Jezid Miranda

Universidad de Cartagena

Introduction: We investigated whether structured maternal lifestyle interventions based on Mediterranean diet or stress reduction influence fetal-infant neurodevelopment detected by detailed fetal neurosonography and Ages and Stages Questionnaires 3rd edition (ASQ) at 12months old. Methods: This was a secondary analysis of a randomized clinical...

Introduction Congenital malformations of the right atrium are rare heart defects with only a few cases described prenatally. Early diagnosis of these anomalies is becoming increasingly important for proper follow-up and due to the possibility of serious complications such as supraventricular arrhythmia, thromboembolic events, and sudden death. Obje...

Objective To demonstrate that successful health systems strengthening (HSS) projects have addressed disparities and inequities in maternal and perinatal care in low‐income countries. Methods A comprehensive literature review covered the period between 1980 and 2022, focusing on successful HSS interventions within health systems' seven core compone...

Objetivos: Describir un caso de diagnóstico prenatal de síndrome de Freeman-Sheldon mediante hallazgos ecográficos y secuenciación completa del exoma fetal. Materiales y métodos: Mujer de 33 años, con antecedentes de hipotiroidismo en tratamiento, a quien en semana 19 se realizó ecografía de detalle anatómico, en la cual se observaron deformidades...

Objective: Maternal hemodynamics can be evaluated with simple- to-use, noninvasive devices, that are affordablde in low resource settings. The aim was to assess maternal hemodynamics in patients with severe preeclampsia with and without fetal growth restriction (FGR). Method: A multicenter prospective cohort study was conducted in Colombia, a middl...

Objectives: To compare the maternal and perinatal outcomes of migrant pregnant women from Venezuela with local pregnant patients in a Colombian institution in the context of a migrant crisis. Methods: This population-based, retrospective cohort study included 11,304 deliveries between 24-42weeks in one obstet- rical centre from Cartagena, Colombia,...

Objectives Our objective was to identify sub-phenotypes of patients with severe pre-eclampsia, including different parameters, and to assess whether the selected variables determine a more severe subgroup of pre-eclampsia. Methods 88 were recruited between Sept. 2019 and Sept. 2021 in a descriptive cross-sectional study in Cartagena, Colombia. A l...

Objectives: Maternal hemodynamics can be evaluated with simple-to-use, non-invasive devices, that are affordable in low resource settings. The aim was to assess maternal hemodynam- ics in patients with severe pre-eclampsia with and without fetal growth restriction (FGR). Methods: A multicentre prospective cohort study was conducted in Colombia, a m...

Fetal growth restriction (FGR) affects 5-10% of pregnancies, is the largest contributor to fetal death, and can have long-term consequences for the child. Implementation of a standard clinical classification system is hampered by the multiphenotypic spectrum of small fetuses with substantial differences in perinatal risks. Machine learning and mult...

Objective To compare maternal and perinatal outcomes of migrant Venezuelan women with local pregnant patients in a Colombian institution in the context of a migratory crisis. Study Design This cross‐sectional study included 11 304 deliveries from the Clínica de Maternidad Rafael Calvo in Cartagena de Indias, Colombia, a tertiary referral center on...

Objectives: This study was conducted to determine whether bacteria, fungi, or archaea are detected in the amniotic fluid of patients who underwent midtrimester amniocentesis for clinical indications. Methods: Amniotic fluid samples from 692 pregnancies were tested by using a combination of culture and end-point polymerase chain reaction (PCR) te...

Objective To evaluate the performance of INTERGROWTH‐21st (IG‐21st) and World Health Organization (WHO) fetal growth charts to identify small‐for‐gestational‐age (SGA) and fetal growth restriction (FGR) neonates, as well as their specific risks for adverse neonatal outcomes. Methods Multicenter cross‐sectional study including 67 968 live births fr...

Coronavirus disease-2019 (COVID-19) infection during pregnancy is associated with severe complications and adverse effects for the mother, the fetus, and the neonate. The frequency of these outcomes varies according to the region, the gestational age, and the presence of comorbidities. Many COVID-19 interventions, including oxygen therapy, high-flo...

Objective: We aimed to assess the association between intrapartum neuraxial labour analgesia (NLA) and shock index values during the peripartum period. Design: A multicentre prospective cohort study. Setting: Two reference centres in Colombia. Population: Obstetric patients in labour with term gestations were divided according to whether they under...

Objective: To evaluate the performance of INTERGROWTH-21st and World Health Organization (WHO) fetal growth charts to identify small-for-gestational-age (SGA) and fetal growth restriction (FGR) neonates as well as their specific risks for adverse neonatal outcomes. Design: Multicenter cross-sectional study. Setting: Ten maternity units across four...

Objectives: The aim of this study was to explore the pattern of fetal cortical development in pregnancies complicated by preeclampsia with and without fetal growth restriction compared to uncomplicated pregnancies. Methods: Prospective observational study including pregnancies complicated by normotensive fetal growth restriction (birthweight <10...

Introduction: Preeclampsia is a multi-system disorder unique to pregnancy responsible for a great part of maternal and perinatal morbidity and mortality. The precise pathogenesis of this complex disorder is still unrevealed. Methods: We examined the pathophysiological pathways involved in early-onset preeclampsia, a specific subgroup representin...

Background Gestational diabetes mellitus (GDM) is a serious public health issue affecting 9–15% of all pregnancies worldwide. Recently, it has been suggested that extracellular vesicles (EVs) play a role throughout gestation, including mediating a placental response to hyperglycaemia. Here, we investigated the EV-associated miRNA profile across ges...

Objectives We aimed to establish new cut-off values for SIRS (Systemic Inflammatory Response Syndrome) variables in the obstetric population. Methods A prospective cohort study in pregnant and postpartum women admitted with systemic infections between December 2017 and January 2019. Patients were divided into three cohorts: Group A, patients with...

