Impact of anthro-metabolic indices and gestational weight gain on maternal and neonatal outcomes: a prospective observational study.

OBJECTIVE: The aim of this study was to examine the relationship of anthro-metabolic indices on maternal and neonatal outcomes. METHODS: This prospective observational study was conducted on healthy mother-baby pairs between January 1, 2023 and July 1, 2023. Detailed sociodemographic information was collected through an interview with the mother. Clinical, biochemical, obstetric, fetal, and neonatal outcomes were abstracted from hospital medical records. Anthropometric measurements were obtained from the examination of mother-baby pairs. RESULTS: A total of 336 healthy mothers-children pairs were included. Mothers of newborn ≥4000 g had higher gestational age (p=0.003), body mass index (p=0.003), gestational weight gain (p=0.016), waist circumferences (p=0.002), and hip circumferences (p=0.001). gestational weight gain was associated with the mode of delivery (p=0.023). waist-to-hip ratio (p=0.005), gestational weight gain (p=0.013), and a body shape index (p<0.001) were associated with longer length of hospital stay. Age (p<0.001) and inter-pregnancy interval (p=0.004) were higher in pre-pregnancy underweight/obese mothers. Receiver operating characteristic analysis revealed that maternal waist circumferences (AUC: 0.708, p=0.005), maternal weight (AUC: 0.690, p=0.010), and hip circumferences (AUC: 0.680, p=0.015) were sufficient to predict macrosomia (p<0.05). CONCLUSION: The study demonstrated a significant association between gestational weight gain and cesarean delivery, prolonged hospital stay, and macrosomia. It was also found that maternal body mass index, waist circumferences, and hip circumferences during pregnancy were associated with macrosomia. On the contrary, no significant relationship was found between maternal anthro-metabolic characteristics and maternal-fetal and birth outcomes.

Gestational diabetes mellitus and size at birth modify early adiposity accretion. Evidence from the OBESO cohort.

AIM: To evaluate the association between maternal obesity, gestational diabetes (GDM), and birth size with infant fat-mass (FM) accretion from 1 to 6 months (M). METHODS: Healthy pregnant women and their term babies from the OBESO cohort were studied (1 M-3 M, n = 122; 1 M-6 M, n = 90). Registered maternal data was: pregestational body-mass-index (preBMI), GDM (2hOGTT), medications, gestational weight gain. Macrosomia (>4000 g), large/small for gestational age (LGA/SGA)(weight/age > 90° and < 90°, respectively-WHO) were recorded at birth. Infant FM (air-displacement plethysmography) was measured (1 M, 3 M, 6 M) and FM accretion computed (ΔkgFM from 1 M-3 M and 1 M-6 M). Exclusive breastfeeding (EBF) was assessed. Adjusted-multiple linear regression models were performed. RESULTS: PreBMI was 27.4 ± 5.2 kg/m2. GDM was present in9%(n = 11) of women; 12.3%(n = 15) of them received metformin/insulin. One newborn was LGA; 20.7%(n = 25) were SGA. From 1 M-3 M, SGA was a predictor of higher FM accretion (B:0.28, 95%CI:0.14-0.43); GDM was not associated. From 1 M-6 M, higher FM accretion was observed in SGA newborns (B:0.43, 95%CI:0.19-0.67) and GDM infants (B:0.48, 95%CI:0.06-0.89). In all models (R2 ≥ 0.48, p < 0.001), infant weight and being female were positively associated, while maternal obesity, metformin/insulin, and EBF were not. CONCLUSIONS: GDM appears to program early higher adiposity accretion, independently of excessive fetal growth. SGA was associated with higher FM accretion in early infancy.

Risk Factors for Intrapartum Cesarean Section Delivery in Low-risk Multiparous Women Following at Least a Prior Vaginal Birth (Robson Classification 3 and 4).

