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      Factores de riesgo asociados al bajo peso al nacer Translated title: Risk factors associated to low birthweight

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          Abstract

          Introducción: el alto índice de bajo peso al nacer trae consigo un aumento de la morbilidad y mortalidad neonatal. Objetivo: profundizar en el conocimiento de los factores de riesgo del bajo peso al nacer para ofrecer una mejor atención a las gestantes con estas posibilidades. Métodos: investigación retrospectiva en una muestra de 114 recién nacidos con bajo peso, en el Policlínico Docente "José Manuel Seguí", municipio de Güira de Melena, Artemisa, de una población de 1 906 nacimientos. El estudio se realizó entre enero de 2004 y diciembre de2008. Resultados: en el quinquenio 2004-2008, se obtuvo el 5,9 % de bajo peso, el año 2004 fue el que más contribuyó con 8,6 %. El parto pretérmino fue el componente del bajo peso de mayor incidencia en el período estudiado con el 58,7 %. El bajo peso al nacer estuvo mediado por la prematuridad y en pacientes con factores de riesgo durante la gestación, como hipertensión arterial, hábito de fumar e infecciones vaginales. Conclusiones: los resultados encontrados contribuyen a mejorar la atención de las gestantes que pudieran tener un recién nacido de bajo peso, en el Policlínico Docente "José Manuel Seguí Jiménez" de Güira de Melena.

          Translated abstract

          Introduction: the high low birthweight rate brings about an increase of neonatal morbidity and mortality. Objective: to delve into knowledge of risk factors for low birthweight to provide better care of pregnant women. Methods: retrospective research study conducted on a sample of 114 low birthweight newborns from a population of 1 906 births in "José Manuel Seguí" teaching polyclinics of Guira de Melena municipality, Artemisa province. Results: in the 2004-2008 five year-period, the low birthweight rate was 5.9%, being 2004 the most significant year with 8.6%. Preterm birth was the most incidental factor in low birthweight with 58.7% in the studied period. Low birthweight was influenced by prematurity, and present in pregnant patients suffering high risks such as blood hypertension, smoking and vaginal infections. Conclusions: the achieved results contributed to improve the care of pregnant women who might have a low birthweight newborn in "José Manuel Seguí Jiménez" teaching polyclinics in Guira de Melena.

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          Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate.

          Women who have had a spontaneous preterm delivery are at greatly increased risk for preterm delivery in subsequent pregnancies. The results of several small trials have suggested that 17 alpha-hydroxyprogesterone caproate (17P) may reduce the risk of preterm delivery. We conducted a double-blind, placebo-controlled trial involving pregnant women with a documented history of spontaneous preterm delivery. Women were enrolled at 19 clinical centers at 16 to 20 weeks of gestation and randomly assigned by a central data center, in a 2:1 ratio, to receive either weekly injections of 250 mg of 17P or weekly injections of an inert oil placebo; injections were continued until delivery or to 36 weeks of gestation. The primary outcome was preterm delivery before 37 weeks of gestation. Analysis was performed according to the intention-to-treat principle. Base-line characteristics of the 310 women in the progesterone group and the 153 women in the placebo group were similar. Treatment with 17P significantly reduced the risk of delivery at less than 37 weeks of gestation (incidence, 36.3 percent in the progesterone group vs. 54.9 percent in the placebo group; relative risk, 0.66 [95 percent confidence interval, 0.54 to 0.81]), delivery at less than 35 weeks of gestation (incidence, 20.6 percent vs. 30.7 percent; relative risk, 0.67 [95 percent confidence interval, 0.48 to 0.93]), and delivery at less than 32 weeks of gestation (11.4 percent vs. 19.6 percent; relative risk, 0.58 [95 percent confidence interval, 0.37 to 0.91]). Infants of women treated with 17P had significantly lower rates of necrotizing enterocolitis, intraventricular hemorrhage, and need for supplemental oxygen. Weekly injections of 17P resulted in a substantial reduction in the rate of recurrent preterm delivery among women who were at particularly high risk for preterm delivery and reduced the likelihood of several complications in their infants. Copyright 2003 Massachusetts Medical Society
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            Progesterone and the risk of preterm birth among women with a short cervix.

