Lumbreras-Márquez, Mario Isaac

Main Affiliation

Facultad de Ciencias de la Salud - CampCM

Preferred name

Official Name

Lumbreras Márquez, Mario Isaac

ORCID

0000-0002-5378-5724

Researcher ID

AAZ-5337-2021

Scopus Author ID

55938270900

Now showing 1 - 10 of 20

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Survival assessment in extremely preterm neonates in a middle-income setting
(Frontiers Media SA, 2025)
Rodriguez-Sibaja, Maria J.
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Herrera-Ortega, Olivo
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Lumbreras-Márquez, Mario Isaac
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Morales-Barquet, Deneb
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Acevedo-Gallegos, Sandra
Introduction: Globally, an estimated 15.1 million preterm neonates are born annually, with 1% classified as extremely preterm (i.e., <28.0 weeks of gestation). The survival and outcomes of this vulnerable population are influenced by multiple factors, particularly gestational age, birth weight, and available medical resources. This study aimed to describe the hospital discharge survival of extremely preterm infants born in a middle-income setting. As a secondary objective, we assessed the neonatal morbidity associated with this group.Material and methods: In this cross-sectional study of singleton pregnancies, neonatal survival following extremely preterm birth was determined using three different denominators and expressed as prevalence (i.e., percentages): (1) the total number of extremely preterm births, including intrapartum fetal deaths; (2) the total number of all live births, including neonatal deaths in the delivery room, and (3) the total number of preterm neonates admitted to the neonatal intensive care unit (NICU). Neonatal morbidity was assessed as a secondary outcome.Results: There were no live births between 22.0 and 23.6 weeks of gestation. Overall mortality decreased with increasing gestational age, from 100% (22/22) at <24.0 weeks of gestation to 87% (14/16), 42% (16/38), and 21% (11/52) at a gestational age of 25, 26, and 27 weeks, respectively. The survival rate to NICU discharge among extremely preterm infants was 49% (65/132), 67% (65/97), and 69% (65/93), depending on whether survival was calculated based on all births, all live births, or NICU admissions, respectively. None of the neonates born before 24.6 weeks of gestation survived to discharge. Notably, 97.0% of NICU survivors were diagnosed with major morbidity.Conclusion: The survival rate at NICU discharge exceeds 50% from 26 weeks onwards in a middle-income setting. Importantly, survival rates varied significantly depending on the denominator used, highlighting the need to carefully select inclusion criteria in neonatal survival analyses. Notably, survival after extremely preterm birth was associated with significant morbidity. ©The authors ©Frontiers in Pediatrics.
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Risk factors for autoimmune liver disease recurrence after liver transplantation
(Baishideng Publishing Group Inc., 2025)
Salgado-de la Mora, Moisés
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Mendez-Guerrero, Osvely
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Torre, Aldo
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Vilatoba, Mario
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Castro Narro, Graciela E
Background: Autoimmune liver disease (AILD) recurrence is common after liver transplantation (LT). While several risk factors for recurrence have been identified, their combined predictive value has yet to be thoroughly investigated. Aim: To evaluate the combined predictive value of clinical and laboratory risk factors for AILD recurrence after LT. Methods: This retrospective cohort study included 79 patients with AILD who underwent LT at a single liver transplant center. We compared clinical and laboratory variables between patients with and without recurrent disease and assessed the predictive performance of these factors using four logistic regression models and their corresponding area under the receiver operating characteristic curve (AUC). Results: Recurrent AILD occurred in 26.58% of patients (95%CI: 17-38), the median time to recurrence was 28 months (interquartile range: 16-38). Patients with recurrent AILD had significantly higher pre-transplant Child-Pugh scores [11.61 ± 1.16 vs 10.58 ± 1.96 points; odds ratio (OR) = 1.43, 95%CI: 1.03-2.00; P = 0.032] and model for end-stage liver disease score (MELD) (22.76 ± 5.47 vs 18.81 ± 7.24 points; OR = 1.08, 95%CI: 1.01-1.16; P = 0.032), compared to those without recurrence. Additionally, baseline alanine aminotransferase (ALT) > 2 times the upper limit of normal (ULN) was significantly associated with recurrence (31% vs 57.1%; OR = 2.96, 95%CI: 1.06-8.28; P = 0.038). Our models, incorporating several risk variables, demonstrated moderate predictive ability for AILD recurrence. The AUCs were as follows: (1) Model 1 (AUC = 0.75, 95%CI: 0.58-0.87); (2) Model 2 (AUC = 0.74, 95%CI: 0.59-0.90); (3) Model 3 (AUC = 0.72, 95%CI: 0.58-0.88); and (4) Model 4 (AUC = 0.63, 95%CI: 0.40-0.76), with no statistically significant difference between the models (P = 0.488). Conclusion: Higher pre-transplant Child-Pugh and MELD scores, as well as ALT > 2 ULN, were associated with an increased risk of AILD recurrence. ©The authors ©Baishideng Publishing Group Inc.
