[Characteristics of immigrant women and their neonates]. / Características de las mujeres inmigrantes y de sus hijos recién nacidos.

BACKGROUND: Immigrant status is frequently assumed to constitute a health risk because migration is inevitably associated with a period of significant adjustment and stress. OBJECTIVE: To compare the social characteristics and perinatal outcomes of mothers who deliver in a third level hospital in Spain according to their socioeconomic level of the country of origin. METHODS: From December 2000 to March 2001, women who delivered were selected according to the socioeconomic status of their birth country. All women from low and middle income countries (immigrant mothers) and a sample (1:2) of those from high income countries (mainly Spanish-born mothers) completed a questionnaire on antenatal care, demographic and social characteristics, and country of birth and were followed-up to monitor neonatal clinical features. RESULTS: During the three months of the study, 203/1352 (15 %, CI 13.2-17.1) of the delivering mothers were immigrants. Most were from Central and South America (56 %, CI 49-62). Prenatal care was appropriate in most of the women (in 92.1 % of immigrant mothers and in 96.8 % of Spanish mothers, p 5 0.01). The proportions of premature births, low birth weight and very-low birth weight showed no statistically significant differences between immigrant and Spanish mothers (15 vs. 10.6, 6.4 vs. 9.4, and 2.1 vs. 1.5, respectively, p > 0.05 in all comparisons). Perinatal complications, including an Apgar score < or = 6, and the need for admission to the neonatal unit or to the intensive or intermediate care units, were not more frequent in the newborns of immigrant mothers. Immigrant women had less social or family support after delivery and maternity leave was much less frequent (62 % vs. 90 %, p < 0.001). CONCLUSIONS: Most of the immigrant women had healthy pregnancies and healthy birth outcomes. Perinatal complications do not seem to be more frequent among immigrant women. Differences were found in social support. To improve the health of these children, social support to immigrant women and their children should be intensified.

Renal effects of experimental obstructive jaundice: morphological and functional assessment.

BACKGROUND: The pathophysiology of renal impairments occurring in obstructive jaundice has been extensively studied, but the underlying mechanism of these derangements remains unclear. The aim of the present study was to investigate the time-related morphological and functional changes occurring in the kidneys of rats undergoing obstructive jaundice. METHODS: Histological examination, renal function assessment and determination of (Na + K)-ATPase activity were performed in the kidneys of rats 7, 14, and 21 days following bile duct ligation (BDL) or sham operation (sham). RESULTS: Glomerular filtration rate was unaffected by BDL throughout the period of the study. Tubular effects occurred at days 7 and 14, being more marked at day 7, and consisted of an increase of about twice in the fractional excretion of sodium and chloride, paralleled by a decreased proximal and distal tubular reabsorption of sodium of about 50 and 40%, respectively. Natriuresis was consistent with augmentation of osmolar clearance but it was not associated with changes in the activity of renal (Na+ + K+)-ATPase. The ability to dilute urine was impaired at days 14 and 21 after BDL. Additionally, these effects were accompanied by decreased tubulointerstitial fibrosis and vasodilation of inner medullary capillaries. At day 21, the parameters of tubular function in BDL and sham groups were not significantly different. CONCLUSIONS: These data support the view that raised natriuresis taking place in the initial 2 weeks following BDL is due mainly to tubular effects. The contribution of hemodynamic, paracrine and humoral mediators is discussed.