Abstract
Introduction: Chronic hypoxia in high altitude environments reduces fetal growth and birthweight and increases child mortality.
Objective: To analyze the relationship between geographic altitude and birthweight, prematurity, and child mortality of Jujenean populations distributed over an altitudinal gradient (500 to 3500 m.a.s.l.)
Subjects and methods: Data proceeded from Statistical Reports on Live Newborns (LN) and fetal deaths (DF) between 1998 and 2003, which were grouped according to the four Jujenean geographical regions (Puna 3500 m.a.s.l., Quebrada 2500 m.a.s.l., Valle 1500 m.a.s.l., Ramal 500 m.a.s.l.). Rates of very low birthweight at birth (VLBW), low birthweight (LBW), insufficient birthweight (IB) (2500-2999 g), normal birthweight (NB) (> 3000 gr) were determined and the residual distribution (RD) was estimated using the Wilcox Statistical Program (http://eb.niehs.nihgov/bwt) (only in LN). A Pearson correlation for these variables and Infant Mortality (IM), Neonatal Mortality (NM), Post-neonatal Mortality (PM) and geographic altitude was done.
Results: Puna and Quebrada show the lowest percentages of VLBW (P= 0.59% and Q= 0.81%), of NB (P= 63.4% and Q= 68.8%) and RD (P= 1.4% and Q= 1.9%). The lowlands (Valle y Ramal) show the lowest values of LBW (V= 5.13% and R= 4.53%), of IB (V= 16.7 and R= 15.9%) and the higher ones of RD (V= 4% and R= 3%). Both in LN as in DF, geographic altitude correlated negatively to VLBW, NB, and RD, while it showed positive correlation to LBW, IM, NM, and PM. All correlations were statistically significant.
Conclusions: In agreement with the literature, data on the complex interactions between IM and intra-uterine growth in high altitude human populations suggest that, on account of an evolutionary adaptation mechanism, gestations at high altitudes tend to restrict intra-uterine growth, and that this reduction is unable to overcome the effect of natural selection due to hypoxia and social and sanitary factors linked to high altitude.
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Alfaro, E., Grande, C., Dipierri, J. et al. 17 Birthweight and Child Mortality in Highlands Populations of Jujuy Province (Argentina). Pediatr Res 57, 923 (2005). https://doi.org/10.1203/00006450-200506000-00045
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DOI: https://doi.org/10.1203/00006450-200506000-00045