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Introducción: La malnutrición en los pacientes hospitalizados tiene implicaciones clínicas y evolutivas, por lo que existe interés en desarrollar métodos de cribado que identifiquen los individuos de riesgo. En la actualidad no existe consenso acerca de la herramienta de cribado nutricional más apropiada para aplicar en población pediátrica. Objetivo: Validar en España la herramienta de cribado nutricional pediátrico STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics). Métodos: Estudio descriptivo transversal en pacientes ingresados en un hospital pediátrico de tercer nivel con diferentes especialidades médicas y quirúrgicas. En las primeras 24 horas de ingreso se aplicó el método de cribado nutricional STAMP. Para la validación de sus resultados se llevó a cabo una valoración del estado nutricional que incluyó datos clínicos, antropométricos y de composición corporal realizada por personal especializado en nutrición. Resultados: Fueron estudiados 250 niños. La valoración nutricional detectó 64 pacientes (25,6%) considerados de riesgo, de los cuales 40 (16%) estaban ya malnutridos. STAMP clasificó un 48,4% de la muestra como de riesgo nutricional elevado. Dicho método mostró una sensibilidad del 75% y una especificidad del 60,8% para identificar los pacientes considerados de riesgo en la valoración nutricional, y una sensibilidad del 90% y especificidad del 59,5% para detectar los malnutridos. Comentarios: La frecuencia de malnutrición fue algo inferior a la de otros países de nuestro entorno, aunque el método diagnóstico fue diferente. El método STAMP es una herramienta sencilla y útil para el cribado nutricional, que evitaría la necesidad de valorar a todos los pacientes al ingreso para detectar los sujetos de riesgo.Background: Malnutrition among hospitalized patients has clinical implications, and interest has arisen to find screening tools able to identify subjects under risk. At present, there is no consensus about the most suitable nutrition screening tool for pediatric patients. Aim: To validate STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics) pediatric screening tool in Spain. Methods: Descriptive cross-sectional study of patients admitted to a 3rd level children's hospital with both medical and surgical specialities. During the first 24 hours of admission, STAMP screening tool was applied. For its validation, results were compared with those obtained from a nutritional assessment performed by specialist staff, which included clinical, anthropometric and body composition data. Results: A sample of 250 children was studied. Nutritional assessment identified 64 patients (25.6%) under risk, 40 of whom were malnourished (16%). STAMP classified 48.4% of the patients as being under nutritional risk. This tool showed 75% sensitivity and 60.8% specificity when identifying patients under risk according to nutritional assessment. It showed 90% sensitivity and 59.5% specificity when identifying malnourished patients. Comments: Malnutrition was less frequent than that reported in other European countries, although diagnosis technique was different. STAMP is a simple and useful tool for nutritional screening, avoiding the need to assess all patients on admission in order to identify those under nutritional risk.

