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Iron deficiency is common during the first years of life. Yet, there is a paucity of data on scholar children. Our main objective was to estimate the prevalence of ferropenic anemia in children 3 to 12 years of age living under conditions of poverty. A total of 323 children were included, 171 attended to a day care institution (group A) and 152 were from the same community but not attended in the day care institution (group B). Hemoglobin (Hb), medium corpuscular volume (MCV) and serum ferritin (SF) were measured in all children. In those with Hb < or = 11 g/dl and/or MCV < or = 73 fl and/or SF < or = 15 microg/l, transferrin saturation (TS) and soluble transferrin receptors (sTR) were also measured. Iron deficiency was defined as SF < or = 15 mg/l and ferropenic anemia was defined as Hb < or = 11 g/dl or MCV < or = 73 fl with sTR > or = 38 mmol/l and SF < or = 10 microg/l or TS < or = 10%. There were no differences between the groups regarding age, weight, height, education, gender and housing conditions. Mean hemoglobin level was 12.6 g/dl (group A: 12.4 g/dl vs. group B: 12.7 g/dl; p=0.012), and mean SF was 45 mg/l, without significant differences between groups. Prevalence of iron deficiency anemia was 2.5% (8/323) and iron deficiency was 4.4% (14/317), without significant differences between groups. These results persisted after controlling for confounding variables. In this group of children living under conditions of poverty in Argentina, iron deficiency anemia was uncommon. We attribute this phenomenon to local affordability of some inexpensive cuts of red meat.

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Iron deficiency is common during the first years of life. Yet, there is a paucity of data on scholar children. Our main objective was to estimate the prevalence of ferropenic anemia in children 3 to 12 years of age living under conditions of poverty. A total of 323 children were included, 171 attended to a day care institution (group A) and 152 were from the same community but not attended in the day care institution (group B). Hemoglobin (Hb), medium corpuscular volume (MCV) and serum ferritin (SF) were measured in all children. In those with Hb < or = 11 g/dl and/or MCV < or = 73 fl and/or SF < or = 15 microg/l, transferrin saturation (TS) and soluble transferrin receptors (sTR) were also measured. Iron deficiency was defined as SF < or = 15 mg/l and ferropenic anemia was defined as Hb < or = 11 g/dl or MCV < or = 73 fl with sTR > or = 38 mmol/l and SF < or = 10 microg/l or TS < or = 10%. There were no differences between the groups regarding age, weight, height, education, gender and housing conditions. Mean hemoglobin level was 12.6 g/dl (group A: 12.4 g/dl vs. group B: 12.7 g/dl; p=0.012), and mean SF was 45 mg/l, without significant differences between groups. Prevalence of iron deficiency anemia was 2.5% (8/323) and iron deficiency was 4.4% (14/317), without significant differences between groups. These results persisted after controlling for confounding variables. In this group of children living under conditions of poverty in Argentina, iron deficiency anemia was uncommon. We attribute this phenomenon to local affordability of some inexpensive cuts of red meat.(AU)

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Zinc is an essential element, important for early growth and development, and immune competence, which deficiency might be especially critical in preterm infants. Since published data have shown that some preterm milks have abnormally low zinc values, we decided to measure zinc levels in term and preterm milk, in order to assess if they were within normal values and if there were differences between both groups. Samples from 24 preterm and 20 term mothers (mean gestational age, 30.9 + 0.5 and 39.5 + 0.2 weeks, respectively) were collected and kept at -20 degrees C until analyzed by atomic absorption spectrophotometry, prior wet ashing with nitric acid. Both term and preterm milk showed zinc values within normal levels. No significant differences were registered between them. A decreasing trend was observed along time, which was significant between colostrum and mature milk samples (ANOVA, p < 0.05). In the term group, zinc concentrations in colostrum and mature milk (microgram/mL) (mean +/- SEM) varied between 6.96 +/- 0.69 y 2.44 +/- 0.11, while in the preterm group the values were 6.20 +/- 0.89 y 2.28 +/- 0.54. According to our results, zinc values in human milk were comparable between preterm and term mothers.

