Embarazo adolescente: características maternas y su asociación con el peso al nacer del neonato / Adolescent pregnancy: maternal characteristics and their association with birth weight of the newborn

En Colombia, el embarazo adolescente es un problema de salud pública, con serias implicaciones en la salud y nutrición del binomio madre-hijo. El objetivo del estudio fue evaluar características sociodemográficas, económicas, de seguridad alimentaria, de salud y el estado nutricional por antropometría en adolescentes en el tercer trimestre de embarazo y asociar estos factores con el peso de los recién nacidos. Se realizó un estudio analítico de corte transversal con 294 embarazadas (semana 27-40) del programa de control prenatal de la Red Pública Hospitalaria de Medellín-Colombia. Se buscó asociación del peso al nacer del neonato con las variables explicativas. El bajo peso en embarazadas se presentó en mayor proporción en adolescentes cuyas familias devengaron menos de un Salario Mínimo Mensual -SMMLV-, en las que tenían 15 años o menos y con edad ginecológica menor de cinco años. La mayor proporción de pequeños para la edad gestacional se presentó en adolescentes con infecciones, bajo peso gestacional e ingresos menores a un SMMLV. Devengar menos de un SMMLV disminuye 118 gramos el peso del recién nacido (IC95%:-2,5a-234,7) y por cada kilogramo que aumentó el peso pregestacional materno, el peso al nacer aumentó 10,3 g (IC95%: 2,0 - 18,5). Los ingresos económicos inferiores a un SMMLV se asociaron con bajo peso materno y con recién nacidos pequeños para la edad gestacional. El peso pregestacional, el índice de masa corporal bajo en tercer trimestre de gestación y la presencia de infecciones urinarias y/o vaginales de la madre se asociaron con recién nacidos pequeños para la edad gestacional.

In Colombia, adolescent pregnancy is a public health problem, with serious implications for the health and nutrition of the binomial mother-child. Objective: assess socio-demographic, economic, food security, health and maternal nutritional status characteristics by anthropometric measures in a group of pregnant adolescents in Medellin-Colombia on their third trimester of pregnancy and associate them with the newborns weight. Methods and materials: A cross sectional analytical study was made with 294 pregnant women (week 27 to 40), who participating in prenatal control program of the public hospital network in Medellin-Colombia. We sought Association of weight at birth with the explanatory variables. Results: underweight in pregnant women was presented in families that had lower income wages than the Standard Minimum Wage Income - SMWI-, adolescents who were younger than 15 years old and those who had a gynecological age less than five years. In newborns, the highest proportion of small children for pregnancy age was found in mothers who presented infections, low pregnancy weight and low family income less than the minimum wage. For those whose earnings was less than the minimum income the newborn weight decreased 118g (CI95%:-2,5 a - 234,7), in addition, for each kilogram that increased the prepregnancy weight, newborn weight increased in 10,26g (CI95%:1,98 a -18,5). Conclusions: low-weight pregnancy and low-weight newborns are associated with low family income. Pre-pregnancy weight, body mass index in the third trimester of pregnancy and mother`s presence of urinary tract and vaginal infections were associated with the newborn´s weight.

Estilos de vida y estado nutricional de trabajadores en empresas públicas y privadas de dos regiones de Chile / Nutritional status and lifestyles of workers from two regions in Chile

Background: Lifestyles and a poor nutritional status are two factors iníluencing the high prevalence of non communicable chronic diseases among Chilean workers. Aim: To characterize lifestyles and nutritional status of workers from the public and prívate sector, residing in the Fifth and in the Metropolitan regions of Chile. Material and methods: Nutritional status, blood pressure, cholesterol, glycemia, previous medical history, feeding habits and smoking status were assessed in 1,036 women and 709 men aged 38+11 years. Results: Feeding habits were characterized by a low consumption of fruits, vegetables, fish and dairy products and a high consumption offat and sugar Forty five percent smoked and 88 percent were sedentary. Forty two percent were overweight, 18 percent were obese, 39 percent had high blood cholesterol, 23 percent hypertension and 4 percent diabetes. There was a positive relationship between obesity and hypertension with an odds ratio (OR) adjusted for sex and educationallevéis of 2.6 (95 percent confidence intervals (Cl) 1.9-3.7) and diabetes with an OR of 2.8 (95 percent CI 1.6-4.7). Eighty two percent of obese and 28 percent of overweight subjects underestimated their nutritional status. Conclusions: A high prevalence of overweight and inadequate lifestyles was found in this population. There was a low self perception of obesity and lack of knowledge about risk factors for chronic diseases.

Análisis de la aceptabilidad, consumo y aporte nutricional del programa alimentario del adulto mayor / Assessment of the acceptability and consumption of a nutritional supplementation program for the elderly in Chile

Background: During 2005, the Chilean Ministry of Health included a fortified milk beverage to the Elderly Food Supplementation Program, to improve the compliance with the program and to increase the provision of micronutrients. This beverage was added to a soup that was distributed since 1999. Aim: To evaluate the long term acceptability, tolerance and consumption of the Milk Beverage and analyze the nutritional contribution of the products provided by the supplementation program to the usual diet of the elderly. Material and methods: One hundred twenty five elderly subjects, aged 77 ± 4 (52 males) living in Metropolitan Santiago, aged over 70 years, beneficiaries of the food supplementation program, were interviewed. The acceptability, consumption and tolerance of the Milk Beverage were evaluated by specially designed surveys. The contribution of the food suplementation products to daily nutrient intake was also analyzed by 24 hours dietary recalls. Results: The mean body mass index of the interviewed elderly subjects was 27.0 ±4.5 Kg/m². Monthly delivery of the products included in the program increased significantly after the incorporation of the Milk Beverage to the program. The milk beverage had a significantly higher daily consumption and a lower family dilution than the soup. The consumption of supplementation products increased significantly the daily intake of energy and most micronutrients. Noteworthy was the case for vitamin B12, C, E and zinc, whose intake doubled (p <0.01). Conclusions: The Milk Beverage had an excellent approval and consumption rate. The consumption of food supplementation products improved daily intake of most nutrients in elderly subjects.

Riesgos nutricionales en embarazadas adolescentes / Nutritional risk in pregnant adolescent

Con el propósito de evaluar las características nutricionales de embarazadas adolescentes se estudiaron 84 gestantes menores de 18 años de nivel socioeconómico bajo, en comparación a un grupo control de 25 a 30 años. Se estableció la relación peso-talla inicial y final y se realizaron 3 encuestas alimentarias de recordatorio de 24 horas, determinándose la ingesta promedio de energía, proteínas, calcio y hierro y su adecuación a las recomendaciones FAO/OMS 1973. A las 20 semanas de gestación, en una submuestra se efectuó una determinación de hemoglobina, hematocrito, hierro sérico y saturación de trasferrina. En el recién nacido se determinó peso, talla y adecuación del crecimiento intrauterino. En el primer control prenatal las adolescentes presentaron una relación peso-talla significativamente menor (p<0,001), que el grupo control. Al finalizar el embarazo se mantuvieron las diferencias iniciales. La ingesta promedio de energía y calcio fue inferior a las recomendaciones FAO/OMS en ambos grupos. No existieron diferencias en los exámenes hematológicos, estando los valores promedios en los rangos de normalidad. La proporción de bajo peso de nacimiento fue significativamente mayor en el grupo de adolescentes (p<0,05). Esta diferencia se atribuye en parte al estado nutricional y en parte a la variable edad. Se concluye que la embarazada adolescente es un grupo de alto riesgo que requiere de una atención prioritaria que incluya aspectos onbstétricos, nutricionales y psicosociales