Secular changes in body size and body composition in schoolchildren from La Plata City (Argentina).

AIM: To analyze the secular changes in body size and composition of two cohorts of children from La Plata City, Argentina, with a 35-year follow-up. subjects and methods: Cohort 1 (C1) was measured in 1969-1970 and included 1772 children (889 boys, 883 girls), and Cohort 2 (C2), measured in 2004-2005, included 1059 children (542 boys, 517 girls). Both cohorts were obtained from matching geographical areas and comprised children from 4 to 12 years. Body weight (W); Height (H); Upper arm circumference (UAC); Tricipital (TS) and Subscapular skinfolds (SS) were measured, and Body Mass Index (BMI) and muscle (UMA) and fat (AFA) brachial areas were calculated. Prevalence of overweight and obesity was estimated by IOTF. To compare C1-C2 we used a generalized linear model with log-transformed variables, and chi square test. RESULTS: There were significant and positive differences between C2-C1 in W, UAC, SS, TS, and AFA. In contrast, H was not significantly different and UMA was significantly different but with negative values. The prevalence of overweight and obesity was 14.5% and 3.8% in C1, and 17.0% and 6.8% in C2. Differences between cohorts were significant for obesity. CONCLUSION: The shifts observed for soft tissues--positive trend for fat and negative for muscle area--occurring without changes in height lead us to suppose that in these three decades, La Plata's population has experienced deterioration in living conditions and important changes in their lifestyle, such as an increased consumption of energy-dense foods and sedentary habits.

Growth of functional cranial components in rats with intrauterine growth retardation after treatment with growth hormone.

The goal of this study was to analyse the effect of growth hormone (GH) on catch-up growth of functional facial (splanchnocranial) and neurocranial components in rats with intrauterine growth retardation (IUGR). Wistar rats were divided into the following groups: control (C), sham-operated (SH), IUGR, and IUGR + GH. IUGR was surgically induced and GH was administered between 21 and 60 days of age. Radiographs were obtained at 1, 21, 42, 63, and 84 days of age in order to measure length, width, and height of neurocranium (NL, NW, and NH) and face length, width, and height (FL, FW, and FH). Analysis of variance was performed at 1 day of age and a principal components analysis (PCA) at 84 days of age. Neurocranial and facial volumetric indexes were calculated as NVI = (3)√NL × NW × NH and FVI = (3)√FL × FW × FH, respectively, and adjusted by non-linear regression analysis. On postnatal day 1, there were significant differences between SH and IUGR (P < 0.01). Also, in both genders, final neurocranial volume was similar between SH and IUGR + GH groups, while the IUGR group had the lower value (P < 0.01). Final facial volume was similar among the three groups. In both genders, facial growth rates were SH = IUGR > IUGR + GH (P < 0.01). The first axis of the PCA exhibited size effect and the second axis showed shape effect. Reductions of placental blood flow modify cranial growth. The functional neurocranial and facial components in rats with IUGR presented different recovery strategies through modular behaviour, mainly related to modifications of growth rate as response to GH administration.

Bone growth and sexual dimorphism at birth in intrauterine-growth-retarded rats.

This paper addresses the effect of a reduction of uterine blood flow (RUB) on postcranial bone growth in rats. The objectives were: (1) to discover and characterize the changes evoked by growth retardation through a reduction in placental blood flow, (2) to see if the resulting growth retardation is different in each bone, and (3) to analyze any sex-specific features. RUB was induced by the partial bending of uterine vessels at day 1 of pregnancy. Control and sham-operated animals were also included. The animals were X-rayed at birth. The lengths and widths of the humerus, radius, and femur and pelvic length, interischial, interpubic, and pubic widths were measured. Data were analyzed by ANOVA and LSD post hoc tests. The intersubject analysis showed significant differences between groups and non-significant differences between sexes. In males, sham-operated and RUB showed significant differences in pelvic lengths and widths, and humeral, radial, femoral, and tibial widths. In females, there were significant differences only for humeral widths, radial lengths and widths, and femoral and tibial widths. We conclude that reduced blood flow delays appendicular bone growth as observed at birth. Pelvic length was more affected than that of the limbs. The widths of the pelvic and limbs bones, in turn, were more altered than the lengths, and the growth of the males more than that of the females. Partial bending of uterine vessels compromised postcranial growth, though under such disadvantageous circumstances the females proved to be more capable of growing and thus more resilient than the males.

