Browsing by Author "Ramalho, Carla"
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- Association between placental weight and birthweight, adjusted for parity, sex and PAPP-A levels: a retrospective cohort studyPublication . Santos, Inês; Moreira, Rui; Gonçalves, Inês Sarmento; Dias, Cláudia Camila; Ramalho, CarlaPlacental weight has been studied as an indicator of placental function, correlating with birthweight and perinatal outcomes. The fetal-to-placental ratio (FPR) reflects the adaptation to hypoxemia and fetal growth needs. This study aims to assess the association between placental weight and birthweight, adjusting for parity, fetal sex and PAPP-A. A retrospective cohort study was conducted at a tertiary university hospital. We included singleton pregnancies undergoing first-trimester screening and delivering at the same hospital between May 2013 and September 2024. Clinical data were gathered from electronic databases (SClínico®, ObsCare®, ASTRAIA®). Categorical data were analyzed using Chi-squared tests. Continuous variables were assessed through ANOVA or T test. Pearson or Spearman correlation was applied as appropriate. For significance, a p-value<0.05 was assumed. All data was processed with IBM SPSS v29.0. Results: Among 16492 singleton pregnancies, 54.9% women were nulliparous and 8.9% newborns were small for gestational age. Placental weight was positively correlated with birthweight (r=0.517,p<0.001), which increased by 1.77g per gram of placental weight, explaining 26.7% of the birthweight variation. Preterm deliveries (6.8%) had lower mean placental weight (493.1g versus 579.2g) and birthweight (900g difference, p<0.001) compared to term group. Mean male fetuses’ birthweight was 121.3g higher than female (p<0.001). Additionally, “female fetuses” and “nulliparity” were associated with decreased placental weight (p<0.001). On average, the FPR was 6:1, with male fetuses exhibiting greater FPR (p<0.001) as well as term deliveries (5.7) compared to preterm (4.8), p<0.001. FPR was also correlated with Apgar score at 5min (Apgar<7:5.0 vs. Apgar≥7:5.7, p<0.001) and PAPP-A levels (p<0.001). However, parity (p=0.121) showed no significant association with FPR. Placental weight correlates with birthweight. FPR reflects placental efficiency and perinatal outcome, influenced by fetal sex and gestational age.
- Association of 3-Phenoxybenzoic Acid Exposure during Pregnancy with Maternal Outcomes and Newborn Anthropometric Measures: Results from the IoMum Cohort StudyPublication . Guimarães, Juliana; Bracchi, Isabella; Pinheiro, Cátia; Moreira, Nara Xavier; Coelho, Cláudia Matta; Pestana, Diogo; Prucha, Maria do Carmo; Martins, Cristina; Domingues, Valentina F.; Delerue-Matos, Cristina; Dias, Cláudia C.; Azevedo, Luís Filipe R.; Calhau, Conceição; Leite, João Costa; Ramalho, Carla; Keating, Elisa; Fernandes, Virgínia CruzThe aims of this study were to characterize the exposure of pregnant women living in Portugal to 3-phenoxybenzoic acid (3-PBA) and to evaluate the association of this exposure with maternal outcomes and newborn anthropometric measures. We also aimed to compare exposure in summer with exposure in winter. Pregnant women attending ultrasound scans from April 2018 to April 2019 at a central hospital in Porto, Portugal, were invited to participate. Inclusion criteria were: gestational week between 10 and 13, confirmed fetal vitality, and a signature of informed consent. 3-PBA was measured in spot urine samples by gas chromatography with mass spectrometry (GC-MS). The median 3-PBA concentration was 0.263 (0.167; 0.458) μg/g creatinine (n = 145). 3-PBA excretion was negatively associated with maternal pre-pregnancy body mass index (BMI) (p = 0.049), and it was higher during the summer when compared to winter (p < 0.001). The frequency of fish or yogurt consumption was associated positively with 3-PBA excretion, particularly during the winter (p = 0.002 and p = 0.015, respectively), when environmental exposure is low. Moreover, 3-PBA was associated with levothyroxine use (p = 0.01), a proxy for hypothyroidism, which could be due to a putative 3-PBA—thyroid hormone antagonistic effect. 3-PBA levels were not associated with the anthropometric measures of the newborn. In conclusion, pregnant women living in Portugal are exposed to 3-PBA, particularly during summer, and this exposure may be associated with maternal clinical features.
