2018 Fetal Medicine Research - FETAL MEDICINE - investigacion
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FETAL
MEDICINE
RESEARCH
CENTER
Fetal
Medicine
Research
Center
2018
Summary
04 12 36
Who we are Research R+D Projects
42 50 54
Scientific
results Education Media
ERASMUS MUNDUS
ANNUAL REPORT 2018 03
Fetal Medicine
Research Center
Annual Report
2018
Health begins before birth. Even though it seems Thanks to them we have ongoing innovative
like an invisible period of our lives, the prenatal human intervention studies that will improve the
period is the most important one. The quality of life prognosis of fetal growth restriction and we have
that we will have in childhood and adulthood is initiated new studies based on microbiota, machine
programmed during the nine months in the womb. deep learning, lung development assessment and
Detecting any anomaly during the development contamination. This year, moreover, we are about
process is a huge opportunity to reverse to close one of our most ambitious projects on new
consequences and improve future health. We have high-precision technologies in fetal medicine and
been working with this premise at the BCNatal Fetal surgery that brings together experts in robotics,
Medicine Research Center since its creation, 15 photonics and bioengineering. Some of its results,
years ago. such as the intrauterine guidance system, are
already being applied to the clinical practice..
During this time we have consolidated a research
model of scientific excellence based on efficiency, We do not forget our teaching and social vocation.
plurisdisciplinarity and innovation. These three Our commitment to the scientific community
pillars make up our DNA. Today we are the team materializes with the PhD programme in Fetal
with the highest number of scientific articles Medicine FetalMed-PhD, a European reference in the
published in the area of fetal medicine. We are field that will come to its final edition in 2019. As a
trusted and supported by great promoters such as bridge between fetal medicine and society, we
CELLEX Foundation, Obra Social “la Caixa”, continue to develop tools and carry out outreach
CEREBRA and other funders, friends and actions to make everyone aware that “health begins
collaborators. Without their support and ifunding before birth”. At the end, our main purpose is to Eduard Gratacós
none of this would be possible. improve science, health, and the lives of people. Director of BCNatal Fetal Medicine Research Center
Who we are Purpose A tem of excellence Nature Scientific results Organizational chart History
ANNUAL REPORT 2018 05
Purpose
We defend the integral understanding
of the fetus and the child as the same patient,
to early diagnose and treat diseases of
childhood and adulthood.
BCNatal Fetal Medicine Research Center is a Our mission Our projects
multidisciplinary research center in fetal and The main mission of our center is to identify Currently we have different ongoing research
perinatal medicine recognized as one of the best methods of early diagnosis and treatment for projects. Among them we would like to highlight
in the world in its field. The center is linked to diseases of prenatal origin that have an impact on the following three projects: a human intervention
BCNatal (the clinical center: Hospital Clinic de childhood and adult life. In this way, we can study that aims to improve the prognosis of fetal
Barcelona and Hospital Sant Joan de Déu) and is reduce the prevalence and severity of certain growth restriction; the development of new fetal
affiliated with the University of Barcelona.. diseases in adults, especially those that have surgery tools that will radically change the future
neurological, cardiovascular and pulmonary perspectives of fetuses that struggle between life
consequences of prenatal origin. and death; and finally, the study that allows us to
advance in the creation of new biomarkers that
Our methodology will detect fetuses at risk.
750m2
We identify the fetus as a patient to demonstrate
and characterize the profound impact that fetal life
has on children and their future health. This way we
ALLOCATED can tackle the same problem from different
TO RESEARCH perspectives to overcome it in an efficient and
innovative way. This way of working allows us to
integrate prenatal and postnatal care through the
services of Maternal-Fetal Medicine and
Neonatology.
We identify methods of
early diagnosis and treatment for
diseases of prenatal origin
+ 450 PUBLICATIONS ARTICLES
published in 2018 in
77
since 2010
33 different scientific journals
06 WHO WE ARE
ent
agem
4P
5 STEM
syc
A team of
9 Man
ho
lo g
ic
as
y
excellence
B
12
18 T
echn
ician
The center has a high transnational capacity thanks HHRR
to a multidisciplinary team made up of more than
100 members including specialists of fetal 1 Engineering
Areas
medicine, cardiology, neurodevelopment and 3 Nursery (%)
reproductive medicine, and also biologists,
pharmacists, bioengineers, epidemiologists and 52
statisticians. Together we aim to achieve highly Cli
nic
2 Degree
competitive research in fetal development, both at
ian
the physiological and pathological level. The team
nic
ch
is led by Eduard Gratacós, together with Fàtima
Te
17
Crispi as the scientific coordinator. In addition, each
research line has its own scientific director and the
nt
management of the entire center is carried out by ude
5 St
an independent unit.
HHRR
55 Bachelor’s
Degree
Categories
(%)
PROFESSIONALS
26
25
Do
cto
from different nationalities r
Germany Greece
Italy
Moldova Russia
Spain Turkey
Cuba
Colombia
Mexico Portugal
Panama Mongolia
Ghana Japan
Brazil Egypt Indonesia
Tunisia
Ecuador
Peru Uruguay Syria
Chile Argentina Pakistan
ANNUAL REPORT 2018 07
Multidisciplinary team
82 Women | 22 Men
Nature
BCNATAL that conform a privileged environment for
BCNatal was born as the result of the integration innovation and clinical translation.
of Hospital Clínic and Hospital Sant Joan de Déu
and has become one of the largest university FUNDACIÓ CLÍNIC & FUNDACIÓ
centers for maternal-fetal and neonatal medicine SANT JOAN DE DÉU
in Europe. With more than 7.000 births, 3.500 The Clinic Foundation for Biomedical Research
consultations in fetal medicine, 2.000 fetal (FCRB) and Sant Joan de Déu Foundation offer
echocardiographies, 150 fetal surgeries and 500 administrative service and support to the
cases of placental disease per year, the center is researchers of the BCNatal Fetal Medicine
positioned as a world leader. It is specialized in Research Center. FCRB also provides administrative
fetal surgery, concentrating 85% of the management to IDIBAPS.
interventions performed in Spain, many of them
carried out to save the life of the baby. The most UNIVERSITAT DE BARCELONA
common surgery is the one that is done to the The University of Barcelona (UB) is the main
twins sharing placenta, which also receives public university in Catalonia, with the greatest
patients from the rest of the world. number of students and delivering the broadest
and most comprehensive offering in higher
IDIBAPS educational courses. UB coordinates the
BCNatal Fetal Medicine Research Center is part of international doctorate programme in Fetal
the Biomedical Research Institute August Pi i Medicine, Erasmus FetalMed-PhD, thanks to the
Sunyer, one of the main health research centers in collaborations between the researchers of the
Europe, with an increasing scientific production of group and UB.