OBJECTIVE: The aim of the present study was to evaluate the risk factors for cesarean section (C-section) in low-risk multiparous women with a history of vaginal birth. METHODS: The present retrospective study included low-risk multiparous women with a history of vaginal birth who gave birth at between 37 and 42 gestational weeks. The subjects were divided into 2 groups according to the mode of delivery, as C-section Group and vaginal delivery Group. Risk factors for C-section such as demographic characteristics, ultrasonographic measurements, smoking, weight gain during pregnancy (WGDP), interval time between prior birth, history of macrosomic birth, and cervical dilatation at the admission to the hospital were obtained from the charts of the patients. Obstetric and neonatal outcomes were compared between groups. RESULTS: The most common C-section indications were fetal distress and macrosomia (33.9% [n = 77 and 20.7% [n = 47] respectively). A bivariate correlation analysis demonstrated that mothers aged > 30 years old (odds ratio [OR]: 2.09; 95% confidence interval [CI]: 1.30-3.34; p = 0.002), parity >1 (OR: 1.81; 95%CI: 1.18-2.71; p = 0.006), fetal abdominal circumference (FAC) measurement > 360 mm (OR: 34.20; 95%CI: 8.04-145.56; p < 0.001)) and < 345 mm (OR: 3.06; 95%CI: 1.88-5; p < 0.001), presence of large for gestational age (LGA) fetus (OR: 5.09; 95%CI: 1.35-19.21; p = 0.016), premature rupture of membranes (PROM) (OR: 1.52; 95%CI: 1-2.33; p = 0.041), and cervical dilatation < 5cm at admission (OR: 2.12; 95%CI: 1.34-3.34; p = 0.001) were associated with the group requiring a C-section. CONCLUSION: This is the first study evaluating the risk factors for C-section in low-risk multiparous women with a history of vaginal birth according to the Robson classification 3 and 4. Fetal distress and suspected fetal macrosomia constituted most of the C-section indications.

Risk Factors for Intrapartum Cesarean Section Delivery in Low-risk Multiparous Women Following at Least a Prior Vaginal Birth (Robson Classification 3 and 4)

Abstract Objective The aim of the present study was to evaluate the risk factors for cesarean section (C-section) in low-risk multiparous women with a history of vaginal birth. Methods The present retrospective study included low-risk multiparous women with a history of vaginal birth who gave birth at between 37 and 42 gestational weeks. The subjects were divided into 2 groups according to the mode of delivery, as C-section Group and vaginal delivery Group. Risk factors for C-section such as demographic characteristics, ultrasonographic measurements, smoking, weight gain during pregnancy (WGDP), interval time between prior birth, history of macrosomic birth, and cervical dilatation at the admission to the hospital were obtained fromthe charts of the patients. Obstetric and neonatal outcomes were compared between groups. Results The most common C-section indications were fetal distress and macrosomia (33.9% [n=77 and 20.7% [n=47] respectively). A bivariate correlation analysis demonstrated that mothers aged>30 years old (odds ratio [OR]: 2.09; 95% confidence interval [CI]: 1.30-3.34; p=0.002), parity >1 (OR: 1.81; 95%CI: 1.18-2.71; p=0.006), fetal abdominal circumference (FAC) measurement>360mm (OR: 34.20; 95%CI: 8.04 -145.56; p<0.001)) and<345mm (OR: 3.06; 95%CI: 1.88-5; p<0.001), presence of large for gestational age (LGA) fetus (OR: 5.09; 95%CI: 1.35-19.21; p=0.016), premature rupture of membranes (PROM) (OR: 1.52; 95%CI: 1-2.33; p=0.041), and cervical dilatation<5cm at admission (OR: 2.12; 95%CI: 1.34-3.34; p=0.001) were associated with the group requiring a C-section. Conclusion This is the first study evaluating the risk factors for C-section in low-risk multiparous women with a history of vaginal birth according to the Robson classification 3 and 4. Fetal distress and suspected fetal macrosomia constituted most of the Csection indications.

Macrosomía fetal e hipertensión arterial, un dúo olvidado / Macrosomic fetus and high blood pressure, a forgotten pair

