDAF). Parametric and non-parametric tests and receiver operating characteristic (ROC) curves were used to assess associations between AGD and the presence of PCOS and its phenotypes. AGDAC, but not AGDAF, was associated with PCOS and all its phenotypes (P-values < 0.001 to 0.048). The highest area under the curve (0.62; 95% confidence interval 0.55 to 0.71) was obtained for all PCOS with AGDAC with a sensitivity and specificity of 50.0% and 73.0%, and positive and negative predictive value of 59.0% and 64.4%, respectively. AGDAC could moderately discriminate the presence of PCOS and may be a useful clinical tool.