RESUMO
OBJECTIVE: To objectively assess the effect of light reduction as an isolated environmental intervention on neonatal morbidity. STUDY DESIGN: Randomized multicenter trial. Neonates < 1251 g birth weight and < 31 weeks gestational age were randomly assigned to receive goggles or to a control group. Goggles that reduced visible light by 97% were placed within 24 hours of birth and remained in use until 31 weeks postmenstrual age or for a minimum of 4 weeks. RESULTS: Four hundred nine infants were enrolled, and outcome data are reported for 359 surviving infants. There were no significant differences between the groups in weight gain, duration of oxygen therapy, mechanical ventilation, or hospital stay either in the unadjusted analyses or in the analyses adjusted for birth weight, gestational age, race, sex, and inborn (born in study hospital) status. There was no difference between the groups in the incidence of intracranial hemorrhage. CONCLUSIONS: This randomized trial of continuous light reduction in the first few weeks of life for very low birth weight infants showed no effect on medical outcomes.
Assuntos
Recém-Nascido Prematuro/fisiologia , Recém-Nascido de muito Baixo Peso/fisiologia , Hemorragias Intracranianas/prevenção & controle , Iluminação , Avaliação de Processos e Resultados em Cuidados de Saúde , Desenvolvimento Infantil/fisiologia , Dispositivos de Proteção dos Olhos , Feminino , Humanos , Recém-Nascido , Hemorragias Intracranianas/fisiopatologia , Tempo de Internação , Masculino , Oxigenoterapia , Respiração Artificial , Aumento de Peso/fisiologiaRESUMO
Populations of Mexican descent have high occurrences of neural tube defects (NTDs). A recent study suggested that folic acid supplements may not protect these populations from NTDs. In a case-control study, the authors investigated the role of folic acid and dietary folate intake in NTD risk among Mexican Americans living along the Texas-Mexico border. From January 1995 to February 1999, 148 Mexican-American women with NTD-affected pregnancies and 158 women with normal live births were interviewed in person about use of vitamin supplements and dietary intakes during a 6-month periconceptional period (from 3 months before conception to 3 months after conception). Daily preconceptional consumption of vitamin supplements containing folic acid was 2.5% in control women and 2.0% in case women (odds ratio = 0.77; 95% confidence interval (CI): 0.19, 3.22). With adjustment for maternal age, education, obesity, and previous stillbirth or miscarriage, the risk estimate was essentially null (odds ratio = 1.12; 95% CI: 0.22, 5.78). Combined folic acid intake from diet and supplements showed only a modest risk reduction for intakes of > or = 1.0 mg per day (adjusted odds ratio = 0.73; 95% CI: 0.31, 1.72). The fact that the primary folic acid exposure was in the form of dietary polyglutamates rather than the more easily absorbed supplemental monoglutamates may explain an apparent decreased effect in this population.