Señor Editor: Dentro de los factores de riesgo para el desarrollo de HTA desde precoces edades de la vida se encuentra el peso al nacer.1,2 Múltiples trabajos han abordado el tema desde la perspectiva del peso insuficiente al nacer apoyados en la Teoría Programadora de Barker, demostrando la genuina asociación entre el bajo peso al nacer y la HTA ulteriormente en la vida.3 Sin embargo, la macrosomía fetal no ha sido estudiada con la suficiente fuerza en este sentido a pesar de que constituye otra de las situaciones clínicas que se añaden a la extensa lista de factores de riesgo cardiovascular para el desarrollo de HTA desde la niñez y la adolescencia.4 El primer reporte de macrosomía fetal en la literatura fue realizado por el monje médico Francois Rabelais en el siglo XVI, quien relató la historia del bebé gigante Gargantúa. Muchos años después, la esposa de Gargantúa murió al parir a Pantagruel porque era tan asombrosamente grande y pesado que no podía venir al mundo sin sofocar a su madre. Macrosomía o macrosomatia (macro: grande; soma: cuerpo), etimológicamente significa tamaño grande del cuerpo.5 El peso al nacer de más de 4 000 g que representa aproximadamente al 5 por ciento de todos los nacimientos ha sido considerado en la mayoría de los estudios como sinónimo de macrosomía fetal. Aunque otros estudios le dan mayor relevancia a la definición de macrosomía que considera la edad gestacional y el percentil 90.6,7 Cualquiera que sea la definición de macrosomia empleada, cabe ahora una pregunta: ¿Cuál es el mecanismo fisiopatológico que vincula a la macrosomía fetal con las cifras elevadas de PA? Trabajos recientes han demostrado que el incremento de la resistencia a la insulina y cambios de tipo inflamatorio como aumentos del factor de necrosis tumoral alfa, las interleuquinas 6,8 y los monocitos durante el embarazo exacerbados por el exceso de peso corporal de la madre y los niveles de triglicéridos en sangre son responsables del incremento de la transferencia de lípidos madre-feto desde las primeras semanas de las gestación, lo que se incrementa gradualmente a medida que avanza la gestación. Del mismo modo se plantea que existe una hidrolisis materna de triglicéridos mediada por la lipasa de las lipoproteínas placentaria con incrementos de ácidos grasos libres, los que son transportados a través de la placenta al feto. Este aumento de la exposición fetal a los lípidos tiene un sostenido impacto sobre el hígado, el músculo esquelético, el tejido adiposo, el cerebro y el páncreas programando cambios metabólicos futuros que pueden acontecer incluso desde la niñez, y van desde aumentos en las cifras de PA hasta el síndrome metabólico que se establecen completamente en la adolescencia o adultez joven.8 Otros estudios han demostrado elevaciones de leptina y adipolectina en fetos sobrepesos, lo que igualmente programa en ellos una adipogenesis perturbada con consecuencias deletéreas futuras en el ámbito cardiovascular.9 A todo lo anterior se añaden los cambios de tipo epigenéticos que alteran la expresión de los genes independientemente de la secuencia de genética en su interacción con el ambiente, que en el caso de la sobrenutrición fetal son hasta el momento poco conocidos. Sin embargo, en estudios en modelos de ratones de laboratorio sugieren que la influencia de esta sobrenutrición se hace patente sobre la metilación del ADN y la regulación del MicroARN de MeCP2 en la expresión alternativa del factor de crecimiento parecido a la insulina (insulin like growth factor-2) en el hígado fetal de ratones embarazadas alimentadas con concentraciones elevadas de grasas, lo anterior puede contribuir a disfunción pancreática que precede a la resistencia a la insulina y la esteatosis hepática fetal contribuyendo a la historia natural del desarrollo de alteraciones metabólicas futuras entre las que se incluye la HTA.10 Se conoce además que la sobrenutrición fetal provoca una alteración del eje adipoinsular que permite el desarrollo de obesidad durante la niñez. Esta última, considerada un reconocido factor de riesgo para prehipertensión (preHTA) y HTA posteriormente en la adultez.11 Tomando como premisa las anteriores evidencias, es evidente la relación potencial entre el peso excesivo al nacimiento con importantes precursores y factores causales de cifras anormalmente elevadas de PA (entiéndase preHTA e HTA) desde la niñez, y posteriormente en la vida. Con estos comentarios pretendimos llamar la atención sobre las no pocas veces olvidada macrosomia fetal como factor de riesgo de HTA desde tempranas edades de la vida. Por lo tanto, incluir la valoración del peso excesivo al nacer dentro del pesquisaje epidemiológico para la estratificación del riesgo cardiovascular sería una razonable y necesaria idea a llevar a cabo sobre todo en el nivel de Atención Primaria de Salud, encargado de manera significativa de la completa estratificación del riesgo de los pacientes y sobre todo de la prevención de futuras enfermedades en la población en general(AU)

Hematoma de la vaina de los rectos en un recién nacido macrosómico después de un parto distócico: A propósito de un caso / Rectus sheath hematoma in a macrosomie neonate following difficult delivery: Case report

La macrosomía es un factor de riesgo de traumatismos obstétricos y se asocia con morbimortalidad neonatal. El cefalohematoma y la fractura clavicular son los más frecuentes. Los traumatismos intrabdominales son poco frecuentes. El hematoma de la vaina de los rectos es una acumulación de sangre en la vaina del músculo recto mayor del abdomen. Se asocia con traumatismos, cirugías y tratamiento anticoagulante, en especial en los adultos y las personas de edad avanzada. En este artículo presentamos el caso de un recién nacido de sexo masculino con parto vaginal distócico. Durante el examen físico se observó un hematoma periumbilical de 1 x 1 cm y un cefalohematoma parietal de 1 x 1 cm. En la ecografía abdominal y la tomografía computada del abdomen se observó un hematoma de la vaina del recto derecho de 7 x 4 x 2 cm.