more than a thousand articles in international
journals and more than 450 first-level researchers
08 WHO WE ARE
Scientific
American Journal of
BJOG: An International Obstetrics & Gynecology
results
Journal of Obstetrics &
Gynecology
IF= 5,732
(3 articles)
IF= 4,876
In the last 10 years the group has published more than 450 articles, (2 articles)
directed more than 40 doctoral theses and has been awarded with Articles with
more than 58 national and international projects, financed by
prestigious institutions such as the CELLEX private foundation,
+ Impact Factor
Cerebra foundation or the Obra Social “la Caixa”. (IF) in 2018
Medical Image Analysis
IF= 5,356
(1 articles)
Ultrasound in Obstetrics & Gynecology
IF= 5,654
(11 articles)
2017 / 252,50
2018 / IF= 241,76
Articles in the
first decile
36%
2011 / 130,2
2016 / 211,21
Impact Factor
accumulated 241,76
2012 / 129,2
2013 / 183,7
2015 / 177,62
77
Articles in the
first quartile
2014 / 201,5 73
51%
62
56
54
45
38 34
2011 2012 2013 2014 2015 2016 2017 2018
Published articles
ANNUAL REPORT 2018 09
Organizational
chart Inflammation in
Prematurity
preterm birth
s • Research a
h area rea
rc s•
ea
s
Re
Environment
Re
Fetal brain
sea
Research areas •
development and pregnancy
rch a
complications
Scientific
reas • Rese
•
board
ar
as
ch
are
are
h as
Res searc •
earch areas • Re
Fetal Placental
programming disease
Fetal
therapy
Project
management
Information
HHRR
Technology
Biobank
Manage-
ment area
Animal Transversal
Image
RSC Scientific model Plataforms
Communication management
Administrative
management
Postnatal
10 WHO WE ARE
History
Twenty years ago the fetus did not exist as a patient. Today babies are born
with a medical history under their arms: we have opened the window of
opportunity to improve their quality of life starting from before birth. These
are the key dates of the Fetal Medicine Research Center, from the beginning
to the present.
2005 2007 2009
Our beginning Focused on fetal Our scientific
Eduard Gratacós creates the research team in cardiology and production grows
Fetal and Perinatal Medicine thanks to the neurodevelopment We publish 46 scientific articles in journals
support of the Hospital Clinic and IDIBAPS. We develop innovative technologies that allow us specialized in maternal-fetal medicine, achieving
to understand how the brain and heart are the highest impact factor up to date: 119.31.
reprogrammed in fetal life.
2013 2013 2014
First specialized BCNatal, a reference Devoted
European doctorate center in pregnancy to the society
We start coordinating the first Erasmus Mundus The consortium formed by the Hospital Sant Joan We organize ludic-scientific sessions
Joint PhD Programme in Fetal and Perinatal de Deu Barcelona and the Hospital Clínic becomes with patient associations and pregnant women
Medicine in collaboration with the University of a reference in the attention to mothers and babies to promote healthy habits in pregnancy. We
Barcelona (Spain), and the Universities of Leuven and also when there are fetal complications. The publish a recipe book for pregnant women
(Belgium) and Lund (Sweden). coordinated assistance network allows us to together with Michelin star chefs.
respond to these situations quickly and safely.ANNUAL REPORT 2018 11
2018
We launch the iNatal app, the first app on pregnancy carried
out by experts in maternal-fetal medicine and the only one
with personalized plans to improve the nutrition and
emotional well-being of pregnant women. A project financed
iNatal app is born, by Obra Social ‘laCaixa’ and developed in collaboration with
100% personalized nutritionists from IDIBAPS and professionals from the
and rigorous institute of esMindfulness.
FREE DOWNLOAD FOR iOS AND ANDROID
2010 2011 2012
The first fetal We publish first iNatal: the bridge
lung surgery annual report between fetal medicine
The team performs a surgical intervention For the first time, we collect all our achievements and the society
for the first time on a fetus with a lethal in a memory of activities, which features the We collaborate in the creation of iNatal, a
congenital pulmonary disease. The baby girl is illustrations of Maria Corte. Since then, we have reference website about pregnancy, birth, and
called Alaitz –means happiness in Basque- and become one of the few research teams with their postpartum, and the first one with 100% reliable
becomes news 16 months later. own annual report. content. It includes a forum moderated by
maternal-fetal medicine specialists.
2015 2016 2017
New research line: IMPACTBCN, clinical Improvements in the
fetal therapy and trial in pregnancy diagnosis of
surgery “Improving Mother for a better Prenatal Care intrauterine growth
Thanks to the support of CELLEX, we bring together Trial” is a broad clinical trial based on restriction
experts in medical imaging, robotics, biomaterials, interventions of nutrition and emotional We publish the RATIO37 protocol, a multicentric
and electronic and optical biosensors in search of well-being of the mother to assess the impact of study that incorporates a new ultrasound
high precision treatments to develop better maternal well-being on the newborn. More than parameter in week 37 to detect low birth weight,
technologies in intrauterine interventions. 1,200 pregnant women with a risk of having a and hence, reduce the rate of fetal death and
baby with growth restriction participate in the trial. complications in childbirth.Research Fetal programming Fetal brain development Prematurity Inflammation in preterm birth Fetal therapy Environment and pregnancy complications Placental disease Platforms Research management
ANNUAL REPORT 2018 13
Research
areas
Our six research areas The fetus as a patient
are aimed to identify new In BCNatal Fetal Medicine Research Center we treat
diagnosis and treatment the fetus as a patient, to whom we can diagnose Our research is
methods for diseases with
and manage certain diseases while still in the womb
in order to minimize or avoid their consequences in
organized in 6 areas
prenatal origin that have the future. Our research focuses particularly on that allow achieving
heart and brain, given the special importance that a comprehensive
an impact on childhood fetal programming has on the development of these
study of the fetus
organs, as well as on the development of new
and adult life. intrauterine treatments that are able to reverse or and the mother
mitigate certain fetal disorders.
Fetal Fetal brain Prematurity Inflammation in Environment Placental
Fetal therapy
programming development preterm birth and pregnancy disease
complications14 RESEARCH
Fetal
programming
Understanding better the effect of pregnancy
complications on fetal development will allow WHAT IS THE IMPACT OF THE FETAL PERIOD ON
us to discover preventive strategies to improve OUR HEALTH?
The prenatal period is critical for the development
the quality of life of many babies. of all organs. An insult during prenatal life such as
intrauterine growth restriction, assisted
reproduction techniques, exposure to toxic agents
or congenital heart diseases may affect this
development and have long-term health effects
that persist during adult life.
IS IT POSSIBLE TO IMPROVE THE PROGNOSIS OF
BABIES WITH FETAL COMPLICATIONS?
Longitudinal studies, combined with animal and
FÀTIMA CRISPI computational models, will allow us to develop
Coordinator of the research line and the scientific coordinator of the new therapies that improve the prognosis of
group. Maternal-Fetal Medicine Specialist at BCNatal. Lecturer in babies who experience some of these
specialized courses of Fetal I+D Education Barcelona. complications. For this purpose, we must
Coordinator
Fátima Crispi Predoctorals
Maria Laura Boutet Clinical research fellow
Maternal-Fetal Laura García Annachiara Basso
Medicine Specialists Laura Guirado Ayako Nakaki
Olga Gómez Ameth Hawkins Laura Salazar Undergraduate
Anna Goncé Grigorios Kalapotharakos Students
Mari Kinoshita Nutritionist Marcos Alonso
Postdoctorals Jezid Miranda Tania Freitas Cristina Miranda
Gemma Casals Cristina Paules Vasili Sircheli The line brings together a multidisciplinary
Francesca Crovetto Álvaro Sepúlveda Master Students
Marta López Iris Soveral Karen Castillo Technicians team of fetal medicine specialists,
Brenda Valenzuela Lina Youseff Lucia Garcia Marta Dacal paediatricians, epidemiologists, biologists
Mónica Zamora Kilian Vellvé Silvana Santamaria Laura Segales and engineers.ANNUAL REPORT 2018 15
characterize the phenotypic variability of small
fetuses and understand cardiovascular diseases
IN 2018… COHORT RECRUITMENT
of prenatal origin in order to develop biomarkers
for early diagnosis and monitoring of fetal (1) We have completed a large cohort • 1200 IUGR cases with matched
cardiovascular remodelling, as well as new study of small fetuses and controls to characterize phenotypic
therapies that improve alterations affecting evidenced placental aging and the variability of small fetuses
fetus’ life. Today, we know that by improving release of exosomes, as well as (PHENOMAPPING cohort).
