Differential rates of induced abortion in Spain: educational attainment and age among native and immigrant women.

OBJECTIVE: Analyzing the variations in induced abortion (IA) rates across different subpopulations in Spain based on country of origin, while considering educational and age composition. METHOD: Using 2021 Voluntary Termination of Pregnancy register and 2021 Spanish Census microdata, we calculated crude IA rates and age-specific abortion rates. We used age-standardized IA rates (ASIAR) to account for the confounding effect of age composition. We compared seven subpopulations residing in Spain, taking into account simple ages and educational levels aggregated into four categories. RESULTS: Immigrant women, especially those from Sub-Saharan and Latin American countries, consistently had higher IA rates compared to native Spanish women. According to age-specific IA rates, university-educated women had considerably fewer abortions than women with other education levels at any age. Age-standardized rates stratified by migratory origin revealed that native Spanish women with primary education or less had higher IA rates than their immigrant counterparts. There was a clear non-linear, association between educational level and IA rates among immigrants. The highest propensity for IA was found among secondary school graduates, while university graduates had the lowest IA rate. CONCLUSIONS: The study demonstrated that variability in sociodemographic characteristics had an impact on IA rates. Young women with middle educational attainment and immigrant background had a higher likelihood of undergoing IA in Spain. The relationship between educational level and IA rates was complex, with variations observed among different groups and changes over time.

Social inequalities, advanced maternal age, and birth weight. Evidence from a population-based study in Spain.

OBJECTIVE: To examine whether advanced maternal age (≥40 years) is linked to an increased likelihood of low or high birth weight among native and foreign-born mothers giving birth in Spain. METHOD: A cross-sectional study was conducted using a novel database provided by the Spanish National Statistics Office which links the 2011 Census with information on individual births (2011-2015) from the Vital Statistics (Natural Movement of the Population). First, multinomial logistic regression models were used to estimate the potential association between maternal age and the likelihood of having a baby with low or high birth weight. Second, average adjusted predictions of giving birth to children with low, high, and adequate weight for the origin and the maternal age at birth were also calculated. RESULTS: Findings indicate that women with advanced maternal age showed an increased probability of giving birth to low birth weight infants. Conversely, mothers aged below <30 years had an elevated risk for high birth weight infants. When considering maternal migratory status, the findings were mixed. On one hand, foreign-born mothers showed a higher likelihood of delivering infants with high birth weight; on the other, they displayed a lower risk of low birth weight among newborns in comparison to Spanish natives. CONCLUSIONS: The study addresses two key aspects. First, it highlights the increased risk of low birth weight in mothers delivering at an advanced age. Second, it emphasizes the importance of accounting for maternal migratory status when investigating the association between age at birth and birth weight outcomes among immigrant mothers.

Latina paradox in Spain? Arrival-cohort effects on the birthweight of newborns of Latina mothers.

This study analyses the arrival-cohort effects on the newborn birthweight of Latina women residing in Spain. First, it has been tested whether women of Latin American origin in Spain have an advantage in terms of birth outcomes, a pattern previously documented in the United States and referred to as the 'Latin American paradox'. Second, it has been examined whether this health advantage of Latina mothers varies by arrival cohort.A novel database provided by the Spanish National Statistics Office that links the 2011 Census with Natural Movement of the Population records from January 2011 to December 2015 has been used. Poisson regression models were applied to test for differences in the incidence rates of low birthweight (LBW) and high birthweight (HBW) among children of Latina and native mothers, controlling for various demographic, socio-economic, and birth characteristics.Two distinct arrival-cohort effects on perinatal health were observed. On one hand, first-generation Latina women were found to be at a lower risk of giving birth to LBW infants; however, they experienced a higher incidence of HBW during the study period. Second, Latina women of 1.5 generation, likely stressed by increased exposure to the receiving country, exhibited adverse birthweight results.