            Previous randomized trials have shown that progesterone administration in women who previously delivered prematurely reduces the risk of recurrent premature delivery. Asymptomatic women found at midgestation to have a short cervix are at greatly increased risk for spontaneous early preterm delivery, and it is unknown whether progesterone reduces this risk in such women. Cervical length was measured by transvaginal ultrasonography at a median of 22 weeks of gestation (range, 20 to 25) in 24,620 pregnant women seen for routine prenatal care. Cervical length was 15 mm or less in 413 of the women (1.7%), and 250 (60.5%) of these 413 women were randomly assigned to receive vaginal progesterone (200 mg each night) or placebo from 24 to 34 weeks of gestation. The primary outcome was spontaneous delivery before 34 weeks. Spontaneous delivery before 34 weeks of gestation was less frequent in the progesterone group than in the placebo group (19.2% vs. 34.4%; relative risk, 0.56; 95% confidence interval [CI], 0.36 to 0.86). Progesterone was associated with a nonsignificant reduction in neonatal morbidity (8.1% vs. 13.8%; relative risk, 0.59; 95% CI, 0.26 to 1.25; P=0.17). There were no serious adverse events associated with the use of progesterone. In women with a short cervix, treatment with progesterone reduces the rate of spontaneous early preterm delivery. (ClinicalTrials.gov number, NCT00422526 [ClinicalTrials.gov].). Copyright 2007 Massachusetts Medical Society.
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              Low birth weight in the United States.

              Pregnancy outcomes in the United States and other developed countries are considerably better than those in many developing countries. However, adverse pregnancy outcomes are generally more common in the United States than in other developed countries. Low-birth-weight infants, born after a preterm birth or secondary to intrauterine growth restriction, account for much of the increased morbidity, mortality, and cost. Wide disparities exist in both preterm birth and growth restriction among different population groups. Poor and black women, for example, have twice the preterm birth rate and higher rates of growth restriction than do most other women. Low birth weight in general is thought to place the infant at greater risk of later adult chronic medical conditions, such as diabetes, hypertension, and heart disease. Of interest, maternal thinness is a strong predictor of both preterm birth and fetal growth restriction. However, in the United States, several nutritional interventions, including high-protein diets, caloric supplementation, calcium and iron supplementation, and various other vitamin and mineral supplementations, have not generally reduced preterm birth or growth restriction. Bacterial intrauterine infections play an important role in the etiology of the earliest preterm births, but, at least to date, antibiotic treatment either before labor for risk factors such as bacterial vaginosis or during preterm labor have not consistently reduced the preterm birth rate. Most interventions have failed to reduce preterm birth or growth restriction. The substantial improvement in newborn survival in the United States over the past several decades is mostly due to better access to improved neonatal care for low-birth-weight infants.
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                Author and article information

                Journal
                rcsp
                Revista Cubana de Salud Pública
                Rev. cub. salud pública
                Centro Nacional de Información de Ciencias Médicas (La Habana, La Habana, Cuba )
                0864-3466
                1561-3127
                2012
                : 38
                : 2
                : 238-245
                Affiliations
                [01] La Habana orgnamePoliclínico Docente José Manuel Seguí Jiménez Cuba
                Article
                S0864-34662012000200006 S0864-3466(12)03800206
                10.1590/s0864-34662012000200006
                9b5a2afe-978e-45cb-b61e-47d78e64e0b4

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 22 June 2011
                : 23 November 2011
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 8
                Product

                SciELO Cuba

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                Investigación

                gestación,mortality,morbidity,pregnancy,Low birth,mortalidad,morbilidad,Bajo peso

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