Abstract
Chronic hypoxia in high altitude constitutes an associated factor for fetal growth restriction, even when there is genetic adaptation, as observed in studies performed in populations living at high altitudes (Tibet, Andes, Europe and North America). Socioeconomic and nutritional deprivation is frequently observed in those populations, being also associated to fetal growth. Objective: To analyze anthropometric measures at birth in relation with altitude, and to assess the effect of maternal nutrition status, socioeconomic conditions and altitude on those measures. Population and methods: The study was based on the information registered in the Perinatal Information System (SIP - Clap-OPS) by the provincial team from the province of Jujuy and forwarded to national level, between 1996–1998. Variables included pre-gestational BMI, maternal weight gain, maternal education, birth weight (BW), length at birth (LB), and head circumference (HC). Cases were grouped in three categories according to the altitude of the institution where the childbirth was attended: 84.1% R1, 5.8% R2 and 10.1% R3, being the latter the area at higher altitude (Puna). Confounding variables were controlled by exclusion and analytical tools. Results: From 25,811 registries, 24,651 with complete information were selected. Mean BW was 3259 ± 538 g in R1; 3162 ± 420 in R2, and 3080 ± 483 in R3, with a difference of 179 grams between R1 and R3, (F 110.7; p < 0.001) and 209 g between R1 and R3 (F 199; p < 0.001) in term deliveries. In this group, LB difference was 0.3 cm (F=274,9, p<0.001), and HC difference was 0.6 cm (F102.7; p < 0.001) between low and highlands (R1 and R3, respectively). Multivariate analysis, by linear regression, showed a final model to predict BW = -1557.4 183.2 * birth at high altitude + 28.9 * parity + 13.3 * 8.7 BMI + 8.7 * maternal weight gain + 113.3 * gestational age at birth + Σ. Conclusion: Altitude influences BW significantly. Nevertheless, nutritional and social factors have a direct and sinergic relationship with BW.
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Duran, P. To be Born at High Altitude: Influence of Altitude, Nutrition and Socioeconomic Conditions on Fetal Growth. Pediatr Res 53, 873 (2003). https://doi.org/10.1203/00006450-200305000-00052
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DOI: https://doi.org/10.1203/00006450-200305000-00052