[Prenatal exposure to drugs of abuse using meconium analysis in a low socioeconomic population in Barcelona]. / Exposición prenatal a drogas de abuso a través del análisis de meconio en una población de bajo nivel socioeconómico en Barcelona.

INTRODUCTION: For the first time in Europe, the <> aimed to estimate the prevalence of drug use by pregnant women and the subsequent foetal exposure to illicit drugs. PATIENTS AND METHOD: Between October 2002 and February 2004, 1209 mother-infant dyads from the Hospital del Mar, Barcelona, Spain met eligibility criteria and agreed to participate in the study. Data on socio-economic and demographic characteristics and on drug habits during pregnancy were collected using a structured questionnaire. Neonatal meconium was collected within 24h after birth and analyzed by standardized chromatographic techniques for the presence of opiates, cocaine, cannabinoids and amphetamines. RESULTS: Meconium analysis showed an overall 10.9% positivity for drugs of abuse, with a specific prevalence of heroin, cocaine and cannabis with foetal exposure of 4.7, 2.6 and 5.3%, respectively. Structured interviews also revealed that 0.3, 1.2 and 1.5% of mothers used heroin, cocaine and cannabis, respectively, while only one mother declared ecstasy consumption, confirmed by meconium analysis. Parental ethnicity and working class was not associated with drug use. Drug consuming mothers were shown to have a higher number of previous abortions when compared to non-consumer mothers, which was probably due to a lack of family planning. Significantly lower birth weight and length was found in newborns from mothers exposed to cocaine alone or in combination with other drugs. CONCLUSIONS: This study, although developed in a low socio-economic-status cohort, may serve as an eye opener for any hidden non-negligible drug consumption during pregnancy. In this sense, meconium analysis can be important to identify neonates with a high suspicion of exposure to drugs of abuse in utero, and provides the basis for appropriate treatment and adequate medical and social follow-up.

Exposición prenatal a drogas de abuso a través del análisis de meconio en una población de bajo nivel socioeconómico en Barcelona / Prenatal exposure to drugs of abuse using meconium analysis in a low socioeconomic population in Barcelona

Introducción: por primera vez en Europa, el «Proyecto Meconio» ha estimado la prevalencia del consumo de drogas ilegales por mujeres embarazadas y la consiguiente exposición fetal. Pacientes y método: entre octubre de 2002 y febrero de 2004, se incluyó en el estudio a 1.209 parejas madre-recién nacido del Hospital del Mar, Barcelona. Se recogieron datos sobre las características socioeconómicas y demográficas y los hábitos tóxicos durante el embarazo empleando un cuestionario. Se recogió el meconio neonatal antes de 24 horas después del nacimiento y se analizó empleando técnicas cromatográficas estandarizadas para detectar opiáceos, cocaína, cannabinoides y anfetaminas. Resultados: el análisis del meconio demostró una positividad para las drogas de abuso del 10,9% del total, con una prevalencia específica de exposición fetal a heroína, cocaína y cannabis del 4,7, el 2,6 y el 5,3%, respectivamente. El cuestionario estructurado detectó que el 0,3, el 1,2 y el 1,5% de las madres habían consumido heroína, cocaína y cannabis, y sólo una madre declaró el consumo de éxtasis, confirmado mediante el análisis del meconio. La etnia de los padres y la clase laboral no se asociaron con el consumo de drogas. Las madres consumidoras de drogas mostraron un número de abortos previos más elevado que las madres no consumidoras. Se encontró que el peso y la talla al nacimiento eran significativamente más bajos en los recién nacidos de las madres expuestas a cocaína sola o en combinación con otras drogas. Conclusiones: este estudio puede servir como aviso de un consumo de drogas durante el embarazo oculto y significativo. En este sentido, el análisis del meconio puede ser importante para identificar a recién nacidos en elevada sospecha de exposición intrauterina a drogas de abuso y proporciona la base para un tratamiento médico y un seguimiento social apropiados (AU)

Introduction: For the first time in Europe, the «Meconium Project» aimed to estimate the prevalence of drug use by pregnant women and the subsequent foetal exposure to illicit drugs. Patients and method: Between October 2002 and February 2004, 1209 mother–infant dyads from the Hospital del Mar, Barcelona, Spain met eligibility criteria and agreed to participate in the study. Data on socio-economic and demographic characteristics and on drug habits during pregnancy were collected using a structured questionnaire. Neonatal meconium was collected within 24h after birth and analyzed by standardized chromatographic techniques for the presence of opiates, cocaine, cannabinoids and amphetamines. Results: Meconium analysis showed an overall 10.9% positivity for drugs of abuse, with a specific prevalence of heroin, cocaine and cannabis with foetal exposure of 4.7, 2.6 and 5.3%, respectively. Structured interviews also revealed that 0.3, 1.2 and 1.5% of mothers used heroin, cocaine and cannabis, respectively, while only one mother declared ecstasy consumption, confirmed by meconium analysis. Parental ethnicity and working class was not associated with drug use. Drug consuming mothers were shown to have a higher number of previous abortions when compared to non-consumer mothers, which was probably due to a lack of family planning. Significantly lower birth weight and length was found in newborns from mothers exposed to cocaine alone or in combination with other drugs. Conclusions: This study, although developed in a low socio-economic-status cohort, may serve as an eye opener for any hidden non-negligible drug consumption during pregnancy. In this sense, meconium analysis can be important to identify neonates with a high suspicion of exposure to drugs of abuse in utero, and provides the basis for appropriate treatment and adequate medical and social follow-up (AU)

[Childhood circumcision: review of the evidence]. / Circuncisión infantil: revisión de la evidencia.

Circumcision is one of the most frequent surgical procedures in children. Because of greater immigration to Spain, health professionals need to know how to interpret new health demands. One of the most important of these is ritual circumcision. Moreover, in the last few years scientific data showing the potential health benefits of circumcision have been published. The aim of this study was to identify the therapeutic indications of this procedure, to clarify the origins of its cultural and religious bases and, finally, to review the scientific evidence to date on its possible benefits.

Circuncisión infantil: revisión de la evidencia / Childhood circumcision: review of the evidence

La circuncisión es una de las intervenciones quirúrgicas que con más frecuencia se practica a los niños. Con la intensificación del fenómeno social de la inmigración en nuestro entorno, los profesionales de la salud han de saber interpretar las nuevas demandas sanitarias. Entre ellas, destaca la circuncisión ritual. Además, en los últimos años se han publicado algunas evidencias científicas que demuestran sus potenciales beneficios médicos. El objetivo de este artículo es identificar cuáles son las indicaciones terapéuticas de la circuncisión, aclarar los orígenes de los motivos religiosos y culturales y, por último, conocer la evidencia existente hasta el momento sobre los posibles beneficios de la circuncisión. (AU)