Asociación entre Restricción del Crecimiento Fetal y presencia de microplásticos en placentas de gestantes atendidas en un hospital de tercer nivel de Manizales-Colombia, 2024-2025
Tablas
- Autores:
- Tipo de recurso:
- Fecha de publicación:
- 2026
- Institución:
- Universidad de Caldas
- Repositorio:
- Repositorio Institucional U. Caldas
- Idioma:
- spa
- OAI Identifier:
- oai:repositorio.ucaldas.edu.co:ucaldas/26563
- Acceso en línea:
- https://repositorio.ucaldas.edu.co/handle/ucaldas/26563
- Palabra clave:
- 610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría
3. Ciencias Médicas y de la Salud
Microplásticos
Placenta
Restricción del crecimiento fetal
Embarazo
Exposición ambiental
Salud materno-fetal
Contaminación ambiental
Salud pública
Toxicología
Embriología
- Rights
- License
- https://creativecommons.org/licenses/by-nc-nd/4.0/
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Asociación entre Restricción del Crecimiento Fetal y presencia de microplásticos en placentas de gestantes atendidas en un hospital de tercer nivel de Manizales-Colombia, 2024-2025 |
| title |
Asociación entre Restricción del Crecimiento Fetal y presencia de microplásticos en placentas de gestantes atendidas en un hospital de tercer nivel de Manizales-Colombia, 2024-2025 |
| spellingShingle |
Asociación entre Restricción del Crecimiento Fetal y presencia de microplásticos en placentas de gestantes atendidas en un hospital de tercer nivel de Manizales-Colombia, 2024-2025 610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría 3. Ciencias Médicas y de la Salud Microplásticos Placenta Restricción del crecimiento fetal Embarazo Exposición ambiental Salud materno-fetal Contaminación ambiental Salud pública Toxicología Embriología |
| title_short |
Asociación entre Restricción del Crecimiento Fetal y presencia de microplásticos en placentas de gestantes atendidas en un hospital de tercer nivel de Manizales-Colombia, 2024-2025 |
| title_full |
Asociación entre Restricción del Crecimiento Fetal y presencia de microplásticos en placentas de gestantes atendidas en un hospital de tercer nivel de Manizales-Colombia, 2024-2025 |
| title_fullStr |
Asociación entre Restricción del Crecimiento Fetal y presencia de microplásticos en placentas de gestantes atendidas en un hospital de tercer nivel de Manizales-Colombia, 2024-2025 |
| title_full_unstemmed |
Asociación entre Restricción del Crecimiento Fetal y presencia de microplásticos en placentas de gestantes atendidas en un hospital de tercer nivel de Manizales-Colombia, 2024-2025 |
| title_sort |
Asociación entre Restricción del Crecimiento Fetal y presencia de microplásticos en placentas de gestantes atendidas en un hospital de tercer nivel de Manizales-Colombia, 2024-2025 |
| dc.contributor.none.fl_str_mv |
Giraldo Osorio, Alexandra Grupo Materno Perinatal de Caldas Montoya, María Camila Giraldo, José Fernando |
| dc.subject.none.fl_str_mv |
610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría 3. Ciencias Médicas y de la Salud Microplásticos Placenta Restricción del crecimiento fetal Embarazo Exposición ambiental Salud materno-fetal Contaminación ambiental Salud pública Toxicología Embriología |
| topic |
610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría 3. Ciencias Médicas y de la Salud Microplásticos Placenta Restricción del crecimiento fetal Embarazo Exposición ambiental Salud materno-fetal Contaminación ambiental Salud pública Toxicología Embriología |
| description |
Tablas |
| publishDate |
2026 |
| dc.date.none.fl_str_mv |
2026-01-27T20:48:51Z 2026-01-27T20:48:51Z 2026-01-26 |
| dc.type.none.fl_str_mv |
Trabajo de grado - Especialización http://purl.org/coar/resource_type/c_18ws Text info:eu-repo/semantics/report |
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http://purl.org/coar/resource_type/c_93fc |
| dc.identifier.none.fl_str_mv |
