RESUMO
Toxoplasma gondii congenital transmission depends partially on parasite load and genotype. Both factors were examined in 4 mother/newborn pairs with perinatal infection acquired in central Mexico. Type I and type I-related strains were identified. These results add information regarding T. gondii strains prevailing in humans, although neither the genotype nor the load were related to vertical transmission or damage.
Assuntos
Técnicas de Diagnóstico Molecular/métodos , Toxoplasma/classificação , Toxoplasma/isolamento & purificação , Toxoplasmose/diagnóstico , Toxoplasmose/microbiologia , Carga Bacteriana , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Masculino , México , Tipagem Molecular , Assistência Perinatal , Gravidez , Toxoplasma/genética , Toxoplasmose/transmissãoRESUMO
Introducción. La deficiencia de surfactante causa frecuentemente dificultad respiratoria en prematuros; se realizó este trabajo para conocer los factores asociados a la mortalidad por esta causa. Métodos. Se analizaron 257 casos. Se obtuvieron datos demográficos, antecedentes, enfermedades asociadas, uso de surfactante y desenlace. Se compararon las variables independientes entre sobrevivientes y fallecidos usando χ², razón de momios con intervalo de confianza al 95% o prueba t de Student. Se subdividió la serie en 1500 g de peso buscando diferencias. Resultados. El 60% fueron varones. El peso promedio fue de 1666 g y el promedio de semanas de gestación fue de 31. En 9% hubo inducción de madurez pulmonar. Falleció el 30%. Se encontró diferencia estadística entre vivos y fallecidos en el promedio de peso (1812 g en vivos y 1321g en fallecidos; P<0.001) y en edad gestacional (32 vs 29 semanas, P<0.001). Los factores de riesgo asociados a defunción estadísticamente significativos fueron diabetes materna (RM:9.8; IC95: 1-89) y amenaza de aborto (RM: 13.2; IC95: 2.8-62). No hubo diferencia significativa entre los que se les aplicó surfactante y los que no, ni entre los que se aplicó antes o después de 3,6 o 12 horas. Conclusiones. La mortalidad por deficiencia de surfactante aún es alta, principalmente entre los más pequeños. En esta serie el surfactante no disminuyó la mortalidad.
Background: Surfactant deficiency is a frequent cause of respiratory distress in the preterm newborn. The aim of this study is to determine the factors associated with mortality. Methods: We studied 257 cases in a tertiary-care neonatal intensive care unit with no in-hospital deliveries. We compared survivors and deaths with the χ2 test and calculated odds ratio and confidence interval at 95%. We subdivided the cases at 1500 g looking for any differences. Results: Of the newborns, 60% were male. Mean birth weight was 1666 g and gestational age was 31 weeks. In only 9% was there pulmonary maturation induction with steroids. Overall mortality was 30%. Statistical differences were found between live newborns and deaths according to mean birth weight (1812 g vs 1321 g, p <0.001) and gestational age (32 vs 29 weeks, p <0.001). Associated risk factors were maternal diabetes (OR 9.8, 95% CI: 1-89) and abortion threat (OR 13.2; 95% CI: 2.8-62). There was no difference between those babies who received or did not receive surfactant or when it was received before or after 3, 6 or 12 h. Conclusions: Mortality due to surfactant deficiency was high, especially among lower birth weight infants. Surfactant did not lower mortality in this group.