[Maternal risk factors associated to stillbirth in a public hospital at West of Mexico]. / Factores de riesgo materno asociados a muerte fetal en nacimientos pretérmino en un hospital público del occidente de México.

INTRODUCTION: Mortality rates in preterm births and stillbirth are high. OBJECTIVE: To identify maternal risk factors relating to stillbirth in preterm infants. MATERIAL AND METHODS: We conducted a cross-sectional, analytic study of 1,022 newborns between 20 and 36 weeks of gestation, from September 2004 to August 2005. Stillbirth was defined as fetal death prior to expulsion or extraction from the mother. Data was collected prospectively by directly interviewing the pregnant women and from the medical chart. The dependent variable was stillbirth and the independent ones were the maternal risk factors. Associations were evaluated by logistic regression. RESULTS. One thousand and twenty-four (1,024) preterm births were detected in a total of 14,882 births (6.9%/year). One hundred and fifty-two (152) were stillborn and 870 were live births. The fetal mortality rate was 10.3 per 1,000 live births. The least common maternal factors associated to stillbirth included: urinary tract infection (22/152, 14% vs. 224/869, 26%, p = 0.020), PMR > 24 h (18/152, 12% vs. 172/869, 20%, p = 0.020) and cesarean delivery (24/138, 17% vs. 344/719, 48%, p < 0.001). The crude odd risk ratios for stillbirth included spontaneous preterm delivery (OR 4.38, CI95% 2.70-7.17) and deficient prenatal care (OR 2.64, CI95% 1.83-3.82). By multivariate analysis, stillbirth predictors included: spontaneous preterm delivery (OR 4.00, CI 95% 2.61-6.61) and deficient prenatal care (OR 2.54, CI 95% 1.78-3.62). CONCLUSION: Deficient prenatal care was the only statistically significant and clinically coherent variable predicting stillbirth.

[Preauricular tags: prevalence, clinical characteristics and maternal risk factors]. / Apéndice preauricular: prevalencia, caracteristicas clínicas y factores de riesgo materno.

OBJECTIVE: To determine prevalence and maternal risk factors associated with preauricular tags. MATERIAL AND METHOD: A case-control study of 254 newborns with isolated preauricular tags not considered part of a syndrome and their controls, and who were delivered at the Hospital Civil de Guadalajara Dr. Juan I. Menchaca between 1990 and 2003. The maternal risk factors were demonstrated by means of a direct interview with the mother. RESULTS: The prevalence of the isolated preauricular tags was 1.96 per 1,000 newborns alive, in a 1.2 men for each woman. The history of another affected relative was strongly associated with preauricular tags (OR 19.28; 95% CI: 4.44-117.60). Infants with preauricular tags frequently showed parents consanguinity (OR 3.04; 95% CI: 0.28-76.26), maternal age > or =35 years (OR 1.14; 95% CI: 0.53-2.48), exposure to some disease (OR: 1.23, 95% CI: 0.72-2.12), and drugs use in the first trimester of pregnancy (OR: 1.11; 95% CI: 0.65-1.92). No associations were found for the frequency of abortion, exposure to organic solvents and maternal occupation. CONCLUSIONS: The prevalence of isolated preauricular tags in this population was similar to that reported in other regions of Latin America, but lower to the prevalences in Sweden and Israel. This malformation has an important hereditary component; however, it is probably that some teratogenic factors, such as diabetes mellitus, can increase its frequency.

[Risk factors for dislypidemia in obese children and adolescents]. / Factores de riesgo de dislipidemia en niños y adolescentes con obesidad.

OBJECTIVE: To assess the risk of dislypidemia associated with obesity in children and adolescents. MATERIAL AND METHODS: A cross sectional study was conducted with 62 obese children (BMI > 95 centile and tricipital skinfold thickness > 90 centile) and 70 non-obese children (BMI 5-85 centile) ages 5-15 years, without chronic diseases. Subjects' characteristics and family background of chronic diseases were collected and a lipid profile was determined. The risk of lipid alterations in the obese children was calculated using odds ratio (OR) and multivariate analysis. RESULTS: Mean age was 9.8 +/- 2.7 years in both groups; 63 girls and 69 boys were included. Obesity was associated with abnormal values for cholesterol, triglycerides, LDL, HDL and dislypidemia (> 1 abnormal value) (OR 4.47-15.0). In obese children and adolescents the multivariate analysis showed that female gender was associated with dislypidemia. CONCLUSION: Obesity in children and adolescents is associated with high risk of dislypidemia; the risk is higher among females.