https://repositorio.ucaldas.edu.co/handle/ucaldas/26563 Universidad de Caldas Repositorio Institucional Universidad de Caldas repositorio.ucaldas.edu.co |
| url |
https://repositorio.ucaldas.edu.co/handle/ucaldas/26563 |
| identifier_str_mv |
Universidad de Caldas Repositorio Institucional Universidad de Caldas repositorio.ucaldas.edu.co |
| dc.language.none.fl_str_mv |
spa |
| language |
spa |
| dc.relation.none.fl_str_mv |
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Customized versus population-based growth charts to identify neonates at risk of adverse outcome: systematic review and Bayesian meta-analysis of observational studies. Ultrasound Obstet Gynecol. 2017;50(2):156–166. Alfirevic Z, Stampalija T, Dowswell T. Fetal and umbilical Doppler ultrasound in high risk pregnancies. Cochrane Database Syst Rev. 2017;(6):CD007529 Kumar A, Singh A, Kumari S, Saha SC, Singh T, Saini SS. Role of cerebroplacental ratio in predicting perinatal outcome. Cureus. 2024;16(1):e54816 Lees C, Marlow N, Arabin B, Bilardo CM, Brezinka C, Derks JB, et al. Perinatal morbidity and mortality in early-onset fetal growth restriction: cohort outcomes of the TRUFFLE study. Ultrasound Obstet Gynecol. 2013 Oct;42(4):400–408 Cancarevic Djajic B, Draganovic D, Milic-Radic T, Sobot S, Popovic B, Milidragovic J, et al. Predictive value of ductus venosus Doppler in perinatal outcomes in fetal growth restriction. Cureus. 2025;17(2):e92838 Martínez Egea J, Pumarola Brussosa C, Figueras F. Doppler in the management of the growth-restricted fetus. In: Bilardo CM, Tsibizova V, editors. Ultrasound in Obstetrics. The Continuous Textbook of Women’s Medicine Series. Obstetrics, Vol. 18. London: Global Library of Women’s Medicine; 2024 Liu Q, Yang H, Sun X, Li G. Risk factors and complications of small for gestational age. Pak J Med Sci. 2019 Sep;35(5):1199–1203 Sharma A, Davis A, Shekhawat PS. Hypoglycemia in the preterm neonate: etiopathogenesis, diagnosis, management and long-term outcomes. Transl Pediatr. 2017;6(4):335–340 Roeper M, Hoermann H, Körner LM, Sobottka M, Mayatepek E, Kummer S, et al. Transitional neonatal hypoglycemia and adverse neurodevelopment in midchildhood. JAMA Netw Open. 2024;7(3):e243683 Crispi F, Miranda J, Gratacós E. Long-term cardiovascular consequences of fetal growth restriction: biology, clinical implications, and opportunities for prevention of adult disease. Am J Obstet Gynecol. 2018;218(2 Suppl):S869–S879 Chen G, Xiong S, Jing Q, van Gestel CAM, van Straalen NM, Roelofs D, et al. Maternal exposure to polystyrene nanoparticles retarded fetal growth and triggered metabolic disorders of placenta and fetus in mice. Sci Total Environ. 2022;836:158666. (Volumen/paginación o article number pendiente) Ministerio de Salud de Colombia. Resolution 8430 of 1993 (October 4): scientific, technical, and administrative standards for health research. Bogotá (DC): Ministerio de Salud; 1993 Young MF, Oaks BM, Tandon S, Martorell R, Dewey KG, Wendt AS. Maternal hemoglobin concentrations across pregnancy and maternal and child health: a systematic review and meta-analysis. Ann N Y Acad Sci. 2019;1450:47–68 Maqsood M, Ahad M, Irshad S. Risk factors associated with intrauterine growth restriction: a case-control study. Pak J Health Sci. 2025 Sep 30;:110–114 Zurub RE, Bainbridge S, Rahman L, Halappanavar S, El-Chaâr D, Wade MG. Particulate contamination of human placenta: plastic and non-plastic. Environ Adv. 2024;16:100555 Oliveira CWL, Oliveira LFAM, Garcia J, Weingrill RB, Urschitz J, Souza ST, et al. First evidence of microplastic accumulation in placentas and umbilical cords from pregnancies in Brazil. An Acad Bras Cienc. 2025;97:e20241298 Roslan NS, Lee YY, Ibrahim YS, Anuar ST, Yusof KMKK, Lai LA, et al. Detection of microplastics in human tissues and organs: a scoping review. J Glob Health. 2024;14:04001 Valdivia S, Riquelme C, Carrasco MC, Weisser P, Añazco C, Alarcón A, et al. Polyethylene microplastics and human cells: a critical review. Toxics. 