Macrosomia is a risk factor for birth injuries and is associated with neonatal morbidity and mortality. Cephalohematoma and clavicular fracture are the most frequent birth injuries. Intraabdominal injuries are uncommon birth injuries. Rectus sheath hematoma (RSH) is an accumulation of blood in the sheath of rectus abdominis muscle. It is associated with trauma, operations and anticoagulant therapy, especially in adults and elders. We present a macrosomic male neonate with difficult vaginal delivery, who had in the physical examination periumblical ecchymose of 1x1 cm and a parietal cephalohametoma of 1x1 cm. The abdominal ultrasonogram and the computed tomography scan of the abdomen showed a 7x4x2 cm right rectus sheath hematoma.

Rectus sheath hematoma in a macrosomie neonate following difficult delivery. Case report. / Hematoma de la vaina de los rectos en un recién nacido macrosómico después de un parto distócico. A propósito de un caso.

Macrosomia is a risk factor for birth injuries and is associated with neonatal morbidity and mortality. Cephalohematoma and clavicular fracture are the most frequent birth injuries. Intraabdominal injuries are uncommon birth injuries. Rectus sheath hematoma (RSH) is an accumulation of blood in the sheath of rectus abdominis muscle. It is associated with trauma, operations and anticoagulant therapy, especially in adults and elders. We present a macrosomic male neonate with difficult vaginal delivery, who had in the physical examination periumblical ecchymose of 1x1 cm and a parietal cephalohametoma of 1x1 cm. The abdominal ultrasonogram and the computed tomography scan of the abdomen showed a 7x4x2 cm right rectus sheath hematoma.

La macrosomía es un factor de riesgo de traumatismos obstétricos y se asocia con morbimortalidad neonatal. El cefalohematoma y la fractura clavicular son los más frecuentes. Los traumatismos intrabdominales son poco frecuentes. El hematoma de la vaina de los rectos es una acumulación de sangre en la vaina del músculo recto mayor del abdomen. Se asocia con traumatismos, cirugías y tratamiento anticoagulante, en especial en los adultos y las personas de edad avanzada. En este artículo presentamos el caso de un recién nacido de sexo masculino con parto vaginal distócico. Durante el examen físico se observó un hematoma periumbilical de 1 x 1 cm y un cefalohematoma parietal de 1 x 1 cm. En la ecografía abdominal y la tomografía computada del abdomen se observó un hematoma de la vaina del recto derecho de 7 x 4 x 2 cm.

Diabetes mellitus en niños de 7 a 11 años con alto peso al nacer / Diabetes mellitus among 7- to 11-year-old children with high birth weight

INTRODUCCIÓN: la diabetes mellitus es una enfermedad causada por un desorden nutricional que se caracteriza por eliminación excesiva de orina, que frecuente tiene azúcar. La diabetes también puede producir adelgazamiento, sed intensa y otros trastornos. Es una enfermedad que se asocia a un riesgo incrementado de enfermedad coronaria y que en la actualidad ha adquirido el rango de pandemia. OBJETIVO: identificar asociación del alto peso al nacer con la diabetes mellitus en niños de 7 a 11 años. MÉTODOS: se realizó un estudio descriptivo con un diseño de tipo caso-control con los niños nacidos entre enero de 1992 y diciembre de 1995, con el fin de identificar de forma temprana, asociación de la diabetes con el alto peso al nacer en niños de 7 a 11 años. RESULTADOS: se estudiaron los escolares entre 7 y 11 años que se encontraban en el curso de la enseñanza primaria. La población estudiada estuvo representada por 140 y el grupo control por 100. CONCLUSIONES: el alto peso al nacer no constituyó por si solo un factor predictor para la diabetes mellitus.

INTRODUCTION: Diabetes mellitus is a condition caused by a nutrition disorder characterized by excessive discharge of urine, which often contains sugar. Diabetes may also cause weight loss, intense thirst and other disorders. The condition, which is associated with increased risk for coronary heart disease, has currently achieved the rank of pandemic. OBJECTIVE: Identify the association between high birth weight and diabetes mellitus in 7- to 11-year-old children. METHODS: A descriptive case-control study was conducted with children born from January 1992 to December 1995, aimed at early identification of the association between diabetes and birth weight in 7- to 11-year-old children. RESULTS: The children studied were 7- to 11-year-olds attending elementary education. The study population consisted of 140 children, and the control group of 100. CONCLUSIONS: High birth weight of itself was not a predictor of diabetes mellitus.