Adult height in Turner syndrome girls after long-term growth hormone treatment / Talla adulta en pacientes con síndrome de Turner tratadas con hormona de crecimiento a largo plazo

We studied the adult height (AH) outcome, and factors likely to influence it, in Turner Syndrome (TS) girls treated with growth hormone (GH). A total of 25 TS girls treated with GH were compared with 10 TS girls not treated with GH. The percentage of girls who achieved normal third percentile was determined. Projected AH (PAH) was calculated according to height standard deviation score (HSDS) at the beginning of the treatment. Gain in height was determined as: AH - pretreatment PAH. The percentage of girls who achieved target range (midparental height±2 SD) was determined. Multiple linear regression models were fitted on baseline variables- chronological age (CA), midparental height (MPH) and HSDS; and treatment variablesduration of oestrogen-free GH therapy and duration of GH therapy+oestrogens. As for baseline data: median CA was 13.0 years (5.6-15.8). Mean HSDS was 0.25±1.1 SDS. PAH was 139.2±5.6 cm. MPH was 160.0±5.0 cm. As for follow up data: Median CA at onset oestrogens was 15.1 years (13.2-16.6). Median duration of GH therapy was 3.8 years (2.1-10.3). Median oestrogen-free GH period was 2.0 years (0.7-7.8), and median GH+oestrogens period, 1.8 years (1.0-3.2). Adult height: Mean AH was 150.4±7.0 cm in treated patients and 140.8±7.2 cm in the group not treated with GH (p=0.001). Fourteen (56%) girls achieved normal third percentile compared with an initially predicted 1 (4%). Gain in height was 11.2±3.7 cm. Thirteen (59%) girls reached an AH within target range. HSDS at the beginning of the treatment was the variable most strongly related to AH and duration of oestrogen-free GH period was the variable most strongly related to gain in height.

Se estudió la talla adulta (TA) y los factores que pudieran influenciarla en niñas con síndrome de Turner (ST) tratadas con hormona de crecimiento (HC). Se compararon 25 pacientes con ST tratadas con HC y 10 niñas no tratadas. Se determinó: el porcentaje de niñas que alcanzó el tercer percentilo de la curva de normalidad, la talla adulta proyectada (TAP) de acuerdo al score de desvío estándar de talla (SDST) al inicio del tratamiento, la ganancia en talla (TA - TAP pretratamiento) y el porcentaje de niñas que alcanzó el rango genético (talla media parental ± 2 DS). Se ajustaron modelos de regresión múltiple sobre variables basalesedad cronológica (EC), talla media parental y SDST; y variables durante el tratamiento- duración del tratamiento con GH sin estrógenos y con GH+estrógenos. Resultados: datos basales: la EC mediana fue 13.0 años (5.6- 15.8), el SDST 0.25 ± 1.1 SDS, la TAP 139.2 ± 5.6 cm y la talla media parental 160.0 ± 5.0 cm. Datos en el seguimiento: la EC mediana al inicio del estrógeno fue 15.1 años (13.2-16.6), la duración mediana del tratamiento con GH 3.8 años (2.1-10.3), del tratamiento con GH y sin estrógenos 2.0 años (0.7-7.8), y del tratamiento con GH + estrógenos 1.8 años (1.0-3.2). Talla adulta: la TA media fue 150.4 ± 7.0 cm en pacientes tratadas y 140.8 ± 7.2 cm en el grupo no tratado (p = 0.001). 14 niñas (56%) alcanzaron el tercer percentilo comparado con la predicción inicial de una niña (4%). La ganancia en talla fue 11.2 ± 3.7 cm. 13 niñas (59%) alcanzaron una TA dentro del rango genético. La variable que más se relacionó con la TA fue el SDST al inicio del tratamiento y con la ganancia en talla, la duración del tratamiento con GH libre de estrógenos.

Adult height in Turner Syndrome girls after long-term growth hormone treatment.

