LISANDRA STEIN BERNARDES CIAMPI DE ANDRADE
Projetos de Pesquisa
Unidades Organizacionais
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
LIM/57 - Laboratório de Fisiologia Obstétrica, Hospital das Clínicas, Faculdade de Medicina
16 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 16
- Association between maternal exposure to air pollution before conception and sex determination in the city of Sao Paulo(2020) CARVALHO, Mariana Azevedo; HETTFLEISCH, Karen; RODRIGUES, Agatha S.; BENACHI, Alexandra; VIEIRA, Sandra Elisabete; SALDIVA, Silvia R. D. M.; SALDIVA, Paulo Hilario N.; FRANCISCO, Rossana Pulcineli Vieira; BERNARDES, Lisandra SteinIt has been widely demonstrated that air pollution can affect human health and that some pollutant gases can have negative impacts on female fertility rates and cause adverse obstetric outcomes, such as premature birth and low birth weight. Few studies have evaluated the impact of maternal exposure to urban air pollution on the number of female births. To evaluate the association between maternal exposure to air pollution during the year before conception and sex determination. This was a prospective study using low-risk pregnant women living in Sao Paulo, Brazil. The pollutants were measured by a fixed station during a 1-year period before conception. Sex was confirmed after birth. We used multiple logistic regression models to evaluate the association between the pollutants and the sex determination and to estimate the odds ratio (OR) and the 95% confidence interval (CI) of being female based on a quantitative increase in pollutant concentration. We evaluated 371 patients. Elevated exposure to nitrogen dioxide (NO2) and particulate matter lower than 10 mu m (PM10) prior to conception were associated with increased odds of being female. Each unit increase of NO(2)exposure increased the odds of being female by 8% (OR = 1.08, 95% CI = 1.02, 1.15,p = 0.008), and each unit increase of PM(10)increased the odds of being female by 14% (OR = 1.14, 95% CI 1.02 to 1.28,p = 0.021). In Sao Paulo, maternal exposure to pollutants was significantly associated with the odds of being female.
- Individual exposure to urban air pollution and its correlation with placental angiogenic markers in the first trimester of pregnancy, in Sao Paulo, Brazil(2021) HETTFLEISCH, Karen; CARVALHO, Mariana Azevedo; HOSHIDA, Mara Sandra; PASTRO, Luciana Duzolina Manfre; SALDIVA, Silvia Regina Dias Medici; VIEIRA, Sandra Elisabete; FRANCISCO, Rossana Pulcineli Vieira; SALDIVA, Paulo Hilario Nascimento; BERNARDES, Lisandra SteinPollution of the atmosphere is known that may lead to adverse obstetric outcomes, including fetal growth restriction, gestational hypertension, and preeclampsia. Such disorders are correlated with imbalances in angiogenic factors, which may also be involved in the pathological mechanism as the pollutants impact placental and maternal physiology. In the first trimester of gestation, this study assessed the outcomes of personal maternal short period exposure to air pollution on soluble fms-like tyrosine kinase 1 (sFlt1) and placental growth factor (PLGF) of pregnant women blood concentrations. This was a cross-sectional study, held in the city of Sao Paulo, Brazil, and conducted with low-risk pregnant women, who carried personal passive nitrogen dioxide (NO2) and ozone (O-3) monitors for about a few days preceding the ultrasound evaluation, and on this day, the venous blood sample was collected to measure the angiogenic factors sFlt1 and PLGF and their ratio (sFlt1/PLGF) by enzyme-linked immunosorbent assay (ELISA). By means of multiple regression models, the effect of the studied pollutants on the log-transformed concentrations of the angiogenic factors was evaluated. One hundred thirty-one patients were included. The log of the sFlt1/PLGF ratio increased with rising NO2 levels (p = 0.021 and beta = 0.206), and the log of the PLGF concentration showed a negative correlation with NO2 (p = 0.008 and beta = - 0.234). NO2, an indicator of the levels of primary air pollutants, presented significant positive correlation with an increased sFlt1/PLGF ratio and diminished PLGF levels, which may reflect an antiangiogenic state generated by air pollution exposure.
- Association between exposure to air pollution during intrauterine life and cephalic circumference of the newborn(2021) CARVALHO, Mariana Azevedo; HETTFLEISCH, Karen; RODRIGUES, Agatha S.; BENACHI, Alexandra; VIEIRA, Sandra Elisabete; SALDIVA, Silvia R. D. M.; SALDIVA, Paulo Hilario N.; FRANCISCO, Rossana Pulcineli Vieira; BERNARDES, Lisandra SteinIt has been observed that air pollution can affect newborn health due to the negative effects of pollutants on pregnancy development. However, few studies have evaluated the impact of maternal exposure to urban air pollution on head circumference (HC) at birth. Reduced head growth during pregnancy may be associated with neurocognitive deficits in childhood. The objectives of this study were to evaluate the association between maternal exposure to air pollution and HC at birth and to provide context with a systematic review to investigate this association. This was a prospective study of low-risk pregnant women living in Sao Paulo, Brazil. Exposure to pollutants, namely, nitrogen dioxide (NO2) and ozone (O-3), was measured during each trimester using passive personal samplers. We measured newborn HC until 24 h after birth. We used multiple linear regression models to evaluate the association between pollutants and HC while controlling for known determinants of pregnancy. To perform the systematic review, four different electronic databases were searched through November 2018: CENTRAL, EMBASE, LILACS, and MEDLINE. We selected longitudinal or transversal designs associating air pollution and HC at birth. Two reviewers evaluated the inclusion criteria and risk of bias and extracted data from the included papers. Thirteen studies were selected for the systematic review. We evaluated 391 patients, and we did not observe a significant association between air pollution and HC. Regarding the systematic review, 13 studies were selected for the systematic review, 8 studies showed an inverse association between maternal exposure to pollutants and HC, 4 showed no association, and one observed a direct association. In the city of Sao Paulo, maternal exposure to pollutants was not significantly associated with HC at birth. The systematic review suggested an inverse association between air pollution and HC at birth.
