RESUMEN

OBJECTIVES: Despite the obstacles of limited education and employment opportunities-and the stress associated with immigration and pregnancy-Mexican immigrant women have low rates of preterm birth (PTB) compared to the US national average for all races and ethnicities. Stressors during pregnancy, and stressors associated with acculturation, may accelerate cellular aging manifested by shortened telomere length (TL) in pregnant women. Our objectives were to: (1) determine whether women with PTBs had shorter telomere lengths compared to women who had full term births; (2) assess the association of acculturation with TL and PTB. METHODS: This prospective pilot study collected data from 100 self-identified Mexican-origin pregnant women. Survey data included self-administered sociodemographic and acculturation measures and was collected from participants via paper and pen, while biologic data was collected via a single blood draw during a regularly scheduled prenatal visit between 26 and 36 weeks gestation. PTB data was collected from the participant's medical record after delivery. RESULTS: TL was significantly associated with PTB; the median TL of the women with PTB was less than the median TL for the full sample (p = 0.02). Based on regression analysis for PTB vs acculturation, we found no significant associations between acculturation and PTB or TL. CONCLUSIONS FOR PRACTICE: This study provides important evidence of the association between shortened maternal TL and adverse birth outcomes. By linking social, clinical and biologic data, we can enhance our understanding of social determinants that may affect racial and ethnic disparities in preterm birth.

Asunto(s)

Nacimiento Prematuro , Femenino , Humanos , Recién Nacido , Proyectos Piloto , Embarazo , Mujeres Embarazadas , Nacimiento Prematuro/epidemiología , Estudios Prospectivos , Telómero , Acortamiento del Telómero

RESUMEN

INTRODUCTION: Explanations for racial disparities in preterm birth (PTB) are elusive, especially when comparing high rates in some racial groups with low rates in Mexican-immigrant women. The purpose of this study was to examine potential protective factors against PTB such as religiosity and acculturation. METHODS: This study was a prospective investigation of Mexican- and U.S.-born pregnant women. Women were recruited from a low-income-serving prenatal clinic in Texas. Survey instruments included socioeconomic variables, acculturation, and religiosity/spirituality (R/S). Logistic regression was used to examine the associations between acculturation, religiosity, and PTB. Because of the low prevalence of PTB in our sample, we were not able to adjust for confounding characteristics. RESULTS: Ninety-one low-income women, mostly Mexican immigrants, participated in the study. PTB in our sample was lower than the national average in the United States (5.5% vs. 9.9%) and was positively but moderately associated with high R/S. R/S scores were high, particularly for frequency of attendance, prayer, and religious coping. Women with lower acculturation had higher scores on the religiosity measures. CONCLUSION: Further research is needed with a larger sample to include other ethnic and racial minorities to more fully understand the relationships between acculturation, religiosity, and PTB.

Asunto(s)

Aculturación , Nacimiento Prematuro , Femenino , Humanos , Recién Nacido , Americanos Mexicanos , Proyectos Piloto , Embarazo , Nacimiento Prematuro/epidemiología , Estudios Prospectivos , Religión , Estados Unidos

RESUMEN

Objetivos: A reconstrução pélvica após excisão de tumor é um desafio. Métodos: realizou-se um estudo retrospectivo para comparar os desfechos entre pacientes submetidos a cirurgia de reconstrução da pelve com aloenxerto ósseo após excisão em bloco de tumores pélvicos e pacientes submetidos apenas à excisão. Resultados: os pacientes sem reconstrução tiveram escores funcionais significantemente menores 3 meses (10 vs. 15, P = 0,001) e 6 meses após a cirurgia (18,5 vs. 22, P = 0,0024), menor tempo de hospitalização (16 dias vs. 40 dias, P < 0,001) e menor custo hospitalar (97.500 vs.193.000 yuans, P < 0,001) do que os que foram submetidos a reconstrução pélvica. Os escores funcionais foram similares 12 meses depois da cirurgia (21,5 vs. 23, P = 0,365) sem diferença na taxa de complicações entre os dois grupos (P > 0,05). Conclusões: A reconstrução pélvica com aloenxerto ósseo depois de cirurgia de tumores pélvicos é associada a desfechos cirúrgicos e funcionais satisfatórios. Outros estudos clínicos são necessários para explorar como selecionar o melhor método de reconstrução. Nível de Evidência IV, Séries de Casos.

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Objectives: Pelvic reconstruction after tumor resection is challenging. Methods: a retrospective study had been performed to compare the outcomes between patients undergoing reconstructive surgery of the pelvis with allogeneic bone graft after en bloc resection of pelvic tumors and patients undergoing en bloc resection only. Results: Patients without reconstruction had significantly lower functional scores at 3 months (10 vs. 15, P = 0.001) and 6 months after surgery (18.5 vs. 22, P = 0.0024), a shorter duration of hospitalization (16 days vs. 40 days, P < 0.001), and lower hospital costs (97,500 vs. 193,000 RMB, P < 0.001) than those undergoing pelvic reconstruction. Functional scores were similar after 12 months of surgery (21.5 vs. 23, P = 0.365) with no difference in the rate of complications between the two groups (P > 0.05). Conclusions: pelvic reconstruction with allogeneic bone graft after surgical management of pelvic tumors is associated with satisfactory surgical and functional outcomes. Further clinical studies are required to explore how to select the best reconstruction method. Level of Evidence IV, Case Series.

Asunto(s)

Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Neoplasias Pélvicas/cirugía , Pelvis/cirugía , Trasplante Homólogo/efectos adversos , Trasplante Homólogo/rehabilitación , Biopsia con Aguja , Espectroscopía de Resonancia Magnética , Radiografía , Estudios Retrospectivos , Interpretación Estadística de Datos

RESUMEN

OBJECTIVES: : Pelvic reconstruction after tumor resection is challenging. METHODS: A retrospective study had been preformed to compare the outcomes among patients who received pelvic reconstructive surgery with allogeneic bone graft after en bloc resection of pelvic tumors and patients who received en bloc resection only. RESULTS: Patients without reconstruction had significantly lower functional scores at 3 months (10 vs. 15, P = 0.001) and 6 months after surgery (18.5 vs. 22, P = 0.0024), a shorter duration of hospitalization (16 day vs. 40 days, P < 0.001), and lower hospitalization costs (97,500 vs. 193,000 RMB, P < 0.001) than those who received pelvic reconstruction. Functional scores were similar at 12 months after surgery (21.5 vs. 23, P = 0.365) with no difference in the rate of complications between the two groups (P > 0.05). CONCLUSIONS: : Pelvic reconstruction with allogeneic bone graft after surgical management of pelvic tumors is associated with satisfactory surgical and functional outcomes. Further clinical studies are required to explore how to select the best reconstruction method. Level of Evidence IV, Case Series.