Dona i Salut (DiS), translated as 'Woman & Health' in English, is a research group that aims to integrate all the proposals regarding women as subjects of study. This team gathers diverse and complementary professional profiles, including gynaecologists, obstetricians, midwives, and nurses from the Hospital Germans Trias. Their primary objective is to establish a consistent network with other institutions within the Direcció Clínica Territorial Metropolitana Nord, and in particular the GRASSiR Group, a Research Group in Sexual and Reproductive Health Care.
Even though their projects include a wide range of approaches, from oncology to obstetric violence, they are firmly dedicated to embedding a clear and distinct gender perspective within all their study areas. The vertebral axis that defines this research group is an integral and respectful consideration of women, particularly in terms of sexual and reproductive health rights. Additionally, the group is committed to developing and promoting a new research methodology that acknowledges gender dimension as an essential cornerstone in each one of its projects.
Keywords: Women, health, pregnancy, oncology, gynecology, obstetrics.
Metabolic fetal programming
PI: Inés Velasco
Our most recent line of research is focused on adverse intrauterine environments and the subsequent development of deleterious metabolic pathways during human development. We currently carry on a prospective study to look into the metabolic disturbances in the progeny in cases of maternal obesity as proinflammatory ambient or maternal diabetes as a paradigm of insulin resistance.
Thyroid function, micronutrients and pregnancy
PI: Inés Velasco
Over the last decade, our group has published different articles regarding the physiology of thyroid gland during gestation, as well as the role of several micronutrients (iodine and selenium) on fetal neurodevelopment. The maternal-fetal transfer of iodine or selenoproteins have been thoroughly studied. We also carried out interventional studies with iodine supplementation in healthy pregnant women.
Since 2015, we have been recruiting a cohort of almost 600 mother-baby pairs called "Thyrotest". This observational prospective design, implies an ambitious follow-up: from early stages of pregnancy to one month after birth. Data concerning diet, physical activity and use of supplements have been collected to elucidate their implication in maternal thyroid function and perinatal wellbeing.
Preeclampsia and pro-angiogenic factors
PI: Marta Ricart
Impact and Effectiveness of strategies for screening of preeclampsia. Our group is currently involved in several multicentre studies such as Stop-PRE (Dra Marta Ricart), GRAFD (Dr Iván Hurtado), PE-37 (Dra Vanesa Parriego). Stop-PRE is a Phase III, Multicenter, Randomized, Open-label, Parallel Group Clinical Trial to Detect False Positive Screening for First Trimester Preeclampsia (StopPRE) in the Second Trimester of Pregnancy. Now, Dra Ricart will assess the cost-effectiveness of the screening in a sensitivy analysis obtained from the Stop-PRE study. Dr Hurtado has been studying the role of angiogenic factors in the management of Fetal Growth Restriction at term. Additionally, Dra Parriego will represent HGTiP as partner in the PE-37 study, which is an observational study to analyse the screening of late preeclampsia in third trimester.
COVID and gestation
PI: Laia Pratcorona
Dr Laia Pratcorona is leading the epidemiological surveillance of this pandemic in our unit (COMBAT study), monitoring the incidence of emergent complications, and registering maternal and neonatal outcomes in women infected by SARS-CoV-2 during pregnancy and/or labor.
PI: Bea Lorente
Dra Beatriz Lorente, in collaboration with the Spanish Marcé Society (MARES), is going to develop an interventional (before-after) study among healthcare professionals to offer a better understanding of the main pitfalls and weaknesses in our common clinical practice in terms of obstetric violence. Additionally, we are recruiting participants for an observational cohort study of women who previously gave birth in our hospital.
Telemedicine in obstetrics
PI: Laia Pratcorona
Design and development of new apps or strategies to provide tele-assistance to pregnant women according to their needs. We will set up an interventional study in obese and diabetic pregnant women (Dra Laia Vidal). Additionally, there is a pilot study to assess uterine contractions and fetal heart frequency by tele-monitoring (Laura Tarrats).
PI: Sergio Martínez
Participation in different trials in phase I (MK-5890-001), phase II (W042017) and phase III (Tesaro First and GEICO 69-0/ANITA) to assess innovative therapies and strategies in ginecological cancer. Validation of a protocol for sentinel node in case of endometrial cancer and studies concerning PARP inhibitors in ovarian cancer (Ovarisec and iPARPresist).
