Teresa de Haro-Romero

Introduction: Our objective was to compare the predictive performance of the Fetal Medicine Foundation (FMF) competing‐risk model for preterm preeclampsia (PE) screening using placental growth factor (PlGF) measurements obtained at 11–13⁺⁶ weeks versus before 11 weeks of gestation.Material and Methods: This multicenter prospective cohort study included women with singleton pregnancies attending their routine first‐trimester assessment (11⁺⁰ to 13⁺⁶ weeks) in four hospitals across Spain from 2021 to 2023. Maternal characteristics, biophysical parameters (mean arterial pressure and uterine artery pulsatility index), and biochemical markers (PlGF measured twice in each woman, before 11 weeks and between 11 and 13⁺⁶ weeks) were assessed. Risk assessment for preterm PE was estimated by the FMF algorithm. Predictive performance was evaluated by comparing detection rates (DR) at different fixed screen‐positive rates (SPR), area under the receiver‐operating characteristic curve (AUROC), and calibration plots. Statistical adjustments were made to account for prophylactic aspirin use.Results: The study population comprised 3448 women, including 19 (0.55%) who developed preterm preeclampsia and 47 (1.36%) who developed term preeclampsia. At 10% SPR, the detection rates (adjusted for aspirin use) were highest for the model incorporating PlGF between 11 and 13⁺⁶ weeks (72.9%; 95% CI, 42.2%–90.9%), compared to models with PlGF before 11 weeks (66.4%; 95% CI, 39.9%–85.4%) and without PlGF (66.0%; 95% CI, 39.3%–85.3%). Similar trends were observed at higher SPR thresholds. The best discrimination (AUROC: 0.863; 95% CI, 0.754–0.971) and calibration were also achieved by the model using PlGF between 11 and 13⁺⁶ weeks.Conclusions: PlGF measured before 11 weeks did not improve preterm PE screening performance. Due to the small number of cases, further validation is needed. Maternal and biophysical markers remain a viable alternative when PlGF is unavailable.

Major concerns have been raised about human exposure to endocrine-disrupting chemicals (EDCs) during pregnancy. Effective methodologies for the assessment of this exposure are needed to support the implementation of preventive measures and the prediction of negative health effects. Meconium has proven a valuable non-invasive matrix for evaluating cumulative exposure to xenobiotics during the last two trimesters of pregnancy. The study objective was to develop a novel method to determine the presence in meconium of perfluoroalkyl substances (PFASs), bisphenols, parabens, and benzophenones, EDCs that are widely used in the manufacture of numerous consumer goods and personal care products, including cosmetics. Ten PFASs, two bisphenols, four parabens, and four benzophenones were measured in meconium samples prepared by using a combination of Captiva Enhanced Matrix Removal (EMR) lipid cartridges with salt-assisted liquid–liquid extraction (SALLE) and dispersive liquid–liquid microextraction (DLLME) before the application of liquid chromatography–tandem mass spectrometry (LC–MS/MS). Experimental parameters were optimized by applying different chemometric techniques. Limits of detection ranged from 0.05 to 0.1 ng g⁻¹, and between-day variabilities (relative standard deviations) ranged from 6.5% to 14.5%. The method was validated by matrix-matched standard calibration followed by a recovery assay with spiked samples, obtaining percentage recoveries of 89.9% to 114.8%. The method was then employed to measure compounds not previously studied in this matrix in 20 meconium samples. The proposed analytical procedure yields information on cumulative in utero exposure to selected EDCs.

α-Klotho protein is a powerful predictor of the aging process and lifespan. Although lowered circulating soluble α-Klotho levels have been observed in aged non-healthy individuals, no specific reference values across a wide range of ages and sex using an enzyme-linked immunosorbent assay (ELISA) are available for larger cohorts of healthy individuals. The present analytical cross-sectional study was aimed to establish the reference values of soluble α-Klotho serum levels in healthy adults by age and sex groups. A total of 346 (59% women) healthy individuals aged from 18 to 85 years were recruited. Subjects were divided by sex and age as: (i) young (18–34.9 years), (ii) middle-aged (35–54.9 years), and (iii) senior (55–85 years) individuals. The soluble α-Klotho levels were measured in serum using ELISA. Senior adults were the age-group that presented the lowest soluble α-Klotho serum levels (p < 0.01), with age showing a negative association with soluble α-Klotho serum levels (p < 0.001). No differences between sexes were observed. Therefore, soluble α-Klotho levels were especially decreased—regardless of sex—in our cohort of healthy individuals because of the physiological decline derived from the aging process. We recommend routine assessments of soluble α-Klotho levels using ELISA as a simple and cheap detectable marker of aging that improves quality of life in the elderly.