Neonatal mortality and altitude in Peru.
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This paper reports measurements of weight and recumbent length for a cross-sectional sample of 149 Shipibo infants and children between birth and 35.99 months of age from eight villages in the Peruvian Amazon Basin. The Shipibo are an Amerindian population experiencing a period of local environmental disruption and rapid cultural change. Compared with the National Center for Health Statistics (NCHS) references values, Shipibo children are smaller and shorter than American children. The differences are least at birth. Deficits in linear growth begin between 3 and 6 months of age and continue through 35.99 months of age. Weight-for-length ratios are generally adequate compared to the NCHS values in all age groups. This pattern of growth is similar to that reported for non-Amerindians in many developing countries and is assumed to represent a pattern of growth under mild-to-moderate undernutrition. High infant mortality rates suggest that an interaction of suboptimal nutrition and infectious diseases is contributing to the pattern of growth retardation seen; however, genetic differences cannot yet be discounted.
OBJECTIVES: To compare fetal biometry measurements obtained in a Peruvian population with reference fetal size charts obtained in Peruvian and non-Peruvian populations. METHODS: Fetal biometry measurements collected prospectively in 195 uncomplicated pregnancies were included in the presented analysis. At 20, 24, 28, 32, 36 and 38 weeks' gestation, fetal head circumference, abdominal circumference and femur diaphysis length were measured. Fetal biometry measurements were compared with fetal size charts obtained from another Peruvian and two non-Peruvian populations from North America and Europe. RESULTS: When compared with ultrasound-based reference fetal size charts obtained from North American and European populations, fetuses from the studied population appeared to grow more slowly with advancing gestational age. This trend was not observed when a Peruvian population, similar to the one studied here, was used as a reference. CONCLUSIONS: The results suggest that fetal growth in this Peruvian population may not be adequately assessed by using reference charts obtained from other populations and have implications for the use of growth standards in antenatal management.
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Sleep organisation in eight young [mean (SD); 20.9 (2.6) years] Peruvian high-altitude residents was studied in a laboratory in Cerro de Pasco at 4300 m. Electroencephalograms, electromyograms, electro-oculograms, electrocardiograms, respiratory movements and arterial oxygen saturation were recorded on an 8-channel Medilog recorder and analysed later in England. Haematocrits ranged from 48% to 64% [57.9 (5.6)%]. The amount of slow wave rapid eye movement (REM) sleep was similar to that reported in young lowlanders sleeping at sea level but very different to the disturbed sleep in visitors sleeping at high altitude. All the Peruvians showed episodes of periodic breathing and respiratory apnoeas [29 (15) night-1] resulting in marked arterial oxygen desaturation [81 (4.5)%; changes of 6 (2.5)%]. These events occurred either during stage 2 or REM sleep and were more frequent in those with lower haematocrits. The amount of wakefulness during the night was 2-3 times greater than would be expected in an age-matched lowland population at sea level. The awakenings were strongly associated with apnoeas (P < 0.02) but were negatively correlated with haematocrit, although this was only significant for seven of the subjects (P < 0.05).
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Quantitative evaluation of the myocardial left ventricular capillarity was performed in three groups of guinea pigs: a) animals native to high altitude collected in Andean mountains, b) animals born at sea level and subjected to a stimulated high altitude postnatally, c) animals born and kept at sea level. The number of capillaries and muscle fibers/mm(2) as well as the fiber capillary ratio and the diffusion distance were similar in all three experimental groups. The only difference found during the detailed analysis of the myocardial capillarity was a slightly lower percentage of the myocardial tissue in the extreme distance from the capillary found in the hearts of high altitude natives when compared to sea level animals. From these morphometric data the distribution of diffusion distances was derived which can be approximated by lognormal distribution. Capillary inhomogeneity expressed as log standard deviation was found to be similar in all three groups.
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