La edad paterna como factor de riesgo para malformaciones congénitas / Paternal age as a risk factor for congenital malformations

The role of advanced maternal age as a risk factor for congenital malformations in offspring is known. However, the influence of paternal age is not clear. Aim: To evaluate the association between advanced paternal age and the risk for congenital malformations. Patients and Methods: Analysis of maternal and paternal age of cases (malformed newborns) and controls from ECLAMC Database (Latin American Collaborative Study of Congenital Malformations) registered at the University of Chile Clinical Hospital during the decade from Jan 1 1997 to Dec 31 2006. Newborns and stillborns were grouped according to maternal age into 6 intervals. In each interval, paternal ages of cases and controls were compared. The inverse procedure was performed to assess maternal age effect. Other variables as gestational age and birth weight were analyzed for the intervals of maternal and paternal ages. Results: No significant differences were observed in paternal age between cases and controls in any of the intervals of maternal age. However, mean maternal age was higher for cases than for controls (p =0,0149). Gestational age and birth weight depend more on being case or control than on the age of parents. Conclusions: No differences in paternal age were observed between cases and controls in this series of newborns.

Problemas auditivos en preescolares, según estudio audiológico y percepción de educadores: Región Metropolitana, diciembre 2005 / Hearing problems in preschool children according to audiologic examination and teachers perception: Metropolitan Region, 2005

Introducción: La relación entre audición y desarrollo neuropsicológico está ampliamente demostrada. Pérdidas auditivas leves o incluso unilaterales se asocian a retraso del lenguaje y dificultades escolares. En Chile no existe un tamizado auditivo masivo para los preescolares y escolares, sino una pesquisa en base a estimación subjetiva de la audición en los programas de salud escolar de la Junta Nacional de Auxilio Escolar y Becas. Objetivo: Conocer la prevalencia de hipoacusia en preescolares y correlacionarlo con la percepción de educadores sobre la audición y lenguaje de los niños. Sujetos y Métodos: Durante diciembre de 2005 se citó a todos los niños de 4 y 5 años de un jardín infantil del área norte de la RM, a una evaluación audiológica consistente en otoscopía, audiometría e impedanciometría, realizada en el laboratorio de Otoneurología de la Escuela de Tecnología Médica (Universidad de Chile). Previamente y sin mediar entrenamiento se interrogó a las educadoras acerca de la sospecha de pérdida auditiva o problemas de lenguaje en los niños evaluados. Resultados: Se evaluaron 87 de 100 preescolares, edad promedio 4,4 años. Trece niños (15%) tenía problemas audiológicos, de éstos, diez no pasaron el tamizado auditivo, lo que da una tasa de hipoacusia de 11,6%; todos correspondieron a hipoacusia de transmisión. La sensibilidad de las educadoras para pesquisarla fue 50%. No se correlacionó la percepción de problemas de lenguaje con hipoacusia. Conclusión: Destaca la alta frecuencia de problemas audiológicos encontrados. La sola sospecha de hipoacusia por parte de los educadores es insuficiente como método de preselección, ya que pesquisa sólo a la mitad de los afectados. Estos hallazgos hacen plantearnos la necesidad de implementar tamizados auditivos objetivos a todos los niños al comenzar su educación formal.

The relationship between hearing and neuropsychological development has been widely demostrated. Mild or unilateral hearing lost are linked to language development delay and learning difficulties. Chile does not have a universal audition screening program for preschool and school children. The school health programs sponsored by the JUNAEB relay on teachers suspicion for early detection of hearing problems. Objective: To determine the prevalence of hearing lost in preschool children and correlate these findings with teachers perception in relation to audition and language development. Method: Children 4 and 5 years-old attending school in the northern area of Santiago during December 2005 were scheduled for an audiological evaluation, consisting in otoscopy, audiometry and tympanometry performed at the School of Medical Technology and Otoneurology Laboratory, University of Chile. Previously and without training, teachers gave their perception on hearing lost and language problems in the evaluated children. Results: 87 children were evaluated, with mean age 4,4 years-old. 15% presented audition problems and 8,7% did not pass the hearing evaluation, corresponding to conductive hearing lost. Detection of hearing problems by teachers presented a 50% sensibility. There was no correlation between language problems and hearing lost. Conclusions: The frequency of audition problems is remarkable high. The teachers suspicion alone is not enough as a screening method, because it only detects 50% of children with hearing problems. These findings point out the need to implement a universal audition screening for children beginning their formal education.