Factores de riesgo de dislipidemia en niños y adolescentes con obesidad / Risk factors for dislypidemia in obese children and adolescents

OBJETIVO: Evaluar el riesgo de dislipidemia asociado a obesidad en niños y adolescentes. MATERIAL Y MÉTODOS: En un estudio transversal analítico se incluyeron 62 niños y adolescentes obesos (IMC > centila 95 y pliegue cutáneo tricipital > centila 90) y 70 no obesos (IMC centilas 5-85), con edades de 5 a 15 años, sin enfermedades crónicas. Se investigaron características personales y antecedentes familiares de enfermedades crónicas y se determinó el perfil sérico de lípidos. Se calculó el riesgo de presentar alteraciones en el perfil sérico de lípidos en niños con obesidad mediante la razón de momios (RM) y se realizó análisis multivariado. RESULTADOS: La edad promedio para todo el grupo fue de 9.8 ± 2.7 años; 63 individuos eran del sexo femenino y 69 del masculino. La presencia de obesidad se asoció a riesgo de valores anormales de colesterol, triglicéridos, LDL, HDL y dislipidemia (>1 valor anormal) (RM 4.47-15.0). En obesos el análisis multivariado mostró que la pertenencia al sexo femenino se asoció significativamente a dislipidemia. CONCLUSIONES: La obesidad en niños y adolescentes se asocia a riesgo elevado de presentar dislipidemia; este riesgo es mayor en las mujeres.

OBJECTIVE: To assess the risk of dislypidemia associated with obesity in children and adolescents. MATERIAL AND METHODS: A cross sectional study was conducted with 62 obese children (BMI > 95 centile and tricipital skinfold thickness > 90 centile) and 70 non-obese children (BMI 5-85 centile) ages 5-15 years, without chronic diseases. Subjects' characteristics and family background of chronic diseases were collected and a lipid profile was determined. The risk of lipid alterations in the obese children was calculated using odds ratio (OR) and multivariate analysis. RESULTS: Mean age was 9.8 ± 2.7 years in both groups; 63 girls and 69 boys were included. Obesity was associated with abnormal values for cholesterol, triglycerides, LDL, HDL and dislypidemia (> 1 abnormal value) (OR 4.47-15.0). In obese children and adolescents the multivariate analysis showed that female gender was associated with dislypidemia. CONCLUSION: Obesity in children and adolescents is associated with high risk of dislypidemia; the risk is higher among females.

Hábitos de alimentación e ingestión de calorías en un grupo de niños y adolescentes obesos / Dietary habits and calories intake of overweight and non overweight children and adolescents

Introducción. Objetivo: comparar los hábitos alimentarios y consumo de energía en niños y adolescentes obesos y no obesos. Material y métodos. Estudio transversal analítico en 71 sujetos obesos (índice de masa corporal [IMC] > centila 95) y 75 no obesos (IMC centilas 5 a 85) de 5 a 15 años de edad (promedio 9.8). Se realizaron encuestas alimentarias por recordatorio de 24 horas. Se calcularon: consumo de energía, macronutrimentos y alimentos de consumo común. Resultados. El consumo de energía y grasas fue mayor en niños obesos (P < 0.001). Los 5 alimentos referidos más frecuentemente fueron: leche, tortillas, frijoles, refrescos y agua de frutas. Los productos chatarra fueron referidos más frecuentemente que frutas y verduras. Conclusiones. El consumo de energía en niños obesos fue superior al de no obesos, lo que puede explicar la presencia de obesidad. Es preocupante el consumo frecuente de refrescos y productos chatarra. La obesidad se debe prevenir a través de la educación y fomento de hábitos de alimentación y estilos de vida saludables.

Introduction. Objective. To compare the dietary habits/energy intake of overweight and non-overweight children and adolescents. Material and methods. A cross-sectional 24-hour dietary recall study was conducted of 71 overweight (body mass index > 95th percentile) and 75 non-overweight children and adolescents ages 5 to 15 years (mean 9.8 ± 2.8). Energy and nutrient intake were calculated and foods most frequently eaten were identified. Results. Overweight children consumed more total kilocalories and fats (P < 0.001). The 5 top foods consumed were milk, corn tortillas, beans, sodas and fruit water in both groups. Junk food was consumed more frequent than fruits and vegetables. Conclusions. Energy intake was higher in obese children and adolescents, and can be related with the presence of obesity. It is worrisome that sodas were among the most frequently consumed food items. Obesity should be prevented by promoting healthy food habits and lifestyle.

[Prenatal risk factors in late fetal death]. / Factores de riesgo prenatal en la muerte fetal tardía.

OBJECTIVE: To identify the sociodemographics, obstetrical and perinatology factors of risk most frequently associated to fetal death in greater pregnancies of 27 weeks. PATIENTS AND METHODS: From January 2001 to May 2005, in the Hospital Civil de Guadalajara Dr Juan I. Menchaca, we carried out a study of cases and controls with 450 cases of fetal death of more than 27 weeks of gestation and 450 newborn alive whose birth happened immediately later. We compared the frequency of different maternal and fetal variables that in previous forms was associated with fetal death, by means of Chi squared test and exact test of Fisher, the association among these variables and fetal death with the reason of momios was considered. In all the cases the chosen interval of confidence was of 95%. RESULTS: The risk factors associated with fetal death were: maternal age over 35 years, low schooling, multiparity, antecedent of abortion and fetal death, deficient prenatal care, complications in the pregnancy, abnormal amniotic fluid, double circular of umbilical cord to neck of the product and great congenital malformations of newborn. It was not associated with fetal death, the single marital status, primigesta, smoking, male sex of the fetus, simple circulate of umbilical cord to the neck and fetal macrosomia. CONCLUSIONS: Of the risk factors associated with fetal death, the main one is a deficient prenatal care, that of being improved, might diminish the association of some other variables that were associated with fetal death.