RESUMEN
OBJECTIVE: To investigate the association of preterm delivery with polymorphisms of IL-6, IL-10, IFN-gamma, TGFbeta1 and TNF-alpha genes. STUDY DESIGN: The study group consisted of 45 Caucasian, 81 mixed race and 13 black women with a history of preterm labor, consecutively referred. All of them had delivered before 37 weeks' gestation. The control group was composed of 56 Caucasian, 48 mixed race and 15 black women with successful pregnancy. DNA was extracted from whole blood, and cytokine genotyping was performed using the Cytokine Genotyping Tray (One-Lambda, Canoba Park, California). The polymorphisms analyzed were: TNF-alpha (-08 G --> A), IL-10 (-1082 G --> A), IL-6 (-174 G --> C), TGFbeta1 (+10 T --> C e 25 C --> G) and IFN-gamma (+874 A --> T). RESULTS: There were no differences in genotype frequencies of IL-10, TGF-beta, TNF-alpha or IL-6 polymorphisms between the groups. In the Caucasian group there was a trend toward increased frequencies of the TT genotype of IFN-gamma in controls. CONCLUSION: Preterm delivery is not associated with TNF-alpha (-308), IL-10 (-1082), IL-6 (-174), TGFbeta1 (+10 e 25) or IFN-gamma (+874) polymorphisms.
Asunto(s)
Citocinas/genética , Trabajo de Parto Prematuro/genética , Trabajo de Parto Prematuro/inmunología , Polimorfismo Genético/genética , Adolescente , Adulto , Femenino , Genotipo , Humanos , Interferón gamma/genética , Interleucina-10/genética , Persona de Mediana Edad , Trabajo de Parto Prematuro/etnología , Embarazo , Factor de Crecimiento Transformador beta/genética , Factor de Necrosis Tumoral alfa/genéticaRESUMEN
OBJECTIVES: This analysis explores the association between preterm birth and maternal country of birth in a French district with a multiethnic population. DESIGN: Prospective observational study. SETTING: District of Seine-Saint-Denis in France POPULATION: 48,746 singleton live births from a population-based birth register between October 1998 and December 2000. METHODS: We compare preterm birth rates by mother's country of birth controlling for demographic and obstetric factors as well as insurance coverage and timing of initiation of antenatal care. MAIN OUTCOME MEASURES: Overall preterm birth rates and preterm birth rates by timing of delivery (<33 weeks versus 33-36 weeks of gestation), mode of onset (spontaneous or indicated preterm birth) and the presence of hypertension in pregnancy. RESULTS: Women born in Northern Africa, Southern Europe and South/East Asia did not have higher preterm birth rates than women born in continental France. Rates were significantly higher for women born in the overseas French districts in the Caribbean and Indian Ocean and Sub-Saharan Africa. Excess risk was greatest for early preterm births, medically indicated births and preterm births associated with hypertension. CONCLUSIONS: Patterns of preterm birth with relation to timing, mode of onset and medical complications among of Afro-Caribbean origin should be confirmed in future research.
Asunto(s)
Trabajo de Parto Prematuro/etnología , Adulto , África/etnología , Europa (Continente)/etnología , Femenino , Francia/epidemiología , Humanos , Embarazo , Estudios Prospectivos , Características de la Residencia , Factores de Riesgo , Indias Occidentales/etnologíaRESUMEN
OBJECTIVE: To examine whether routinely measured variables explained the increased risk of preterm delivery in some UK ethnic groups. DESIGN: Cross sectional study of deliveries recorded in the Child Health Record System. SETTING: North Birmingham, UK. POPULATION: All North Birmingham women delivering singletons, 1994-1997 inclusive. METHOD: Logistic regression. MAIN OUTCOME MEASURES: Odds ratio (OR) and 95% confidence interval (CI) for preterm delivery, defined as less than 37 weeks, less than 34 weeks and less than 28 weeks, unadjusted and adjusted for maternal age, an area-based socio-economic status measure, and marital status, year of birth, fetal sex and past obstetric history. RESULTS: For Afro-Caribbean women, the ORs (95% CIs) were: for delivery less than 37 weeks, 1.44 (1.26-1.64) unadjusted and 1.22 (1.07-1.41) adjusted; for delivery less than 34 weeks, 1.55 (1.25-1.92) unadjusted and 1.29 (1.02-1.61) adjusted; for delivery less than 28 weeks, 1.66 (1.08-2.55) unadjusted and 1.32 (0.84-2.06) adjusted. For African women, the risk of delivery less than 37 weeks was not significantly raised; for delivery less than 34 weeks, the OR (95% CI) was 1.88 (0.99-3.58) unadjusted and 1.78 (0.93-3.40) adjusted; for delivery less than 28 weeks, the OR (95% CI) was 4.02 (1.60-10.12) unadjusted and 4.10 (1.66-10.16) adjusted. In Afro-Caribbeans, deprivation and marital status explained the differences between the unadjusted and adjusted ORs. There was a linear relation between deprivation and preterm delivery for all ethnic groups, except for Asians. CONCLUSIONS: Factors associated with deprivation and marital status explain about half of the excess of preterm births in Afro-Caribbeans, but not Africans. The risk of preterm delivery might not be related to deprivation in Asians.