We studied the adult height (AH) outcome, and factors likely to influence it, in Turner Syndrome (TS) girls treated with growth hormone (GH). A total of 25 TS girls treated with GH were compared with 10 TS girls not treated with GH. The percentage of girls who achieved normal third percentile was determined. Projected AH (PAH) was calculated according to height standard deviation score (HSDS) at the beginning of the treatment. Gain in height was determined as: AH - pretreatment PAH. The percentage of girls who achieved target range (midparental height +/- 2 SD) was determined. Multiple linear regression models were fitted on baseline variables- chronological age (CA), midparental height (MPH) and HSDS; and treatment variables- duration of oestrogen-free GH therapy and duration of GH therapy+oestrogens. As for baseline data: Median CA was 13.0 years (5.6-15.8). Mean HSDS was 0.25 +/- 1.1 SDS. PAH was 139.2 +/- 5.6 cm. MPH was 160.0 +/- 5.0 cm. As for follow up data: Median CA at onset oestrogens was 15.1 years (13.2-16.6). Median duration of GH therapy was 3.8 years (2.1-10.3). Median oestrogen-free GH period was 2.0 years (0.7-7.8), and median GH+oestrogens period, 1.8 years (1.0-3.2). Adult height: Mean AH was 150.4 +/- 7.0 cm in treated patients and 140.8 +/- 7.2 cm in the group not treated with GH (p=0.001). Fourteen (56%) girls achieved normal third percentile compared with an initially predicted 1 (4%). Gain in height was 11.2 +/- 3.7 cm. Thirteen (59%) girls reached an AH within target range. HSDS at the beginning of the treatment was the variable most strongly related to AH and duration of oestrogen-free GH period was the variable most strongly related to gain in height.

Efecto del retardo de crecimiento intrauterino sobre el dimorfismo sexual en recien nacidos de termino: una adaptación prenatal en perspectiva evolutiva / Effect of intrauterine growth retardation on sexual dimorphism in full-term newborns: a prenatal adaptation of development

OBJETIVOS: identificar si se modifica el dismorfismo sexual del crecimiento frente a retardo de crecimiento intrauterino. MÉTODOS: se compararon 4931 recién nacidos con (n=497) y sin (n=4434) retardo de crecimiento intrauterino. Todos fueron de término (para Argentina >37 semanas). La población se dividió en dos grupos de acuerdo a la condición de crecimiento fetal y el sexo. Los indicadores antropométricos del crecimiento prenatal incluyeron el peso corporal, la longitud y el perímetro cefálico. RESULTADOS: no hubo diferencias estadísticas significativas entre sexos en el peso al nacer y la longitud corporal en neonatos con retardo de crecimiento intrauterino. De forma contraria, los neonatos con crecimiento fetal normal evidenciaron diferencias significativas en ambos indicadores entre sexos siendo más grandes los varones. CONCLUSIONES: la inhibición del dismorfismo sexual está ya presente en etapas prenatales cuando ocurre una situación que afecte el crecimiento como es el caso del retardo de crecimiento intrauterino. Se considera la perspectiva evolutiva de dicho fenómeno inhibitorio.

OBJECTIVES: determine full-term newborns sexual dimorphism inhibition in fetal growth under the condition of uterine growth retardation. METHODS: 4931 full-term newborns with (497) and without (4434) intrauterine growth retardation were studied. All were > 37 weeks of gestation. The population was divided into two groups according to intrauterine growth conditions and sex. Anthropometric indicators of prenatal growth included body weight, length and cephalic perimeter. RESULTS: there were no statistically significant sex differences for birth weight and length for newborns submitted to intrauterine growth retardation. On the other hand, newborns with normal intrauterine growth showed a statistically significant difference between sex, males were heavier and longer than females. CONCLUSIONS: inhibition of sexual dimorphism is present in fetuses under stress as in the intrauterine growth retardation condition. Development perspective for this inhibitory phenomenon is discussed.