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Reply: Enhancing diagnostic approaches for placental dysfunction in fetal growth restriction
(Elsevier BV, 2025)
Rodriguez-Sibaja, Maria J.
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Lopez-Diaz, Jimena
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Lumbreras-Márquez, Mario Isaac
We appreciate Dr Carbillon's insightful commentary on our study comparing the performance of the International Society of Ultrasound in Obstetrics and Gynecology and the Society for Maternal-Fetal Medicine definitions of fetal growth restriction (FGR) in identifying maternal vascular malperfusion (MVM) lesions and adverse neonatal outcomes.1 His insights into the role of Doppler studies and angiogenic biomarkers in placental dysfunction diagnostics highlight important considerations for advancing FGR assessment. However, our study focused on the histopathological confirmation of MVM lesions associated with the FGR definitions mentioned above. We agree with Dr Carbillon that integrating uterine artery Doppler and angiogenic biomarkers, such as placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1–to–PlGF ratio, into the diagnostic framework for FGR could enhance the diagnostic precision of FGR and placental dysfunction, as supported by recent research and international guidelines. ©The authors ©American Journal of Obstetrics & Gynecology MFM ©Elsevier.
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Early Initiation of Low-Dose Aspirin in Pregnancy: Clarifying Safety Analyses from the ASPIRIN Trial
(Elsevier BV, 2026)
Rodriguez-Sibaja, Maria J.
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Lumbreras-Márquez, Mario Isaac
No abstract available.
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Fetal and Neonatal Outcomes in Fetuses with an Estimated Fetal Weight Percentile of 10–20 in the Early Third Trimester: A Retrospective Cohort Study
(MDPI AG, 2025)
Mendez-Piña, Miguel A.
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Lumbreras-Márquez, Mario Isaac
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Acevedo-Gallegos, Sandra
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Velázquez-Torres, Berenice
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Rodriguez-Sibaja, Maria J.
first_pagesettingsOrder Article Reprints Open AccessArticle Fetal and Neonatal Outcomes in Fetuses with an Estimated Fetal Weight Percentile of 10–20 in the Early Third Trimester: A Retrospective Cohort Study by Miguel A. Mendez-Piña 1ORCID,Mario I. Lumbreras-Marquez 1,2,Sandra Acevedo-Gallegos 1,Berenice Velazquez-Torres 1ORCID,Maria J. Rodriguez-Sibaja 1,Dulce M. Camarena-Cabrera 1 andJuan M. Gallardo-Gaona 1,*ORCID 1 Maternal-Fetal Medicine Department, Instituto Nacional de Perinatologia, Mexico City 11000, Mexico 2 Department of Epidemiology and Public Health, Universidad Panamericana School of Medicine, Mexico City 03920, Mexico * Author to whom correspondence should be addressed. Diagnostics 2025, 15(17), 2251; https://doi.org/10.3390/diagnostics15172251 Submission received: 12 June 2025 / Revised: 1 August 2025 / Accepted: 1 August 2025 / Published: 5 September 2025 (This article belongs to the Special Issue Diagnosis and Management of Contemporary Issues in Maternal-Fetal Medicine) Downloadkeyboard_arrow_down Browse Figures Review Reports Versions Notes Abstract Background: Fetal size is often dichotomized as normal or abnormal using the 10th percentile of estimated fetal weight (EFW) or abdominal circumference as a cutoff. While the risk of adverse perinatal outcomes decreases with increasing fetal weight percentile, no percentile completely eliminates that risk. Objective: The aim of this study was to compare perinatal outcomes between fetuses with an EFW between the 10th and 20th percentiles and those with an EFW between the 20th and 90th percentiles (i.e., >20 and <90) at the beginning of the accelerated growth stage (28.0–30.0 weeks’ gestation). Methods: We conducted a retrospective cohort study of singleton pregnancies managed at a quaternary center in Mexico City (2017–2024). Outcomes were compared based on EFW percentiles at 28.0–30.0 weeks. The primary outcome was adverse neonatal outcome (ANeO), defined as the presence of at least one of the following: umbilical artery pH ≤ 7.1, 5 min Apgar ≤ 7, NICU admission, early neonatal hypoglycemia, non-reassuring fetal status, respiratory distress syndrome, intraventricular hemorrhage, hypoxic–ischemic encephalopathy, or perinatal death. Secondary outcomes included progression to fetal growth restriction (FGR) and low birth weight. Modified Poisson regression was used to estimate adjusted risk ratios (aRRs) with 95% confidence intervals (CIs). Results: Among 650 cases, ANeO occurred in 45.8% of fetuses in the 10th–20th percentile group vs. 29.4% in the 20th–90th percentile group (aRR: 1.51, 95% CI: 1.22–1.86; p < 0.001). FGR and low birth weight were also more frequent in the 10th–20th percentile group (21.1% and 27.6% vs. 6.4% and 5.8%, respectively; p < 0.001). Conclusions: Fetuses between the 10th and 20th percentiles at 28–30 weeks have increased risks of neonatal morbidity, FGR, and low birth weight. ©The authors ©Diagnostics © MDPI AG.
