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.

Duration of residence and offspring birth weight among foreign-born mothers in Spain: a cross-sectional study.

BACKGROUND: Duration of residence has been used to monitor changes in the health of a foreign-born population in a destination country. This study assesses whether the mother's duration of residence influences the relationship between maternal origin and birth weight. METHODS: We conducted a cross-sectional study using Spanish census microdata (2011) linked to Vital Statistics (2011-15). Linear and multinomial logistic regression models were used to estimate birth weight differences between children born to foreign-born mothers by duration of residence and those born to natives. Maternal countries of origin were classified according to the Human Development Index (HDI). RESULTS: Our findings revealed significant differences in birth weight of 109 683 births from both foreign- and native-born mothers. Overall, in descriptive statistics, compared with Spanish mothers, foreign-born mothers gave birth more frequently to high-birth weight (HBW) newborns (8.4% vs. 5.3%, respectively) and less frequently to low-birth weight (LBW) newborns (4.8% vs. 5.1%). According to the model's estimations, the risk of giving birth to HBW babies remains relatively high in foreign-born mothers. Especially, mothers from very high-HDI countries experienced changes in the RRR of HBW (1.59-1.28) and LBW (0.58-0.89) after spending over 10 years in Spain. CONCLUSIONS: Foreign-born mothers residing in Spain are at increased risk of delivering a HBW child regardless of their duration of residence. In fact, given the long-term health consequences associated with HBW, our results highlight the need to improve prenatal care in the foreign-born population.

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)

Partnership, living arrangements, and low birth weight: evidence from a population-based study on Spanish mothers.

BACKGROUND: Birth weight is considered a crucial indicator of individual and population health, as it determines a newborn's growth and development. An extensive body of research has explored various determinants of perinatal health, including the impact of living arrangements. This population-based study analyzes the relationship between mothers' partnership status and household structure and children's low birth weights. It addresses two basic research objectives: on one hand, how living/not living in a couple affects birth weight; on the other, how partnership status impact on birthweight when mothers live in extended households with other non-nuclear members. METHODS: A novel database provided by the Spanish Office for National Statistics (INE), which links the 2011 census with births registered from 2011 to 2015 (sample size 22,433) is used. Llogistic regression models are estimated tto obtain adjusted odds ratios (OR) for the relative effects of living arrangements and other covariates such as characteristics of births and mothers' socioeconomic profiles, on birth weight. RESULTS: Differences in low-birth-weight rates may be attributed to the dissimilar socio-demographic characteristics of the groups of mothers in the different coresidential situations. Although our models revealed that the impact of the covariates on birth weight was similar to that shown by previous studies, this was not the case for the effect of the main explanatory variable. Contrary to expectations, the presence/absence of a male partner in nuclear or in extended households does not reveal significant protection against low birth weight. Children born in households in which the male partner was absent were not more likely to have a low birth weight. On the other hand, analyzing the possible protective effect of extended households, we did not detect significant differences in the likelihood of low birth weight between single mothers without and with non-nuclear coresidents in their households. CONCLUSIONS: Our analysis provides novel evidence regarding the effect of partnership status and household type on perinatal health in Spain. First, contrary to what has been observed in previous studies in Spain and elsewhere, our study shows that living without a partner has no effect on low birth weight. Second, we reveal that households including non-nuclear coresidents are associated with low birth weight suggesting that even in a basically familist societal context such as the Spanish one, the extended family does not fully protect against poor perinatal outcomes.

Case report: Venetoclax therapy in a boy with acute myeloid leukemia in Shwachman Diamond syndrome.

Shwachman-Diamond syndrome (SDS) is a rare bone marrow failure syndrome characterized by exocrine pancreatic insufficiency, bone abnormalities, progressive cytopenia, and predispositions to myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). AML, in these patients, is associated with a poor prognosis and with an increased risk of organ toxicity and infectious complications from chemotherapy and hematopoietic stem cell transplantation (HSCT), thus leading to high rates of treatment-related morbidity and mortality. The BCL-2 inhibitor venetoclax has revolutionized the treatment of AML in elderly adults, especially for treatment-naive elderly patients who are ineligible for intensive chemotherapy. There is limited evidence on the use of venetoclax in pediatric patients with SDS-related MDS or AML. Here, we report a case of a 14-year-old boy with SDS with AML arising from MDS. The patient was treated with two cycles of conventional chemotherapy with fludarabine and cytarabine with an initial good response but immediate relapse and substantial toxicity. Treatment with venetoclax and azacitidine was started, with a substantial reduction of leukemic burden (good response on peripheral leukemic infiltration and partial response in the bone marrow after one course). However, it was followed by multiple infectious complications and worsening of the general condition not allowing treatment to be continued, and the patient eventually died from multiorgan failure. With the limitations of observation of a single patient, our experience suggests that venetoclax/azacitidine combination therapy may represent a therapeutic possibility for patients with SDS and AML, even though it may be associated with significant toxicity.

Effects of General Fatigue Induced by Exhaustive Exercise on Posture and Gait Stability of Healthy Young Men.

Bipedal walking is a composite task requiring integration of many control circuitries in the brain and spinal cord. The present study was carried out to verify whether an increase in blood lactate, such as that associated with a high intensity exercise, is able to significantly modify the qualitative and/or quantitative aspects of human walking. Eighteen healthy physically male participants, aged between 20 and 24 years (M = 21.8, SD = 1.22), were recruited for the study. For this purpose, the experimental protocol included the measure of blood lactate levels with the aim of assessing possible relations between lactate blood values and different aspect of walking after an exhaustive exercise. An exhaustive exercise was associated with a strong increase of blood lactate levels and produced a significant worsening in the ability to maintain the bipodalic upright posture as well as the fluidity of walking. Our results suggest that exhausting bouts impose greater challenges on postural control.