bookPart Procedimentos invasivos(2020) OSMUNDO JUNIOR, Gilmar de Souza; BERNARDES, Lisandra Stein; CARVALHO, Mário Henrique Burlacchini de; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, VictorbookPart Rastreamento das anomalias cromossômicas(2020) OSMUNDO JUNIOR, Gilmar de Souza; BERNARDES, Lisandra Stein; CARVALHO, Mário Henrique Burlacchini de; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, VictorbookPart Malformações fetais(2020) OSMUNDO JUNIOR, Gilmar de Souza; BERNARDES, Lisandra Stein; CARVALHO, Mário Henrique Burlacchini de; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, Victor- Pregnancy outcomes in severe polyhydramnios: no increase in risk in patients needing amnioreduction for maternal pain or respiratory distress(2016) KLEINE, Rodolpho Truffa; BERNARDES, Lisandra Stein; CARVALHO, Mariana Azevedo; CARVALHO, Mario Henrique Burlachini de; KREBS, Vera Lucia; FRANCISCO, Rossana Pulcineli VieiraIntroduction: Polyhydramnios is a common complication of fetal malformations and has been described to have high risk of pregnancy complications such as prematurity and placental abruption. In a subgroup of women severe polyhydramnios may lead to maternal dyspnea or untreatable pain, and amnioreduction is the procedure indicated to relieve those symptoms. There is a lack of information concerning the increase in the risk for the pregnancy when the procedure is indicated. Therefore, this study sought to evaluate the risk of complications in pregnancies with severe polyhydramnios that needed amnioreduction in relation to the basal risk for the pregnancy of having polyhydramnios without the need for the procedure.Materials and methods: Patients with singleton pregnancies and severe polyhydramnios followed in our fetal medicine center were evaluated retrospectively. Pregnancy complications (prematurity rate, fetal death, premature rupture of membranes, placental abruption and chorioamnionitis) were studied in the group of patients needing the procedure and their risk was compared to the risk of having a pregnancy with severe polyhydramnios but with no need for the procedure.Results: One hundred and thirty-five patients were evaluated. Forty-four patients (32.6%) needed amnioreduction. There was no increase in the risk of having complications when the procedure was needed OR=1.4 (CI 0.46-1.26).Conclusion: Amnioreduction performed to relieve maternal symptoms did not statistically increase the risk of pregnancy complications with severe polyhydramnios in single pregnancies.
- Short-Term Exposure to Urban Air Pollution and Influences on Placental Vascularization Indexes(2017) HETTFLEISCH, Karen; BERNARDES, Lisandra Stein; CARVALHO, Mariana Azevedo; PASTRO, Luciana Duzolina Manfre; VIEIRA, Sandra Elisabete; SALDIVA, Silvia R. D. M.; SALDIVA, Paulo; FRANCISCO, Rossana Pulcineli VieiraBackground: It has been widely demonstrated that air pollution can affect human health and that certain pollutant gases lead to adverse obstetric outcomes, such as preeclampsia and fetal growth restriction. Objectives: We evaluated the influence of individual maternal exposure to air pollution on placental volume and vascularization evaluated in the first trimester of pregnancy. Methods: This was a cross-sectional study on low-risk pregnant women living in Sao Paulo, Brazil. The women carried passive personal NO2 and O-3 monitors in the week preceding evaluation. We employed the virtual organ computer-aided analysis (VOCAL) technique using three-dimensional power Doppler ultrasound to evaluate placental volume and placental vascular indexes [vascularization index (VI), flow index (FI), and vascularization flow index (VFI)]. We analyzed the influence of pollutant levels on log-transformed placental vascularization and volume using multiple regression models. Results: We evaluated 229 patients. Increased NO2 levels had a significant negative association with log of VI (p = 0.020 and beta = -0.153) and VFI (p = 0.024 and beta = -0.151). NO2 and O-3 had no influence on the log of placental volume or FI. Conclusions: NO2, an estimator of primary air pollutants, was significantly associated with diminished VI and VFI in the first trimester of pregnancy.
bookPart Cirurgia fetal(2020) OSMUNDO JUNIOR, Gilmar de Souza; BERNARDES, Lisandra Stein; CARVALHO, Mário Henrique Burlacchini de; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, VictorbookPart Infecções congênitas(2020) OSMUNDO JUNIOR, Gilmar de Souza; BERNARDES, Lisandra Stein; CARVALHO, Mário Henrique Burlacchini de; FRANCISCO, Rossana Pulcineli Vieira; BUNDUKI, Victor