Alicia B. Orden

Age at menarche in urban Argentinian girls: association with biological and socioeconomic factors.

Age at menarche is regarded as a sensitive indicator of physical, biological, and psychosocial environment. The aim of this study was to determine the age at menarche and its association with biological and socioeconomic factors in girls from Santa Rosa (La Pampa, Argentina). An observational cross-sectional study was carried out on 1,221 schoolgirls aged 9-15 years. Menarche data were obtained by the status-quo method. Height, sitting height, weight, arm circumference, tricipital and subscapular skinfolds were measured. We also calculated body mass index, measures of body composition and proportions, and fat distribution. To assess socioeconomic factors, parents completed a self-administered questionnaire about their occupation and education, family size, household, and other family characteristics. The median age at menarche - estimated by the logit method--was 12.84 years (95% CI: 12.71, 12.97). Compared with their premenarcheal age peers, postmenarcheal girls had greater anthropometric dimensions through age 12. After this age, only height was higher in the latter group. Data were processed by fitting two logistic regressions, both including age. The first model included anthropometric variables and birth weight, while the second model included the socioeconomic variables. The significant variables derived from each model were incorporated into a new regression: height, sitting height ratio (first model), and maternal education (second model). These three variables remained significantly associated with menarche. The results suggest a relationship between linear growth and menarche and agree with those found in other populations where the advancement of menarche is associated with improved living conditions. In relatively uniform urban contexts, maternal education may be a good proxy for the standard of living.

Trends in weight, height, BMI and obesity in schoolchildren from Santa Rosa (Argentina), 1990-2005/07.

Abstract Aim: To assess secular changes in physical growth and the current prevalence and trend of overweight/obesity in Argentinian schoolchildren. Subjects and methods: One thousand and forty-nine schoolchildren aged 6 and 12 years attending schools in 1990 were compared with an age-matched sample of 935 boys and girls collected between 2005–2007. Changes in weight, height and BMI by age between the surveys were analysed using one-way analysis of variance. Overweight and obesity were defined according to IOTF criteria and compared by Chi-squared test. Odds ratios (OR) and intervals of confidence (95% CI) were also calculated. Results: Six and 12 year-old boys and girls were significantly heavier (1.2–3.2 kg) and had higher BMIs (0.7–1.0 kg/m2) in 2005–2007 than in 1990. Significant differences in height were seen in 6 year old boys (1.5 cm) and 12 year old girls (1.3 cm). Overweight and obesity increased by 4.4% (OR = 1.4, 1.1–1.8) and 5.9% (OR = 4.3, 2.8–6.5), respectively; obesity being higher in younger children. Conclusion: The disharmonic secular change in weight and height has led to high overweight/obesity. The obesity increase is consistent with global and regional trends, indicating a shift in BMI distribution, especially at the higher centiles.

Herramientas de Screening del Desarrollo Psicomotor en Latinoamérica

El medico que trabaja en atencion primaria cumple un papel fundamental en la deteccion de los problemas del desarrollo psicomotor. Actualmente se dispone de una gran cantidad de herramientas utiles para la pesquisa de este tipo de trastornos. En este articulo se presenta una revision actualizada de algunos de los metodos de evaluacion del desarrollo psicomotor mas frecuentemente utilizados en America Latina, con especial enfasis en las tecnicas de screening. Tambien se presenta un esquema de seguimiento de los pacientes con retraso psicomotor a fin de simplificar el proceso diagnostico y, por ultimo se plantean algunas dificultades para implementar la vigilancia del desarrollo.

Weight and height centiles of Argentinian children and adolescents: a comparison with WHO and national growth references

Abstract Background: Studies in several countries comparing the performance of WHO references and their own national growth standards reported differences that could affect screening and growth monitoring. Aim: To estimate weight and height centiles on a sample of Argentinian children and adolescents and compare selected centiles with WHO and national growth references. Subjects and methods: A cross-sectional school survey was conducted on 6239 boys and girls aged 5–18. Data were collected between 2005–2009 in Santa Rosa, Argentina. Smoothed weight and height centiles were estimated by the LMS method and compared with WHO 2007 and Argentinian (ARG) growth references. Results: Weight centiles were higher than those of WHO and ARG. Height centiles were above the ARG and below the WHO ones. The greatest differences with ARG were seen before puberty and then declined up to age 18. In contrast, differences with WHO increased from puberty onwards. Conclusion: Compared with the ARG reference, linear growth of these schoolchildren shows a secular acceleration without substantial improvements in the adult height. In relation to WHO, the results suggest that around the adolescent growth spurt differences in linear growth between populations became larger, limiting the clinical usefulness of international growth references in adolescents.

Maternal behavioral factors influencing postpartum weight retention. Clinical and metabolic implications

Abstract Objectives: to describe some factors of maternal behavior such as breastfeeding, diet,physical activity, sleep and clinical-metabolic disorders associated with retention and/orweight gain during postpartum.Methods: specific articles on the subject were searched in LILACS, MEDLINE/PubMedand SciELO databases.Results: the literature review suggests that breastfeeding or physical activity alone arenot enough to return to the pre-pregnancy weight, if they are not combined with restrictionsof energy intake. Reduced sleep affects both eating habits and activity patterns resulting inlower energy expenditure, in addition to altering the glycemic metabolism. Conclusions: maternal obesity increases the risk of metabolic syndrome. Interventionsduring postpartum are critical for maternal health and could be the key in reducing the riskof transgenerational maternal/childhood obesity. Key words Postpartum period, Maternal behavior, Obesity, Metabolic syndrome X, Sleepdeprivation, Insulin resistance

El desarrollo psicomotor y sus alteraciones: entre lo normal y lo patológico

El siguiente articulo discute aspectos propios del desarrollo psicomotor (DPM) y sus alteraciones, con especial enfasis en el retraso psicomotor. Se hace referencia a las clasificaciones diagnosticas para los problemas del desarrollo como el DSMIV y el CIE 10, y se analizan sus ventajas y desventajas. Tambien se problematiza el concepto de normalidad en tanto sinonimo de promedio estadistico en el contexto de los problemas del DPM, para considerar su dinamica y variabilidad, evitando la oposicion normalidad/patologia, y valorando aspectos como el sociocultural que permiten repensar la universalidad y la relatividad del DPM.