Gastos en salud de hijos de consumidores de pasta base de cocaína / Health care expenses among the offspring of cocaine base paste consumers

Background: Health care costs of the offspring of mothers addicted to cocaine are three times higher than those of children not exposed to cocaine during gestation. Aim: To calculate the health care costs of the offspring of addict mothers that consumed cocaine during gestation. To verify the diseases or health conditions in these children, that generated the expenses. Material and methods: One hundred offspring of addict women consuming cocaine base paste were studied. The health care expenses generated by hospital admissions and ambulatory follow up were calculated. Expenses were expressed in Chilean pesos, according to the value at June, 2000. The fares of the South Orient Metropolitan Health Service were used as a reference. Results: Twenty four of the 100 children were lost from follow up. Among the 76 followed children, 48 were admitted to hospitals in 2.3 (range 1.2) occasions. Mean hospital stay was 21.7 days (range 1-186) and hospital mortality was 4 percent. Mean expense per hospital discharge was $1,556,098 and per patient was $3,457,995. The monthly expenses per children during ambulatory follow up were $120,372 that increased to $395,200 if family placing was added. Conclusions: These figures confirm that health care expenses of cocaine addicts offspring are more than three times the cost of a normal child. Primary and secondary prevention of cocaine addiction is urgently needed

Curva de crecimiento intrauterino para prematuros entre 23 a 36 semanas de edad gestacional / Intrauterine growth curves for premature babies with a gestational age between 23 and 36 weeks

Objetivo: diseñar una curva de crecimiento intrauterino para prematuros nacidos entre las 23 y 36 semanas de edad gestacional en base a datos recopilados prospectivamente entre 1990-1998 en el Hospital Dr. Sótero del Río Santiago, Chile. Método: se incluyeron en este estudio 2.830 prematuros menores de 37 semanas con edad gestacional confiable, producto de embarazo único sin patología materna ni fetal. Se calculó peso promedio, desviación estándar, percentiles 5, 10, 25, 50, 75, 90 y 95 para cada edad gestacional. Resultados: se presenta una curva suavizada de peso para cada edad gestacional y se compara con la actualmente en uso. Conclusión: considerando el gran número de niños en el estudio esta curva es una herramienta útil para evaluar el peso de nacimiento en niños prematuros especialmente en edades gestacionales menores

Drogadicción embriofetal por abuso de pasta base de cocaína durante el embarazo / Fetal drug addiction as a consequence of maternal cocaine base paste abuse during pregnancy

Background: Fetal drug addiction is a serious public health problem. In the United States 10 to 15 percent of children have been exposed "in utero" to cocaine. In a Chilean public health service, more than 200 offspring of cocaine free base abuser have been detected. Aim: To analyze the clinical and social features of 100 children exposed to cocaine free base during fetal development. Patients and methods: Clinical features of children born from cocaine free base consume mothers were described at birth. During subsequent follow up, growth and development, disease episodes, developmental alterations and social situation were recorded. Data was compared with other newborns from the same health service. Results: Compared to their normal counterparts, exposed children has a lower birth weight, the frequency of premature babies was thrice higher, and small-for-gestational age children were four times more common. There was also a higher prevalence of cardiac malformations, seizures and apnea. Hospital admissions were more frequent, prolonged and required more complex facilities. During follow up, undernutrition and stunting were more prevalent. Psychomotor retardation was present in 67 percent of children and behavioral disturbances in 93 percent. Most of these children are governmental protection. Conclusions: Strategies to prevent drug abuse during pregnancy and its devastating medical and social consequences should be urgently developed

Talla, peso y perímetro craneano según edad gestacional en recién nacidos de menos de 35 semanas / Height, weight and head circumference in newborns under 35 weeks gestational age

Con el objetivo de tener datos nacionales de peso, talla y circunferencia de cráneo en recién nacidos de 24 a 34 semanas de gestación se realizó un estudio colaborativo restrospectivo de niños nacidos en Santiago, en las Maternidades de los Hospitales José Joaquín Aguirre, del Salvador, Sótero del Río y Clínica Alemana, entre 1982 y 1987. Se incluyó en el estudio a 379 niños nacidos de embarazos simples, con edad gestacional confiable y sin patología fetal ni materna de importancia. Se presentan las tablas con promedios y desviaciones estándar de peso, talla y circunferencia craneana, para cada edad gestacional entre 24 y 34 semanas, así como las respectivas curvas con variación de +- 1,5 desviaciones estándar. Se recomienda el uso de estas tablas y curvas a nivel nacional