Childhood Growth Trajectories of Etiological Subgroups of Large for Gestational Age Newborns.

OBJECTIVE: To evaluate whether large for gestational age (LGA) etiological subgroups have differential growth trajectories during early childhood. STUDY DESIGN: Approximately 10,700 infants and their parents were included in the Early Childhood Longitudinal Study-Birth Cohort in 2001-2002. Research staff collected data in 5 waves when participating children were approximately 9 months and 2, 4, 5, and 6 years of age. We analyzed 2950 LGA and appropriate-for-gestational-age (AGA) children with at least 1 growth outcome at ages 9 months, 2 years, and 4 years. We divided 600 LGA newborns into 8 subgroups by maternal overweight or obesity before pregnancy (OW/OB), diabetes mellitus (DM), and excessive gestational weight gain (ExGWG). We used mixed effect regression models to compare trajectories of height (length)-for-age or body mass index (BMI) z scores across LGA subgroups and the AGA reference group. RESULTS: Relative to the reference group, the LGA subgroup with maternal OW/OB and DM but normal gestational weight gain had "continuous high rising" BMI z-score trajectory from 9 months to 4 years and the greatest mean z score at 4 years (2.14 [95% CI, 1.29, 2.98]). The LGA subgroup free of maternal OW/OB, DM, or ExGWG had a similar BMI z-score trajectory ("stable low") from 9 months to 4 years and a similar 4-years mean z score (0.97 [95% CI, 0.75, 1.18] vs 0.72 [95% CI, 0.67, 0.78]) relative to the AGA reference group. CONCLUSIONS: The LGA subgroup with co-occurrence of maternal OW/OB and DM had the greatest 4-year BMI, whereas the LGA subgroup free of maternal OW/OB, DM, or ExGWG were tall but lean ("a healthy phenotype").

Macrosomía fetal y complicaciones maternas y neonatales en usuarias de parto vaginal. Hospital Nacional Daniel Alcides Carrión, Callao 2014 / Fetal macrosomia and maternal complications and neonatal in women with vaginal delivery. National Hospital Daniel Alcides Carrion, Callao 2014

Objetivo: Determinar las complicaciones maternas y neonatales asociadas a la macrosomía fetal en usuarias de parto vaginal atendidas en el hospital nacional Daniel Alcides Carrión durante el año 2014. Metodología: Estudio observacional descriptivo-comparativo. Resultados: La hemorragia posparto se asocia con la presencia de macrosomía fetal (p=0.03); otras complicaciones maternas como: el desgarro perineal, el desgarro cervical, la hipodinamia, la hipotonía y el trabajo de parto prolongado no se asociaron con los casos de macrosomía fetal. El Apgar al minuto menor a 7 puntos se asoció con la presencia de macrosomía fetal (p=0.004); otras complicaciones neonatales como: la distocia de hombros, la asfixia neonatal, el moldeamiento, el caput succedaneun, el cefalohematoma, la parálisis braquial, la hipoglicemia y la muerte neonatal tampoco se asociaron con los casos de macrosomía fetal. Conclusión: La complicación materna y neonatal asociada a la macrosomía fetal en usuarias de parto vaginal atendidas en el Hospital Nacional Daniel Alcides Carrión durante el año 2014 fueron la hemorragia posparto y Apgar al minuto menor a 7 puntos.

Objective: Determine maternal and neonatal complications associated with fetal macrosomia in women using vaginal delivery at the National Hospital Daniel Alcides Carrion during 2014. Methodology: Observational study of comparative-descriptive. Results: Postpartum hemorrhage is associated with the presence of fetal macrosomia (p = 0.03), other maternal complications such as: perineal tear, cervical tear, hypodynamic, hypotonia and prolonged labor were not associated with cases of fetal macrosomia. The Apgar at minute less than 7 points was associated with the presence of fetal macrosomia (p = 0.004), other neonatal complications such as shoulder dystocia, neonatal asphyxia, head molding, the succedaneum caput, cephalohematoma, brachial palsy, neonatal hypoglycemia and death were not associated with cases of fetal macrosomia. Conclusions: Maternal and neonatal complication associated with macrosomia in women using vaginal delivery at the National Hospital Daniel Alcides Carrion during 2014 was the postpartum bleeding, Apgar less than 7.

