Antonio Mur Sierra

METHADONE AND NEONATAL THROMBOCYTOSIS

Maternal treatment with methadone sometimes induces a late-onset neonatal withdrawal in the offspring. Thrombocytoses in the newborn are very rare and sometimes are induced by methadone. These newborns must be admitted for at least 2 weeks and their platelet counts must be monitored.

Consumo de drogas durante la gestacion y su repercusion neonatal. Analisis de los periodos 1982-1988 y 2002-2008

BACKGROUND AND OBJECTIVE The use of illicit drugs during pregnancy becomes a high risk situation. Our objective is to determine the currently prevalence, pregnancy, delivery and newborns characteristics of mothers who use illicit drugs. PATIENTS AND METHODS Retrospective study of children exposed prenatally to illicit drugs in the Neonatologys Unit of the Hospital del Mar during 2002-2008 and comparison with 1982-1988 data. RESULTS Heroin use is lower currently and it is always associated with other drugs, mainly inhaled or smoked. There is an increase of the maternal age (28.4 years), an improved gestational control (60.5%) and more newborns are attended in shelters (13.1%). Methadone programs provide better overall results. Human immunodeficiency virus (HIV) (25%) and hepatitis B (BHV) (2.5%) infections have decreased. Placental abruption rate in cocaine users is very high (11%). By comparing both periods, there were statistically significant differences in maternal age, gestational control, delivery way, neonatal withdrawal syndrome treatment and newborn destination. CONCLUSIONS Drug abuse remains prevalent in native pregnants. Heroin use has decreased. At present, there is a better gestational control and less HIV and HBV infections. The gestational age and somatometric parameters have not changed over the years. Methadone programs improve the deleterious aspects of opioid use. Placental abruption in pregnancy and neurobehavioral disorders in newborn are common in cocaine users.

Concentraciones plasmáticas de 25-OH vitamina D y parathormona en sangre de cordón umbilical

Background: Plasma 25(OH)D levels in the newborn are dependent on maternal stores, thus, neonates of vitamin D-deficient mothers present a greater risk of hypocalcaemia, rickets and infections the first year of life. Several studies showing a high prevalence of vitamin D deficiency in pregnant women have been published recently. The aim of the study is to analyze the levels of 25(OH)D in cord blood and determine whether there is a relation with nutritional, socioeconomic and clinical factors of pregnant women and their newborns. Metthods: Between March and May 2013, 99 pregnant women were recruited in Hospital del Mar (Barcelona), in whom plasma 25(OH)D and PTH levels were measured in cord blood at birth. Clinical history data were collected and a nutritional survey was made on maternal vitamin D and calcium intake and sun exposure. Statistical analysis was performed using SPSS. Comparisons were performed using Kruskal-Wallis and Mann-Whitney U tests, and correction for multiple comparisons using Bonferroni. P value <0.05 and <0.0083 for multiple comparisons were considered statistically significant. Results: Mean 25(OH)D value in cord blood was 10.4±6.1 ng/ml. 94% of pregnant women had 25(OH)D levels in cord blood <20 ng/ml. Vitamin D and calcium intake was considered adequate in 92% although sun exposure was deficient in 47%. A correlation between serum 25(OH)D and vitamin D (p 0.033) and calcium intake (p 0.005), sun exposure (p<0.001), ethnicity (p<0.001), skin phototype (p<0.001) and use of traditional clothing (p<0.001) was found. Conclusions: There is a high prevalence of low levels of vitamin D after winter months in cord blood. The lowest 25(OH D levels were observed in Indo-Pakistani ethnicity, dark phototype and deficient sun exposure.

Análisis del maltrato prenatal en Cataluña entre los años 2011 y 2014

INTRODUCTION Foetal abuse is that intentional or negligent act that causes a harmful effect to the foetus. It is a type of abuse difficult to diagnose and handle. Some indicators of suspicion are the absence of gestational control, the maternal consumption of toxic substances, or the problematic maternal social environment. OBJECTIVE To analyse the cases of foetal abuse registered in Catalonia between 2011 and 2014 to identify the risk profile. METHODS A cross-sectional descriptive study was conducted on a sample of 222 cases of prenatal abuse registered in Catalonia between 2011 and 2014. RESULTS The mean maternal age was 28.11 years, with 63% of Spanish nationality, 76% were unemployed, 60% had not followed correct gestational control, 76% had previous pregnancy interruptions, 20% reported to have been mistreated by the partner, had history of social problems (76% social intervention, 30.5% previous child retention, 13% custody of the mother by the administration, 7% deprivation of liberty), with high rates of mother-to-child transmission of infection (HIV 4.95%, HCV 9%, HIV+HCV co-infection 1.8%), and 73% reported toxic use (in order of frequency, cannabis, cocaine and heroin). In newborns, the rate of prematurity (26.3%) is highlighted, as well as the diagnosis of withdrawal syndrome in 34 cases. Just over half (51.6%) of the infants are currently with their mother. CONCLUSIONS In our reference population with a diagnosis of prenatal abuse, there are high rates of maternal toxic consumption, HIV-HCV infection, unemployment, history of previous social intervention, and poor gestational control.