Biomedical subjects

Rubén Grajeda

Publications and source records attributed to Rubén Grajeda.

6 recordsLinked to original sources

PubMed2005

Maternal and childhood nutrition and later blood pressure levels in young Guatemalan adults.

BACKGROUND: Low birth weight and subsequent rapid child growth are associated with later blood pressure levels. The role of maternal and child nutrition in this association remains unclear. METHODS: We studied 450 men and women (ages 21-29 years) born during a randomized trial of protein-energy supplementation (Atole) vs low energy/no protein supplementation (Fresco) in pregnancy and early childhood in four rural Guatemalan villages from 1969 to 1977. RESULTS: Protein-energy supplementation was not associated with differences in blood pressure in adulthood (diastolic blood pressure (DBP): beta = 0.69 mm Hg, 95% confidence internal (CI) (20.82-2.19); P = 0.37; systolic blood pressure (SBP): beta = 0.17 mm Hg, 95% CI (21.68-2.02); P = 0.86). Within the Atole group, maternal height was associated with later SBP (0.22 mm Hg/cm, 95% CI (20.002-0.45); P = 0.05). No other associations between maternal nutritional status, birth size, child growth, or supplement intake were observed for adult blood pressure. CONCLUSIONS: Our data do not support the role of maternal nutrition during pregnancy, birth size, or early child growth in programming adult blood pressure. Likewise, we found no effect of protein-energy supplementation in pregnancy or in early childhood on blood pressure in young adults.

Adult↗

PubMed2005

The human capital study 2002-04: tracking, data collection, coverage, and attrition.

Between 2002 and 2004, the Institute of Nutrition of Central America and Panama (INCAP), in collaboration with Emory University, the International Food Policy Research Institute (IFPRI), and the University of Pennsylvania, re-surveyed young Guatemalan adults who had, as children, been participants in a nutrition supplementation trial conducted by INCAP between 1969 and 1977. This "Human Capital Study 2002-04" complements and extends data obtained in previous studies by collecting new information on measures of physical health and well-being, schooling and cognitive ability, wealth, consumption and economic productivity, and marriage and fertility histories. This paper describes the study domains and data collection procedures. Among 2,393 members of the original sample, 1,856 (77%) were targets for enrollment. Response rates varied by gender, current place of residence, and domain of data collection, with 80% of males and 89% of females completing at least one data collection instrument. Attrition was not random and appears to be associated with a number of initial characteristics of individuals and their households that should be controlled for in future analyses. We conclude that data collection was successful and data quality is high, facilitating the successful undertaking of our planned investigation of important study hypotheses.

Adult↗

PubMed2005

Schooling, educational achievement, and cognitive functioning among young Guatemalan adults.

Quantity and quality of schooling obtained and the resulting skills and knowledge acquired are important components of human capital. We describe the distribution of selected measures of schooling, educational achievement, and cognitive functioning among individuals who participated as children in a nutrition supplementation trial in Guatemala and were followed up in 2002-04. Among 1,469 respondents (response rate 80%), who were 26-41 years of age in 2003, more than 90% of men and women had attended at least some school; more than half of men and more than one-third of women had completed sixth grade. Schooling attainment of both men and women has increased across birth cohorts but the schooling gap between men and women has increased. Parental socioeconomic status, as measured in 1975, is a strong predictor of schooling attainment. Basic literacy is high among those studied, with more than 80% able to read simple sentences. The gap in educational achievement favoring men narrowed across birth cohorts due to increases among younger women. The greater performance among men on the Raven's Progressive Matrices test persisted despite increased scores in the younger birth cohorts for both men and women. Migrants to Guatemala City have completed more years of school and scored higher on the tests of educational achievement and cognitive functioning than have cohort members who have remained in the study villages.

Adult↗

PubMed2005

Fertility behavior and reproductive outcomes among young Guatemalan adults.

Fertility rates have declined in many developing countries and this has implications for health and development of subsequent generations. Guatemala has the highest fertility rates in Central America. Reproductive histories were obtained by interview in 2002-04, in a cohort of 779 women and 647 men who had participated as young children in a nutrition supplementation trial in Guatemala conducted between 1969 and 1977. Most women (77%) and men (79%) are currently married. Among the 700 women and 524 men reporting at least one birth, mean age at first birth was 20.7 +/- 3.8 years and 23.1 +/- 3.9 years respectively. Knowledge (> 80%) and use (approximately 70%) of modern contraceptive methods is fairly high; knowledge increases with parental socioeconomic status (SES) as measured in 1975. Younger respondents have experienced fewer pregnancies and live births compared with older respondents; age-specific fertility rates between 20 and 24 years were 294, 249, 236, and 261 births per 1,000 women, respectively, for women born from 1962-65, 1966-69, 1969-73, and 1974-77. Women in the top tertile of parental SES have had significantly fewer pregnancies (3.3) compared with those in the middle (3.7) and lower (3.8) tertiles. Migrants to Guatemala City reported greater knowledge of contraceptive methods, fewer pregnancies and living children, higher age at first birth, and more pregnancy and newborn complications as compared with cohort members who remained in the original villages (p < .05 for each comparison). Fertility rates, especially between 20 and 24 years, have declined over time. Differences in reproductive behaviors by parental SES and current residence suggest the role of social transitions in determining family formation in Guatemala.