Perfil de la Sociedad Latinoamericana de Investigación Pediátrica (SLAIP) a 40 años de su fundación / Profile of the Latinamerican Society for Pediatric Research (SLAIP) since 40 years from foundation

Objetivo: Delinear el perfil actual de la Sociedad Latinoamericana de Investigación Pediátrica (SLAIP) calculando, sobre las reuniones anuales (RAs) de los años 2000 a 2003: 1) la razón: trabajos presentados/participante (rT/P), 2) el porcentaje de socios asistentes (por ciento SA) y 3) la tasa anual de crecimiento de participación de socios a las RAs (TAC). Así mismo se calculó el porcentaje de trabajos publicado de los presentados en las RAs de 1998 y 1999 (TPP). La rT/P promedio fue 0,92, el por ciento SA 24 por ciento y la TAC negativa (-19 por ciento). Los TPP representaron 20 por ciento del total. Concluyendo: Actualmente la SLAIP es efectivamente un foro de encuentro de investigadores. Sin embargo, presenta dos debilidades: 1) baja presencia de socios en las RAs y 2) bajo número de trabajos publicados luego de presentados, lo que probablemente limite su influencia en la pediatría regional. Un problema en la dinámica de la SLAIP podría ser la escasa relación existente entre los socios fuera de las RAs, la realización de estudios colaborativos, incentivando el contacto permanente entre los mismos, sería un medio de mejorarla.

Catch-up in body weight of intrauterine growth retarded (IUGR) rats castrated and treated with growth hormone.

The aim of the present study was to assess body weight recovery in rats with intrauterine growth retardation (IUGR) castrated and treated with growth hormone (GH). Wistar albino rats were divided into the following experimental groups: control (C), sham-operated (SH), IUGR, IUGR castrated (IUGR+C), and IUGR castrated and injected with GH (IUGR+C+GH). IUGR was induced by partial bending of uterine vessels at day 14 of pregnancy. GH (Genotropin 3.0 mg/kg/day) was administered from weaning (21 days old) to 60 days of age. SH rats were injected only with diluent. Castration was performed at weaning. Body weight, body weight velocity and relative food intake were registered weekly. Data were analyzed by ANOVA and LSD post hoc test. The between-subjects analysis showed significant differences for sex and treatment factors. Differences in body weight were significant among treatments, being SH > IUGR > IUGR+ C+GH > IUGR+C in males, and SH > IUGR+C > IUGR+C+GH > IUGR in females. Differences in relative food intake were IUGR+C > IUGR+C+GH > IUGR > SH in males, and IUGR+C+GH > IUGR+C > IUGR > SH in females. These results indicate that nutritional rehabilitation impairs the effects of IUGR. While the absence of testosterone inhibited body weight gain, the absence of estrogens promoted catch-up growth. Castrated animals with or without GH treatment ate relatively more, suggesting the absence of an anabolic effect of gonadal steroids.

Tendência secular de crescimento em escolares de Paulínia, São Paulo-Brasil (1979/80 - 1993/94) / Secular trends of growth of schoolchildren from Paulínia, São Paulo - Brazil (1979/80 - 1993/94)

OBJETIVO: Avaliar a tendência secular de altura, peso e da relação peso/altura em escolares de Paulínia, São Paulo, Brasil, entre 1979/80 e 1993/94. MÉTODOS: Medidas antropométricas de peso (P) e altura (A) e da relação P/A de 1.903 crianças de 6,5 a 12,5 anos (51,5 por cento M e 48,5 por cento F) de escolas públicas de Paulínia foram comparadas com dados de estudo anterior realizado na mesma cidade, com intervalo de 15 anos. Calculou-se o incremento por década e alisou-se os dados pela técnica de médias e medianas móveis (3H3H3). RESULTADOS: As médias de altura e peso foram sempre superiores às do estudo anterior, com incrementos positivos. Os incrementos para a altura variaram de 1,13 a 5 cm no sexo masculino e 1,2 a 4,33 cm nas meninas, já para o peso a variação foi de 0,53 a 4,13 kg nos meninos e 0,87 a 3,0 kg nas meninas. Para a relação P/A, as médias dos dois estudos foram muito semelhantes em ambos os sexos. CONCLUSÕES: A tendência secular positiva da estatura e do peso neste período deve-se principalmente ao desenvolvimento econômico, de saneamento básico, de habitação, de educação e na área de saúde ocorrido na cidade de Paulínia. A tendência secular positiva encontrada foi semelhante à observada em países desenvolvidos após a II Guerra Mundial e de outros trabalhos brasileiros.

