Publications by authors named "Salvador Espino y Sosa"

Background: Hemolytic disease of the fetus and newborn (HDFN) is a condition due to maternal blood group antibodies targeting antigens in fetal red blood cells, with significant prenatal/perinatal morbidity and mortality. Severe HDFN cases are often associated with alloimmunization against Rhesus D (RhD) or Kell antigens. Information about HDFN epidemiology and treatment in Latin American countries is limited.

View Article and Find Full Text PDF

Pregnancy increases the demand for essential metal ions to support fetal development, making the maternal metal ion status a critical determinant of perinatal outcomes. This prospective cohort study examined changes in metal ion levels across the three trimesters, evaluated the influence of preexisting metabolic conditions on the metal ion status, and assessed the associations between maternal metal ion levels and perinatal outcomes in 206 pregnant women from the Biochemical and Epigenetic Origin of Overweight and Obesity (OBESO) cohort receiving care at the Instituto Nacional de Perinatología in Mexico City from 2017 to 2020. Six essential metal ions (iron, zinc, copper, calcium, magnesium, and phosphorus) were measured in blood samples using inductively coupled plasma optic emission spectrometry.

View Article and Find Full Text PDF

Gestational diabetes (GD) is a metabolic disorder characterized by glucose intolerance during pregnancy, significantly impacting maternal and fetal health. Its global prevalence is approximately 14%, with risk factors including obesity, family history of diabetes, advanced maternal age, and ethnicity, which are linked to cellular and molecular disruptions in glucose regulation and insulin resistance. GD is associated with short- and long-term complications for both the mother and the newborn.

View Article and Find Full Text PDF

Background: Laparoscopic cholecystectomy is known for its minimally invasive nature, but postoperative pain management remains challenging. Despite the enhanced recovery after surgery (ERAS) protocol, regional analgesic techniques like modified perichondral approach to thoracoabdominal nerve block (M-TAPA) show promise. Our retrospective study evaluates M-TAPA's efficacy in postoperative pain control for laparoscopic cholecystectomy in a middle-income country.

View Article and Find Full Text PDF
Article Synopsis
  • - Preeclampsia (PE) is a complex pregnancy disorder characterized by high blood pressure and protein in urine, posing risks to mothers and their babies; its underlying mechanisms involve abnormal placentation and systemic responses.
  • - The condition is driven by inadequate placental development, leading to hypoxia and the release of anti-angiogenic factors, which cause endothelial dysfunction and increased inflammation; genetic factors also play a crucial role.
  • - Despite some promising therapeutic strategies targeting oxidative stress and inflammation, effective prevention and treatments for PE are still lacking, emphasizing the need for ongoing research in understanding and managing the disorder.
View Article and Find Full Text PDF

Aim: Gestational diabetes (GD) is a global health concern with significant implications for maternal and neonatal outcomes. This study investigates the association between early GD (eGD) diagnosis (<24 weeks), pharmacotherapy requirements and adverse neonatal outcomes.

Materials And Methods: A cohort of 369 pregnant women underwent a 75-g oral glucose tolerance test.

View Article and Find Full Text PDF
Article Synopsis
  • HIV infection affects around 1.7 million reproductive-aged women globally, and while PI-HAART has reduced vertical transmission from mother to child, concerns about its long-term effects on subcutaneous fat tissue in fetuses remain largely unexplored.
  • A study compared fetuses from HIV-pregnant women on PI-HAART to a control group and used 3D ultrasound to measure subcutaneous fat in the arms and thighs, finding significant fat reduction in those exposed to the treatment.
  • The results indicate that reduced subcutaneous fat is linked to lower newborn serum glucose levels, highlighting potential long-term health implications for infants exposed to PI-HAART and emphasizing the need for careful management of HIV-positive pregnant women.
View Article and Find Full Text PDF

Antepartum fetal surveillance (AFS) is essential for pregnant women with diabetes to mitigate the risk of stillbirth. However, there is still no universal consensus on the optimal testing method, testing frequency, and delivery timing. This review aims to comprehensively analyze the evidence concerning AFS and the most advantageous timing for delivery in both gestational and pregestational diabetes mellitus cases.

View Article and Find Full Text PDF

Introduction: Clinical practice guidelines (CPGs) contain recommendations for specific clinical circumstances, including maternal malnutrition. This study aimed to identify the CPGs that provide recommendations for preventing, diagnosing, and treating women's malnutrition. Additionally, we sought to assess the methodological quality using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.

View Article and Find Full Text PDF

The early identification of women with an increased risk of preeclampsia (PE) is desirable, but apart from soluble fms-like tyrosine kinase-1 (sFlt-1), few biomarkers have previously been identified as relevant for predicting preeclampsia. Since kinases and phosphatases regulate critical biological processes and previous evidence suggests a potential role of these molecules in preeclampsia, we performed this systematic review and metanalysis. The objective was to determine if there are kinases and phosphatases whose serum levels are different between women with and without PE, being relevant biomarkers of PE.

View Article and Find Full Text PDF

Objective: To identify and quantify the effects of maternal characteristics and medical history on the distribution of Placental Growth Factor (PlGF), mean arterial pressure (MAP), and Uterine Artery Mean Pulsatility Index (UtA-PI); and to standardize the expected values for these biomarkers in the first trimester to create unique multiples of the median (MoMs) for Latin-American population.

Methods: This is a prospective cohort built exclusively for research purposes of consecutive pregnant women attending their first-trimester screening ultrasound at a primary care center for the general population in Mexico City between April 2019 and October 2021. We excluded fetuses with chromosomal abnormalities, major fetal malformations, and women delivering in another care center.

