Melatonin profiles during the third trimester of pregnancy and health status in the offspring among day and night workers: A case series.

Successful pregnancy requires adaptation in maternal physiology. During intrauterine life the mother's circadian timing system supports successful birth and postnatal development. Maternal melatonin is important to transmit circadian timing and day length to the fetus. This study aims to describe the third trimester of pregnancy among day (n = 5) and night (n = 3) workers by assessing their melatonin levels in a natural environment. Additionally, we describe the worker's metabolic profiles and compare the health status of the newborns between groups of day and night working mothers. Our results indicate an occurrence of assisted delivery (cesarean and forceps) among night workers. Moreover, the newborns of night workers showed lower Apgar index and breastfeeding difficulty indicating a worse condition to deal with the immediate outside the womb environment. Additionally, there was lower night-time melatonin production among pregnant night workers compared to day workers. These findings may be related to light-induced suppression of melatonin that occurs during night work. We conclude that night work and consequent exposure to light at unconventional times might compromise the success of pregnancy and the health of the newborn. Further studies need to be carried out to monitor pregnancy and newborn health in pregnant night workers.

Ethical issues in research on control of the HIV/AIDS epidemic: report from a workshop of the world federation of scientists, Erice, Sicily, Italy, 22-24 August 2003.

In research on control of the HIV/AIDS epidemic there are many ethical issues to be considered. The problem of personal autonomy versus the interest of society to prevent the spread of the disease in various settings makes it difficult to follow the regulations of the Declaration of Helsinki in all respects. This is particularly clear in the evaluation of trials aimed at preventing mother-to-child transmission of HIV. The interest of the child does not always conform to the policy of avoiding stigmatization of the mother. Programmes for the implementation of antiretroviral therapy and vaccine trials may differ in countries with different mean incomes of the inhabitants, and are also influenced by local patterns. For this reason, the Declaration of Helsinki should be changed in such a way that it conforms with the ways in which it may be possible to combat such a disastrous epidemic as that caused by HIV.

[Secular trends of height in adulthood of children born in the city of São Paulo, Brazil from 1950-1976]. / Tendência secular da altura na idade adulta de crianças nascidas na cidade de São Paulo entre 1950 e 1976.

OBJECTIVE: The purpose of this study was to estimate the secular trend/change in the height of young males born in the city of S. Paulo between 1950 and 1976 and measured in the year they turn 18 years. METHODS: A random and representative sample (6,942 individuals) was evaluated in military draft. Statistical analyses included Shapiro-Wilk test for normality of height distribution in each birth cohort, and linear regression analysis for trend on heights. RESULTS/CONCLUSIONS: Stature has increased 3.42 centimeters during the 27 years covered by the study (1.26 cm/decade). The trend was not linear: in the 50s, there was a statistically significant increase (0.84 cm/decade); in the 60s, a smaller but non-significant increase (0.5 cm/decade) was seen; in the period of 1970-76, a greater increase in heights (2.9 cm/decade) was observed. The secular change rate observed was comparable to the rate seen in other countries. The most recent birth cohorts (1975 and 1976) achieved the higher statures in the study (approximately 175 cm). Despite these height increments, deficits of 1.8 e 6.2 cm were seen when the taller cohorts of the study were compared to American young males born in 1961 (NCHS) and Dutch men born in 1972. If there won't be any changes in the accelerated rates of the 70s, young people of São Paulo may overcome these deficits in about one or three decades.

[Evolution of maternal and child health care in São Paulo (1984-1996)]. / Evolução da assistência materno-infantil na cidade de São Paulo (1984-1996).

OBJECTIVE: Two consecutive household surveys undertaken in mid-80s and mid-90s in the city of S. Paulo, Brazil, made possible to establish time trends of several child health determinants and indicators as well as to analyse the relationships among them. The study intends to report trends in maternal and child health care. METHODS: Random samples of the population aged from zero to 59 months were studied: 1,016 children in the period of 1984-85 and 1,280 children in 1995-96. Both surveys investigated three components of maternal and child health care: prenatal care, delivery and newborn care and routine health care provided to children up to five years of age (including development follow-up and vaccination). RESULTS: Favourable changes seen in the period between the two surveys were the continuing universal birth coverage, significant increase in rooming-in in maternity hospitals and the number of routine visits for babies in their first year of life and, particularly, the universal outreach of the DPT, measles and tuberculosis vaccinations. Unfavourable trends were seen regarding the slight and clearly insufficient growth of prenatal care, the still high percentage (of near 50%) of cesarean sections, and the limited routine visits for children after their first year of age. CONCLUSIONS: Estimates in the same period for the outreach of maternal and child health care in other urban areas of Brazil reinforce the unsatisfactory trends of the prenatal care in S. Paulo. Favourable comparisons are only seen regarding the outreach of child vaccination. The influence that changes in the maternal and child health care provided in the city may have exerted on several child health indicators is examined in subsequent articles.