2025;13(9):756 Primpke S, Fischer M, Lorenz C, Gerdts G, Scholz-Böttcher BM. Comparison of pyrolysis gas chromatography/mass spectrometry and hyperspectral FTIR imaging spectroscopy for the analysis of microplastics. Anal Bioanal Chem. 2020;412(30):8283-8298 Zeng G, Zhao B, Deng C, Zhu C, Cheng MMC, Gao PX. Microplastic detection and monitoring in biological and environmental systems: a mini review of techniques and strategies. Int J High Speed Electron Syst. 2025;35(1):2640001 Murugan P, Sivaperumal P, Balu S, Arya S, Atchudan R, Sundramoorthy AK. Recent advances on the methods developed for the identification and detection of emerging contaminant microplastics: a review. RSC Adv. 2023;13:36223-36241 Du X, Zhang S, Zou E. Marine microplastics and infant health. NBER Working Paper Series. Working Paper No. 33094. Cambridge (MA): National Bureau of Economic Research; 2024 Oct. Revised 2025 May Li Y, Tao L, Wang Q, Wang F, Li G, Song M. Potential health impact of microplastics: a review of environmental distribution, human exposure, and toxic effects. Environ Health. 2023;1:249-257 Tang KHD. A review of the toxic effects of microplastics based on studies on mammals and mammalian cell lines. Environ Sci Adv. 2024;3:1669-1678 Kim D, Kim D, Kim HK, Jeon E, Sung M, Sung SE, et al. Organ-specific accumulation and toxicity analysis of orally administered polyethylene terephthalate microplastics. Sci Rep. 2025;15:91170 Ruíz-Santoyo V, Cruz-Mérida JA, García-Carvajal S, Arenas-Arrocena MC. Microplastics and nanoplastics: a threat to human health and the environment. Mundo Nano Rev Interdiscip Nanocienc Nanotecnol. 2025;18(34):e69832 Harvey NE, Mercer GV, Stapleton D, Steeves KL, Hanrahan J, Cui M, et al. Maternal exposure to polystyrene nanoplastics impacts developmental milestones and brain structure in mouse offspring. Environ Sci Adv. 2023;2(4):622-628 Leclerc F, Dubois MF, Aris A. Maternal, placental and fetal exposure to bisphenol A in women with and without preeclampsia. Hypertens Pregnancy. 2014;33(3):341 348 Hunt PA, Lawson C, Gieske M, Murdoch B, Smith H, Marre A, et al. Bisphenol A alters early oogenesis and follicle formation in the fetal ovary of the rhesus monkey. Proc Natl Acad Sci U S A. 2012;109(43):17525-17530 Kwabena Danso I, Woo JH, Hoon Baek S, Kim K, Lee K. Pulmonary toxicity assessment of polypropylene, polystyrene, and polyethylene microplastic fragments in mice. Toxicol Res. 2024;40(2):313–23 |
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https://creativecommons.org/licenses/by-nc-nd/4.0/ Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0) |
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https://creativecommons.org/licenses/by-nc-nd/4.0/ Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0) http://purl.org/coar/access_right/c_abf2 |
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Universidad de Caldas Facultad de Ciencias para la Salud Colombia, Caldas, Manizales Especialización en Obstetricia y Ginecología |
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Universidad de Caldas Facultad de Ciencias para la Salud Colombia, Caldas, Manizales Especialización en Obstetricia y Ginecología |
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Universidad de Caldas |
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Asociación entre Restricción del Crecimiento Fetal y presencia de microplásticos en placentas de gestantes atendidas en un hospital de tercer nivel de Manizales-Colombia, 2024-2025610 - Medicina y salud::618 - Ginecología, obstetricia, pediatría, geriatría3. Ciencias Médicas y de la SaludMicroplásticosPlacentaRestricción del crecimiento fetalEmbarazoExposición ambientalSalud materno-fetalContaminación ambientalSalud públicaToxicologíaEmbriologíaTablasLa contaminación ambiental por microplásticos (MPs) constituye una crisis global de salud pública, con evidencia creciente de su presencia en tejidos humanos incluyendo