PI: Rosana Díaz
Dra Carla Lecumberri is involved in a multicenter study regarding the usefulness of intraoperative test of Human Papillomavirus (HPV) in patients with high-grade cervical intraepithelial neoplasia (CIN2-3). In Pelvic Floor, Dra Rosana Diaz is participating in a proof of concept (PEXIA2020) of pectopexia versus sacropexia as tretatment of female genital prolapse.
Mammary gland and breastfeeding
PI: Miguel Ángel Luna
Dr Miguel Ángel Luna is involved as local PI in different multicenter studies focused in breast cancer: from assessment of new diagnostic tools (fluorescence-mode confocal microscopy, microenvironment-based diagnosis) to analysis of treatment proceedings in breast cancer patients.
A successful breastfeeding experience is an absolute challenge in breast cancer survivors. Isabel Navarri-Ramos is conducting an innovative study with a mixed design (qualitative and quantitative) to obtain a valuable insight from these women, in order to pinpoint the attitudes and obstacles that they found when decided to breastfeed their babies.
Characterization of Adverse Metabolic Programming Scenarios: Role of Maternal Metainflammation in Fetal Metabolic Imprinting
PI: Berta Soldevila & Inés Velasco
Funding agency: ISCIII
Agency code: PI22/01350
Start date: 01/01/2023
End date: 31/12/2025
Fetal metabolic programming is the adaptive response of the fetus to the circumstances (genetic, nutritional, environmental) that it encounters in the mother and/or in the placenta, and which have consequences for the rest of the individual's life. From pregnant women with an altered metabolic profile, we will analyse those parameters (clinical and biochemical) linked to complications in the offspring. Objectives: To identify pathological routes of metabolic imprinting in early stages of fetal development, from intrauterine environments of metainflammation and metabolic dysregulation, such as maternal obesity and pregestational diabetes.
Involvement of maternal thyroid function in foetal metabolic programming
PI: Manel Puig & Inés Velasco
Funding agency: ISCIII
Agency code: PI18/01857
Start date: 01/01/2018
End date: 30/06/2023
Thyroid hormones intervene in key processes of intrauterine growth and development, as well as in processes of metabolic regulation in adults. However, the role of maternal thyroid hormones as an epigenetic modulator of fetal metabolic programming has not been elucidated. Objectives: To analyze the implication of maternal and neonatal thyroid function in different metabolic programming scenarios, as well as the identification of early detection markers of energy expenditure and epigenetic interest.
Role of thyroid autoimmunity in adverse metabolic programming scenarios. TODAY study (Thyroid-Obesity-Diabetes Adequate Yield)
PI: Inés Velasco
Funding agency: Fundación Merck Salud
Agency code: Merck Grants for clinical research 2022
Start date: 01/01/2022
End date: 31/12/2023
Thyroid autoimmunity (AIT) is present in about 5-15% of women of childbearing age. Obesity aggravates the pathogenic effect of AIT, increasing the risk of hypothyroidism and, conversely, the presence of anti-thyroid antibodies determines the activity of adipose tissue. Similarly, positivity for antithyroid antibodies is more frequent in type I diabetes and, probably, in gestational diabetes. This project aims to elucidate the role of AIT during pregnancy, especially in adverse situations of fetal programming (proinflammatory environment, insulin resistance), and its involvement in the epigenetic regulation and metabolic profile of newborns.
Arias-Borrego A, Velasco I, Gómez-Ariza JL, García-Barrera T. Iodine deficiency disturbs the metabolic profile and elemental composition of human breast milk. Food Chem. 2022 Mar 1;371:131329. DOI: 10.1016/j.foodchem.2021.131329. PMID: 34808765.
Velasco I, Soldevila B, Julián T, García-Riaño N, Puig-Domingo M. Euglycemic diabetic ketoacidosis and COVID-19: A combination to foresee in pregnancy. J Diabetes. 2022 Jan;14(1):88-89. DOI: 10.1111/1753-0407.13237. PMID: 34729932; PMCID: PMC9060032.
Hoová J, Velasco I, Soblechero E, Arias-Borrego A, García-Barrera T. Digging deeper into the mother-offspring transfer of selenium through human breast milk. Journal of Food Composition and Analysis. Journal of Food Composition and Analysis. 2021 Jun;99:103870. DOI: 10.1016/j.jfca.2021.103870.