The prevalence of glucose metabolism disturbances in Chinese Muslims and possible risk factors: a study from northwest China.

OBJECTIVE: To survey the prevalence of diabetes mellitus (DM) and pre-diabetes mellitus (PDM) in the Muslim population in northwest China, and discuss the risk factor. MATERIALS AND METHODS: According to the income and the population, we randomly selected 3 villages with stratified and cluster sampling. The subjects were residents ≥ 20 years of age, and were from families which have been local for > 3 generations. The questionnaire and oral glucose tolerance test (OGTT) were completed and analyzed for 660 subjects. RESULTS: The prevalence of DM and PDM between the Han and Muslim populations were different (P = 0.041). And the prevalence were also different with respect to age in the Han (P < 0.001) and Muslim population (P < 0.001) respectively. Except for the 20-year-old age group the prevalence of DM and PDM within the Muslim population was higher than the Han (P = 0.013), we did not find any significant difference for other age groups (P > 0.05). The intake of salt (P < 0.001) and edible oil (P < 0.001) in the Muslim population was higher than the Han, while cigarette smoking (P < 0.001) and alcohol consumption (P < 0.001) was lower. BMI (P < 0.001), age (P = 0.025), and smoking cigarettes (P = 0.011) were risk factors for DM and PDM, but alcohol consumption (P < 0.001) was a protective factor. CONCLUSIONS: In northwest China, the prevalence of DM was higher in the Muslim population, and it was special higher on the 20-year-old age compared to the Han. This might be explained by the potential genetic differences and poor dietary habits.

The prevalence of glucose metabolism disturbances in Chinese Muslims and possible risk factors: a study from northwest China / Prevalência e possíveis fatores de risco de distúrbios no metabolismo da glicose em chineses muçulmanos: um estudo no noroeste da China

Objective To survey the prevalence of diabetes mellitus (DM) and pre-diabetes mellitus (PDM) in the Muslim population in northwest China, and discuss the risk factor. Materials and methods According to the income and the population, we randomly selected 3 villages with stratified and cluster sampling. The subjects were residents ≥ 20 years of age, and were from families which have been local for > 3 generations. The questionnaire and oral glucose tolerance test (OGTT) were completed and analyzed for 660 subjects. Results The prevalence of DM and PDM between the Han and Muslim populations were different (P = 0.041). And the prevalence were also different with respect to age in the Han (P < 0.001) and Muslim population (P < 0.001) respectively. Except for the 20-year-old age group the prevalence of DM and PDM within the Muslim population was higher than the Han (P = 0.013), we did not find any significant difference for other age groups (P > 0.05). The intake of salt (P < 0.001) and edible oil (P < 0.001) in the Muslim population was higher than the Han, while cigarette smoking (P < 0.001) and alcohol consumption (P < 0.001) was lower. BMI (P < 0.001), age (P = 0.025), and smoking cigarettes (P = 0.011) were risk factors for DM and PDM, but alcohol consumption (P < 0.001) was a protective factor. Conclusions In northwest China, the prevalence of DM was higher in the Muslim population, and it was special higher on the 20-year-old age compared to the Han. This might be explained by the potential genetic differences and poor dietary habits. .

Objetivo Avaliar a prevalência de diabetes melito (DM) e pré-diabetes melito (PDM) na população muçulmana no noroeste da China e discutir os fatores de risco. Materiais e métodos Selecionamos três vilarejos de acordo com a renda e a população, usando uma amostra estratificada e por cluster. Os sujeitos eram residentes com ≥ 20 anos de idade e de famílias que estavam no local há mais de três gerações. Foram feitos e analisados um questionário e o teste de tolerância oral à glicose (TTOG) para 660 sujeitos. Resultados A prevalência do DM e PDM entre as populações Han e muçulmana foi diferente (P = 0,041), e as prevalências também foram diferentes com relação à idade na população Han (P < 0,001) e muçulmana (P < 0,001), respectivamente. Exceto pela faixa etária de 20 anos de idade, a prevalência do DM e PDM na população muçulmana foi maior do que na população Han (P = 0,013), não havendo diferenças significativas para as outras faixas etárias (P > 0,05). A ingestão de sal (P < 0,001) e óleos comestíveis (P < 0,001) na população muçulmana foi mais alta do que na população Han, enquanto o tabagismo (P < 0,001) e consumo de álcool (P < 0,001) foram mais baixos. O IMC (P < 0,001), a idade (P = 0,025) e o tabagismo (P = 0,011) foram fatores de risco para o DM e PDM, mas o consumo de álcool (P < 0,001) foi um fator protetor. Conclusões No noroeste da China, a prevalência de DM é maior na população muçulmana e é especialmente mais alta na faixa etária de 20 anos de idade, quando comparada com a população Han. Isso pode ser explicado por diferenças genéticas potenciais e hábitos alimentares ruins. .