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Maternal, fetal, and neonatal serious adverse events associated with low-dose aspirin during the first trimester of pregnancy: A secondary analysis of the Aspirin Supplmentation for Pregnancy Indicated Risk Reduction In Nulliparas (ASPIRIN) trial
(Elsevier BV, 2025)
Rodriguez-Sibaja, Maria J.
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Gálvez Rubalcava, Natalia
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Hagerman-Sucar, Gonzalo
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Alcocer González-Camarena, Paulina
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Gómez Woodworth, Juan Ramón
Background: Low-dose aspirin (LDA) has been shown to reduce the risk of preterm preeclampsia, particularly when initiated early in pregnancy. However, the safety of starting LDA before 11 0/7 weeks of gestation remains unclear. Objective: To assess whether initiating LDA before 11 0/7 weeks of gestation is associated with increased maternal, fetal, or neonatal serious adverse events compared to later initiation. Study Design: This secondary analysis of the ASPIRIN (Aspirin Supplmentation for Pregnancy Indicated Risk Reduction In Nulliparas) trial included 11,879 nulliparous women with singleton pregnancies randomized to receive LDA (81 mg/d) or placebo between 6 0/7–13 6/7 weeks of gestation. Severe adverse events (ie, maternal death, antepartum hemorrhage, postpartum hemorrhage, anemia, preeclampsia or eclampsia, preterm labor, hypertension admission, fever or infection, fetal loss, neonatal death up to 28 days, miscarriage, abortion, or medical termination of pregnancy, and congenital anomalies) were analyzed based on gestational age at LDA initiation (<11 0/7 vs ≥11 0/7 weeks). Furthermore, congenital anomalies were assessed for therapy initiated during the embryonic (ie, <9 0/7 weeks) or fetal period. Interaction tests were performed via logistic regression models on the ASPIRIN trial safety population (ie, participants who received at least one dose of LDA or placebo) and on the subset of participants who had an adherence to the exposure of ≥90%. Results: Among the 11,879 eligible participants for this secondary analysis, 62% (n=7324) initiated the allocated exposure before 11 0/7 weeks vs 38% (n=4555) that initiated LDA or placebo at a later gestational age. Furthermore, in this population, 84.4% (n=10,030) had an adherence to the intervention of 90% or more. Moreover, the proportion of adherence of ≥90% to LDA or placebo was similar between strata (84.6% [n=6195] for <11 0/7 vs 84.2% [n=3835] ≥11 0/7 weeks, P=.570). No significant differences were observed in the maternal, fetal, or neonatal adverse events described above based on the timing of LDA initiation (P>.05 for all interactions). Likewise, congenital anomalies did not significantly differ between embryonic and fetal exposure periods (interaction P-value = .095). Results remained consistent in participants who had an adherence to the exposure of ≥90%. Conclusions: LDA (81 mg/d) initiated before 11 0/7 weeks of gestation may not increase the risk of maternal, fetal, or neonatal serious adverse events or congenital anomalies. These findings provide reassuring evidence of the safety of LDA exposure during early pregnancy. ©The authors ©American Journal of Obstetrics & Gynecology MFM © Elsevier BV.
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Labor Analgesia Initiation With Dural Puncture Epidural Versus Conventional Epidural Techniques: A Randomized Biased-Coin Sequential Allocation Trial to Determine the Effective Dose for 90% of Patients of Bupivacaine
(2023)
Ayumi Maeda
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Diego Villela-Franyutti
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Lumbreras-Márquez, Mario Isaac
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Anarghya Murthy
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Kara G. Fields
