Prevalence and risk factors for vitamin D deficiency among mothers in labor and their newborns

Vitamin D deficiency is recognized as a global public health problem. Studies of vitamin D levels in mothers in labor and their newborns in Bahrain are lacking. The aim of this study is to identify the prevalence of vitamin D [25[OH]D] deficiency among mothers in labor and their newborns in Bahrain. A cross-sectional multicenter study. Four Public and Four Private Maternity Hospitals in Bahrain. The study was conducted in April 2012. It included mothers in labor and their newborns. Differences between the subgroups were analyzed using Chi-Square or Student's t-test as appropriate. Linear regression analysis was used to evaluate independent predictors of 25[OH]D level. The study included 403 mothers and 403 newborns. Overall prevalence of 25[OH]D deficiency [<50 nmol] was 358 [88.8%] of the mothers and 364 [90.3%] of the newborns. The mean maternal alkaline phosphatase level was significantly higher than the neonatal level and the maternal mean calcium was significantly lower than the neonatal level. Significant association with vitamin D deficiency was found among Bahraini and non-Bahraini Arab mothers, delivering in public rather than private hospital, living in flats, low education, the use of veil, gravida >/= 4, not using multivitamins, vitamin D or calcium supplements. Vitamin D deficiency among mothers and their newborns is high. This mandates increasing awareness, vitamin D supplementation among mothers in labor and their infants; in addition to the introduction of vitamin D fortification of dairy products and flour at the national level

Cesárea eletiva: complicações maternas e fetais / Elective cesarean: maternal and fetal complications

Objetivos: Conhecer o índice de complicações maternas e fetais imediatas nas cesáreas eletivas realizadas nos Hospital São João Batista de Criciúma no período de janeiro a junho de 2008. Métodos: Estudo do tipo coorte prospectivo, observacional,exploratório e documental com 107 pacientes que foram submetidas à cesárea eletiva, sendo excluídasaquelas que entraram em trabalho de parto antes da cirurgia. Resultados: Das 107 pacientes estudadas, duas nãopreencheram os critérios de inclusão, resultando em 105 pacientes na amostra. A idade média das pacientes foide 27,3 anos, com idade mínima de 18 anos e idade máxima de 41 anos. Com relação à idade gestacional, a média foi 38,5 semanas, variando de 36 a 41 semanas. Neste estudo, foram observadas duas complicações imediatas; sendo uma materna e uma fetal. Das 105 pacientes submetidas à cesárea, uma (0,95%) apresentouinfecção puerperal; enquanto nos recém nascidos, um (0,95%) apresentou taquipnéia transitória. Conclusão: Concluiu-se nesse trabalho, que apesardo índice de complicações imediatas maternas e fetais evidenciados nas cesáreas eletivas ter sido de 0,95%, acesárea eletiva não é um procedimento isento de risco.

Objectives: To know the rate of immediate maternal and fetal complications in the elective cesareans achieved in São João Hospital in Criciúma, from January to June of 2008.Methods: Cohort prospective study, observational, exploratory and documental with 107 patients who weresubmitted to elective cesarean, excluding those one who started the delivery labor until the surgery.Results: From the 107 patients studied, two didn’t fill includes criterion, resulting in 105 patients in the sample.The median age of the patients was 27,3 years, with the minimal of 18 years and the maximum of 41 years. About the gestational age, the median was 38,5 weeks, changing between 36 and 41 weeks. In this study, was observed two immediate complications; one maternal and one fetal. From the 105 patients submitted to cesarean, one (0,95%) presents puerperal infection; while in theinfant, one (0,95%) presents transient tachypnea. Conclusion: Concluded in this study, that although the rate of immediate maternal and fetal complications evidenced in the elective cesarean was about 0,95%, the elective cesarean is not a procedure without risks.

Induction of c-Jun mRNA without changes of estrogen and progesterone receptor expression in myometrium during human labor

To elucidate the endocrine mechanism of human parturition, the expression of c-Jun and c-Fos mRNA were examined in relation to estrogen receptor (ER) and progesterone receptor (PR) in human myometrium. c-Jun mRNA was detected in all myometrial tissues (n=5) during labor but not before labor (n=5) and in oxytocin-resistant postterm pregnancy (n=3). c-Fos mRNA was detected in only one myometrial tissue from a woman in labor. The distribution and intensity of immunostaining for ER and PR were semiquantitatively scored. During the late pregnancies, no significant difference was seen in the receptor scores for myometrial ER and PR between the patients who experienced labor and those who did not. Receptor scores for ER and PR were significantly lower in postterm pregnancy than in late pregnancy, regardless of the labor status. These data suggest that there are no changes in ER and PR in human myometrium during parturition. On the other hand, postterm pregnancy is associated with low ER and PR. c-Jun, induced during labor without changes in ER and PR, may play a role as a signaling mechanism in human myometrium.

Niveles séricos materno y neonatales de insulina y factores de crecimiento insulino-similes I y II (IGF y II) en la altura y a nivel del mar / Serum maternal and neonates levels of insuline and grow factors insuline-simil I and II (IGF and II) at high altitude and sea level

El presente estudio se ha diseñado para determinar los niveles de IGF-I en insulina en gestantes durante la labor del parto y en recién nacidos. Para tal efecto se han estudiado diez mujeres de ambas altitudes apareadas por edad, paridad, peso y talla. Ellas fueron estudiadas durante la labor del parto. La IGF-I e IGF-II fueron medidas por radioinmunometría (IRMA) e insulina por radioinmunoensayo (RIA) en suero materno y en sangre de cordón de los productos. En relación a las mujeres del nivel del mar, las concentraciones séricas de IGF-I e Insulina de las mujeres de altura fueron menores, 78.3 + 45.3 vs 455.2 _ 499.1 ng/ml(p es igual a 0.029) y 11.3 + 7.3 vs 22.9 + 15.1 uU/ml(p es igual a 0.045), respectivamente. No se encontró diferencia en IGF-II. La relación peso placentario/peso neonatal fue mayor en la altura, 0,18 + 0.03 vs 0,15 + 0,025 (p es igual a 0.026). No hubo diferencia por efecto de la altura en los niveles séricos neonatales de IGF-I, IGF-II ni insulina. La IGF-I correlacionó con el peso al nacer en ambas altitudes, NM: r es igual a 0.87 (p es igual a 0.005), altura: r es igual a 0.97 (p es igual a 0.0001), e insulina cortrelacionó con el peso al nacer en NM, r es igual a 0.82 (p es igual a 0.024), no siendo significativa esta correlación en la altura, r es igual a 0.60 (p es igual a 0.065); valor marginal, probablemente por el tamaño de la muestra. Se concluye que el menor peso del recién nacido en la altura puede deberse a los menores niveles de IGF-I e insulina.

Analgesia e anestesia no parto normal / Analgesie and anesthesie in natural delivery

Os autores abordam, historicamente, os métodos analgésicos utilizados no trabalho de parto e parto vaginal, citando suas vantagens e efeitos colaterais. O mecanismo da dor, a transferência placentar de drogas e sua influência na motilidade uterina, na progressäo do parto, na mäe, feto e recém-nascido säo discutidos