maternal health we can have an influence on altered maternal and fetal lipid
fetal development, thereby improving the profiles in these pregnancies. • 500 adult IUGR cases with matched
prognosis of some fetal diseases. controls for the ADULTHEART study
(2) Following previous studies about the to assess the long-term
effect of assisted reproductive cardiovascular impact of IUGR.
techniques on cardiac function, we
have reported their postnatal • We have recruited half of the
persistence and implications in twin patients necessary for a large
pregnancies. randomized trial IMPACTBCN that
studies how the interventions in
(3) In addition, we have provided pregnant women, such as
evidence of the harmful introducing a balanced diet or
transgenerational effect of growth reducing stress, can improve fetal
retardation. growth.
Publications
• ( 1) The impact of prenatal insults on the
human placental epigenome: A systematic
review. Palma-Gudiel H, Cirera F, Crispi F,
Eixarch E, Fañanás L. Neurotoxicology
Teratology. 66:80-93 (2018).
We want to understand and
prevent long-term consequences
• Macronutrient and fibre intake of young
Spanish children with reference to their in
utero growth status: Are they eating a healthy of prenatal diseases
diet? Nuruddin R, Urpi-Sarda M, Rodriguez-
Lopez M, Garcia-Arenas D, Gratacos E, Crispi F,
Acosta-Rojas R. Journal of Paediatrics and Child
Health. 54(5):563-571 (2018).
• ( 2) Differential changes in myocardial
performance index and its time intervals in • Comparison of 2D versus M-mode Casacuberta I, Juárez-Flores DL, Ugarteburu O,
donors and recipients of twin-to-twin echocardiography for assessing fetal myocardial Matalonga L, Cascajo MV, Tort F, Cortés A,
Transfusion Syndrome before and after laser wall thickness. Sepúlveda-Martínez A, Tobias E, Milisenda JC, Grau JM, Crispi F,
therapy. Ortiz JU, Torres X, Eixarch E, Bennasar García-Otero L, Soveral I, Guirado L, Valenzuela Gratacós E, Garrabou G, Cardellach F.
M, Cruz-Lemini M, Gómez O, Lobmaier SM, B, Torres X, Rodriguez-Lopez M, Gratacos E, Biochimica et Biophysica Acta. 1862(5):1157-
Martínez JM, Gratacós E, Crispi F. Fetal Gómez O, Crispi F. The Journal 1167 (2018).
Diagnosis and Therapy. 44(4):305-310 (2018). of Maternal-Fetal & Neonatal Medicine.
11:1-9 (2018). •R
emodeling of the cardiovascular circulation in
• L ong-term cardiovascular consequences of fetal fetuses of mothers with diabetes: A fetal
growth restriction: biology, clinical • Cardiac and placental mitochondrial computational model analysis. Kulkarni A,
implications, and opportunities for prevention characterization in a rabbit model of Garcia-Cañadilla P, Khan A, Lorenzo JM, Beckerman
of adult disease. Crispi F, Miranda J, Gratacós E. intrauterine growth restriction. Guitart- K, Valenzuela-Alcaraz B, Cruz-Lemini M, Gomez O,
The American Journal of Obstetrics and Mampel M, Gonzalez-Tendero A, Niñerola S, Gratacos E, Crispi F, Bijnens B. Placenta. 63:1-6
Gynecology. 218(2S):S869-S879 (2018). Morén C, Catalán-Garcia M, González- (2018).16 RESEARCH
• Characterizing cardiac dysfunction in fetuses • Intrauterine growth restriction and later • Postnatal persistence of fetal cardiovascular
with left congenital diaphragmatic hernia. cardiovascular function. Crispi F, Crovetto F, remodeling associated with assisted
Cruz-Lemini M, Valenzuela-Alcaraz B, Gratacos E. Early Human Development. 126:23- reproductive technologies: a cohort study.
Granados-Montiel J, Martínez JM, Crispi F, 27 (2018). Valenzuela-Alcaraz B, Serafini A, Sepulveda-
Gratacós E, Cruz-Martínez R. Prenatal Martínez A, Casals G, Rodríguez-López M,
Diagnosis. 38(6):422-427 (2018). • Metabolic profiling and targeted lipidomics Garcia-Otero L, Cruz-Lemini M, Bijnens B, Sitges
reveals a disturbed lipid profile in mothers and M, Balasch J, Gratacos E, Crispi F. BJOG.
• Placental exosomes profile in maternal and fetuses with intrauterine growth restriction. 126(2):291-298 (2019).
fetal circulation in intrauterine growth Miranda J, Simões RV, Paules C, Cañueto D,
restriction - Liquid biopsies to monitoring fetal Pardo-Cea MA, García-Martín ML, Crovetto F,
growth. Miranda J, Paules C, Nair S, Lai A,
Collaborations
Fuertes-Martin R, Domenech M, Gómez-Roig
Palma C, Scholz-Romero K, Rice GE, Gratacos E, MD, Eixarch E, Estruch R, Hansson SR, Amigó N,
Crispi F, Salomon C. Placenta. 64:34-43 (2018). Cañellas N, Crispi F, Gratacós E. Scientific
Reports Nature. 8(1):13614 (2018). Nationals
• ( 3) Premature placental aging in term • Universitat de Barcelona
small-for-gestational-age and fetal-growth- • (3) Transgenerational transmission of small for • Universitat Pompeu Fabra
restricted fetuses. Paules C, Dantas AP, Miranda gestational age. Sepúlveda-Martínez Á, • IDIBAPS, Barcelona
J, Crovetto F, Eixarch E, Rodriguez-Sureda V, Rodríguez-López M, Paz-Y-Miño F, Casu G, • Universidad Rovira i Virgili, Tarragona
Dominguez C, Casu G, Rovira C, Nadal A, Crispi F, Crovetto F, Gratacós E, Crispi F. Ultrasound in • Instituto Aragonés de Ciencias de la Salud
Gratacos E. Ultrasound in Obstetrics & Obstetrics & Gynecology. (I+CS), Zaragoza
Gynecology. 2018 [2018 Epub ahead or print]. • Hospital Vall d’Hebron de Barcelona
• Hospital del Mar-IMIM, Barcelona
• Parque Tecnológico de Andalucía, Málaga
Internationals
• Oxford University, UK
• The Labatt Family Heart Center, Division of
Cardiology, Hospital for Sick Children and
University of Toronto, Toronto, Canada
Strategic goals • Division of Pediatric Cardiology, Bronx
Lebanon Hospital Center, Bronx, NY, USA
• Frauenklinik und Poliklinik, Technische
Research Areas Universität München, Munich, Germany
• Fetal Medicine Mexico, Universidad Nacional
Clinical Basic Engineering
Autónoma de México (UNAM), Campus
Characterizing the phenotypic Stress test to reveal cardiac 3D microstructure analysis Juriquilla, Querétaro, Mexico
UNDERSTANDING
FOR A BETTER
variability of small fetuses susceptibility in IUGR of the cardiovascular • Neonatologist, Monash Newborn, Monash
system Children’s Hospital, Monash University,
Understanding cardiovascular and
pulmonary diseases of prenatal Melbourne, VIC, Australia
origin • The Boden Institute of Obesity, Nutrition,
Exercise & Eating Disorders, The University of
Sydney, Camperdown, NSW, Australia
• European Synchrotron Radiation Facility,
Developing biomarkers for the early Developing computational
FOR A BETTER
Grenoble, France
DIAGNOSIS
diagnosis of fetal cardiovascular models of the fetal
remodelling cardiovascular system and • University of Lund, Sweden
the cardiomyocyte • UQ Centre for Clinical Research and
University of Queensland, Australia
FOR AN EFFICIENT
Improving healthy habits of Therapeutic strategies
THERAPY
pregnant women to improve fetal to prevent cardiovascular
development remodelling of prenatal
originANNUAL REPORT 2018 17
18 RESEARCH
Fetal brain We evaluate the prenatal brain evelopment
in the most detailed way in order to select
develop-
the best biomarkers that will identify babies
with greater risk of suffering neurological
ment
alterations.
