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2004, Number 1

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Gac Med Mex 2004; 140 (1)

Mortality Risk Factors in the Child of a Toxemic Mother.

Gómez-Gómez M, Danglot-Banck C, Silvia GG, Antonio-Ocampo A, Fajardo-Gutiérrez A, Sánchez-García ML, Ahumada-Ramírez E

Language: Spanish
References: 74
Page: 33-46
PDF size: 516.53 Kb.


ABSTRACT

Introduction. Toxemia of pregnancy is the main cause of perinatal mortality in Mexico. Objective. To determine risk factors of mortality in the infant of toxemic mother. Material and methods. A cases-controls study, nested in a cohort, with two controls for case. Were included newborn children of mothers with toxemía, single product only, of 28 to 42 weeks of gestation, attended in the Hospital de Gineco-Obstetricia, National Medical Center “La Raza”, Mexican Institute of Social Security; the cases were either stillborn and neonatal deaths. The controls were the survivors. Results. There were 57 cases,13 stillborn (23%) and 44 neonatal deaths (77%), and 114 controls. In the cases the toxemia degree was severe in 56 (98%), 19 had eclampsia (33%) while in the controls it was of severe degree in alí of them,12 (10.5%) with eclampsia. As significant risk factors were observed to eclampsia (OR 4.25, 95%CI 1.76-10.39, p=0.0002), premature placental detachment (OR= 8.13, 95%CI 2.29-31.4, p= 0.00007), general anesthesia (OR 5.32, 95%Gl 1.74-16.51, p=O.0005), respiratory distress syndrome (OR 23.68, 95%CI 3.31-478 p= 0.00004), mechanic ventilation (OR= 334, 95%CI 42.63-7084, p= 0.000000001), pen-intraventricular hemorrhage (OR 64.57, 95%CI 8.36-1361, p= 0.0000001), acute renal failure (OR 26.13, 95%Ci 5.21-177, p= 0.0000002) and pulmonary hemorrhage (OR 8.40, 95%Cl 2.71-27.11, p= 0.000006). There were observed as protective factors a high maternal educational level (OR=0. 110, 95%CI 0.01-0.66, p= 0.02), intrauterine malnutrition (OR= 0.39, 95%CI 0.18-0.84, p= 0.008) and transient tachypnea of the newborn (OR= 0.021, 9~%Cl 0.00-0.15, p= 0.00000001). Three significant models of logistical regression were obtained. Conclusions. Were founded as maternal risk factors; eclampsia, premature placental detachment, general anesthesia and maternal death; in the newborn were respiratory distress syndrome, mechanical ventilation and pen-intraventricular hemorrhage. it is interesting the finding of protection factors líke high maternal educational level, intrauterinne malnutrition and transient tachypnea of the newborn.


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