Caracterización de la morbi-mortalidad de los neonatos cuyo peso oscila entre 4000-4500 gr. según el tipo de parto en el Hospital Nacional Daniel Alcides Carrión entre Enero a Diciembre del 2012 / Characterization of the morbidity and mortality of newborn whose weight ranges between 4000-4500 g depending on the type of labor in the National Hospital Daniel Alcides Carrion between January to December 2012

Objetivo: Caracterizar la morbi-mortalidad de los neonatos cuyo peso oscila entre 4000-4500 gr. según el tipo parto en el Hospital Nacional Daniel Alcides Carrión entre enero y diciembre del 2012. Métodos: Estudio de tipo observacional, descriptivo, transversal y retrospectivo. Se incluyó a todas las madres cuyo parto fue atendido entre enero y diciembre del 2012 y cuyos productos hayan pesado entre 4000 y 4500 gramos en el servicio de Ginecología y Obstetricia del Hospital Nacional Daniel A. Carrión. Se revisó las historias clínicas de las madres y los neonatos y se analizaron las variables según la vía de parto (vaginal o cesárea). La investigación fue aprobada por el Comité Ético y Metodológico del HNDAC. Resultados: Se recolectaron los datos de 180 pares de madres y sus neonatos. La media de edad de las madres fue de 27.31 ± 6.7 años. El 33.6 por ciento de las madres tuvieron algún antecedente de aborto y 12.5 por ciento algún antecedente de macrosomia. La vía de parto más común fue la vía vaginal con un 73.4 por ciento, mientras que la vía vaginal representó un 26.6 por ciento de los partos. Con respecto a las complicaciones neonatales, existieron mayores complicaciones en la vía vaginal (6.67 por ciento) en comparación con los partos por cesárea (5.26 por ciento); sin embargo la diferencia encontrada no fue significativa. Al análisis bivariado se encontró diferencias significativas entre el número de gestaciones previas (p=0.004), la multiparidad (p=0.002), la obesidad materna (p=0.002), la talla al nacer (p=0.003); siendo estas mayores en los partos nacidos por vía vaginal; mientras que se encontró un mayor número de casos de sufrimiento fetal agudo (p=0.004) en los neonatos nacidos de cesárea. Conclusiones: Los partos de neonatos cuyo peso oscila entre 4000 y 4500 gr cursan con complicaciones tanto obstétricas como perinatales, sin embargo no se encontró diferencias según la vía de parto. Variables como el número de gestaciones previas, la...

Objective: To characterize the morbidity and mortality of neonates weighing between 4000-4500 g according to the type of delivery in Daniel Alcides Carrion National Hospital between January and December 2012. Methods: An observational, descriptive, cross-sectional and retrospective study. We included all mothers and neonates whose birth was attended between January and December 2012 and whose products have weighed between 4000 and 4500 grams in the service of Gynecology and Obstetrics Hospital National Daniel A. Carrion. Medical records of the mothers and infants were reviewed and variables were analyzed according to mode of delivery (vaginal or cesarean). The research was approved by the Ethical and Methodological Committee of HNDAC. Results: Data from 180 pairs of mothers and their infants were collected. The mean age of the mothers was 27.31 ± 6.7 years. 33.6 per cent of the mothers had a history of abortion and 12.5 per cent a history of macrosomia. The most common route of delivery was vaginal with 73.4 per cent, while the vaginal represented 26.6 per cent of births. Regarding neonatal complications, no major complications were found in vaginal (6.67 per cent) compared with cesarean deliveries (5.26 per cent), been the difference not significant. In bivariate analysis, significant differences between the number of previous pregnancies (p=0.004), multiparity (p=0.002), maternal obesity (p=0.002), birth length (p=0.003) was found, being higher in these births born vaginally, while a greater number of cases of acute fetal distress (p=0.004) in infants born cesarean was found. Conclusions: The births of infants weighing between 4000 and 4500 g present with both obstetric and perinatal complications, however no differences were found according to the route of delivery. Variables such as the number of previous pregnancies, multiparity and maternal obesity are related to the completion of vaginal delivery. An association between acute fetal distress and birth...