Asunto(s)
Etnicidad , Trabajo de Parto Prematuro/etnología , África/etnología , Asia/etnología , Estudios Transversales , Inglaterra/epidemiología , Femenino , Humanos , Modelos Logísticos , Estado Civil/etnología , Estado Civil/estadística & datos numéricos , Pobreza/etnología , Pobreza/estadística & datos numéricos , Embarazo , Análisis de Regresión , Factores de Riesgo , Sensibilidad y Especificidad , Indias Occidentales/etnologíaRESUMEN
The outcome of 11046 infants, from 20 weeks' gestation, born to mothers of different ethnic origins within one London borough has been analysed. There was no difference in perinatal death rates between the Asian and white infants. Among those with mothers from Africa and the West Indies there were overall significantly more intrauterine deaths (26.8/1000 and 20.0/1000) and neonatal deaths (8.6/1000 and 9.6/1000) than for the white mothers (intrauterine deaths 8.3/1000; neonatal deaths 3.7/1000). At less than 28 weeks', gestation specific death rates were similar in all groups and the overall higher death rates were due to an increase in the proportion of preterm deliveries among the black mothers. From 28 to 36 weeks' gestation, black infants born alive had lower neonatal death rates (7.7/1000) than the white infants (19/1000). The cause of the increased incidence of preterm labour among the black mothers is uncertain, though differences in intrauterine infection rates may be an important factor.
Asunto(s)
Muerte Fetal/etnología , Mortalidad Infantil , Madres , Adulto , África/etnología , Asia/etnología , Causas de Muerte , Femenino , Edad Gestacional , Humanos , Recién Nacido , Londres/epidemiología , Trabajo de Parto Prematuro/etnología , Embarazo , Resultado del Embarazo/etnología , Indias Occidentales/etnologíaRESUMEN
The outcomes of 11046 infants, from 20 weeks gestation, born to mothers of different ethnic origins within one London borough has been analysed. There was no difference in perinatal death rates between the Asian and white infants. Among those with mothers from Africa and the West Indies there were overall significantly more intrauterine deaths (26.8/1000) and 20.0/1000) and neonatal deaths (8.6/1000) and 9.6/1000) than for the white mothers (intrauterine deaths 8.3/1000; neonatal deaths 3.7/1000). At less than 28 weeks's gestation specific death rates were similar in all groups and the overall higher death rates were due to an increase in the proportion of preterm deliveries among black mothers. From 28 to 36 week's gestation, black infants born alive had lower neonatal death rates (7.7/1000) than the white infant (19/1000). The cause of the increased incidence of preterm labour among the black mothers is uncertain, though differences in intrauterine infection rates may be an important factor (AU)
Asunto(s)
Humanos , Embarazo , Recién Nacido , Adulto , Femenino , Muerte Fetal/etnología , Mortalidad Infantil , Madres , África/etnología , Asia/etnología , Causas de Muerte , Edad Gestacional , Trabajo de Parto Prematuro/etnología , Resultado del Embarazo/etnología , Indias Occidentales/etnologíaRESUMEN
Se llevó a cabo un estudio retrospectivo comparativo sobre las características del parto pretérmino (PPT) entre pacientes de un hospital a nivel del mar y otro de altura, con el objeto de hallar su incidencia e identificar diferencias en los factores asociados a esta entidad. Se analizaron 752 casos de PPT en el Hospital Cayetano Heredia (HNCH) de Lima (150 metros sobre el nivel del mar) entre abril de 1988 y septiembre de 1990 y 532 casos del Hospital Daniel A. Carrión (HDAC) de Huancayo (3200 metros sobre el nivel del mar) entre marzo de 1988 y julio de 1992. La incidencia de PPT fue de 11.42 por ciento en el HDAC y 6.26 por ciento en el HNCH (p menor que 0.001). El control prenatal se hizo en el 26.5 de PPT del HDAC vs 52.6 por ciento del HNCH (p menor que 0.001). Hubo mayor frecuencia de ruptura prematura de membranas (17.5 por ciento vs 1.9 por ciento), preeclampsia (11.4 por ciento vs 2.2 por ciento) y eclampsia (3.5 por ciento vs 1.1 por ciento) en el HNCH (p menor que 0.001). Hubo mayor frecuencias de cesáreas (25.75 vs 18.2 por ciento) partos inducidos (7.15 vs 1.3 por ciento), en el HNCH (p menor que 0.01). El RCIU se presentó en el 12.6 por ciento de los PPT del HNCH vs el 8.3 por ciento del HDAC (p menor que 0.01). El Apgar promedio al minuto fue de 7.33 en el HNCH y 6.52 en el HDAC (p menor que 0.005).