Abortion, Induced↗

PubMed2004

Smoky indoor cooking fires are associated with elevated hemoglobin concentration in iron-deficient women.

OBJECTIVE: Indoor air pollution from the burning of such biomass fuels as wood and agricultural waste is associated with a higher risk of a number of respiratory problems. The effect on other health outcomes, such as fetal growth, has not yet been adequately documented. The objective of this study was to determine whether, among women who burn biomass fuels for cooking indoors, the use of "smoky" fires is associated with elevated hemoglobin concentration in comparison to women using "smokeless" stoves, that is, stoves that are designed to reduce indoor air pollution. This research was conducted as part of a series of preliminary studies to determine the feasibility and potential health benefits of a randomized stove intervention to reduce indoor air pollution from the burning of biomass fuels for cooking. METHODS: A cross-sectional observational study was conducted in rural highland communities of Guatemala from March to August 1994. Venous blood samples were collected and analyzed for hemoglobin and ferritin. All the women studied burned biomass fuels and cooked indoors, and none of the women was pregnant. Eighty-nine indigenous women using smokeless stoves (designated as the not-exposed group) and 185 indigenous women from the same communities using smoky fires (the exposed group) were studied. Multiple linear regression analyses were used to investigate the relationship between exposure (smokeless stove or smoky fire) and hemoglobin concentration, with adjusting for potential confounding factors. RESULTS: No effect of exposure (smokeless stove or smoky fire) on hemoglobin concentration was found in univariate or multivariate analyses. In routine post hoc analysis to determine whether hemoglobin elevation is observed in some particular subgroup, we found that the use of a smoky fire was associated with a 5.2 g/L elevation in hemoglobin concentration among women with low ferritin stores (P < 0.10). CONCLUSIONS: The elevation of hemoglobin concentration through exposure to indoor air pollution resulting from the burning of biomass fuels in smoky fires for cooking could have important implications for the diagnosis of anemia. However, considering the observational nature of this study, further research using more rigorous measures of exposure to carbon monoxide as well as additional measures of iron status are needed to confirm the relationships among iron status, exposure to smoke from the burning of biomass fuels indoors, and hemoglobin concentration of women living at moderately high altitude. Further study of this matter could help to assure that appropriate adjustments to anemia cutoffs are made, if warranted, and could assist in clarifying potentially negative outcomes of exposure to smoke from biomass fuels burned indoors.

Adolescent↗

PubMed2002

Stress during labor and delivery is associated with delayed onset of lactation among urban Guatemalan women.

A delayed onset of lactation (OL) is likely to have a negative influence on breast-feeding outcomes. Thus, it is important to identify risk factors for delayed OL. We examined prospectively the association between stress during labor and delivery and OL in a cohort of urban Guatemalan women. Healthy women (n = 136) were recruited during the first stage of labor in the labor unit of a social security hospital in Guatemala City. Women provided salivary samples for cortisol determinations 3.2 +/- 3.2 h before birth and 1.7 +/- 1.9 h and 17.1 +/- 4.7 h after delivery. At the same time points women were asked to respond to a 17-item psychosocial stress and anxiety questionnaire. Women were called daily until OL occurred. Primiparous women had higher antepartum and early postpartum cortisol levels that were twice as high as those among multiparous women (P < 0.05). The parity differential in salivary cortisol concentrations vanished with time. General linear model multivariate analysis indicate that multiparous women (n = 77), irrespective of mode of delivery, had an earlier OL (P < 0.05) than primiparae who underwent emergency cesarean section deliveries (n = 11) (adjusted mean +/- SEM, 2.5 +/- 0.1 vs. 3.4 +/- 0.3 d postpartum, respectively). OL took longer to occur among multiparous women with prenatal salivary cortisol levels above (vs. below) the 40th percentile [3 +/- 0.2 (n = 28) vs. 2.4 +/- 0.2 d postpartum (n = 38), respectively; P = 0.02]. Thus, stress during labor and/or delivery is likely to be a significant risk factor for delayed OL in urban Guatemala.

Adult↗