ELISENDA EIXARCH
Coordinator of the research line. Maternal-Fetal Medicine
Specialist at BCNatal. Member of the fetal surgery team.
Lecturer in specialized courses of Fetal I+D Education Barcelona.
WHY IS IT IMPORTANT TO STUDY THE BRAIN
DEVELOPMENT OF A FETUS?
The brain is an organ with a long and complex
development process that is susceptible to
different conditions that may occur throughout
the pregnancy. Evaluating this development
process in a detailed way during the pregnancy,
that is, during the fetal period, allows us to select
biomarkers that help us identify children with a
risk of suffering neurodevelopmental alterations.
HOW DO WE PERFORM THE SEARCH FOR THESE
BIOMARKERS?
To discover these biomarkers we apply different
advanced technologies. Among them we can
mention the evaluation of cortical development
by ultrasound and resonance imaging, the
evaluation of brain microstructure by means of
spectroscopy and diffusion technqiues, and the
analysis of brain connectivity by magnetic
resonance in different situations such as
Coordinator intrauterine growth restriction, congenital
Elisenda Eixarch heart diseases and ventriculomegaly, a
condition in which the size of one or both
Clinical Research Fellow
Elena Monterde lateral ventricles increase.
Miriam Pérez
Predoctorals
Nadine Hahner
Lucas Trigo
In the line we gather fetal medicine
specialists and engineers.ANNUAL REPORT 2018 19
IN 2018…
(1) We have shown that ventricular ventriculomegaly, was published in
dilation may be related to the worst ‘Prenatal Diagnosis Journal’.
neurodevelopmental outcomes. Today
we know that babies with (2) Today we also know that it is posible to
ventriculomegaly have a lower cortical perform an automatic analysis of the
development during pregnancy. This cortical development during pregnancy by
finding, the result of the application of applying advanced 3D reconstruction
advanced ultrasound analysis in techniques of the fetal brain, which will
fetuses with isolated non-severe allow us to advance in this research.
Publications Collaborations
• ( 1) Cortical folding alterations in fetuses with Nationals Strategic
isolated non-severe ventriculomegaly. • Speech, Acquisition & Perception Group, goals
Benkarim OM, Hahner N, Piella G, Gratacos E, Universitat Pompeu Fabra
González Ballester MA, Eixarch E, Sanroma G. • Simulation, Imaging and Modelling for
Neuroimage Clinical. 18:103-114 (2018). Biomedical Systems, Universitat
Pompeu Fabra
• ( 2) Altered cortical development in fetuses with • CIBERSAM (grupo 8), Universitat de Research Areas
isolated non-severe ventriculomegaly assessed Barcelona Clinical/Basic Engineering
by neurosonography. Hahner N, Puerto B,
Perez-Cruz M, Policiano C, Monterde E, Crispi F, Internationals The systematic Tools for the
evaluatuon of automatic
DESVELOPING
Gratacos E, Eixarch E. Prenatal Diagnosis. • Center for the Developing Brain,
cortical evaluation of the
38(5):365-375 (2018). King’s College, UK
maturation by cortical maturation
• Ecole Polytechnique Federal, Laussane, ultrasound and pattern.
• L earning to combine complementary Switzerland fetal MRI.
segmentation methods for fetal and 6-month • Hospital Universitaire Geneve, Switzerland
infant brain MRI segmentation. Sanroma G,
Benkarim OM, Piella G, Lekadir K, Hahner N, The evaluation of Changes in the
the cortical pattern of cortical
Eixarch E, González Ballester MA. Computerized
maturation development in
Medical Imaging and Graphics. 69:52-59
VALIDATING
pattern in other clinical intervention
(2018). populations at studies.
risk, including
• Fetal cortical parcellation based on growth heart disease,
patterns. Xia J, Zhang C, Wang F, Benkarim OM, IUGR & exposure
Sanroma G, Piella G, González Balleste MA, to toxic agents.
Hahner N, Eixarch E, Shen D, Li G. Proceedings
IEEE International Symposium on Biomedical
Imaging (ISBI). 2018:696-699 (2018).
• Patch spaces and fusion strategies in
patch-based label fusion. Benkarim OM, Piella
We want to develop imaging
G, Hahner N, Eixarch E, González Ballester MA, biomarkers to identify the fetuses
Sanroma G. Computerized Medical Imaging and with neurodevelopmental
Graphics. 71:79-89 (2019).
alterations20 RESEARCH
Prematurity
WHY IS IT IMPORTANT TO STUDY PREMATURITY?
Preterm birth is the most frequent cause of
perinatal morbidity and mortality. Each year 15
million babies in the world are born prematurely,
that is, before 37 weeks of gestation. In Spain,
this ratio is one in ten. For this reason, it is crucial
to advance in their knowledge as well as in the
Our aim is to detect improvement of their management, two of the
patients with a real risk main objectives of this line. Any progress that
allows us to extend preterm pregnancies only two
of premature birth to or three weeks more, would let us change the
optimize their treatment lives of hundred thousands of families.
and prolong pregnancy WHAT ADVANCES WOULD ALLOW TO REDUCE IT?
as long as possible, and The line investigates non-invasive interventions
that improve the decision-making capacity of
thus to improve the professionals against the risk of premature birth.
neonatal prognosis. One of the main research tools of the
Prematurity line is the quantitative analysis of
the pulmonary and cervical textures through
images obtained by ultrasound. The first one is
already applicable to the clinical practice and is
also useful to better predict the outcome of labor
induction. As for the second one, today we know
that cervical texture may be of great help as a
screening tool for the risk of prematurity in the
MONTSERRAT PALACIO
general population.
Coordinator of the research line. Specialist in Prematurity at BCNatal.
Lecturer in specialized courses of Fetal I+D Education Barcelona.