Preeclampsia (PE) and fetal growth restriction (FGR) are both placenta-mediated disorders with unclear pathogenesis. Metabolomics of maternal and fetal pairs might help in understanding these disorders. We recruited prospectively pregnancies with normotensive FGR, PE without FGR, PE + FGR and uncomplicated pregnancies as controls. Nuclear magnetic...

Fetal growth restriction is one of the most common obstetric complications, affecting 7-10% of all pregnancies. Affected fetuses are exposed to an adverse environment in utero during a critical time of development and may face long-term health consequences such as increased cardiovascular risk in adulthood. Growth restricted fetuses develop remodel...

Background: Gestational diabetes mellitus (GDM) is a serious public health issue affecting 9-15% of all pregnancies worldwide. Recently, it has been suggested that extracellular vesicles (EVs) play a role throughout gestation, including mediating a placental response to hyperglycaemia. Here, we investigated the EV-associated miRNA profile across ge...

Preeclampsia is a pregnancy-specific multisystem disorder and a leading cause of maternal and perinatal morbidity and mortality. The exact pathogenesis of this multifactorial disease remains poorly defined. We applied proteomics analysis on maternal blood samples collected from 14 singleton pregnancies with early-onset severe preeclampsia and 6 unc...

Objective: The aim of this study was to explore whether neurosonography can detect differences in cortical development and corpus callosum length in late-onset small fetuses sub-classified into small-for-gestational age (SGA) or fetal growth restriction (FGR). Methods: A prospective cohort study in 318 singleton pregnancies including 97 normally...

ANTECEDENTES: Las enfermedades respiratorias graves suelen afectar de manera desproporcionada a las mujeres embarazadas y representan un mayor riesgo de morbilidad y mortalidad materna y neonatal severas. Los informes clínicos de los desenlaces maternos y neonatales en mujeres embarazadas con COVID-19 siguen siendo escasos a pesar de la cantidad de...

Fetal growth restriction defined as the failure to achieve the fetal genetic growth potential is a major cause of perinatal morbidity and mortality. The role of maternal adaptations to placental insufficiency in this disorder is still not fully understood. We aimed to investigate the biological processes and protein–protein interactions involved in...

Objective To assess clinical impact, psychological effects, and knowledge of pregnant women during the COVID‐19 outbreak in seven cities in Colombia. Currently, there are uncertainty and concerns about the maternal and fetal consequences of SARS‐CoV‐2 infection during pregnancy. Methods A cross‐sectional web survey was carried out including pregna...

Hemopexin and α1-microglobulin act as scavengers to eliminate free heme-groups responsible for hemoglobin-induced oxidative stress. The present study evaluated maternal and fetal plasma concentrations of these scavengers in the different phenotypes of placenta-mediated disorders. Singleton pregnancies with normotensive fetal growth restriction [FGR...

Respiratory Disease in Pregnancy - edited by Stephen E. Lapinsky April 2020

The simultaneous determination of a broad panel of steroids provides more accurate information about the hormonal status than the detection of a single hormone. For that reason, the determination of the steroid profile, i.e. the endogenous steroid hormones and their main metabolites, has become the most powerful tool for the study of hormonal imbal...

Objective: To assess the frequency of atypical chromosomal and submicroscopic anomalies [both undetectable using standard cell-free DNA (cfDNA) testing], as well as fetal structural abnormalities observed at the first-trimester scan, in fetuses with an increased nuchal translucency (NT). Methods: From January 2013 to December 2017, 226 fetuses w...

Background: Preeclampsia and fetal growth restriction share some pathophysiologic features and are both associated with placental insufficiency. Fetal cardiac remodeling has been described extensively in fetal growth restriction, whereas little is known about preeclampsia with a normally grown fetus. Objective: To describe fetal cardiac structur...

Objectives: The aim of this study was to describe placental histopathological findings in a large cohort of pregnancies complicated by preeclampsia and/or fetal growth restriction, and to investigate its association with fetoplacental Doppler. Methods: This was a prospective observational study including pregnancies complicated by: 1) normotensi...

Background: The Shock Index is a clinical tool to evaluate the hemodynamic status during hemorrhage. The impact of labor and pre-existing anaemia is unknown. The objective was to describe and discuss its clinical utility in this context. Methods: This was a prospective cross-sectional study. The Shock Index (ratio between heart rate and systolic...

Background Cutaneous squamous cell carcinoma (cSCC) is the leading cause of death in patients with recessive dystrophic epidermolysis bullosa (RDEB). We provide the management and prognosis of cSCC in RDEB patients at a Spanish reference center. Materials and methods We retrospectively included patients with RDEB attended in La Paz University Hosp...

Fetal growth may be impaired by poor placental function or maternal conditions, each of which can influence the transfer of nutrients and oxygen from the mother to the developing fetus. Large-scale studies of metabolites (metabolomics) are key to understand cellular metabolism and pathophysiology of human conditions. Herein, maternal and cord blood...

Background Maternal serum concentrations of folate, homocysteine, and vitamin B12 have been associated with pre-eclampsia. Nevertheless, reported studies involve limited number of cases to reliably assess the nature of these associations. Our aim was to examine the relation of these three biomarkers with pre-eclampsia risk in a large Colombian popu...

Comparison between models for the association of maternal vitamin B12 with pre-eclampsia using imputed and not-imputed data. (DOCX)

Folic acid supplementation of participants from the GenPE study during pregnancy. (DOCX)

Analysis methodology of GenPE data. (DOCX)

Values outside the assay detection limit (DL) for homocysteine, folate and vitamin-B12 maternal levels. (DOCX)