A five-year retrospective review of infants with Erb-Duchenne's palsy at a teaching hospital in North Trinidad.

Birth injuries are devastating to parents and carers alike. They carry the possibility of residual loss of function to the infant and thus the potential for litigation. The aim of this study was to determine the incidence of Erb-Duchenne's palsy and the identification of any contributing factors. A retrospective review over a five-year period, 2005-2009, was performed and an incidence of 0.94 per 1000 live births was noted. An association between both macrosomia and shoulder dystocia and the development of Erb-Duchenne palsy in the newborn was noted. The authors recommended the use of partograms and improved note documentation in the management of labour.

Macrosomia fetal: prevalencia, factores de riesgo asociados y complicaciones en el Hospital Regional de Ica, Perú / Fetal macrosomia: prevalence, risk factors associated and complications in the Regional Hospital in Ica, Peru

Objetivo: Determinar la prevalencia de macrosomía fetal, identificar los factores de riesgo materno asociados y las principales complicaciones de los recién nacidos macrosómicos atendidos en un hospital de la provincia de Ica, Perú. Material y métodos: Estudio descriptivo, retrospectivo, transversal, incluyó a 129 recién nacidos macrosómicos, durante el periodo comprendido entre el 1 de enero al 31 de diciembre del 2,002.Resultados:De 2,550 recién nacidos en el periodo de estudio, 129 (5%) fueron macrosómicos, la edad materna fue de 31 a 40 años en el 58%, el peso habitual de 70 a 99 Kg. en el por81%, multiparidad 65% y embarazo prolongado 7%. El 53% nació por parto vaginal y el 47% cesárea. El sexo predominante fue el femenino con el 62%, el Apgar promedio entre 7 y 10 al minuto representó el 93%, la edad gestacional por examen físico (Test de Capurro) fue de 37 a 41 semanas en el 93% de los casos. Respecto al peso al nacimiento 99.2%pesó entre 4,000 y 4,999gr, 0.8% pesó más de 5,000gr. (Peso promedio 4,194gr,mínimo 4,000gr, máximo 5,180gr). La morbilidad neonatal representó el 30%. No tuvimos mortalidad neonatal. Las principales complicaciones fueron: 5%hiperbilirrubinemia, 2% hipoxia perinatal, 8% hipoglucemia y 15% trauma obstétrico. Conclusiones: La Prevalencia de macrosomía fue 5%, los factores maternos asociados fueron: la edad materna mayor de 30 años y el peso promedio habitual de la madre mayor de 70 Kg, multiparidad y embarazo prolongado. El sexo predominante fue el femenino. No hubo diferencia significativa en lo referente a la vía de terminación del parto. Las principales complicaciones fueron: traumatismo obstétrico (cefalohematoma, caput sucedaneum y fractura de clavícula), hiperbilirrubinemia e hipoglucemia. (AU)

Objective: To Determine the prevalence of fetal macrosomia, identify the maternal risk factors associated and the main complications of macrosomic newborns treated at a hospital in the province of Ica, Peru. Methods: Descriptive study, retrospective, cross-sectional, included 129 macrosomic newborns, during the period from January 1 to December 31 of January 2002.Results:Of 2550 newborns in the study period, 129 (5 %) were macrosomic, maternal age was 31 to 40 years in the 58 %, the usual weight of 70 to 99 kg in the 81 %, 65% and multiparity prolonged pregnancy 7 %. The 53% was born by vaginal birth and 47 per cent by cesarean section. The predominant sex was female with 62 %, the Apgar score average between 7 and 10 to minute represented 93 %, the gestational age by physical exam (Test of Capurro) was 37 to 41 weeks in93% of the cases. With regard to birth weight 99.2 % weight between 4.000 and 4.999 gr, 0.8 % weight more than 5.000 gr.(Average Weight 4.194 gr, minimum 4.000 gr, maximum 5.180 gr). Neonatal morbidity represented 30 %. We had no neonatal mortality. The main complications were: 5% hyperbilirubinemia, 2% perinatal hypoxia, hypoglycemia, and 8% 15% obstetric trauma .Conclusions: The prevalence of macrosomia was 5 %, the associated maternal factors were: the maternal age greater than 30 years and the average weight of the usual mother greater than 70 Kg, multiparity and prolonged pregnancy. The predominant sex was female. There was no significant difference in regard to route of completion of the birth . The main complications were: obstetric trauma (cephalohematoma, caput sucedaneum and clavicle fracture), hyperbilirubinemia and hypoglycemia. (AU)