Coordinator
Montserrat Palacio
Predoctorals
Núria Lorente
Ana Moreno
Àlvaro Pérez
Postdoctorals The research line brings together fetal medicine specialists, as well as
Núria Baños bioengineers and research technicians.ANNUAL REPORT 2018 21
Publications
• ( 1) Clinical feasibility of quantitative
IN 2018… (2) Today we know that cervical texture may be
ultrasound texture analysis: a robustness useful as a screening tool for the risk of
• W
e continued to develop
study using fetal lung ultrasound images. prematurity in the general population..
prediction tools based on the
Perez-Moreno A, Dominguez M, Migliorelli F,
quantitative analysis of lung and
Gratacos E, Palacio M, Bonet-Carne E. Journal
cervical texture: • T he multicentric clinical trial on the impact of
of Ultrasound in Medicine. [2018 Epub ahead the detection and early treatment of
or print]. (1) The tool used for the analysis of asymptomatic carriers of bacterial vaginosis
fetal lung texture is being on the preterm delivery rate has been
• (2) Quantitative analysis of cervical texture by automated and has been shown to cancelled as a result of the publication of the
ultrasound in mid-pregnancy and association be robust. PREMEVA study, which demonstrates that the
with spontaneous preterm birth. Baños N, screening of vaginosis is not beneficial.
Perez-Moreno A, Julià C, Murillo-Bravo C,
Coronado D, Gratacós E, Deprest J, Palacio M.
Ultrasound in Obstetrics & Gynecology. threatened preterm labor: a randomized low-risk population. Baños N, Murillo-Bravo C,
51(5):637-643 (2018). trial. Palacio M, Caradeux J, Sánchez M, Cobo T, Julià C, Migliorelli F, Perez-Moreno A, Ríos J,
Figueras F, Coll O, Gratacós E, Cararach V. Fetal Gratacós E, Valentin L, Palacio M. Ultrasound in
• Mid-Trimester cervical consistency index and Diagnosis and Therapy. 43(3):184-190 (2018). Obstetrics & Gynecology. 51(5):629-636
cervical length to predict spontaneous preterm (2018).
birth in a high-risk population. Baños N, Julià C, • Cervical Alpha-Actinin-4 Is upregulated in
Lorente N, Ferrero S, Cobo T, Gratacos E, Palacio women with threatened preterm labor and
M. AJP Reports. 8(1):e43-e50 (2018). microbial invasion of the amniotic cavity. Cobo
T, Palacio M, Grande M, Sánchez-García AB, Collaborations
• Should previous preterm birth classification Estanyol JM, López M, Bosch J, Martí C, Gratacós Nationals
influence treatment of short cervix in a E. Fetal Diagnosis and Therapy. 44(1):36-43 • Doctorats Industrials
subsequent pregnancy? Comparison of vaginal (2018). • Instituto de Salud Carlos III (ISCIII)
progesterone and Arabin pessary. Care A,
Muller-Myhsok B, Olearo E, Todros T, Caradeux J, • C ontribution of amniotic fluid along gestation Internationals
Goya M, Palacio M, Carreras E, Alfirevic Z. to the prediction of perinatal mortality in • St George University, London, UK
Ultrasound in Obstetrics & Gynecology. [2018 women with early preterm premature rupture • Thomas Jefferson University Hospital,
Epub ahead or print]. of membranes. Cobo T, Munrós J, Ríos J, Ferreri Philadelphia
J, Migliorelli F, Baños N, Gratacós E, Palacio M. • Erasmus Mundus Joint Doctorate in Fetal
• Clinical and sonographic model to predict Fetal Diagnosis and Therapy. 43(2):105-112 Medicine
cesarean delivery after induction of labor at term. (2018).
Migliorelli F, Baños N, Angeles MA, Rueda C, Companies:
Salazar L, Gratacós E, Palacio M. Fetal Diagnosis •M
id-trimester sonographic cervical consistency • Transmural Biotech, Spain
and Therapy. [2018 Epub ahead or print]. index to predict spontaneous preterm birth in a • Laboratorio Reig-Jofre, Spain
• Cervical consistency index and risk of cesarean
delivery after induction of labor at term.
Migliorelli F, Rueda C, Angeles MA, Baños N,
Posadas DE, Gratacós E, Palacio M. Ultrasound
Strategic goals
in Obstetrics & Gynecology. [2018 Epub ahead FOR A BETTER FOR A BETTER FOR AN EFFICIENT
or print]. DIAGNOSIS MANAGEMENT THERAPY
Quantitative analysis Evaluation of the Developing therapies
•U
se of hydrotherapy during labour: Assessment of of lung texture to effect of drugs that for an efficient
Clinical & Bioengineering
pain, use of analgesia and neonatal safety. predict the outcome may delay preterm treatment of bacterial
Research Areas
KMallen-Perez L, Roé-Justiniano MT, Colomé Ochoa of labor induction delivery in patients at vaginosis
N, Ferre Colomat A, Palacio M, Terré-Rull C. and the risk of risk of preterm birth
Enfermería Clínica. 28(5):309-315 (2018). preterm delivery
• Uterine cervical length measurement to Quantitative analysis of cervical texture in patients
reduce length of stay in patients admitted for at risk of preterm birth22 RESEARCH
Inflammation in
preterm birth
We want to predict intraamniotic infection or
inflammation in women at risk of preterm labor
using rapid and non-invasive diagnostic tools to
minimize the impact on the newborn.
TERESA COBO
Coordinator of the research line. Specialist in Prematurity at BCNatal.
Cofounder of Compartim, support group for perinatal loss. Lecturer in
specialized courses of Fetal I+D Education Barcelona.
WHY DO WE STUDY THE INFECTION OF THE
AMNIOTIC LIQUID?
Subclinical intraamniotic infection and the
inflammatory response it generates are the most
frequent causes of spontaneous preterm delivery,
especially at early gestational ages. The main
drawback is that its diagnosis requires an
amniocentesis, an invasive procedure that limits
translationality at the clinical level. For this reason
we want to develop new, non-invasive, rapid
detection tools (through samples such as the
cervicovaginal fluid) that allow a better clinical
management at the patient’s bedside.
DOES INFECTION HAVE A LONG-TERM IMPACT ON
THE FETUS AND THE NEWBORN?
In fact, we lead a clinical project in order to study
the impact of intrauterine exposure to infection
and inflammation at different stages of life. We
evaluate changes occurring at the cardiovascular,
neurological and neurodevelopmental levels
Coordinator
Teresa Cobo during the fetal stage, at birth, at 6 months and
1 year of age. To do this we use technologies
Predoctorals such as metabolomics, proteomics of the
Eduardo Herreros bacterial microbiome, or photonics.
