RESUMEN
BACKGROUND: Prenatal ethylene oxide exposure may have adverse effects on fetal development. We examined the relationships between ethylene oxide hemoglobin (Hb) adduct levels and offspring's size at birth in a prospective European mother-child study. METHODS: This study included 1106 singletons from the NewGeneris project (2006-2010) with ethylene oxide Hb adducts measured in cord blood. We examined the relationships between adduct levels and offspring's size at birth among all infants and separately among infants of nonsmokers, using linear regression models for birth weight and birth head circumference and logarithmic binomial regression models for small for gestational age. We examined potential interactions between CYP2E1 single nucleotide polymorphisms in cord blood and the effects of ethylene oxide Hb adduct levels on offspring birth size. RESULTS: Higher quartiles of adduct levels as a measure of exposure were associated with decreasing birth weight and head circumference in the overall population. Compared to infants in the lowest quartile, those in the highest quartile exhibited lower birth weight (-70.73 g, 95% confidence interval = -141.16, -0.30) and reduced head circumference (-0.30 cm, 95% confidence interval = -0.58, -0.02). We observed similar, albeit less pronounced, patterns among infants of nonsmokers. There was no evidence of an association between ethylene oxide Hb adducts and risk of small for gestational age, nor consistent evidence of an interaction with CYP2E1 polymorphisms on the association between EO Hb adduct levels and offspring's size at birth. CONCLUSION: Results suggest that higher ethylene oxide Hb adduct levels in cord blood are associated with a reduction in offspring birth size.
Asunto(s)
Peso al Nacer , Citocromo P-450 CYP2E1 , Óxido de Etileno , Sangre Fetal , Hemoglobinas , Humanos , Sangre Fetal/química , Femenino , Recién Nacido , Embarazo , Peso al Nacer/efectos de los fármacos , Citocromo P-450 CYP2E1/genética , Estudios Prospectivos , Masculino , Europa (Continente) , Hemoglobinas/análisis , Adulto , Polimorfismo de Nucleótido Simple , Exposición Materna/efectos adversos , Efectos Tardíos de la Exposición Prenatal , Modelos Lineales , Recién Nacido Pequeño para la Edad Gestacional , Estudios de CohortesRESUMEN
Objetivo: El objetivo del estudio fue analizar el perfil sociodemográfico y obstétrico, así como la incidencia de consultas y reingresos, de las mujeres acogidas a un programa de corta estancia puerperal en el hospital del estudio. Metodología: Se realizó un estudio descriptivo de las variables relativas al perfil sociodemográfico, el embarazo, el parto y el puerperio de las mujeres con parto vaginal y alta precoz antes de 48 horas en el Hospital del Mar (Barcelona), desde junio de 2017 a junio de 2019. Resultados: 188 mujeres (un 8,2% del total de partos vaginales) se acogieron a la corta estancia hospitalaria durante el periodo de estudio. El 53,7% (n= 101) eran de nacionalidad española, y el resto eran de 32 nacionalidades distintas más. El 74,5% (n= 140) habían tenido uno o más partos previos, y el 84,6% (159) eran gestantes sin riesgo. El 95,7% de las mujeres (n= 180) tuvieron partos eutócicos. Un 7% (n= 13) de mujeres tuvieron que consultar en el hospital durante la primera semana después del alta por diferentes motivos. Tuvieron que consultar e ingresar un 2,1% (n= 4) de los neonatos con alta precoz, todos ellos por ictericia. No hubo ningún reingreso materno. Conclusiones: El perfil de mujeres que se acogen al programa de alta precoz en el centro del estudio son gestantes de bajo riesgo y presentan menos complicaciones en el parto que el resto de la población. No hubo más complicaciones o readmisiones hospitalarias en las mujeres con alta precoz respecto al global de los partos del centro del estudio. La implementación de un programa de corta estancia puerperal en nuestra institución es un procedimiento seguro, pero aceptado por un perfil de mujeres específico. (AU)
Objective: The objective of the study is to analyze the different mothers and newborns profiles who attend this program, and to analyze the different readmission rates comparing to the overall population that come for the usual childbirth in the hospital. Methodology: A descriptive study was performed, analyzing socio-demographic, obstetrical and partum and post-partum outcomes in women who attended to an early post-partum discharge before 48h after a vaginal delivery in Hospital del Mar (Barcelona), from June 2017 to June 2019. Results: 188 women (8.2% of total of vaginal deliveries) had the early post-partum discharge, 53.7% (n= 101) were Spanish women, 74.5% (n= 140) of women had already children, and 84.6% (n= 159) had no obstetrical risk factors. 95.7% (n= 180) women had eutocic deliveries, 7% (n= 13) of mother had to readmission to the hospital after the early discharge during the first week. There was only a 2.1% (n= 4) of newborns with early discharge that need to readmission; all of them because of neonatal hyperbilirubinemia. Conclusions: Most of women who attend to an early post-partum discharge are low risk pregnancies and deliveries. There are no higher mother readmission rates respect to the overall population. The implementation of an early post-partum discharge in the maternity unit in the institution is a safe process, but still accepted by a specific maternal profile of women. (AU)
Asunto(s)
Humanos , Femenino , Embarazo , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Tiempo de Internación , Servicios de Salud Materno-Infantil , Epidemiología Descriptiva , Alta del Paciente , Responsabilidad Parental , Ictericia , Readmisión del PacienteRESUMEN
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