Modificación del dimorfismo sexual del peso durante la gestación en presencia de retardo de crecimiento intrauterino: relación con factores maternos adversos preconcepcionales, concepcionales y ambientales / Modification of sexual dimorphism of weight in intrauterine growth retardation

El dimorfismo sexual (DS) comprende, en sentido amplio, diferencias morfológicas y funcionales entre sexos. Refleja la relación entre el pool genético y las capacidades del ser humano para reaccionar ante diferentes condiciones ambientales. Ciertos aspectos del DS se inhiben ante factores ambientales adversos. Objetivo:Identificar si se modifica el DS del peso corporal frente a retardo de crecimiento intrauterino (RCIU). Pacientes y método: Se compararon 2 552 recién nacidos con (N = 250) y sin (N = 2 302) RCIU. Todos fueron de término (para Argentina > 37 semanas). La población se dividió en dos grupos de acuerdo a la condición de crecimiento fetal y la presencia de varios factores maternos adversos (preconcepcionales, concepcionales y ambientales). Resultados:No hubo diferencias estadísticas significativas entre sexos en el peso al nacer de neonatos con RCIU, siendo las niñas más pesadas que los varones. De forma contraria, los neonatos con crecimiento fetal normal evidenciaron diferencias significativas en el peso entre sexos siendo los varones más pesados que las niñas. Se concluye que la inhibición del DS está ya presente en etapas prenatales cuando ocurre una situación que afecte el crecimiento.

[Secular trends of growth of schoolchildren from Paulínia, São Paulo-Brazil (1979/80 - 1993/94)]. / Tendência secular de crescimento em escolares de Paulínia, São Paulo-Brasil (1979/80 - 1993/94).

BACKGROUND: The purpose of this study was to evaluate the secular trends in height, weight and weight/height of schoolchildren from the city of Paulínia, São Paulo, Brazil between 1979/80 and 1993/94. METHODS: Anthropometric measurements (height, weight and weight/height) of 1,903 children (6.5-12.5 y); 51.5% M: 48.5% F, from Paulínia public schools were compared with data from a previous study carried out in the same city 15 years earlier. Decade increments were calculated and data was smoothed by the technique of means and medians (3H3H3). RESULTS: Height and weight mean values were always greater than those of the previous study, with positive increments. Height increments ranged from 1.13 to 5.0 cm in boys and from 1.2 to 4.33 cm in girls. Weight increments ranged from 0.53 to 4.13 kg in males and from 0.87 to 3.0 kg in females. In the two studies, weight/height means were very similar for both genders. CONCLUSIONS: Increments in height and weight during this period are an indicator of development on the economical and health levels. A positive secular trend was also observed in developed countries after the 2nd World War and in the Brazilian people.

Composicion corporal y prevalencia estandarizada de desnutricion en niños de 6 a 12 años de edad, La Costa, Argentina / Body composition and standardized prevalence of undernutrition among children from 6 to 12 years old, La Costa, Argentina

OBJETIVOS: evaluar la composición corporal y la prevalencia estandarizada de desnutrición en niños de seis a 12 años de edad de La Costa, Argentina. MÉTODOS: se midieron la estatura, perímetro braquial y el pliegue cutáneo tricipital, calculando los siguientes indicadores: circunferencia muscular braquial, área muscular braquial, área grasa braquial (AGB), índice área muscular braquial/estatura (AMBE), índice energía/proteína (EP) e índice grasa/músculo braquiales. Se calculó la prevalencia estandarizada de desnutrición (PE). Se consideraron además tres indicadores sociales. El análisis estadístico incluyó ANOVA multifactorial, correlación de Pearson y de Spearman. RESULTADOS: existió dimorfismo sexual sólo para el AGB. A mayor tamaño de la familia los indicadores antropométricos fueron menores. La PE mostró diferencias con el estándar. El tejido muscular resultó más desviado que el adiposo, aunque el índice AMBT se mantuvo dentro de la normalidad. CONCLUSIONS: El tamaño de la familia modificó el crecimiento global de la población viéndose más afectados los indicadores que incluyen tejido adiposo. Las PE reflejaron mayor sesgo de los indicadores de reserva proteica: AM, PMB que los de reserva energética: PCT, AG.

[Body mass index and triceps skinfold correlation in children from Paulínia city, São Paulo, SP]. / Correlação entre o índice de massa corporal e a prega cutânea tricipital em crianças da cidade de Paulínia, São Paulo, SP.