la placenta. La restricción del crecimiento fetal (RCF) representa una de las principales causas de morbilidad y mortalidad perinatal en el mundo, afecta aproximadamente 23.4 millones de recién nacidos anualmente. Aunque la exposición a MPs ha sido documentada en placentas humanas mediante técnicas avanzadas como espectroscopía infrarroja por transformada de Fourier (FTIR) y pirólisis-cromatografía de gases/espectrometría de masas, la evidencia epidemiológica sobre su asociación con desenlaces perinatales adversos en humanos permanece limitada. En Colombia, estudios en la costa Caribe han documentado concentraciones de microplásticos entre 249-1.387 partículas/m²; sin embargo, no existen investigaciones que evalúen sistemáticamente el impacto de esta exposición sobre la salud materno-fetal en población colombiana. La magnitud de la exposición humana y los mecanismos fisiopatológicos identificados que vinculan microplásticos con disfunción placentaria justifican la necesidad de investigaciones epidemiológicas robustas en poblaciones latinoamericanas. Objetivo: determinar la asociación entre restricción del crecimiento fetal y exposición a microplásticos en placentas de gestantes atendidas en un hospital de tercer nivel de Manizales-Colombia, 2024-2025. Métodos: estudio observacional analítico prospectivo de tipo caso-control en gestantes que dieron a luz en un hospital de tercer nivel de Manizales, Colombia, entre 2024-2025. Se incluyeron 46 casos con diagnóstico de RCF y 138 controles sin RCF (relación 1:3). Los criterios de exclusión fueron gestaciones múltiples, malformaciones genéticas fetales, datos incompletos y menores de edad. La exposición principal se definió como presencia cualitativa de microplásticos en tejido placentario analizado mediante FTIR y microscopía electrónica de barrido. Se evaluaron variables sociodemográficas, clínicas y obstétricas mediante historias clínicas. El análisis incluyó descripción de características (frecuencias, medias± desviación estándar (DE), medianas con rangos intercuartílicos), cálculo de odds ratio (OR) crudos con IC95% mediante chi-cuadrado o prueba exacta de Fisher, y modelos de regresión logística binaria ajustados por edad materna, paridad y variables sociodemográficas. El nivel de significancia se estableció en p<0,05. Resultados: se analizaron 184 gestantes con edad media 26 años, predominando residencia urbana (80,4%) y régimen contributivo (56,5%). La prevalencia de microplásticos en placentas fue 91,85%, sin diferencias significativas entre casos (91,3%) y controles (92,0%) (p=1,00). El OR crudo fue 0,91 (IC95%: 0,27-3,01). La distribución de polímeros fue polietileno 46,2%, polipropileno 32,6%, poliestireno 7,1% y polivinilo 2,2%. Al analizar polímeros específicos, polipropileno vs polietileno mostró OR=1,49 (IC95%: 0,70-3,16; p=0,298). Los desenlaces obstétricos difirieron significativamente: peso neonatal 2.521±321g en casos vs 3.129±328g en controles (p<0,001); cesárea 47,8% vs 23,2% (p=0,001); edad gestacional mediana 37,2 vs 39,1 semanas (p<0,001). La anemia materna mostró asociación marginalmente significativa (6,5% vs 0,7%; p=0,049). Conclusión: la contaminación placentaria por MPs constituye un fenómeno universal en la población estudiada, con prevalencia de 91,8% independiente de RCF. No se demostró asociación estadísticamente significativa entre presencia cualitativa de microplásticos y RCF (OR=0,91; IC95%: 0,27-3,01; p=1,00). La ausencia de asociación puede atribuirse a la universalidad de exposición y evaluación cualitativa sin cuantificación de concentraciones. El perfil de polímeros (polietileno 46,2%, polipropileno 32,6%) concuerda con literatura internacional. Estos hallazgos subrayan la necesidad de metodologías que cuantifiquen concentraciones, caractericen tamaños de partículas y evalúen aditivos químicos para establecer relaciones dosis-respuesta. Mientras se genera esta evidencia, los