Clara Murillo
The line gathers specialists in
Technician maternal-fetal medicine and neonatology,
Ana Belén Sánchez biochemists, biophysicists, microbiologists,
Project Manager biotechnology engineers, biologists,
Rosa López biostatisticians and technicians.ANNUAL REPORT 2018 23
We have observed that intraamniotic IN 2018…
inflammation is a risk factor for the
neurovelopment of extreme premature • W
e have strengthened our
collaboration with other research
groups to deepen the development
of a robust, non-invasive diagnostic
Publications Collaborations tool applicable in any sanitary
environment (hospital or not) to
• Interleukin-6 measured using the automated Nationals detect intraamniotic infection/
electrochemiluminescence immunoassay •C
entro de Investigación Príncipe Felipe de inflammation in vaginal discharge in
method for the identification of intra-amniotic Valencia (Antonio Pineda) women at risk of premature birth.
inflammation in preterm prelabor rupture of • Instituto de Ciencias Fotónicas (ICFO)
membranes. Musilova I, Andrys C, Holeckova M, (Valerio Pruneri / Romain Quidant) • W
e have collaborated with
Kolarova V, Pliskova L, Drahosova M, Bolehovska • Departamento de Bioquímica y Biomedicina companies, such as HOLOGIC in the
R, Pilka R, Huml K, Cobo T, Jacobsson B, Molecular de la Universidad de Barcelona ‘SCUBA’ clinical project that aims to
Kacerovsky M. The Journal of Maternal-Fetal & (Marta Cascante) identify intraamniotic infection/
Neonatal Medicine. [2018 Epub ahead or • Departamento de Biotecnología del Instituto inflammation in women at risk of
print]. de Agroquímica y Tecnología de Alimentos premature birth by determining
(IATA) perteneciente a la Agencia Estatal proteins in the vaginal discharge.
• T he association between selected mid- Consejo Superior de Investigaciones Likewise, we signed an agreement
trimester amniotic fluid candidate proteins and Científicas (CSIC) (M. Carmen Collado) with the MEDIX Biochemica Industry
spontaneous preterm delivery. Hallingström M, • Plataforma de Bioestadística del IDIBAPS to test a rapid device that measures
Cobo T, Kacerovsky M, Skogstrand K, Hougaard (José Ríos) the MMP-8 protein (intraamniotic
DM, Holst RM, Tsiartas P, Bullarbo M, Carlsson Y, inflammation marker) in the
Nilsson S, Jacobsson B. The Journal of Internationals amniotic fluid in women at risk of
Maternal-Fetal & Neonatal Medicine. 10:1-10 • University of Gothenburg, Sweden (Bo premature birth.
(2018). Jacobsson)
• University Hospital Hradec Kralove, Czech • T hanks to an agreement with the
•N
oninvasive sampling of the intrauterine Republic (Marian Kacerovsky) Department of Biochemistry of
environment in women with preterm labor and Hospital Clínic, we have carried out
intact membranes. Cobo T, Kacerovsky M, Companies the necessary experiments to
Jacobsson B. Fetal Diagnosis and Therapy. •H ologic, USA implement the use of IL-6 in amniotic
43(4):241-249 (2018). • Medix Biochemica, Finland fluid at the clinical level in women at
risk of premature birth, scheduled for
2019. This will allow the
personalization of patient
management (hospital admission,
Strategic goals antibiotics, etc.).
Research Areas “AJUDAS JOSEP FONT” AWARD
Clinical Basic FROM HOSPITAL CLÍNIC
To individualize the clinical management of
To advance in the development • The project “Impact of the threat of
FOR A BETTER DIAGNOSIS
women at risk of preterm birth by studying
of a non-invasive clinical solution premature birth and premature
intraamniotic infection/inflammation.
to diagnose intraamniotic rupture of membranes on fetal and
infection/inflammation in women neonatal neurodevelopment and
at risk of premature delivery
To evaluate the impact of intrauterine exposure cardiovascular system. Influence of
using technologies based on
to intraamniotic infection/inflammation at the
metabolomics, proteomics, intraamniotic inflammation”, that is
cardiovascular, neurological and developed by Clara Murillo, has
bacterial microbiome and
neurodevelopmental levels, in the fetus, received the “Ajudas Josep Font”
photonics.
newborn, 6 months and 1 year of life. award from Hospital Clínic.24 RESEARCH
Fetal
WHAT KIND OF FETAL THERAPIES DO WE
DEVELOP?
The main reason of our research team is to
therapy
prevent or treat pathologies of fetal origin. To this
end, we evaluate specific therapeutic strategies
with a potential neuroprotective effect that could
be useful in certain diseases of fetal origin, such as
intrauterine growth restriction (IUGR). Before
applying these therapies to clinical practice, we
evaluate their effects in animal models of IUGR.
WHAT WILL TECHNOLOGICAL ADVANCES ALLOW IN
FETAL SURGERY?
Research on new surgical procedures in the fetal
We want to develop new therapies and intrauterine environment will allow us to save more lives
treatments that overcome the limitations that have before birth and improve the prognosis of
babies with more serious conditions. For this,
existed up to now in fetal surgeries. we focus our work on developing technological
advances through robotics, photonics,
miniaturization and the use of sensors. Uniting
all these disciplines will allow us to improve the
results of the fetal surgeries that we currently
perform and create new treatments for the
problems that have no solution at the moment.
The use of ex vivo and experimental models is
ELISENDA EIXARCH Y MIRIAM ILLA key to achieving our objectives.
Coordinators of the research line. Maternal-Fetal
Medicine Specialists at BCNatal. Lecturers in specialized
courses of Fetal I+D Education Barcelona.
Coordinators
Elisenda Eixarch Predoctorals Clinical Research Fellows
Miriam Illa Alex Agyemang Diana Lip
Mirza Awais Marta Barenys
Posdoctorals Alexander Engels Master Students
Sergio Berdún David Basurto Technicians Cristina Baques
Narcís Masoller Molka Kammoum Sabrina Gea Paula Vazquez
Talita Micheletti Anna Rocabert Mari Carmen López
Maternal-Fetal Johanna Parra
Medicine Specialists Laura Pla Undergraduate Engineers
Mar Bennasar Ximena Torres Student Joan Junyent The line gathers medical specialists in fetal
Josep María Martínez Lucas Trigo Montse Mayol Rocío Lopez medicine, biologists and research technicians.ANNUAL REPORT 2018 25
Publications
• Early environmental enrichment enhances
IN 2018…
abnormal brain connectivity in a rabbit model
•W
e have shown that the •W
e have developed a surgical
of Intrauterine Growth Restriction. Illa M, Brito
administration of Lactoferrin and DHA planning system based on 3D
V, Pla L, Eixarch E, Arbat A, Batallé D,
during gestation and lactation reconstruction that allows us to
Muñoz-Moreno E, Crispi F, Udina E, Figueras F,
reduces the negative effects on brain improve the accuracy of the
Ginés S, Gratacós E. Fetal Diagnosis and development, secondary effects of surgeries in twin-to-twin
Therapy. 44(3):184-193 (2018). IUGR, in animal models. transfusion syndrome.
• Nutritional intra-amniotic therapy increases •W
e have described, for the first time in •W
e have developed the first prototype
survival in a rabbit model of fetal growth an experimental setting, the positive of the membrane sealing system that
restriction. Gümüs HG, Illa M, Pla L, Zamora M, effects of postnatal stimulation both on has proven to work well in ex vivo
Crispi F, Gratacos E. PLoS One. 13(2):e0193240 cerebral structure and function. models.
(2018).
• Genetic profile of isolated congenital
diaphragmatic hernia revealed by targeted diaphragmatic hernia. Van der Veeken L,
next generation sequencing. Kammoun M, Russo FM, De Catte L, Gratacos E, Benachi A,
Strategic
goals
Souche E, Brady P, Ding J, Cosemans N, Gratacos Ville Y, Nicolaides K, Berg C, Gardener G,
E, Devriendt K, Eixarch E, Deprest J, Vermeesch Persico N, Bagolan P, Ryan G, Belfort MA,
JR. Prenatal Diagnosis. 38(9):654-663 (2018). Deprest J. Gynecological Surgery. 15(1):9
(2018).
