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 21

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Association of neuraxial labor analgesia with autism spectrum disorder in children: a systematic review and meta-analysis
(2022)
Lumbreras-Márquez, Mario Isaac
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Capdeville, G.
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Ferrigno, A.S.
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Villela-Franyutti, D.
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Bain, P.A.
Conflicting results exist on the association between neuraxial labor analgesia (NLA) exposure in parturients and autism spectrum disorder (ASD) risk in their children. An assessment of the occurrence and extent of published studies up to December 16, 2021, was performed via systematic review and meta-analysis to provide the most up-to-date information on the potential association between NLA and ASD.
1 11Scopus© Citations 4
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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
9Scopus© Citations 11
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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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Mindful meditation for epidural catheter placement during labor: a single-center randomized controlled trial
(Oxford University Press (OUP), 2025-06-16)
Lumbreras-Márquez, Mario Isaac
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Lazaridou, Asimina
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Villela-Franyutti, Diego
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Fields, Kara G.
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Farber, Michaela K.
Importance: Labor epidural placement can cause significant procedural anxiety for patients. Behavioral interventions, such as mindful meditation, can effectively reduce anxiety, including during pregnancy. Objective: This study aimed to assess the impact of a 10-minute mindful meditation session on anxiety and pain during labor epidural placement. Design, Setting, Participants, Intervention, and Outcome Measures: Pregnant women were recruited and randomized into 2 groups: A 10-minute guided mindful meditation, or a neutral content recording, both delivered via headphones before the epidural procedure as a recording. After the procedure, participants reported their levels of anxiety, pain, and satisfaction. Linear regression analyses were used to evaluate the main effects of the intervention on anxiety, pain, and satisfaction. Additionally, an exploratory post hoc moderation analysis assessed the role of baseline pain catastrophizing and its interaction with the intervention. Results: A total of 100 participants were included (50 per group). There were no overall main effect of mindful meditation on primary outcomes of anxiety and pain, or secondary outcome of procedural satisfaction, compared to the neutral content recording (P’s > .05). Exploratory post hoc analysis indicated a moderation of treatment effect, such that participants with higher baseline pain catastrophizing experienced greater benefits from mindful meditation compared to neutral content on anxiety (b = −0.18, P = .01) and pain (b = −0.14, P = .03). Conclusions and Relevance: While no overall group-level effects of mindful meditation were found, exploratory analysis suggested that the intervention may be more beneficial for participants with high baseline pain catastrophizing. Future studies enrolling a larger sample, or enriching for patients with these characteristics are needed to confirm these results. ©The authors ©Oxford University Press.
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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.
10 2
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Episiotomy Decision‐Making and Perceived Consequences: A Qualitative Study From Two Public Hospitals in Mexico
(Wiley, 2026)
Jaimes‐Jiménez, Ithandehui
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Valtierra‐Gutiérrez, Erika Sofia
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González‐De Ita, Rodrigo A.
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Caballero‐Torres, Luis Ernesto
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González‐Ledesma, Arturo
Introduction: Episiotomy remains a widely performed procedure in many countries, despite international recommendations favoring a restrictive approach. In Mexico, high rates persist in several settings, including public hospitals. Understanding the factors that sustain this practice is key to designing evidence-based respectful birth care strategies. This study aimed to explore healthcare professionals' perspectives on the decision-making process, performance, and perceived consequences of episiotomy, and to engage them in the co-design of behavioral science–informed interventions to promote its restrictive use. Methods: A two-phase qualitative study was conducted in two public hospitals in Mexico, as part of a broader project aimed at promoting the restrictive use of episiotomy. In Phase 1, we conducted 22 semi-structured interviews with maternal health care workers, selected through purposive sampling. Interviews were analyzed inductively using iterative coding and thematic grouping. In Phase 2, group interviews were conducted to discuss findings and collaboratively design interventions for a future pilot quasi-experimental study. Results: Episiotomy decisions are often guided by clinical and preventive considerations. Non-clinical factors, including productivity burdens and training, also contributed to the high rates of episiotomy. Despite the absence of formal institutional monitoring of episiotomy rates, professionals expressed a strong interest in receiving feedback and training. Conclusion: Episiotomy practices in this setting are influenced by clinical, systemic, and educational factors. Addressing potential overuse of episiotomy requires institutional feedback systems, evidence-based training, and strategies to improve dignity in care. Engaging stakeholders through a participatory approach helps ensure that potential interventions are contextually relevant and feasible to implement. ©the authors © Wiley.