principios de precaución justifican intervenciones de salud pública orientadas a reducir exposición gestacional a plásticos.Introduction: Environmental contamination by microplastics (MPs) constitutes a global public health crisis, with increasing evidence of their presence in human tissues, including the placenta. Fetal growth restriction (FGR) represents one of the leading causes of perinatal morbidity and mortality worldwide, affecting approximately 23.4 million newborns annually. Although MP exposure has been documented in human placentas using advanced techniques such as Fourier-transform infrared spectroscopy (FTIR) and pyrolysis-gas chromatography/mass spectrometry, epidemiological evidence regarding its association with adverse perinatal outcomes in humans remains limited. In Colombia, studies on the Caribbean coast have documented microplastic concentrations between 249–1,387 particles/m²; however, there are no systematic investigations evaluating the impact of this exposure on maternal-fetal health in the Colombian population. The magnitude of human exposure and the identified pathophysiological mechanisms linking microplastics to placental dysfunction justify the need for robust epidemiological research in Latin American populations. Objective: To determine the association between fetal growth restriction and microplastic exposure in the placentas of pregnant women treated at a tertiary-level hospital in Manizales, Colombia, 2024–2025. Methods: A prospective analytical observational case-control study was conducted among pregnant women who gave birth at a tertiary-level hospital in Manizales, Colombia, between 2024 and 2025. The study included 46 cases with an FGR diagnosis and 138 controls without FGR (1:3 ratio). Exclusion criteria were multiple pregnancies, fetal genetic malformations, incomplete data, and underage patients. The primary exposure was defined as the qualitative presence of microplastics in placental tissue analyzed via FTIR and scanning electron microscopy (SEM). Sociodemographic, clinical, and obstetric variables were evaluated through medical records. Analysis included characteristic descriptions (frequencies, means ± standard deviation (SD), medians with interquartile ranges), calculation of crude odds ratios (OR) with 95% CI using chi-square or Fisher's exact test, and binary logistic regression models adjusted for maternal age, parity, and sociodemographic variables. The significance level was set at p < 0.05. Results: A total of 184 pregnant women were analyzed (mean age 26 years), with a predominance of urban residence (80.4%) and contributory health insurance regime (56.5%). The prevalence of microplastics in placentas was 91.85%, with no significant differences between cases (91.3%) and controls (92.0%) (p = 1.00). The crude OR was 0.91 (95% CI: 0.27–3.01). The polymer distribution was polyethylene (46.2%), polypropylene (32.6%), polystyrene (7.1%), and polyvinyl (2.2%). When analyzing specific polymers, polypropylene vs. polyethylene showed an OR = 1.49 (95% CI: 0.70–3.16; p = 0.298). Obstetric outcomes differed significantly: neonatal weight was 2,521 ± 321g in cases vs. 3,129 ± 328g in controls (p < 0.001); cesarean section rates were 47.8% vs. 23.2% (p = 0.001); and median gestational age was 37.2 vs. 39.1 weeks (p < 0.001). Maternal anemia showed a marginally significant association (6.5% vs. 0.7%; p = 0.049). Conclusion: Placental MP contamination constitutes a universal phenomenon in the studied population, with a prevalence of 91.8% regardless of FGR. No statistically significant association was demonstrated between the qualitative presence of microplastics and FGR (OR = 0.91; 95% CI: 0.27–3.01; p = 1.00). The lack of association may be attributed to the universality of exposure and the qualitative assessment without concentration quantification. The polymer profile (polyethylene 46.2%, polypropylene 32.6%) is consistent with