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To evaluate if calcium supplementation during pregnancy could have any influence on primary dentition measured as the reduction of dental caries of the child.Individual randomized controlled trial.One hospital in Rosario, Argentina.Random sample of 195 12-year-old children from a follow-up study of 614 women who were randomized during pregnancy to calcium supplementation or placebo.An independent researcher blinded to the group where the mothers were assigned performed a dental examination of the children.Proportion of children with at least one decayed, missing or filled teeth (DMFT/dmft) and mean number of decayed, missing or filled surfaces (DMFS/dmfs) per children.Ninety-eight children were assessed in the calcium supplementation group and 97 in the placebo group. 63.3% of the children whose mother took calcium supplementation had at least one DMFT/dmft compared to 86.6% in the placebo group (0.001). The children whose mother received the intervention had a 27% reduction in the risk of developing at least one DMFT/dmft (RR: 0.73, CI 95%: [0.62; 0.87]).This study shows a modeling effect of calcium intake during pregnancy on dental caries of the offspring. At around 12 years of age children whose mothers received calcium supplementation when pregnant showed a significant reduction in dental caries.

Although the prevalence of tobacco use is decreasing in many high-income countries, it is increasing in many low- and middle-income countries. The health and economic burden of increasing tobacco use and dependence is predictable and will have devastating effects in countries with limited resources, particularly for vulnerable populations such as pregnant women. We sought to review effective tobacco prevention and intervention strategies for decreasing tobacco use and secondhand smoke exposure before and during pregnancy in high-, middle-, and low-income countries. We reviewed several types of interventions, including population-level efforts (increasing tobacco prices, implementing tobacco control policies), community interventions, clinical interventions, and pharmacological treatments. A second purpose of this report is to present findings of an international expert working group that was convened to review the evidence and to establish research priorities in the following areas: (a) preventing the uptake and reducing tobacco use among girls and women of reproductive age; and (b) reducing tobacco use and secondhand smoke exposure among pregnant women. The working group considered the evidence on existing interventions in terms of burden of disease, intervention impact, intervention costs, feasibility of integration into existing services, uniqueness of the contribution, and overall feasibility. Finally, we present the working group's recommendations for intervention research priorities.

To identify risk factors associated with fetal death and to measure the rate and the risk of fetal death in a large cohort of Latin American women. We analyzed 837232 singleton births recorded in the Perinatal Information System Database of the Latin American Center for Perinatology and Human Development (CLAP) between 1985 and 1997. The risk factors analyzed included fetal factors and maternal sociodemographic obstetric and clinical characteristics. Adjusted relative risks were obtained after adjustment for potential confounding factors through multiple logistic regression models based on the method of generalized estimating equations. There were 14713 fetal deaths (rate=17.6 per 1000 births). The fetal death risk increased exponentially as pregnancy advanced. Thirty-seven percent of all fetal deaths occurred at term and 64% were antepartum. The main risk factors associated with fetal death were lack of antenatal care (adjusted relative risk [aRR]= 4.26; 95% confidence interval 3.84– 4.71) and small for gestational age (aRR=3.26; 95% CI 3.13–3.40). In addition the risk of death during the intrapartum period was almost tenfold higher for fetuses in noncephalic presentations. Other risk factors associated with stillbirth were: third trimester bleeding eclampsia chronic hypertension preeclampsia syphilis gestational diabetes mellitus Rh isoimmunization interpregnancy interval 6 months parity =4 maternal age =35 years illiteracy premature rupture of membranes body mass index =29.0 maternal anemia previous abortion and previous adverse perinatal outcomes. There are several preventable factors that should be dealt with in order to reduce the gap in fetal mortality between Latin America and developed countries. (authors)

To examine the association between maternal pre-pregnancy weight status and the risk of stillbirth, pre-eclampsia and preterm delivery.Hospital-based cohort study using prospectively recorded data.Ten public hospitals in Buenos Aires, Argentina.46,964 pregnant women who had a delivery during 2003-2006.Prepregnancy body mass index (BMI) was used to categorize women in four weight categories from underweight to obese. The reference group were women with BMI between 18.5 and 24.9. Crude and adjusted odds ratios were calculated using multiple logistic regression analysis.Preterm birth, pre-eclampsia and stillbirth.The risk of preterm delivery decreased with increasing BMI, with the highest risk among underweight women (OR: 1.45; 95% CI: 1.26-1.67), and the lowest risk among the overweight. The risk of pre-eclampsia was highest among overweight (OR: 1.55; 95%CI: 1.30-1.86) and obese women (OR: 3.10; 95%CI: 2.54-3.78). Obese or overweight women did not have an increased risk of stillbirth in this study.Overweight and obese women have an increased risk for pre-eclampsia, while underweight women have an increased risk for preterm delivery. There is a high prevalence of overweight women in the obstetric population in Buenos Aires.