• Assessment of prenatal cerebral and cardiac
Collaborations
metabolic changes in a rabbit model of fetal FETAL THERAPY
growth restriction based on 13C-labelled
substrate infusions and ex vivo multinuclear Nationals: To evaluate the
HRMAS. Simões RV, Cabañas ME, Loreiro C, • Universitat Pompeu Fabra neuroprotective effect
of therapies in
Illa M, Crispi F, Gratacós E. PLoS One. • Instituto de Ciencias Fotónicas (ICFO)
Clinical/Basic
experimental models.
13(12):e0208784 (2018). • Instituto de Bioingeniería de Cataluña (IBEC)
• Institut Químic de Sarrià (IQS)
To perform a clinical
• Fetal MRI Synthesis via balanced auto- • Departamento de Biología Celular,
study to evaluate the
encoder based generative adversarial Inmunología y Neurociencias de la effectiveness of
networks. Torrents J, Piella G, Masoller N, Universitat de Barcelona (UB) different therapies.
Gratacos E, Eixarch E, Ceresa M, Ballester MAG.
Conference proceedings: IEEE Engineering in Internationals FETAL SURGERY
Medicine and Biology Society. 2018:2599- • University Hospitals Leuven, Belgium
• Institute of Mechanical Systems, Switzerland To validate the use of
Research Areas
2602 (2018).
• Leibniz Research Institute for Environmental a membrane sealing
• Segmentation and classification in MRI and US Medicine, Germany system in the clinical
setting.
fetal imaging: Recent trends and future • University of São Paulo, Brazil
prospects. Torrents J, Piella G, Masoller N,
To complete the
Engineering
Gratacós E, Eixarch E, Ceresa M, Ballester.
development of a
Medical Image Analysis. 51:61-88 (2019).
robotic assistance
system for fetal.
• Consensus definition and essential reporting
parameters of selective fetal growth restriction Robotics,
To implement the
in twin pregnancy: a Delphi procedure. Khalil
A, Beune I, Hecher K, Wynia K, Ganzevoort W,
photonics and use of a planning
Reed K, Lewi L, Oepkes D, Gratacos E, miniaturization will and guidance system
for fetal surgeries
Thilaganathan B, Gordijn SJ. Ultrasound in allow us to make a using computerized
Obstetrics & Gynecology. 53(1):47-54 (2018).
generational leap in image.
• Fetoscopic endoluminal tracheal occlusion and fetal surgeries
reestablishment of fetal airways for congenital26 RESEARCH
Environment
and pregnancy
complications
Discovering how environmental factors
such as exposure to tobacco, alcohol,
drugs and environmental toxins
influence growth retardation or other
pregnancy complications is our purpose. WHY IS IT IMPORTANT TO STUDY TOXIC EXPOSURE
IN PREGNANCY?
Toxic exposure during pregnancy can have serious
effects on fetal growth and neurodevelopment. It
is imperative to know the exposure of the mother
to substances of abuse (tobacco, alcohol, drugs)
LOLA GÓMEZ-ROIG and environmental toxins (air pollution, chemicals
Coordinator of the research line. Maternal-Fetal Medicine Specialists such as heavy metals, pesticides, and endocrine
and Head of the Department at BCNatal-Sant Joan de Déu Hospital. disruptors) during pregnancy in order to
Lecturer in specialized courses of Fetal I+D Education Barcelona. understand their effects on fetal development.
Coordinator
Lola Gómez-Roig
Postdoctorals
Silvia Ferrero
Edurne Mazarico
Miriam Perez Clinical Research Fellow
Giulia Casu
Predoctorals Marta Muniesa
Laura Almeida
Marc Cahuana Technician The line gathers fetal medicine specialists, pathologists,
Paz Ahumada Erica Muñoz Sanz biologists and research technicians.ANNUAL REPORT 2018 27
WHAT IS THE MAIN OBJECTIVE OF THE RESEARCH
LINE? Studying the influence of the environment on
Our objective is to characterize the effect of toxic pregnancy will help us to reduce its effects in
exposures to all these substances during
pregnancy to improve our knowledge about them
the prenatal and postnatal stages of the baby
and to predict pregnancy complications related to
environmental factors, such as IUGR.
SPECIAL ATTENTION IS PAYED TO THE EFFECTS OF Publications Collaborations
ALCOHOL CONSUMPTION DURING PREGNANCY,
WHAT ARE THE NEXT STEPS? • ( 1) Differential correlations between maternal Internationals
Our previous research indicates an incipient hair levels of tobacco and alcohol with fetal • Icahn School of Medicine, Mount Sinai
alcohol consumption in pregnant women. That is growth restriction clinical subtypes. Sabra S, Hospital, New York, USA
why we are carrying out a study to evaluate the Malmqvist E, Almeida L, Gratacos E, Gomez Roig
effectiveness of an intervention program based MD. Alcohol. 70:43-49 (2018). Nationals
on motivational interviewing during pregnancy. • Hospital de la Santa Creu i Sant Pau de
Our objetive? Decreasing alcohol consumption • Associations between neural injury markers of Barcelona
during pregnancy, as well as the deleterious intrauterine growth-restricted infants and • Instituto de Salud Global de Barcelona
effects on perinatal and infant health associated neurodevelopment at 2 years of age. Mazarico (IsGlobal)
with prenatal alcohol exposure. E, Llurba E, Cabero L, Sánchez O, Valls A, • Instituto de Salud Carlos III (ISCIII)
Martín-Ancel A, Cardenas D, Gómez Roig MD. • RD16/0022/0014, Red de Salud materno-
The Journal of Maternal-Fetal & Neonatal infantil y del desarrollo, Instituto de Salud
Medicine. 18:1-7 (2018). Carlos III (ISCIII)
• Institut de Recerca Sant Joan de Déu (IRSJD)
•M
aternal hair and neonatal meconium to • Cognitive Neuroscience Department,
assess gestational consumption and prenatal Brainlab, University of Barcelona
IN 2018…
exposure to drugs of abuse and psychoactive
drugs. Cortes L, Almeida L, Sabra S, Muniesa M,
Busardo FP, Garcia-Algar O, Gomez-Roig MD.
(1) We have published an article
Current Pharmaceutical Biotechnology.
evidencing the serious problem of
19(2):136-143 (2018).
alcohol consumption during
pregnancy. In this study, we
• Estimated fetal weight percentile as a tool to
detected the presence of ETG (a
metabolite of alcohol) in the hair of
predict collection of cord blood units with higher
cellular content: implications for prenatal Strategic
goals
a significant number of pregnant
selection of cord blood donors. Lin X,
women. For this reason, in 2018
we initiated an intervention study Torrabadella M, Amat L, Gómez S, Azqueta C,
in order to reduce alcohol Sánchez M, Cuadras D, Martínez Lorenzo MJ, Brull
JM, Gayà A, Cemborain A, Pérez Garcia C, Arroyo STUDYING PREDICTING
consumption in pregnant women.
