[Body composition in women with gestational diabetes mellitus]. / Composición corporal en mujeres con diabetes mellitus gestacional.

BACKGROUND: Several techniques have been used to determine body composition during pregnancy. OBJECTIVE: To determine the characteristics of body composition in women with gestational diabetes mellitus in comparison with women with normal glucose tolerance and pre-gestacional diabetes. MATERIAL AND METHODS: Pregnant women with gestational diabetes mellitus, pre-gestacional diabetes, and normal glucose tolerance, between 24 to 32 weeks of single gestation, were enrolled in a cross-sectional study. Screening of DMG was carried out using 50 g of glucose load; diagnosis was confirmed by oral glucose tolerance test. Evaluation of body composition was carried out by bioelectrical impedance. The Kruskal Wallis test was used for statistical analysis. RESULTS: A total of 79 women were included; of these, diagnosis of gestational diabetes mellitus, pre-gestacional diabetes, and normal glucose tolerance was established in 14, 9, and 56 women, respectively. Pre-gestational body mass index was greater in women with diabetes (p < 0.01). Fat free mass and total body water were similar in the studied groups. Fat mass was greater in women with gestational diabetes mellitus (range 21.0-29.4 kg) and patients with pre-gestacional diabetes (range 26.4-32.7 kg) than in the women with normal glucose tolerance (range 150.8-25.9 kg), p < 0.01. CONCLUSION: The body composition of women, between 24 to 32 weeks of single gestation, is different in the women with gestational diabetes mellitus compared with women with normal glucose tolerance. Women with gestational diabetes mellitus show a significant increase in fat mass without significant changes in the fat free mass and total body water.

Body composition of women with newborns who are small for gestational age.

BACKGROUND: The relationship between maternal and placental hemodynamic disorders and fetal growth is well known, but few studies have evaluated a link between maternal extracellular water (EW) and newborn birth weight. OBJECTIVE: To identify the characteristics of body composition (BC) of women with small for gestational age (SGA) newborns, and to determine the relationship between maternal EW and birth weight of the baby. METHODS: We studied maternal BC using multifrequency bioelectric impedance in the second and third trimesters of pregnancy. Newborns with weight below the 10th percentile were classified as SGA; those with weights between the 10th and 90th percentiles as appropriate for gestational age (AGA), and large for gestational age (LGA) were those with weights above the 90th percentile. RESULTS: We studied 460 women and their BC varied depending on whether their newborns were SGA, AGA or LGA. EW was lower in the mothers of SGA (11 +/- 2 l) compared to AGA (12 +/- 3 l) newborns (p < 0.01). We identified a significant relationship (p < 0.01) between maternal EW in the second trimester and the weight of the newborn, beta = 43 (95% CI 27-58). CONCLUSION: BC of women whose newborns are SGA differs significantly from that of women whose newborns are AGA, a result which suggests that the mothers of SGA infants may have a disordered hemodynamic state during the second trimester of pregnancy.

Birthweight percentiles by gestational age and gender for children in the North of Mexico.

The objective of this study was to determine the 10th, 50th and 90th percentiles of birthweight, by gestational age and sex, for newborns covered by the Mexican Institute of Social Security (IMSS) in the State of Chihuahua. To generate the database, we used IMSS hospitals' records in the State of Chihuahua, covering the period between 1 January 2000 and 31 December 2004. We included singleton live births only, and excluded babies with congenital malformations. The birthweights of 88,368 children born at 21-44 weeks of gestation comprised our data. From these data, we calculated the 10th, 50th and 90th percentiles for each sex, at 32-44 weeks of gestation. The observed cutoffs for the 10th percentile in our population were 40-250 g higher than those reported in other references with Mexican populations. These results constitute an updated birthweight reference that will allow the identification of newborns in the North region of the country with low birthweight-for-gestational age. Such information can be a useful instrument for preventing or diminishing associated risks.

Body composition of patients with hypertensive complications during pregnancy.