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El zinc es un elemento esencial, muy importante para el crecimiento y desarrollo temprano y para una adecuada inmunocompetencia, cuya deficiencia puede ser especialmente crítica en neonatos prematuros. Algunos estudios han hallado valores anormalmente bajos de zinc en leche pretérmino. El objetivo de este trabajo fue determinar si los niveles de zinc en leche de término y pretérmino en nuestra población presentaban valores normales y si se observaban diferencias entre ambos tipos de leche, durante el primer mes de lactancia. Para ello, se analizaron muestras obtenidas de madres de 24 neonatos pretérmino y 20 de término (edad gestacional 30,9 ñ 0,5 y 39,5 ñ 0,2 semanas, respectivamente) Se mantuvieron a -20ºC hasta su análisis por espectrometría de absorción atómica, previa digestión con ácido nítrico. Tanto en la leche de término como en la pretérmino, los niveles de zinc estuvieron dentro de valores normales, sin que se registraran diferencias significativas entre estos dos tipos de leche. Se observó una tendencia decreciente en el tiempo, que fue significativa entre las muestras de calostro y las de leche madura (ANOVA, p<0,05). En el grupo de término, las concentraciones de zinc en calostro y leche madura (µg/mL) (X ñ ESM) variaron entre 6,96 ñ 0,69 y 2,44 ñ 0,11 mientras que en el grupo de pretérmino lo hicieron entre 6,20 ñ 0,89 y 2,28 ñ 0,54. Se concluye que en el contenido de zinc en la leche de pretérmino no fue significativamente menor que en la leche de término

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OBJECTIVE: Even though there is no doubt that human milk is the best nourishment for the neonate, there is still controversy regarding its suitability for preterm infants. The aim of this study was to contribute to the knowledge of the anti-infective properties of preterm milk, measuring lactoferrin levels, which are a non-specific protective factor. METHODS: Samples from 26 preterm and 20 term mothers (mean gestational age +/- standard deviation, 30.9+/-2.6 and 39.5+/-1.1 weeks, respectively) were collected during the first month post-partum. Milk samples were obtained by total expression of one breast between 10 a.m. and noon. An aliquot was kept at -20 degrees C until analyzed by SDS-PAGE (sodium dodecyl sulfate-polyacrylamide gel electrophoresis). Each sample was run in duplicate. RESULTS: Lactoferrin levels (X +/- SD) in colostrum and mature milk varied from 575.0+/-218.2 mg/dL to 459.4+/-190.7 mg/dL in preterm samples and from 970.6+/-288.6 mg/dL to 292.0+/-167.4 mg/dL in term samples. No significant differences were observed between preterm and term groups, in spite of the trend observed in colostrum, where term milk tended to show higher levels than preterm milk. Decreasing values were observed in both groups along time (ANOVA, p<0.05). However, in the preterm group, lactoferrin levels seemed to maintain rather constant values from the eighth post-partum day onwards. CONCLUSIONS: The trend to higher levels of lactoferrin in preterm mature milk would allow maintenance of the protective effect of human milk in preterm infants in spite of the small volumes ingested by these neonates. These findings support the practice of feeding premature infants with their own mothers' milk at a time when their immune systems have not completely developed.