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Second-Line Uterotonics for Uterine Atony
(Lippincott, Williams & Wilkins, 2024)
Cole, Naida M.
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Kim, Jimin J.
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Lumbreras-Márquez, Mario Isaac
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Fields, Kara G.
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Mendez-Pino, Laura
Objective: To evaluate the comparative efficacy of two of the most commonly used second-line uterotonics—methylergonovine maleate and carboprost tromethamine. Methods: We conducted a double-blind randomized trial at two large academic perinatal centers in patients undergoing nonemergency cesarean delivery with uterine atony refractory to oxytocin, as diagnosed by the operating obstetrician. The intervention included administration of a single dose of intramuscular methylergonovine or carboprost intraoperatively at diagnosis. The primary outcome, uterine tone on a 0–10 numeric rating scale 10 minutes after study drug administration, was rated by operating obstetricians blinded to the drug administered. Secondary outcomes included uterine tone score at 5 minutes, administration of additional uterotonic agents, other interventions for uterine atony or hemorrhage, quantitative blood loss, urine output, postpartum change in serum hematocrit, transfusion, length of hospital stay, adverse drug or transfusion reactions, and postpartum hemorrhage complications. A sample size of 50 participants per group was planned to detect a 1-point difference (with estimated within-group SD of 1.5) in the mean primary outcome with 80% power at a two-sided α level of 0.05 while accounting for potential protocol violations. © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.
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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.
10 8Scopus© Citations 1
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Fetal cardiac rhabdomyomas susceptible to prenatal treatment with mTOR inhibitors: literature review and proposal of a prenatal management algorithm
(Frontiers Media SA, 2025)
Martinez-Garcia, Alfonso
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Tirado-Aguilar, Omar A.
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Acevedo-Gallegos, Sandra
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Gallardo-Gaona, Juan M.
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Velazquez-Torres, Berenice
Certain types of fetal cardiac rhabdomyomas can lead to severe complications, including intrauterine death, yet no specific criteria have been established for the prenatal use of pharmacological therapies to mitigate the impact of rhabdomyomas. We conducted a narrative review of case reports and case series published between January 1, 2000, and February 28, 2025, identified through PubMed, Scopus, Web of Science, and Google Scholar, describing the prenatal use of mammalian target of rapamycin inhibitors in this context. Thirteen studies reporting on 15 fetuses were included. Five fetuses (33.3%) had a single rhabdomyoma, and 10 (66.6%) had multiple lesions. Prenatal genetic testing for Tuberous Sclerosis Complex was performed in 9 cases (60%): 1 with a TSC1 mutation, 7 with TSC2 mutations, and 1 negative. Sirolimus was the most frequently used inhibitor (86.6%), while everolimus was used in 2 cases (13.3%). The main indication for treatment was progressive tumor growth causing outflow obstruction and/or hemodynamic compromise, including reduced cardiac output, arrhythmias, and fetal hydrops. Therapy was initiated at a median of 30.0 weeks (IQR 26.7–33.1) and completed at 38.0 weeks (IQR 36–39). All reports documented tumor reduction and improved cardiac function, though regrowth occurred in 5 cases (33.3%) after discontinuation. No fetal or neonatal deaths were reported, and none required postnatal cardiac surgery before discharge. Based on these findings, we proposed echocardiographic criteria to identify suitable candidates, including inflow/outflow tract obstruction, severe atrioventricular valve insufficiency, tachyarrhythmia, impaired cardiac function, or hydrops, and developed a structured prenatal management algorithm. Prenatal therapy with mTOR inhibitors, therefore, appears to improve fetal cardiac function by reducing tumor burden and may contribute to better perinatal outcomes, although validation in future studies is required. TSC1: urn:lsid:hgnc.org: HGNC:12362 TSC2: urn:lsid:hgnc.org: HGNC:12363 Sirolimus: urn:lsid:ebi.ac.uk:chebi:9168 Everolimus: urn:lsid:ebi.ac.uk:chebi:68478. ©The authors ©Frontiers Media SA.
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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.
15Scopus© Citations 20

Lumbreras-Márquez, Mario Isaac

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