OBJECTIVE: To determine the body composition of women with the diagnoses of gestational hypertension or preeclampsia. METHODS: Cross-sectional study, including four groups of patients who were in the third trimester: those with an uncomplicated pregnancy (n = 110), those with a diagnosis of gestational hypertension (n = 38), those with mild preeclampsia (n = 8), and those with severe preeclampsia (n = 11). Their fat mass, fat-free mass, and total body water were estimated by bioelectric impedance. RESULTS: The fat mass was 20 +/- 7 kg in the control group and 26 +/- 13 kg in the group with gestational hypertension (p < 0.05). The total body water was 36 +/- 6 L in the control group, 50 +/- 10 L in the patients with gestational hypertension, 52 +/- 10 L in those with mild preeclampsia, and 48 +/- 9 L in those with severe preeclampsia (p < 0.05). CONCLUSION: The results suggest that maternal body composition shows significant differences in patients with hypertensive complications during pregnancy. These data may be related to a possible inadequate distribution of the volume of water as a result of alterations in capillary permeability.

[Frequency of antibodies against rubella virus in puerperium women]. / Frecuencia de anticuerpos frente al virus de la rubéola en mujeres en posparto inmediato.

BACKGROUND: The significance of clinical and epidemiological rubella lies in its teratogenic effects on fetus; thus, rubella and congenital rubella represent great public health problems. OBJECTIVES: To determine the frequency of antibodies against rubella virus in early puerperium women, and to identify factors related to the absence of immunity against it. MATERIAL AND METHODS: During the period 2000-2002, a cross-sectional study was conducted. Women in puerperium period, residents of urban and rural areas of Delicias, Chihuahua, Mexico, were included. Women were interviewed and asked about factors that have been associated with the absence of immunity against rubella virus such as age, schooling, number of gestations, and residence area. We collected a blood sample between 1 and 6 hours after delivery, and anti-rubella IgG was determined. RESULTS: 396 patients aged 24 +/- 6 years were studied. The frequency of antibodies against rubella virus was of 87% (CI 95% 84-90). The factors related to the absence of antibodies against rubella were: number of gestations and schooling; patients whose pregnancy was the first or second gestation had a smaller frequency of antibodies against rubella virus (84%) compared to those with two previous gestations (95%, p = 0.03). CONCLUSION: The observed frequency of antibodies of rubella virus in this population is smaller than the informed one in industrialized countries. It is recommended to reinforce procedures of vaccination for susceptible women and after delivery, in order to prevent the infection consequences, as well as routinely carry out tests for detection of antibodies against rubella like protocol of premarital study.

Relación entre el índice de masa corporal pregestacional y la composición corporal en el puerperio inmediato / Correlation between pregestational body mass index and body composition parameters in immediate puerperal period

Con los objetivos de establecer la correlación entre el índice de masa corporal pregestacional y los parámetros de la composición corporal medidos por impedancia bioeléctrica (porcentaje de peso graso, masa de grasa y peso magro) y comparar la composición corporal de mujeres en el puerperio inmediato con mujeres sanas no embarazadas, se realizó un estudio transversal que incluyó 86 mujeres en puerperio fisiológico y 90 sanas no embarazadas, derechohabientes del Instituto Mexicano del Seguro Social, en Chihuahua, México con edad entre 16 y 40 años. Las variables consideradas fueron índice de masa corporal (IMC) pregestacional, porcentaje de grasa, masa de grasa, peso magro, agua total y biorresistencia. La composición corporal se midió por impedancia bioeléctrica (IBE) entre cuatro y 12 horas después del parto. El coeficiente de correlación entre IMC y porcentaje de grasa fue r = 0.66 (p < 0.01) y entre IMC y masa grasa fue r = 0.74 (p < 0.01). En mujeres no embarazadas el total de agua fue de 35.5 ñ 5 L y en las mujeres del grupo en puerperio de 38.5 ñ 5 L (p < 0.01). En conclusión, el IMC pregestacional es un predictor adecuado de la composición corporal en el puerperio. Sin embargo, no discrimina variables importantes como el agua corporal total, por lo cual quizá sea conveniente el uso de BIA para la vigilancia de la composición corporal durante el embarazo.