[Longitudinal study of the growth of preterm newborn infants]. / Estudio longitudinal de crecimiento de recién nacidos pretérmino.

BACKGROUND: The growth and nutrition of premature infants should be accurately assessed. To do this, reference values of normality, obtained from population to be studied, are required. OBJECTIVES: To study the postnatal growth of premature infants in our environment and to compare their growth with intrauterine growth (Lubchenco et al). PATIENTS: A total of 103 premature infants born at 28-36 weeks of gestation in the Virgen de la Arrixaca University Children's Hospital in Murcia (Spain) from April 1994 to June 1995 were studied. Children who received medical care during the first 24 hours of life and who had no prenatal condition that could affect their growth were selected. Those who suffered from serious disease were excluded. The study was carried out from birth to a postconceptional age of 48-52 weeks. The 2-step regression model was used to calculate the percentile graphs. RESULTS: Percentile growth graphs were drawn up for the following variables: weight, length, arm circumference, head circumference, subscapular fold, and tricipital fold. In premature infants, postnatal growth in weight and length was uniform, progressive, and practically linear and did not show the flattening that is characteristic of intrauterine growth. Other corporal segments such as the head and arm circumference showed a certain slowing down at a postconceptional age of 42 or 43 weeks, and the folds showed a moderate dispersion of values as the study progressed. CONCLUSIONS: Intrauterine growth charts do not accurately assess postnatal growth in premature infants.

Estudio longitudinal de crecimiento de recién nacidos pretérmino / Longitudinal study of the growth of preterm newborn infants

Antecedentes. Es importante la valoración adecuada del crecimiento y nutrición de los recién nacidos pretérmino. Es preciso para ello disponer de valores de referencia de normalidad, obtenidos de la población que se va a estudiar. Objetivos. Estudiar el crecimiento posnatal de nuestros recién nacidos pretérmino, y comparar este crecimiento con el crecimiento intrauterino. Pacientes. Se incluyen 103 recién nacidos pretérmino de 28 a 36 semanas de gestación, ingresados en el Hospital Universitario Infantil Virgen de la Arrixaca de Murcia en el período comprendido entre abril de 1994 y junio de 1995. Se seleccionaron niños captados en las primeras 24 h de vida, sin condiciones prenatales que afectaran al crecimiento. Se excluyeron aquellos que sufrían enfermedad grave. Se realizó el estudio desde el nacimiento hasta las semanas 48 a 52 de edad posconcepcional. Se utilizó el modelo de regresión en dos etapas como método estadístico para el cálculo de las gráficas de percentiles. Resultados. Se construyeron gráficas de crecimiento de percentiles para los siguientes parámetros: peso, longitud, perímetro de brazo, perímetro cefálico, pliegue subescapular y pliegue tricipital. El crecimiento posnatal de los recién nacidos pretérmino en peso y longitud es uniforme, progresivo, prácticamente lineal, y no muestra el aplanamiento característico del crecimiento intrauterino. Otros segmentos corporales como perímetro cefálico, perímetro de brazo, experimentan una cierta disminución de la velocidad de crecimiento a las 42 o 43 semanas de edad posconcepcional, los pliegues muestran moderada dispersión de valores al avanzar el período de estudio. Conclusiones. Las gráficas de crecimiento intrauterino no son adecuadas para valorar el crecimiento posnatal del recién nacido pretérmino (AU)

[Mortality rates in childhood and their causes in Spain. 1991]. / Tasas de mortalidad en la infancia y sus causas en España. 1991.

OBJECTIVE: The purpose of this study is to present the different pediatric mortality rates in Spain during 1991 and to describe the groups of mortality causes for the different ages in relationship to these rates. PATIENTS AND METHODS: We have used data from the National Institute of Statistics for the year studied. These data were summarized, grouped and simplified. In order to clarify them, causes of death have been expressed in percentage. RESULTS: The different mortality rates were: Infant mortality 7.19; neonatal mortality 4.57; early neonatal mortality rate 3.32; late neonatal mortality rate 1.25; postneonatal mortality 2.62; perinatal mortality 7.24; preschool mortality 1.75; mortality within the age group 5-9 years 1.26. For infantile, neonatal, early neonatal, late neonatal and postneonatal mortality the biggest percentage was due to causes depending upon congenital malformations and perinatal diseases. For preschool and school mortality accidents and tumors were the most frequent causes of death, although causes related to congenital anomalies were also responsible for a large percentage of deaths. CONCLUSIONS: Pediatric mortality rates in our country are more than acceptable and their causes are similar to those of other civilized countries.

[Alcohol consumption in children: polling the parents]. / Consumo de alcohol en niños: encuesta realizada a los padres.

Alcoholism is a major health problem in Spain. Frequently, the first drink is offered in the home. We report the results of a poll in which parents were asked when they offer alcohol to their children. We found that 76.1% offered alcohol anytime. Furthermore, 15% of the mothers answered that this may be of benefit to their children. Drinks with a higher level of alcohol (brandy, punch, anis) were offered more frequently after seven years of age and to those children whose mother had offered the first alcoholic beverage at an earlier age.

[Nutritional state as reflected in chromium levels in a population of healthy and diabetic children]. / Estado nutricional de cromo en una población de niños sanos y de niños diabéticos.

The importance of chromium (Cr) for carbohydrate metabolism is unclear from the existing literature. Therefore, we have measured the concentration of chromium in the hair of 44 insulin dependent diabetic children and 95 healthy children. In the diabetic children the mean +/- SEM of Cr was 1.96 +/- 0.51 micrograms/ml, with 1.04 +/- 0.18 micrograms/ml being the mean for the females and 2.66 +/- 0.93 micrograms/ml the mean for the males. In the healthy children the mean concentration +/- SEM of Cr was 1.69 +/- 0.27 micrograms/g with 1.18 +/- 0.21 micrograms/ml and 2.35 micrograms/ml being the result for females and males, respectively. No significant differences were found in Cr levels in the hair with regard to age, sex, weight and height, neither when comparing between the two groups (diabetic children and healthy children) nor within these groups. A distribution has been made of the Cr levels in hair according to percentiles in both groups. For concentrations under 0.457 +/- g/g there is a significantly larger percentage of healthy children than diabetic children (p less than 0.001). A new, fast and reliable method for the determination of Cr in hair is described. This method employs spectrophotometry of atomic absorption with a graphite oven and dramatically reduces the time normally required for this determination.

[Importance of childhood accidents. Results of a regional study]. / Importancia de los accidentes en la infancia. Datos de un estudio regional.

In order to know the importance and epidemiology of childhood accidents, a prospective study was made in a Spanish region, this study was founded in death certificates and 3,344 questionnaires from children under 7 years old, accidented in 1986 and attended in emergency departments in our region. The information was coded and analysed by computer of the Murcia University. Accidents are the main cause of death in children aged over 1 year, as a common cause of assistance in emergency departments. Its characteristic are common to most countries, but the authors find some differences in our region. It is necessary to dedicate bigger effort to study and prevention of childhood accidents.

[Non-immune hydrops fetalis. Review of 11 cases]. / Hydrops fetalis no inmune. Revisión de 11 casos.

Eleven cases of non-immune hydrops fetalis (NIHF) are presented. Incidence was 1.8 out of 10,000 births. NIHF became more common than immune hydrops fetalis (1.4/10,000 births). Mortality was of 81% and complications were frequent. NIHF is associated with prematurity, neonatal anoxia, polyhydramnios, hypoalbuminemia and hypoproteinemia. Considerable emphasis must be placed on antenatal diagnosis to achieve a precocious treatment and so improve the present poor prognosis.