UNLABELLED: Body mass index (BMI) has been considered a criterion to define and analyse obesity in adults and children. BACKGROUND: the purpose of this study was to evaluate the correlation between BMI and triceps skinfold (TSF). METHODS: there were studied 4,236 children (3.1-10.9y); 48.3%M:51.6%F, from four studies made in Paul nia, SP-Brazil. Height, weight and TSF (Holtain caliper) were measured. For each children BMI was calculated and transformed in SDS, according to North American data (Frisancho, 1993). Multiple linear regression analysis (stepwise) was used for the whole population and in three groups according to BMI: A) SDS < or = -1.0; B) -1.0 < SDS< 1.0) SDS(3) 1.0. Data were processed with SPSS software. RESULTS: in group A, the TSF (7.8 +/- 2.3) variability was lower when compared with the groups B (10.1 +/- 4.0) and C (17.8 +/- 6.2). In multiple linear regression with the whole population, R = 0.478 for TSF. In groups B and C, R = 0.364 and 0.368 respectively for TSF, and in group A it was only 0.032. CONCLUSIONS: these observations demonstrated a height correlation between BMI and TSF in children with obesity risk (group C). Therefore, we conclude that, in Brazil BMI can be used for children's research of obesity in population studies, instead of TSF.

Correlaçäo entre o índice de massa corporal e a prega cutânea tricipital em crianças da cidade de Paulínia, São Paulo, SP / Body mass index and triceps skinfold correlation in children from Paulínia city, São Paulo, SP

O índice de massa corporal (IMC) tem sido indicado como método de escolha para o diagnóstico da obesidade em adultos e crianças. OBJETIVO: Estudar a correlaçäo existente entre o IMC e a prega cutânea tricipital (PCT). MÉTODOS: Foram avaliadas 4.236 crianças de 3,1 a 10,9 anos, 48,3 por cento do sexo masculino e 51,6 por cento feminino, de quatro estudos realizados em Paulínia, SP, Brasil. Mediu-se o peso e a estatura, com os quais calculou-se o IMC. A PCT foi medida com paquímetro Holtain. Os dados foram transformados em escores Z e comparados à curva norte-americana (Frisancho, 1993). A populaçäo foi dividida em grupos de acordo com os escores Z do IMC: grupo A) escore Z < - 1; B) -1 < escore Z < 1; C) escore Z > 1. Realizou-se uma análise de regressäo linear múltipla (método stepwise). Os dados foram processados no SPSS. RESULTADOS: O grupo A apresentou menor variabilidade na PCT (média 7,8; DP = 2,3) quando comparado aos demais (B: média 10,1; DP=4 e C: média 17,8; DP=4,4). Na análise da regressäo linear, considerando todos os casos, a PCT apresentou R²=0,478. Nos grupos B e C a PCT teve R²=0,364 e 0,368, respectivamente enquanto no grupo A foi apenas 0,032. CONCLUSÄO: A correlaçäo entre o IMC e a PCT é elevada no grupo de crianças com risco de obesidade (grupo C), o que justifica a substituiçäo do uso da PCT pelo IMC em estudos populacionais de obesidade em escolares brasileiros

Antropometría pregestacional y gestacional en adolescentes y sus recién nacidos / Pregestational and gestational anthropometric measurements in adolescentes and their newborns

Introducción.La adolescencia constituye una etapa de la vida de creciente interés en pediatría y neonatología.El crecimiento en adolescentes gestantes y de sus neonatos es un tópico especial.Objetivos.Presentar la distribución de indicadores antropométricos en adolescentes gestantes y sus recién nacidos(RN)evaluar el efecto de la edad y la paridad sobre el crecimiento neonatal y evaluar el riesgo de retardo de crecimiento intrauterino(RCIU)de acuerdo al incremento de peso gestacional.Población.815 adolescentes(12-19 años) y RN pertenecientes al distrito de la Costa durante el período 1996 -2000.Material y métodos.Se midió el peso materno el en primer,segundo y tercer trimestres,constándose el peso pregravídico por recordatorio y la talla en la primera visita,considerándose 3 grupos de edad materna.En el RN se midieron peso,longitud corporal y perímetro cefálico,calculándose el índice de masa corporal materno y neonatal.Se clasificó como RCIU al peso para la edad gestacional inferior al percentilo 10 y como bajo incrementso de pesos gestacional al menor del percentilo 23.Se efectuo ANOVA de una vía y prueba de mantel Haenszel.Resultados.Hubo diferencias significativas entre los indicadores antropométricos pregestacionales de acuerdo a la edad materna,no así durante la gestación.El mismo fenómeno se observó en los RN.La paridad mostró ser un factor estadísticamente significativo sobre las medidad longitudinales del RN.El RCIU fue dependiente del incremento del peso materno,no así de la edad,Conclusión.La población estudiada mostró un sesgo haciael sobrepeso de la curva de referencia,una tasa de RCIU levemente superior a la esperada y una baja pero significativa asociación entre aumento de peso gestacional y crecimiento neonatal

