Suchergebnisse

AIMS—To measure the prevalence of hypoglycaemia among newborn infants in Nepal, where classic risk factors prevail, and to evaluate their importance. METHODS—A cross sectional study was done of 578 term newborn infants aged 0 to 48 hours on the postnatal wards of a government maternity hospital in Kathmandu, with unmatched case-control analysis of risk factors for moderate hypoglycaemia (less than 2.0 mmol /l). RESULTS—Two hundred and thirty eight (41%) newborn infants had mild (less than 2.6 mmol/l) and 66 (11%) moderate hypoglycaemia. Significant independent risk factors for moderate hypoglycaemia included postmaturity (OR 2.62), birthweight under 2.5 kg (OR 2.11), small head size (OR 0.59), infant haemoglobin >210 g/l (OR 2.77), and raised maternal thyroid stimulating hormone (TSH) (OR 3.08). Feeding delay increased the risk of hypoglycaemia at age 12-24 hours (OR 4.09). Disproportionality affected the risk of moderate hypoglycaemia: lower with increasing ponderal index (OR 0.29), higher as the head circumference to birthweight ratio increased (OR 1.41). Regression expressing blood glucose concentration as a continuous variable revealed associations with infant haemoglobin (negative) and maternal haemoglobin (positive), but no other textbook risk factors. CONCLUSIONS—Neonatal hypoglycaemia is more common in a developing country, but may not be a clinical problem unless all fuel availability is reduced. Some textbook risk factors, such as hypothermia, disappear after controlling for confounding variables. Early feeding could reduce moderate hypoglycaemia in the second 12 hours of life. The clinical significance of raised maternal TSH and maternal anaemia as prenatal risk factors requires further research.

This volume on the ecology of Mauritanian coastal waters and in particular the Banc d'Arguin, allows us to understand the functioning of this remarkable coastal wetland. Major questions concern the interaction between the Banc d'Arguin ecosystem on the one hand and the adjoining systems of the open ocean with its intensive upwelling phenomena and the Sahara desert on the other. Is the Banc d'Arguin ecosystem relatively isolated from its surroundings and does it function as a tropical pocket in a more temperate surrounding, as suggested by Sevrin-Reyssac (1983); or does it interact with both the Sahara and the Atlantic Ocean? At the Banc d'Arguin, the area between the estuarine parts and the open ocean is extremely shallow and largely uncharted. Large research vessels cannot penetrate the shallows, whereas small vessels are often unable to negotiate the outer part of the shallow area due to rough weather conditions. Hence, separate teams report on work at the seaward side of this shallow sill and at the landward side. In addition, other teams address different questions, such as the productivity of the seagrass beds and the benthic fauna, the number of birds spending the summer at the Banc d'Arguin, and the distribution of several taxonomic groups of flora and fauna