Hernández JM, Soldevila B, Velasco I, Moreno-Flores F, Ferrer L, Pérez-Montes de Oca A, Santillán C, Muñoz C, Ballesta S, Canal C, Puig-Domingo M, Granada ML. Reference Intervals of Thyroid Function Tests Assessed by Immunoassay and Mass Spectrometry in Healthy Pregnant Women Living in Catalonia. J Clin Med. 2021 May 31;10(11):2444. DOI: 10.3390/jcm10112444. PMID: 34072898; PMCID: PMC8198941.
Mariscal Martínez A, Vives Roselló I, Salazar Gómez A, Catanese A, Pérez Molina M, Solà Suarez M, Pascual Miguel I, Blay Aulina L, Ríos Gozálvez C, Julián Ibáñez JF, Rodríguez Martínez P, Martínez Román S, Margelí Vila M, Luna Tomás MA. Advantages of preoperative localization and surgical resection of metastatic axillary lymph nodes using magnetic seeds after neoadjuvant chemotherapy in breast cancer. Surg Oncol. 2021 Mar;36:28-33. DOI: 10.1016/j.suronc.2020.11.013. PMID: 33285433.
Arias-Borrego A, Callejón-Leblic B, Rodríguez-Moro G, Velasco I, Gómez-Ariza JL, García-Barrera T. A novel HPLC column switching method coupled to ICP-MS/QTOF for the first determination of selenoprotein P (SELENOP) in human breast milk. Food Chem. 2020 Aug 15;321:126692. DOI: 10.1016/j.foodchem.2020.126692. PMID: 32251923.
Velasco I, Sánchez-Gila M, Manzanares S, Taylor P, García-Fuentes E. Iodine Status, Thyroid Function, and Birthweight: A Complex Relationship in High-Risk Pregnancies. J Clin Med. 2020 Jan 8;9(1):177. DOI: 10.3390/jcm9010177. PMID: 31936405; PMCID: PMC7019691.
Taylor PN, Muller I, Nana M, Velasco I, Lazarus JH. Indications for treatment of subclinical hypothyroidism and isolated hypothyroxinaemia in pregnancy. Best Pract Res Clin Endocrinol Metab. 2020 Jul;34(4):101436. DOI: 10.1016/j.beem.2020.101436. PMID: 32828674.
Merced C, Goya M, Pratcorona L, Rodó C, Llurba E, Higueras T, Cabero L, Carreras E; PECEP-RETARD Trial Group. Cervical pessary for preventing preterm birth in twin pregnancies with maternal short cervix after an episode of threatened preterm labor: randomised controlled trial. Am J Obstet Gynecol. 2019 Jul;221(1):55.e1-55.e14. DOI: 10.1016/j.ajog.2019.02.035.
Velasco I, Bath SC, Rayman MP. Iodine as Essential Nutrient during the First 1000 Days of Life. Nutrients. 2018 Mar 1;10(3):290. DOI: 10.3390/nu10030290. PMID: 29494508; PMCID: PMC5872708.
Velasco I, Taylor P. Identifying and treating subclinical thyroid dysfunction in pregnancy: emerging controversies. Eur J Endocrinol. 2018 Jan;178(1):D1-D12. DOI: 10.1530/EJE-17-0598. PMID: 29070512.
Pratcorona L, Goya M, Merced C, Rodó C, Llurba E, Higueras T, Cabero L, Carreras E; Trial Group. Cervical pessary to reduce preterm birth <34 weeks of gestation after an episode of preterm labor and a short cervix: a randomized controlled trial. Am J Obstet Gynecol. 2018 Jul;219(1):99.e1-99.e16. DOI: 10.1016/j.ajog.2018.04.031. PMID: 29704487.
Velasco I, Taylor P. The role of levothyroxine in obstetric practice. Ann Med. 2018 Feb;50(1):57-67. DOI: 10.1080/07853890.2017.1387928. PMID: 28972798.
Santos C, García-Fuentes E, Callejón-Leblic B, García-Barrera T, Gómez-Ariza JL, Rayman MP, Velasco I. Selenium, selenoproteins and selenometabolites in mothers and babies at the time of birth. Br J Nutr. 2017 May;117(9):1304-1311. DOI: 10.1017/S0007114517001155. PMID: 28534447.
Paredes P, Vidal-Sicart S, Campos F, Tapias A, Sánchez N, Martínez S, Carballo L, Pahisa J, Torné A, Ordi J, Carmona F, Lomeña F. Role of ICG-99mTc-nanocolloid for sentinel lymph node detection in cervical cancer: a pilot study. Eur J Nucl Med Mol Imaging. 2017 Oct;44(11):1853-1861. DOI: 10.1007/s00259-017-3706-4. PMID: 28492965.