View Article and Find Full Text PDF

Evidence from studies in the general population suggests an association between vitamin D insufficiency/deficiency and COVID-19 susceptibility and disease severity. The present study was performed on 165 third-trimester pregnant women at the time of delivery. Seventy-nine women tested negative for SARS-CoV-2.

View Article and Find Full Text PDF

This work aimed to identify clinical practice guidelines (CPGs) that include recommendations for the prevention, diagnosis, and treatment of women’s malnutrition during pregnancy and to evaluate the quality of these guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. We conducted a literature review using PubMed and different websites from January 2009 to February 2021. The quality of the CPGs was independently assessed by reviewers using the AGREE II instrument, which defines guidelines scoring >70% in the overall assessment as “high quality”.

View Article and Find Full Text PDF

Pregnancy makes women more susceptible to infectious agents; however, available data on the effect of SARS-CoV-2 on pregnant women are limited. To date, inflammatory responses and changes in serum metal concentration have been reported in COVID-19 patients, but few associations between metal ions and cytokines have been described. The aim of this study was to evaluate correlations between inflammatory markers and serum metal ions in third-trimester pregnant women with varying COVID-19 disease severity.

View Article and Find Full Text PDF

Passive transplacental immunity is crucial for neonatal protection from infections. Data on the correlation between neonatal immunity to SARS-CoV-2 and protection from adverse outcomes is scarce. This work aimed to describe neonatal seropositivity in the context of maternal SARS-CoV-2 infection, seropositivity, and neonatal outcomes.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the link between sFlt-1 levels and adverse maternal outcomes in pregnant women with COVID-19, specifically focusing on those with and without hypertensive disorders.
  • The researchers conducted a multicenter retrospective cohort study with 148 pregnant women, using statistical methods to analyze the data and identify key predictors of adverse outcomes.
  • Results indicate that higher sFlt-1 levels and the presence of hypertensive disorders significantly increase the risk of adverse outcomes, highlighting sFlt-1 as an independent predictor regardless of hypertension status.
View Article and Find Full Text PDF

Maternal metabolic status influences pregnancy and, consequently, the perinatal outcome. Resistin is a pro-inflammatory adipokine predominantly expressed and secreted by mononuclear cells, adipose tissue, and placental trophoblastic cells during pregnancy. Recently, we reported an inverse association between maternal resistin levels and fetal low-density lipoprotein cholesterol (LDL-C).

View Article and Find Full Text PDF

Oxidative stress (OS) induced by SARS-CoV-2 infection may play an important role in COVID-19 complications. However, information on oxidative damage in pregnant women with COVID-19 is limited. Objective: We aimed to compare lipid and protein oxidative damage and total antioxidant capacity (TAC) between pregnant women with severe and non-severe COVID-19.

View Article and Find Full Text PDF
Article Synopsis
  • Cardiomyocyte injury and elevated troponin T levels in COVID-19 patients are linked to a worse prognosis, particularly among those who are pregnant.
  • The study analyzed the relationship between troponin T levels in severely ill COVID-19 pregnant women and their risk of complications like viral sepsis, ICU admission, or maternal death.
  • Among 87 pregnant patients, a significant correlation was found between high troponin T levels and maternal death, suggesting that elevated troponin T can be a critical indicator of severe pneumonia and increased mortality risk in this group.
View Article and Find Full Text PDF

Intrauterine infections caused by bacteria like group B streptococcus (GBS) and the subsequent activation of the maternal inflammatory response have been long suspected to be the underlying cause of preterm labor. The inflammatory network triggered by maternal decidua has been widely described and includes the secretion of pro- and anti-inflammatory cytokines as IL-1β and IL-10; however, the mechanisms that regulate their secretion have not been completely elucidated. MicroRNAs (miRNAs) are critical modulators of the inflammatory response by regulating cytokine expression in several cell types.

View Article and Find Full Text PDF
Article Synopsis
  • This study aimed to determine if combining intensive medical nutrition therapy (MNT) with metformin could prevent gestational diabetes mellitus (GDM) in high-risk Mexican women.
  • An open-label randomized clinical trial included women with multiple GDM risk factors, assigning them to either receive MNT with metformin or MNT alone before 15 weeks of pregnancy.
  • Results showed no significant difference in GDM incidence between the two groups, indicating that adding metformin to MNT does not provide additional benefits for preventing GDM in this population.
View Article and Find Full Text PDF

In healthy pregnancies, components of the Renin-Angiotensin system (RAS) are present in the placental villi and contribute to invasion, migration, and angiogenesis. At the same time, soluble fms-like tyrosine kinase 1 (sFlt-1) production is induced after binding of ANG-II to its receptor (AT-1R) in response to hypoxia. As RAS plays an essential role in the pathogenesis of COVID-19, we hypothesized that angiogenic marker (sFlt-1) and RAS components (ANG-II and ACE-2) may be related to adverse outcomes in pregnant women with COVID-19; Methods: Prospective cohort study.

View Article and Find Full Text PDF
Article Synopsis
  • * Conducted in Mexico City, the research analyzed data from 828 women who tested negative and 298 who tested positive for COVID-19, finding that only a small percentage of the positive group exhibited symptoms.
  • * Key findings included a higher occurrence of placental fibrinoid in women with low C values and a significant association between preeclampsia and COVID-19 symptoms, particularly in those diagnosed early in their pregnancy.
View Article and Find Full Text PDF

Introduction And Objective: The weight gained during pregnancy could determine the immediate and future health of the mother-child dyad. Excessive gestational weight gain (EGWG) due to abnormal adipose tissue (AT) accumulation is strongly associated with adverse perinatal outcomes as gestational diabetes, macrosomia, obesity, and hypertension further in life. Dysregulation of adipokine, AT dysfunction, and an imbalance in the prooxidant-antioxidant systems are critical features in altered AT accumulation.

View Article and Find Full Text PDF