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BACKGROUND: The kidney is the most damaged organ in asphyxiated full-term infants. Experiments in rabbits and rats have shown that renal adenosine acts as a vasoconstrictive metabolite in the kidney after hypoxemia and/or ischemia, contributing to the fall in glomerular filtration rate (GFR) and filtration fraction. Vasoconstriction produced by adenosine can be inhibited by the nonspecific adenosine receptor antagonist, theophylline. Gouyon and Guignard performed studies in newborn and adult rabbits subjected to normocapnic hypoxemia. Their results clearly showed that the hypoxemia-induced drop in GFR could be avoided by the administration of low doses of theophylline. OBJECTIVE: This study was designed to determine whether theophylline could prevent and/or ameliorate renal dysfunction in term neonates with perinatal asphyxia. SETTING: Buenos Aires, Argentina. STUDY DESIGN: We randomized 51 severe asphyxiated term infants to receive intravenously a single dose of either theophylline (8 mg/kg; study group: n = 24) or placebo (control group: n = 27) during the first 60 minutes of life. The 24-hour fluid intake and the urine volumes formed were recorded during the first 5 days of life. Daily volume balances (water output/input ratio and weights) were determined. Severe renal dysfunction was defined as serum creatinine elevated above 1.50 mg/dL, for at least 2 consecutive days after a fluid challenge, or rising levels of serum creatinine (.3 mg/dL/day). The GFR was estimated during the second to third days of life by endogenous creatinine clearance (mL/minute/1.73 m2) and using Schwartz's formula: GFR (mL/minute/1.73 m2) =.45 x length (cm)/plasma creatinine (mg/100 mL) during the first 5 days of life. Tubular performance was assessed as the concentration of beta2-microglobulin (beta2M) determined by enzyme immunoassay, on the first voided urine 12 hours after theophylline administration. The statistical analysis for the evaluation of the differences between the groups was performed with Student's t and chi(2) tests as appropriate. RESULTS: During the first day of life, the 24-hour fluid balance was significantly more positive in the infants receiving placebo compared with the infants receiving theophyline. Over the next few days, the change in fluid balance favored the theophyline group. Significantly higher mean plasma values were recorded in the placebo group from the second to the fifth days of life. Severe renal dysfunction was present in 4 of 24 (17%) infants of the theophylline group and in 15 of 27 (55%) infants of the control group (relative risk:.30; 95% confidence interval:.12-.78). Mean endogenous creatinine clearance of the theophylline group was significantly increased compared with the creatinine clearance in infants receiving placebo (21.84 +/- 7.96 vs 6.42 +/- 4.16). The GFR (estimated by Schwartz's formula) was markedly decreased in the placebo group. Urinary beta2M concentrations were significantly reduced in the theophylline group (5.01 +/- 2.3 mg/L vs 11.5 +/- 7.1 mg/L). Moreover, 9 (33%) patients of the theophylline group versus 20 (63%) infants of the control group had urinary beta2M above the normal limit (<.018). There was no difference in the severity of the asphyxia between infants belonging to the theophylline and control groups in regards of Portman's score. Except for renal involvement, a similar frequency of multiorganic dysfunction, including neurologic impairment, was observed in both groups. The theophylline group achieved an average serum level of 12.7 microg/mL (range: 7.5-18.9 microg/mL) at 36 to 48 hours of live versus traces (an average serum level of .87 microg/mg) in the placebo group. CONCLUSIONS: Our data suggest that prophylactic theophylline, given early after birth, has beneficial effects on reducing the renal dysfunction in asphyxiated full-term infants. (ABSTRACT TRUNCATED)

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OBJECTIVE: To determine the impact of hypertensive disorders in pregnancy on birth weight, small-for-gestational age births (SGA) and neonatal outcome. DESIGN: Matched case-control study. SETTING: A Tertiary Neonatal Intensive Care Unit. POPULATION AND METHODS: The effects of maternal hypertension were analyzed in 11,358 infants born between January 1990 and December 1996 at the Italian Hospital of Buenos Aires. Infants born to mothers with pregnancy-induced hypertension, preeclampsia or eclampsia were included. Each infant was matched for gestational age to 1 control infant born to normotensive mothers. Exclusion criteria were: twins, intrauterine infections, chronic hypertension and major malformations. MAIN OUTCOME MEASURES: Birth weight, incidence of SGA infants, neonatal outcome. RESULTS: 279 infants of hypertensive mothers and 279 controls met the inclusion/exclusion criteria and were enrolled. Maternal hypertension was significantly associated with a higher rate of C-section (OR = 3.80; 95% CI: 2.64-5.50); SGA infants (OR = 7.08; 95% CI: 3.07-18.6), low birth weight (LBW) (OR = 1.8, 95% CI: 1.24-2.60) and very low birth weight infants (VLBW) (OR = 2.14; 95% CI: 1.13-4.19). The frequency of low Apgar score at 5 minutes (OR = 3.63; 95% CI: 1.12-15.3), necrotizing enterocolitis (OR = 3.33; 95% CI: 1.23-10.30) and polycythemia (OR = 3.63; 95% CI: 1.12-15.3) was significantly increased in infants born to hypertensive mothers. There were no significant differences regarding other causes of neonatal morbidity and mortality rate. CONCLUSIONS: Hypertension in pregnancy mainly increased the risk of SGA infants. Furthermore, infants of hypertensive mothers had a higher incidence of LBW, VLBW, low Apgar score at 5 minutes, necrotizing enterocolitis and polycythemia.

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