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      Bajo peso al nacer, morfometría renal y cifras de tensión arterial en adolecentes femeninas Translated title: Low Birth Weight, Renal Morphometry and Blood Pressure in Adolescent Females

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          Abstract

          Fundamento: la hipertensión arterial constituye un problema de salud en la actualidad, siendo una causa directa de discapacidad y muerte. Datos epidemiológicos sugieren que la nutrición pre y posnatal puede ser un factor importante en la etiopatogenia de esta enfermedad. Objetivo: evaluar la influencia del bajo peso al nacimiento sobre la tensión arterial y el tamaño del riñón de las adolescentes. Métodos: se realizó un estudio transversal en 50 adolescentes del sexo femenino del municipio Marianao, La Habana. Se midieron las siguientes variables: peso, talla, tensión arterial sistólica y diastólica, peso y talla al nacimiento e índice de masa corporal. Mediante ultrasonido se midió longitud, ancho, parénquima y volumen del riñón. Resultados: no hubo diferencias apreciables en los valores de tensión arterial de acuerdo al peso y la talla al nacimiento. Tampoco las variables renales mostraron cambios significativos de acuerdo a la clasificación de las adolescentes según su peso al nacimiento. Se encontró una relación significativa entre la tensión arterial sistólica y dos indicadores del tamaño relativo del riñón. Conclusión: los resultados no evidenciaron una asociación entre el bajo peso al nacer y las cifras de tensión arterial altas. Se reafirma que las cifras de tensión arterial se relacionan positivamente con la adiposidad corporal y con el tamaño relativo pequeño del riñón.

          Translated abstract

          Background: nowadays, hypertension is a health problem directly causing disability and death. Epidemiological data suggest that pre- and postnatal nutrition can be an important factor in the etiopathogenesis of this disease. Objective: to evaluate the effects of low birth weight on blood pressure and kidney size in adolescent females. Methods: a cross-sectional study was conducted in 50 adolescent females from Marianao, Havana. The following variables were measured: weight, height, systolic and diastolic blood pressure, birth weight and length and body mass index. Kidney length, width, parenchyma and volume were measured by ultrasound. Results: differences in blood pressure related to weight and length at birth were nonsignificant. Renal variables did not show significant changes in the classification by birth weight. An important relationship between systolic blood pressure and two indicators of the relative kidney size was found. Conclusion: results did not show an association between low birth weight and high blood pressure. It is demonstrated that blood pressure values are positively related to body adiposity and small kidney size.

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          Fetal programming and adult health.

          Low birthweight is now known to be associated with increased rates of coronary heart disease and the related disorders stroke, hypertension and non-insulin dependent diabetes. These associations have been extensively replicated in studies in different countries and are not the result of confounding variables. They extend across the normal range of birthweight and depend on lower birthweights in relation to the duration of gestation rather than the effects of premature birth. The associations are thought to be consequences of 'programming', whereby a stimulus or insult at a critical, sensitive period of early life has permanent effects on structure, physiology and metabolism. Programming of the fetus may result from adaptations invoked when the materno-placental nutrient supply fails to match the fetal nutrient demand. Although the influences that impair fetal development and programme adult cardiovascular disease remain to be defined, there are strong pointers to the importance of maternal body composition and dietary balance during pregnancy.
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            Birthweight and mortality in adulthood: a systematic review and meta-analysis.

            Small birth size may be associated with increased risk of cardiovascular diseases (CVD), whereas large birth size may predict increased risk of obesity and some cancers. The net effect of birth size on long-term mortality has only been assessed in individual studies, with conflicting results. The Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines for conducting and reporting meta-analysis of observational studies were followed. We retrieved 22 studies that assessed the association between birthweight and adult mortality from all causes, CVD or cancer. The studies were systematically reviewed and those reporting hazard ratios (HRs) and 95% confidence intervals (95% CIs) per kilogram (kg) increase in birthweight were included in generic inverse variance meta-analyses. For all-cause mortality, 36,834 deaths were included and the results showed a 6% lower risk (adjusted HR = 0.94, 95% CI: 0.92-0.97) per kg higher birthweight for men and women combined. For cardiovascular mortality, the corresponding inverse association was stronger (HR = 0.88, 95% CI: 0.85-0.91). For cancer mortality, HR per kg higher birthweight was 1.13 (95% CI: 1.07-1.19) for men and 1.04 (95% CI: 0.98-1.10) for women (P(interaction) = 0.03). Residual confounding could not be eliminated, but is unlikely to account for the main findings. These results show an inverse but moderate association of birthweight with adult mortality from all-causes and a stronger inverse association with cardiovascular mortality. For men, higher birthweight was strongly associated with increased risk of cancer deaths. The findings suggest that birthweight can be a useful indicator of processes that influence long-term health.
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              The epidemiology of adverse pregnancy outcomes: an overview.

              This paper provides an overview of the occurrence, etiology and temporal trends of adverse pregnancy outcomes. Disparities between developed and developing countries are highlighted for maternal mortality, infant mortality, stillbirth and low birth weight. The higher rate of low birth weight in developing countries is primarily due to intrauterine growth restriction rather than preterm birth. Much of the excess intrauterine growth restriction is caused by short maternal stature, low prepregnancy body mass index and low gestational weight gain (due to low energy intake). No important contribution has been established for micronutrient intake, nor have different fetal growth trajectories been demonstrated to reflect the timing of exposure to nutritional or other etiologic factors. Infant mortality has declined substantially over time both in developed and developing countries despite no decline (and even an increase) in low birth weight. Several developed countries have reported a temporal increase in fetal growth in infants born at term, a reduction in stillbirth rates and prevention of neural tube defects. More progress is required, however, in understanding the etiology and prevention of preterm birth.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                ms
                MediSur
                Medisur
                Facultad de Ciencias Médicas de Cienfuegos, Centro Provincial de Ciencias Médicas Provincia de Cienfuegos. (Cienfuegos )
                1727-897X
                December 2014
                : 12
                : 6
                : 851-858
                Affiliations
                [1 ] Instituto de Ciencias Básicas y Preclínicas Victoria de Girón Cuba
                [2 ] Facultad de Ciencias Médicas 10 de Octubre Cuba
                Article
                S1727-897X2014000600006
                95534f4f-651b-485f-ac69-859d45d8fca0

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Cuba

                Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=1727-897X&lng=en
                Categories
                HEALTH CARE SCIENCES & SERVICES

                Health & Social care
                infant, low birth weight,kidney,blood pressure,adolescent,female,recién nacido de bajo peso,riñón,presión sanguínea,adolescente,femenino

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