Social inequalities, advanced maternal age, and birth weight. Evidence from a population-based study in Spain / Desigualdades sociales, edad materna avanzada y peso al nacer. Evidencia de un estudio basado en la población en España

Objective To examine whether advanced maternal age (≥40 years) is linked to an increased likelihood of low or high birth weight among native and foreign-born mothers giving birth in Spain. Method A cross-sectional study was conducted using a novel database provided by the Spanish National Statistics Office which links the 2011 Census with information on individual births (2011-2015) from the Vital Statistics (Natural Movement of the Population). First, multinomial logistic regression models were used to estimate the potential association between maternal age and the likelihood of having a baby with low or high birth weight. Second, average adjusted predictions of giving birth to children with low, high, and adequate weight for the origin and the maternal age at birth were also calculated. Results Findings indicate that women with advanced maternal age showed an increased probability of giving birth to low birth weight infants. Conversely, mothers aged below < 30 years had an elevated risk for high birth weight infants. When considering maternal migratory status, the findings were mixed. On one hand, foreign-born mothers showed a higher likelihood of delivering infants with high birth weight; on the other, they displayed a lower risk of low birth weight among newborns in comparison to Spanish natives. Conclusions The study addresses two key aspects. First, it highlights the increased risk of low birth weight in mothers delivering at an advanced age. Second, it emphasizes the importance of accounting for maternal migratory status when investigating the association between age at birth and birth weight outcomes among immigrant mothers. (AU)

Objetivo Examinar si la edad materna avanzada (>40 años) está relacionada con una mayor probabilidad de bajo o alto peso al nacer en los nacidos de madres inmigrantes y nativas en España. Método Se utiliza una base de datos novedosa proporcionada por el Instituto Nacional de Estadística de España que vincula el Censo de 2011 con información sobre nacimientos individuales (2011-2015) de las Estadísticas Vitales (Movimiento Natural de la Población). Los modelos de regresión logística multinomial se utilizaron para estimar la posible asociación entre la edad materna y la probabilidad de bajo o alto peso en los nacidos. Se calcularon predicciones ajustadas promedio para el peso bajo, alto y adecuado según el origen y la edad materna. Resultados La edad materna avanzada se asocia con una mayor probabilidad de bajo peso en los nacidos. Por el contrario, las madres menores de 30 años presentan un riesgo elevado de tener bebés con alto peso. Sin embargo, al considerar el origen materno, los resultados fueron mixtos. Por un lado, las madres nacidas en el extranjero mostraron una mayor probabilidad de nacidos con alto peso; por otro, presentaron un menor riesgo de bajo peso en los nacidos. Conclusiones El estudio destaca dos aspectos clave. En primer lugar, pone de relieve el mayor riesgo de bajo peso al nacer en las madres que dan a luz a una edad avanzada. En segundo, la importancia de tener en cuenta el estatus migratorio materno en la asociación entre la edad materna y el peso al nacer. (AU)

Eficacia de la glibenclamida con metformina en el control de la glicemia en pacientes con diabetes mellitus tipo 2 / Effectiveness of glibenclamida with metformina in the check of glicemia in patients with diabetes mellitus type 2

Para evaluar la glicemia de la combinación glibenclamida-metformina en pacientes diabéticos con diabetes mellitus tipo 2 que no lograron el control glicémico con glibenclamida sola, se realizó un estudio longitudinal en 138 pacientes diabéticos del Hospital I Luis Albrecht EsSalud de Trujillo. El promedio de edad fue 58,1 (+ DE 9,14 años) y el índice de masa corporal (28,32 (+ DE 4,17 kg/m²). Se administró la combinación glibenclamida (5 a 10 mg/día) más metformina (850 a 1700 mg/día). El control glicémico a los tres meses de tratamiento con la combinación se logró en 30, 43 por ciento de pacientes según el criterio de la glucosa de ayuno y en 42,03 por ciento sgún el criterio de la HbA1c. La terapia con la combinación glibenclamida-metformina permitió reducir el valor promedio de glicemia de ayuno de 219,71 mg/dL (+DE 56,07) a 164,22 mg/dL (+De=53,53)( p < 0,01), y la HbA1c de 9,03 por ciento (+ DE=1,35) a 7,99 por ciento (+ DE=1,89) (p< 0,01). Además, se logró una reducción del peso de los pacientes a los tres meses de 71,48 kg (+ DE = 11,33) a 68,90 kg (+DE = 11,40) ( p < 0,01). Se concluye que la combinación glibenclamida-metformina es eficaz para mejorar el control de glicemia de los pacientes con diabetes mellitus tipo 2 que no habían logrado un control adecuado con la sulfonilurea sola. Además posterga el empleo de insulina por lo que, probablemente, reduce costos y la utilización de recursos.