international literature. These findings highlight the need for methodologies that quantify concentrations, characterize particle sizes, and evaluate chemical additives to establish dose-response relationships. While this evidence is generated, precautionary principles justify public health interventions aimed at reducing gestational plastic exposure.Introducción -- Planteamiento del problema -- Pregunta de investigación -- Justificación -- Referente teórico -- Antecedentes -- Marco teórico -- Definición de microplásticos -- Clasificación según su origen: primarios y secundarios -- Clasificación según morfología -- Clasificación según tamaño -- Clasificación según composición química -- Aditivos químicos en plásticos -- Bisfenoles (bpa) -- Ftalatos -- Retardantes de llama bromados (pbdes) -- Fuentes de exposición a microplásticos en humanos -- Agua de consumo -- Aire ambiente -- Alimentos -- Vías de exposición humana -- Ingestión -- Inhalación -- Absorción dérmica -- Evidencia de microplásticos en tejidos humanos y animales -- Detección en múltiples órganos y sistemas humanos -- Placenta humana -- Anatomía y fisiología -- Función de barrera y de intercambio -- Microplásticos en placentas -- Vías de entrada de microplásticos y efectos sobre la placenta -- Alteración de la función endocrina placentaria -- Restricción del crecimiento fetal -- Definiciones -- Feto pequeño para la edad gestacional -- Restricción del crecimiento fetal -- Criterios diagnósticos -- Rcf inicio temprano -- Rcf inicio tardío -- Clasificación -- Rcf simétrica -- Rcf asimétrica -- Fisiopatología -- Factores maternos -- Factores fetales -- Factores placentarios -- Evaluación diagnóstica -- Biometría fetal por ecografía -- Velocimetría doppler -- Arteria umbilical -- Arteria cerebral media y relación cerebroplacentaria -- Ductus venoso -- Complicaciones neonatales -- Morbilidad a corto plazo -- Asociación entre restricción de crecimiento fetal y exposición a microplásticos -- Objetivos -- General -- Específicos -- Materiales y métodos -- Tipo, nivel y diseño del estudio -- Hipótesis -- Hipótesis nula -- Hipótesis alterna -- Población de estudio -- Muestra -- Criterios de inclusión -- Definición de caso -- Definición de control -- Criterios de exclusión -- Definición operacional de las variables -- Técnicas e instrumentos de recolección de la información -- Recolección y procesamiento de muestras -- Análisis estadístico -- Consideraciones éticas -- Declaración de uso de inteligencia artificial -- Resultados -- Características sociodemográficas y clínicas -- Desenlaces obstétricos -- Presencia de microplásticos en placentas humanas -- Caracterización del polímero encontrado -- Asociación entre restricción del crecimiento fetal y microplásticos -- Discusión -- Fortalezas del estudio -- Limitaciones metodológicas y de diseño del estudio -- Líneas de investigación futuras -- Conclusiones -- Recomendaciones -- Referencias bibliográficas -- AnexosEspecializaciónEstudio observacional, analítico, prospectivo, transversal, de nivel relacional, con diseño de casos y controles.Especialista en Obstetricia y GinecologíaSalud AmbientalUniversidad de CaldasFacultad de Ciencias para la SaludColombia, Caldas, ManizalesEspecialización en Obstetricia y GinecologíaGiraldo Osorio, AlexandraGrupo Materno Perinatal de CaldasMontoya, María CamilaGiraldo, José FernandoOcampo Palacio, Alejandro2026-01-27T20:48:51Z2026-01-27T20:48:51Z2026-01-26Trabajo de grado - Especializaciónhttp://purl.org/coar/resource_type/c_18wsTextinfo:eu-repo/semantics/reporthttp://purl.org/coar/resource_type/c_93fc78 páginasapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttps://repositorio.ucaldas.edu.co/handle/ucaldas/26563Universidad de CaldasRepositorio Institucional Universidad de Caldasrepositorio.ucaldas.edu.cospaGarcia MA, Liu R, Nihart A, Hayek El E, Castillo E, Barrozo ER, et al. 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