J, Querol S, Gómez Roig MD. Transfusion. The effect of
58(7):1732-1738 (2018). exposure to
• W
e have participated in the “BiSC” environmental
Basic
(Barcelona Life Study Cohort) study, a • The effects of alcohol and drugs of abuse on pollutants
during El riesgo de
collaborative project of ISGlobal maternal mutritional profile during pregnancy. complicaciones
(Barcelona Institute for Global Health), Sebastiani G, Borrás-Novell C, Casanova MA, pregnancy
en el embarazo
Research Areas
BCNatal and Hospital de Sant Pau to Pascual Tutusaus M, Ferrero Martínez S, Gómez debido a
understand the effect of air pollution Roig MD, García-Algar O. Nutrients. 10(8) factores
on placental function, fetal growth, (2018). The exposure ambientales
to drugs of
and the cardiovascular and cerebral
abuse and
development of the fetus. Currently, • The frequency-following response (FFR) to environmental
Clinical
the group is in the recruitment phase speech stimuli: A normative dataset in healthy pollutants
of 600 volunteers who live in newborns. Ribas-Prats T, Almeida L, Costa- during
Barcelona and are in the first trimester Faidella J, Plana M, Corral MJ, Gómez-Roig MD, pregnancy
of the pregnancy. Escera C. Hearing Research. Epub 2018 Nov 9.28 RESEARCH
Placental We improve the diagnosis and
management of pregnancies with
disease
growth restriction to avoid possible
neurodevelopmental alterations.
FRANCESC FIGUERAS
Coordinator of the research line. Maternal Fetal Medicine
Specialists and Head of the Department at BCNatal-Hospital Clinic.
Lecturer in specialized courses of Fetal I+D Education Barcelona.
WHAT IS THE IMPACT OF THE INTRAUTERINE
GROWTH RESTRICTION ON BABIES?
Babies with IUGR have an increased risk of
complications before and after birth. But that is
not all; in addition, they may present
neurodevelopmental alterations. These, although
may be mild and may not have important
sequelae, are more and more frequently
recognized as family and social problems.
WHY IS PREVENTION IMPORTANT?
The evaluation of the longitudinal growth in
pregnancy is key to making an accurate prediction
of fetal growth restriction and its consequences.
The correct definition and diagnosis of IUGR is
especially important for fetal medicine, since it
will allow implementing preventive measures
during pregnancy and childbirth, as well as
Coordinator therapies during early childhood.
Francesc Figueras
ANOTHER AREA OF THIS LINE RESEARCH FOCUSES
Predoctorals
Tri Rahmat Basuki ON PREECLAMPSIA, ARE THERE NEW
Raigam Martínez DEVELOPMENTS?
Katerina Nedopekina Preeclampsia is the second cause of maternal
Anna Peguero death in the world. Today, thanks to research, its
Marta Rial
diagnosis is predictable and we continue to study
Clinical Research Fellow it to determine possible causes, such as its
Annalisa Cancemi supposed relationship with oocyte donation.
Javier Caradeux
Santiago Castelazo
Javiera Alejandra Fuenzalida This line gathers fetal medicine specialists,
Fernanda Paz y Miño psychologists and research technicians..ANNUAL REPORT 2018 29
IN 2018…
(1) We have mainly investigated the
role of longitudinal growth
assessment in the prediction of IUGR
and its consequences, which led to
the publication of 5 studies in Diagnosing Intrauterine Growth
indexed journals (which summarize
17 impact factor points) and the
Restriction allows us implementing
defense of 2 doctoral theses. preventive measures during pregnancy,
childbirth and early childhood
(2) In addition, the research about the
relationship between oocyte
donation and preeclampsia has
resulted in a doctoral thesis and the
publication of 2 additional studies.
Publications
• ( 1) Longitudinal growth assessment for • E vidence-based national guidelines for the Obstetrics & Gynecology. 53(4):481-487
prediction of adverse perinatal outcome in management of suspected fetal growth (2019).
fetuses suspected to be small-for-gestational restriction: comparison, consensus, and
age. Caradeux J, Eixarch E, Mazarico E, Basuki controversy. McCowan LM, Figueras F, •U
sing cerebroplacental ratio in non-SGA infants
TR, Gratacos E, Figueras F. Ultrasound in Anderson NH. American Journal of Obstetrics to predict adverse perinatal outcome: caution
Obstetrics & Gynecology. 52(3):325-331 & Gynecology. 218(2S):S855-S868 (2018). is required. Kumar S, Figueras F, Ganzevoort W,
(2018). Turner J, McCowan L. Ultrasound in Obstetrics &
•A
dded value of cerebro-placental ratio and Gynecology. 52(4):427-429 (2018).
• ( 2) Risk of fetal death in growth-restricted uterine artery Doppler at routine third
fetuses with umbilical and/or ductus venosus trimester screening as a predictor of SGA and • E ssential variables for reporting research
absent or reversed end-diastolic velocities FGR in nonselected pregnancies. Rial-Crestelo studies on fetal growth restriction - a Delphi
before 34 weeks of gestation: a systematic M, Martinez-Portilla RJ, Cancemi A, Caradeux J, consenus. Khalil A, Gordijn SJ, Beune IM, Wynia
review and meta-analysis. Caradeux J, Fernandez L, Peguero A, Gratacos E, Figueras F. K, Ganzevoort W, Figueras F, Kingdom J, Marlow
Martinez-Portilla RJ, Basuki TR, Kiserud T, The Journal of Maternal-Fetal & Neonatal N, Papageorghiou AT, Sebire N, Zeitlin J, Baschat
Figueras F. American Journal of Obstetrics & Medicine. 4:1-7 (2018). AA; Fetal Growth Restriction Minimum
Gynecology. 218(2S):S774-S782.e21 (2018). Reporting Set Working Group. Ultrasound in
• Risk of pre-eclampsia after fresh or frozen Obstetrics & Gynecology. [2018 Epub ahead or
• Longitudinal assessment of abdominal embryo transfer in patients undergoing oocyte print].
circumference versus estimated fetal weight in donation. Blazquez A, García D, Vassena R,
the detection of late Fetal Growth Restriction. Figueras F, Rodriguez A. European Journal of •R
isk of preeclampsia in pregnancies resulting
Basuki TR, Caradeux J, Eixarch E, Gratacós E, Obstetrics & Gynecology and Reproductive from double gamete donation and from oocyte
Figueras F. Fetal Diagnosis and Therapy. [2018 Biology. 227:27-31 (2018). donation alone. Blazquez A, García D, Vassena
Epub ahead or print]. R, Figueras F, Rodriguez A. Pregnancy
• Cerebroplacental ratio assessment in early Hypertension. 13:133-137 (2018).
• Diagnosis and surveillance of late-onset fetal labor in uncomplicated term pregnancy and
growth restriction. Figueras F, Caradeux J, Crispi prediction of adverse perinatal outcome: •M
aternal and perinatal outcomes after elective
F, Eixarch E, Peguero A, Gratacos E. American prospective multicenter study. Dall’Asta A, labor induction at 39 weeks in uncomplicated
Journal of Obstetrics & Gynecology. Ghi T, Rizzo G, Cancemi A, Aloisio F, Arduini D, singleton pregnancies: a meta-analysis.
218(2S):S790-S802.e1 (2018). Pedrazzi G, Figueras F, Frusca T. Ultrasound in Sotiradis A, Petousis S, Thilaganathan B,You can also read