Relación entre el índice de masa corporal durante la gestación en embarazadas adolescentes y adultas, indicadores antropométricos de crecimiento fetal y retardo de crecimiento intrauterino. La Costa, Argentina, 1999 / Relationships between body mass index during pregnancy in adolescent and adult women, anthropometric indicators of fetal growth and intrauterine growth retardation. La Costa, Argentina, 1999

Body mass index (BMI) has been employed as an epidemiologic predictor of fetal growth. But most of the studies are focused on BMI values for non pregnancy women, while BMI varies according to gestational age. On the other hand, adolescence has been considered as a risk factor for intrauterine growth retardation (IUGR: birthweight for gestational age < 10th. centile). The aims of this study were: 1) to identify the distribution for weight, height and BMI in adolescent and adult pregnancies, 2) to measure the association between maternal BMI and fetal growth and 3) to evaluate the relative risk to have an intrauterine growth retardation (IUGR) according to maternal BMI. 2409 pregnancies and their newborns were studied. Maternal height and weight were measured and BMI by gestational age was calculated by trimesters of gestation. Birthweight, recumbent length, cephalic perimeter, BMI and weight by gestational age were determined in the newborns. Z score by gestational age were calculated in each pregnant woman taken into account the cut of point of BMI of -1 standard deviation. There were highly statistically significants differences in both body size and body composition between adolescent and adult mothers and in their newborns. The newborns from mothers with BMI under -1 standard deviation were smaller and the relative risk to have an IUGR was double for newborns whose mothers had BMI under -1 standard deviation. CONCLUSIONS: 1--Both body size and composition values differs between newborns from mothers under or above the cut off point of -1SD of BMI and 2--The risk to have an IUGR was double in pregnancies under -1 SD of BMI, independently to the age of the mother.

Efecto del tratamiento con estrogenos sobre el crecimiento en noñas con sindrome de Turner tratadas con hormona de crecimento / Effect of estrogen therapy on the growth of Turner syndrome in girls treated with growth hormone

Para analizar el efecto de los estrógenos sobre el crecimiento en niñas con ST tratadas con GH, se estudiaron veinticuatro pacientes divididas en dos grupos: Grupo1 (G1): 14 pacientes tratadas con GH que iniciaron estrógenos (IE) (Premarínâ) a los 15.3ñ0.9 años. Grupo 2 (G2): 10 niñas no tratadas con GH que iniciaron Premarínâ a los 14.3ñ2.3 años. Se comparó la mejoría en el SDS de talla en períodos de tiempo comparables de tratamiento con GH y con GH más estrógenos en el G1, y durante el tratamiento con estrógenos entre ambos grupos. Se calculó la ganancia de talla durante el tratamiento con estrógenos (talla final talla proyectada al IE). En el G1 se efectuó regresión múltiple entre la ganancia de talla durante el tratamiento con GH (talla final- talla proyectada al inicio de la GH) y la edad ósea de IE, la edad cronológica de IE, y el tiempo de tratamiento con GH previo al IE. En el G1 la mejoría en el SDS de talla fue 0.43ñ0.11 cm durante la GH y 0.59ñ0.18 cm durante la GH más estrógenos (p=0.064). La mejoría en el SDS de talla durante el tratamiento con estrógenos en el G2 fue 0,14ñ0,19 cm, menor que en el G1 (p<0.001). La ganancia de talla durante el tratamiento con estrógenos fue 5.3ñ1.8 cm en el G1 y .6ñ4.2 cm en el G2 (p=0.001).En el G1 el mayor factor predictor de la ganancia de talla durante el tratamiento con GH fue el tiempo de tratamiento previo al IE (r=0.89).