The dural puncture epidural (DPE) technique has a faster onset, better sacral spread, and improved bilateral coverage when compared to the conventional epidural (EPL) technique. Whether these qualities translate into a lower bupivacaine dose to provide initial analgesia is unknown. We sought to determine the effective dose of bupivacaine to achieve initial (first 30 minutes) labor analgesia in 90% of patients (ED90) with the DPE and EPL techniques, using a biased-coin, sequential allocation method. A total of 100 women of mixed parity with term, singleton gestation at ≤5 cm dilation with no major comorbidities were randomized to receive a DPE or an EPL technique. An experienced anesthesiologist performed these techniques and administered an allocated dose of plain bupivacaine diluted with isotonic sterile 0.9% saline to a total volume of 20 mL via the EPL catheter. Bupivacaine doses for each subject were determined by the response of the previous subject, using a biased-coin sequential allocation method, with success defined by a numeric rating scale (NRS) < 3 at 30 minutes. Outcome assessments were performed by an investigator blinded to the technique and bupivacaine dose. Sensory and motor blockade and maternal or fetal side effects were recorded every 5 minutes for the first 30 minutes. The ED90 of bupivacaine with each technique was estimated using centered isotonic regression. A total of 95 women were included in the final analysis. The ED90 of bupivacaine was estimated at 29.30 mg (90% confidence interval [CI], 28.55–31.56) with a DPE technique and 45.25 mg (90% CI, 42.80–52.03) with an EPL technique. Using a biased-coin, sequential allocation method, the DPE technique requires less bupivacaine to achieve effective initial analgesia (ED90) when compared to the EPL technique.
Scopus© Citations 5 22
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Placental pathology lesions: International Society for Ultrasound in Obstetrics and Gynecology vs Society for Maternal-Fetal Medicine fetal growth restriction definitions
(2024)
Maria J. Rodriguez-Sibaja
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Ana J. Lopez-Diaz
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Maria Y. Valdespino-Vazquez
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Sandra Acevedo-Gallegos
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Yubia Amaya-Guel
24
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Intended delivery mode and neonatal outcomes in pregnancies with fetal growth restriction
(2023)
Rodriguez-Sibaja, Maria J.
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Mendez-Piña, Miguel A.
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Lumbreras-Márquez, Mario Isaac
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Acevedo-Gallegos, Sandra
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Velazquez-Torres, Berenice
Objective: To compare neonatal outcomes in pregnancies with fetal growth restriction (FGR) by intended delivery mode.Methods: This is a retrospective cohort study of singleton pregnancies with FGR that were delivered ≥34.0 weeks gestation. Neonatal outcomes were compared according to the intended delivery mode, which the attending obstetrician determined. Of note, none of the subjects had a contraindication to labor. Crude and adjusted odds ratios (ORs) and corresponding confidence intervals (CIs) were calculated via logistic regression models to assess the potential association between intended delivery mode and neonatal morbidity defined as a composite outcome (i.e. umbilical artery pH ≤7.1, 5-min Apgar score ≤7, admission to the neonatal intensive care unit, hypoglycemia, intrapartum fetal distress requiring expedited delivery, and perinatal death). A sensitivity analysis excluded intrapartum fetal distress requiring emergency cesarean delivery from the composite outcome since only patients with spontaneous labor or labor induction could meet this criterion. Potential confounders in the adjusted effects models included maternal age, body mass index, hypertensive disorders, diabetes, FGR type (i.e. early or late), and oligohydramnios.
Scopus© Citations 1 10 1
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Cumulative sum learning curve for cordocentesis among maternal‐fetal medicine fellows in a low‐cost simulation model
(Wiley, 2024)
Pérez-Estrada, Bibiana A.
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Acevedo-Gallegos, Sandra
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Lumbreras-Márquez, Mario Isaac
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Gardner, Roxane
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Gallardo, Juan Manuel
Objective: To determine the individual learning curves for cordocentesis in a low-cost simulator for maternal-fetal medicine (MFM) fellows. Methods: This observational, descriptive, educational, and prospective study was performed from July through November 2022. After an introductory course based on a standardized technique for cordocentesis, each second-year MFM fellow who accepted to participate in the study performed this procedure using a low-cost simulation model, and experienced operators supervised the cordocenteses. Learning curves were then created using cumulative sum analysis (CUSUM). Copyright © 1999-2024 John Wiley & Sons.
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Lumbreras-Márquez, Mario Isaac

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