- Essential trace elements status in portuguese pregnant women and their association with maternal and neonatal outcomes: A prospective study from the IoMum CohortPublication . Bracchi, Isabella; Guimarães, Juliana; Rodrigues, Catarina; Azevedo, Rui; Coelho, Cláudia Matta; Pinheiro, Cátia; Morais, Juliana; Barreiros-Mota, Inês; Fernandes, Virgínia Cruz; Delerue-Matos, Cristina; Pinto, Edgar; Moreira-Rosário, André; Azevedo, Luís Filipe Ribeiro de; Dias, Cláudia Camila; Lima, Jorge; Sapinho, Inês; Ramalho, Carla; Calhau, Conceição; Leite, João Costa; Almeida, Agostinho; Pestana, Diogo; Keating, ElisaCobalt (Co), copper (Cu), manganese (Mn), molybdenum (Mo), and zinc (Zn) are essential trace elements (ETEs) important in cellular chemical reactions and antioxidant defense. Ingestion of ETEs during pregnancy is crucial but their role in specific pregnancy outcomes is largely unknown. This study aimed to quantify urinary levels of these ETEs in pregnancy and to evaluate their role in pregnancy health. First trimester pregnant women of Porto and Lisbon regions provided a urine sample, and sociodemographic and lifestyle data. Clinical data were obtained from clinical records. Urinary ETEs were quantified by inductively coupled plasma mass spectrometry (ICP-MS). Our results show that having urinary Zn levels above the 50th percentile (P50) increases the risk of pre-eclampsia (PE). On the other hand, urinary Zn levels above the P50 decreased the risk of being born with head circumference small for gestational age but it increased the risk having length small for gestational age at birth. This study may provide valuable information for public health policies related to prenatal nutrition, while informing future efforts to de-fine urinary reference intervals for ETEs in pregnant women
- Exposure to naturally occurring metals during early-pregnancy and pregnancy outcomes: results from the IoMum cohortPublication . Marques, Beatriz; Dias, Ana; Brachi, Isabella; Guimarães, Juliana; Coelho, Cláudia M.; Pinheiro, Cátia; Prucha, Carmo; Martins, Cristina; Pinto, Edgar; Azevedo, Rui; Delerue-Matos, Cristina; Fernandes, Vírginia C.; Almeida, Agostinho; Ramalho, Carla; Keating, ElisaThis work aimed to characterize exposure to Aluminium (Al), Lithium (Li), Barium (Ba), and Strontium (Sr) and their association with sociodemographic and lifestyle factors, anthropometric parameters of the newborn and pregnancy complications. Spot urine samples (n=349) of eligible pregnant women attending the routine 1st-trimester ultrasound scan from April 2018 to April 2019 at Centro Hospitalar Universitário de S. João were analysed through ICP-MS to quantify the metals’ urinary concentrations (MUC). Inclusion criteria were: gestational age between 10 weeks and 13 weeks plus 6 days with confirmed foetal vitality and signature of the informed consent. MUCs are presented through median (IQR) in µg/L or µg/g creatinine.
- Iodine knowledge is associated with iodine status in Portuguese pregnant women: results from the IoMum cohort studyPublication . Pinheiro, Cátia; Moreira, Nara Xavier; Ferreira, Pedro; Coelho, Cláudia Matta; Guimarães, Juliana; Pereira, Gonçalo; Cortez, Alice; Bracchi, Isabella; Pestana, Diogo; Mota, Inês Barreiros; Prucha, Carmo; Martins, Cristina; Ribeiro, Célia Alves; Pinto, Edgar; Almeida, Agostinho; Delerue-Matos, Cristina; Montenegro, Nuno; Dias, Cláudia Camila; Moreira-Rosário, André; Azevedo, Luís Filipe; Brantsæter, Anne-Lise; Ramalho, Carla; Fernandes, Virgínia Cruz; Leite, João Costa; Calhau, Conceição; Keating, ElisaLack of knowledge about iodine has been suggested as a risk factor for iodine deficiency in pregnant women, but no studies have addressed this issue in Portugal. So, the aim of this study was to investigate iodine knowledge among Portuguese pregnant women and its association with iodine status. IoMum, a prospective observational study, included 485 pregnant women recruited at Centro Hospitalar e Universitário de S. João, Porto, between the 10th and 13th gestational weeks. Partial scores for knowledge on iodine importance, on iodine food sources or on iodised salt were obtained through the application of a structured questionnaire. Then, a total iodine knowledge score was calculated and grouped into low, medium and high knowledge categories. Urinary iodine concentration (UIC) was measured in spot urine samples by inductively coupled plasma MS. Of the pregnant women, 54 % correctly recognised iodine as important to neurocognitive development, 32 % were unable to identify any iodine-rich food and 71 % presented lack of knowledge regarding iodised salt. Of the women, 61 % had a medium total score of iodine knowledge. Knowledge on iodine importance during pregnancy was positively associated with iodine supplementation and also with UIC. Nevertheless, median UIC in women who correctly recognised the importance of iodine was below the cut-off for adequacy in pregnancy (150 µg/l). In conclusion, knowledge on iodine importance is positively associated with iodine status. Despite this, recognising iodine importance during pregnancy may not be sufficient to ensure iodine adequacy. Literacy-promoting actions are urgently needed to improve iodine status in pregnancy.
