RESUMO
OBJECTIVE: We sought to assess reproductive fitness differences between mitochondrial deoxyribonucleic acid haplogroups at high altitude. STUDY DESIGN: This study considers differences in outcomes of conception, birth weight, and neonatal mortality rates for 62 women classified according to haplogroups (B or non-B). RESULTS: The number of low-weight births (<2500 g) for the non-B group was significant (P =.019). Mothers in the non-B group reported more spontaneous abortions (P =.171) and stillbirths (P =.301). The difference in conceptions per woman between groups was significant (P =.036). However, no difference in infants alive at 1 month of age was evident. Neonatal death was significant (P =.017). The odds of an unsuccessful outcome among mothers in the B group was compared with mothers in the non-B group and was significant (P =.029). The chance of an adverse outcome, that is, fetal or infant death before 1 month, for mothers in the B group was between 11.1% and 88.7% lower than for mothers in the non-B group. CONCLUSIONS: The neonatal mortality rate for the non-B group was significantly elevated relative to the B group. The molecular basis for these observations is not clear.
Assuntos
Altitude , DNA Mitocondrial/genética , Haplótipos , Mortalidade Infantil , Recém-Nascido de Baixo Peso , Aborto Habitual/epidemiologia , Adulto , Peso ao Nascer , Feminino , Fertilização , Morte Fetal/epidemiologia , Humanos , Incidência , Recém-Nascido , Prontuários Médicos , Gravidez , Complicações na Gravidez/epidemiologia , Resultado da Gravidez , Fatores de RiscoAssuntos
Testes de Fixação do Látex , Complicações Infecciosas na Gravidez/diagnóstico , Infecções Estreptocócicas/diagnóstico , Streptococcus agalactiae , Adolescente , Adulto , Feminino , Ruptura Prematura de Membranas Fetais , Humanos , Recém-Nascido , Trabalho de Parto Prematuro , Gravidez , Sensibilidade e EspecificidadeRESUMO
The maternal-fetal/neonatal considerations regarding management near the limits of viability are becoming increasingly complex. This article presents a data base upon which to formulate clinical decisions. Epidemiologic and financial considerations are discussed, and a perinatal management approach to the more common clinical situations is provided.