Trastornos de la lactancia materna y otros factores asociados a la pérdida de peso neonatal excesiva en un hospital de la seguridad social en Lima, Perú
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Tresierra Cabrera, Julio
Segura, Eddy R.
KeywordsPérdida de peso neonatal
Pérdida de peso neonatal excesiva
Periodo neonatal temprano
Trastornos de la lactancia materna
Neonatal weight loss,
Neonatal excessive weight loss
Early neonatal period
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AbstractIntroduction: During the first days of life the mother is the main source of nutrients for the newborn. However, breastfeeding difficulties are common and may generate excessive neonatal weight loss. Objective: Estimate the magnitude and association between breastfeeding problems and excessive neonatal weight loss beyond the physiological norm in the neonatology ward in a social security hospital in Lima, Peru Methods: We conducted a cross sectional analysis of the recorded neonatal weight in a routine evaluation (between 24 and 72 hours of life) and compared it against birth weight. Excessive weight loss was defined as a difference greater than or equal to 7 %. Breastfeeding problems (defined as problems with breastfeeding initiation, mouth position, breastfeeding duration, breastfeeding frequency, too much clothing, nipple pain and C form) were investigated using a survey and visual verification. The association between excessive weight loss and breastfeeding problems, adjusted by other factors, was quantified using a multiple generalized linear model. Results: Excessive weight loss was present in 18.8% (74/393) of the newborns. Improper positioning of the mouth on the nipple was present in 53.7% (211/393) of neonates while nipple pain was reported by 44.0% (173/393) of mothers. In the adjusted analysis, nipple pain [PR = 1.50 (95% CI: 1.02 to 2.22)] and improper positioning of the mouth [PR = 1.67 (95% CI: 1.09- 2.57)] were associated with an increased occurrence of excessive neonatal weight loss. Conclusions: Breastfeeding problems are common. These difficulties are significantly associated with an increased occurrence of excessive neonatal weight loss. Improvements in breastfeeding practices, for example through educational programs, may decrease the occurrence of excessive neonatal weight loss.
CollectionsNutrición y Dietética
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Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trialsPerez López, Faustino R.; Pasupuleti, Vinay; Mezones Holguín, Edward; Benites Zapata, Vicente A.; Thota, Priyaleela; Deshpande, Abhishek; Hernández, Adrian V. (Elsevier B.V., 2015-03-30)Objective: To assess the effects of vitamin D supplementation during pregnancy on obstetric outcomes and birth variables. Design: Systematic review and meta-analysis of randomized controlled trials (RCTs). Setting: Not applicable. Patient(s): Pregnant women and neonates. Intervention(s): PubMed and 5 other research databases were searched through March 2014 for RCTs evaluating vitamin D supplementation calcium/vitamins/ferrous sulfate vs. a control (placebo or active) during pregnancy. Main Outcome Measure(s): Measures were: circulating 25-hydroxyvitamin D [25(OH)D] levels, preeclampsia, gestational diabetes mellitus (GDM), small for gestational age (SGA), low birth weight, preterm birth, birth weight, birth length, cesarean section. Mantel-Haenszel fixed-effects models were used, owing to expected scarcity of outcomes. Effects were reported as relative risks and their 95% confidence intervals (CIs). Result(s): Thirteen RCTs (n ¼ 2,299) were selected. Circulating 25(OH)D levels were significantly higher at term, compared with the control group (mean difference: 66.5 nmol/L, 95% CI 66.2–66.7). Birth weight and birth length were significantly greater for neonates in the vitamin D group; mean difference: 107.6 g (95% CI 59.9–155.3 g) and 0.3 cm (95% CI 0.10–0.41 cm), respectively. Incidence of preeclampsia, GDM, SGA, low birth weight, preterm birth, and cesarean section were not influenced by vitamin D supplementation. Across RCTs, the doses and types of vitamin D supplements, gestational age at first administration, and outcomes were heterogeneous. Conclusion(s): Vitamin D supplementation during pregnancy was associated with increased circulating 25(OH)D levels, birth weight, and birth length, and was not associated with other maternal and neonatal outcomes. Larger, better-designed RCTs evaluating clinically relevant outcomes are necessary to reach a definitive conclusion. (Fertil Steril 2015;-:-–-. 2015 by American Society for Reproductive Medicine.)
Assessment with liver function tests and hydroperoxides in short term very-lowbirth-weight neonatal parenteral nutritionUniversidad Peruana de Ciencias Aplicadas (UPC) (Elsevier B.V., 2015-03-23)Rationale: It has been reported that PN (parenteral nutrition) in preterm neonates may have deleterious effects on hepatic function. We also studied the influence of peroxidation in PN bags, with and without light protection. Methods: 30 neonates weighing 1000 1500 g on TPN were studied prospectively. Serum samples were taken at start and at end of PN. Peroxides from 31 bags at 0, 5, 18 and 24 hours were measured. PN samples were taken from both light protected and not light protected PN bags. Results: Patients: (1) With PN: GOT = 28.63±13.00 IU; GPT = 7.37±5.10 IU; TB = 9.03±3.40 IU; DB = 0.845 ±0.43 UI; GGT = 110.41±81.87 IU. (2) Without PN: GOT = 28.73±16.36 IU; GPT = 10.53±8.38 IU; TB = 6.36±3.91 IU; DB = 1.35±1.53 IU; GGT = 128.38±75.74 IU. Significant differences: GPT, TB and DB (p < 0.05). Peroxides in bags: light protected and not, respectively, at 0 hours: 278.01±139.92 and 299.87±166.00, at 5 hours: 142.28±117.93 and 155.11±140.81, at 18 hours 183.39±115.40 and 212.92±133.72 and at 24 hours 258.58±187.81 and 284.55±162.78. At 18 hours the difference was significant (p < 0.05). Conclusions: 1. TB and 18-hour hydroperoxides concentrations were higher in serum, with PN and in light unprotected PN bags, respectively. 2. GPT and DB serum levels were lower with PN. 3. Within the conditions of this study, no association was found between hepatic function alterations and short-term TPN as well as with bag light exposure in neonates.
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