- Potential pathogenic and opportunistic oral bacteria in early life: the role of maternal factors in a portuguese populationPublication . Fernandes, Mariana; Azevedo, Maria João; Campos, Carla; Ferreira, Ana Filipa; Azevedo, Álvaro; Falcão-Pires, Inês; Zaura, Egija; Ramalho, Carla; Campos, Joana; Sampaio-Maia, BeneditaIn early life, maternal factors are of the utmost relevance for oral microbiome acquisition and maturation. Therefore, our study explored the impact of maternal factors, such as saliva and breastmilk colonization, cardiovascular risk factors (CRF), type of delivery, oral health, and caregiving habits on the prevalence of potential pathogenic and opportunistic oral bacteria in early life. A total of 26 healthy mothers, 23 mothers with CRF, and their 50 children were included and samples (child’s oral swabs, mother’s saliva, and breastmilk) were collected 4 to 12 weeks after delivery and inoculated in selective and differential media for detection of non-fastidious Gram-negative and Gram-positive bacteria to isolate potential pathogenic and opportunistic bacteria identified by MALDI-TOF MS (414 isolates). Within mother–child dyads, the same species were identified in 86% of the pairs and potential pathogenic microorganisms from the Staphylococcaceae and Enterobacteriaceae families were found to be statistically significantly concordant between mother–child samples, particularly in the healthy group. Staphylococcus saprophyticus and Stenotrophomonas maltophilia oral colonization in mother–child pairs were associated with the presence of CRF. Breastfeeding was related to the early life oral colonization of Staphylococcus epidermidis in children from healthy mothers and C-section was associated with higher diversity of pathogens, independent of cardiovascular status (p = 0.05). This study reveals the presence of potential oral opportunistic and pathogenic bacteria in early life and highlights the importance of maternal factors in its acquisition.
- The association of milk and dairy consumption with iodine status in pregnant women in Oporto regionPublication . Ferreira, Pedro; Pinheiro, Cátia; Coelho, Cláudia Matta; Guimarães, Juliana; Pereira, Gonçalo; Moreira, Nara Xavier; Cortez, Alice; Bracchi, Isabella; Pestana, Diogo; Mota, Inês Barreiros; Prucha, Carmo; Martins, Cristina; Ribeiro, Célia Alves; Pinto, Edgar; Almeida, Agostinho; Delerue-Matos, Cristina; Montenegro, Nuno; Dias, Cláudia Camila; Moreira-Rosário, André; Azevedo, Luís Filipe; Brantsæter, Anne-Lise; Ramalho, Carla; Fernandes, Virgínia Cruz; Calhau, Conceição; Leite, João Costa; Keating, ElisaThe role of milk and dairy products in supplying iodine to pregnant women is unknown in Portugal. The aim of this study was to evaluate the association between milk and dairy product consumption and the iodine status of pregnant women in the IoMum cohort of the Oporto region. Pregnant women were recruited between 10 and 13 weeks of gestation, when they provided a spot urine sample and information on lifestyle and intake of iodine-rich foods. Urinary iodine concentration (UIC) was determined by inductively coupled plasma MS. A total of 468 pregnant women (269 iodine supplement users and 199 non-supplement users) were considered eligible for analysis. Milk (but not yogurt or cheese) intake was positively associated with UIC, in the whole population (P = 0·02) and in the non-supplement users (P = 0·002), but not in the supplement users (P = 0·29). In non-supplement users, adjusted multinomial logistic regression analysis showed that milk consumption <3 times/month was associated with a five times increased risk of having UIC < 50 µg/l when compared with milk consumption ≥2 times/d (OR 5·4; 95 % CI 1·55, 18·78; P = 0·008). The highest UIC was observed in supplement users who reported consuming milk once per d (160 µg/l). Milk, but not yogurt or cheese, was positively associated with iodine status of pregnant women. Despite the observed positive association, daily milk consumption may not be sufficient to ensure adequate iodine intake in this population.
- Vertical transmission and antifungal susceptibility profile of yeast isolates from the oral cavity, gut, and breastmilk of mother–child pairs in early lifePublication . Azevedo, Maria João; Araújo, Ricardo; Campos, Joana; Campos, Carla; Ferreira, Ana Filipa; Falcão-Pires, Inês; Ramalho, Carla; Zaura, Egija; Pinto, Eugénia; Sampaio-Maia, BeneditaYeast acquisition begins at birth; however, the contribution of the mother on yeast trans mission to the offspring and associated resistance is yet to be clarified. The aim of this study was to explore the vertical transmission of yeasts and their antifungal susceptibility profile in early life. Oral, fecal, and breastmilk samples were collected from 73 mother–child pairs four to twelve weeks after delivery and cultured on Sabouraud dextrose agar with chloramphenicol. The isolates were identified by MALDI-TOF MS. The vertical transmission was studied by microsatellite genotyping. Antifungal susceptibility was determined for fluconazole, voriconazole, miconazole, anidulafungin, and nystatin by broth microdilution assay, following CLSI–M60 guidelines. A total of 129 isolates were identified from 53% mother–child pairs. We verified the vertical transmission of Candida albicans (n = three mother–child pairs) and Candida parapsilosis (n = one mother–child pair) strains, includ ing an antifungal resistant strain transmitted from breastmilk to the gut of a child. Most isolates were susceptible to the tested antifungals, with the exception of four C. albicans isolates and one R. mucilaginosa isolate. The vertical transmission of yeasts happens in early life. This is the first work that demonstrated the role of the mother as a source of transmission of antifungal-resistant yeasts to the child.