Introducción y objetivo: Los estándares poblacionales de crecimiento intrauterino son necesarios para evaluar si el recién nacido (RN) ha crecido bien, si su estado nutricional es adecuado y para identificar grupos de riesgo como los pequeños para su edad gestacional (PEG). Se analizan las diferencias entre las curvas de crecimiento intrauterino utilizadas habitualmente en nuestro medio y el número de RN que cada una de ellas identifica como PEG. Material y métodos: Estudio transversal en 4.486 RN caucásicos (2.361 niños y 2.125 niñas), con una edad gestacional entre 35 y 41 semanas. La valoración antropométrica del RN (peso y longitud) se realizó siguiendo la metodología estándar. Se comparó el porcentaje de RN que quedaba con un peso y una longitud por debajo del percentil 10 (P10) para su edad gestacional a partir de cuatro curvas de crecimiento intrauterino (Olsen et al. 2010, Lubchenco et al. 1966, Delgado et al. 1996, Carrascosa et al. 2008), siendo diagnosticado de PEG. Resultados: El peso y longitud de los niños eran significativamente mayores que los de las niñas en todas las edades estudiadas. Los valores para el P10 en cada edad gestacional son globalmente similares entre las curvas analizadas y superponibles a los de nuestra población, con la clara excepción de la gráfica de Lubchenco et al. cuyos valores para el P10 son de hasta 300 g. menos en los RN de mayor edad gestacional. Las gráficas de Lubchenco et al. identifican un menor número de PEG que las otras. El porcentaje de niños PEG de nuestra muestra osciló entre un 1,7% y 14% en dependencia del estándar, sexo y edad gestacional considerados. Conclusión: El número de niños clasificados como PEG varía según el estándar utilizado. Las gráficas de Lubchenco, pese a su amplio uso, se alejan del patrón de crecimiento de nuestra población e identifican un menor número de PEG. El resto de curvas son similares entre ellas y parecen adecuadas para nuestro medio. La correcta identificación de los PEG permitirá valorar con mejor criterio los riesgos a corto y largo plazo de estos RN.Introduction and objective: Population standards of intrauterine growth are necessary to evaluate if the newborn has grown well, if their nutritional conditions are appropriate and to identify groups at risk as those small for gestational age (SGA). Differences in the number of SGA newborns identified, depending on the standard applied, have been analyzed in this study. Material and methods: Cross-sectional study conducted in 4,486 Caucasian newborns (2,361 boys and 2,125 girls), born between 35 and 41 weeks. Weight and length valuation was performed following the standard methodology. Percentage of children under the 10th percentile for weight and length was calculated depending on the standard used (Olsen et al. 2010, Lubchenco et al. 1966, Delgado et al. 1996, Carrascosa et al. 2008), being diagnosed of SGA. Results: Weight and length were significantly higher in boys than in girls at all ages. 10th percentile values defined for every gestational age are globally similar among the different standards and our population, with the clear exception of Lubchenco curves whose 10th percentile values are even 300 g. lower for the newborns at the highest gestational ages. Lubchenco charts do not fit the pattern of intrauterine growth of our population and identify a smaller number of SGA. The percentage of SGA of our sample ranged between 1.7% and 14% in depending on the standard, sex and gestational age considered. Conclusion: The number of children classified as SGA is different according to each standard used. Lubchenco charts identify a smaller number of SGA than the others. The rest of curves show similar values and seem to be well adapted for our population. The correct identification of SGA will allow a better assessment of short and long-term risks of these newborns.

Introducción: El crecimiento es un fenómeno complejo que en pediatría tiene especial relevancia por constituir un indicador fundamental del estado nutricional. Objetivo: Evaluar las diferencias en la interpretación del peso en una muestra de niños de nuestro medio, desde el nacimiento hasta los 18 meses, según los estándares nacionales e internacionales existentes. Métodos: Estudio longitudinal del peso y longitud en una cohorte de 383 niños de 0 a 18 meses representativa de la población aragonesa. Tras un análisis descriptivo se calculó la "puntuación típica" a partir de cinco tablas de crecimiento poblacional. Finalmente se calculó el porcentaje de niños que quedaban por encima o debajo de 2 DE para el peso según el estándar utilizado. Resultados: Del total, 50,1% eran varones y 49,9% mujeres. El peso y longitud de los niños fueron mayores que en las niñas en todas las edades (pIntroduction: Growth is a complex phenomenon that has in pediatric age special relevancy because it constitutes a fundamental indicator of nutritional status. Objective: To evaluate differences about weight analysis of infants aged 0-18 months depending on the population reference used. Methods: This is a longitudinal weight and length study in a representative sample of 383 infants from Aragon since birth until 18 months of age. A descriptive analysis was realized and "z-scores" were calculated from five growth curves. Finally there was calculated the percentage of children who were staying above or under 2DS for weight depending on the standard used. Results: 50,1 % were males and 49,9 % women. Weight and length of the children were higher in girls than in boys in all the ages (p

Background: Malnutrition among hospitalized patients has clinical implications, and interest has arisen to find screening tools able to identify subjects under risk. At present, there is no consensus about the most suitable nutrition screening tool for pediatric patients., Aim: To validate STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics) pediatric screening tool in Spain., Methods: Descriptive cross-sectional study of patients admitted to a 3rd level children's hospital with both medical and surgical specialities. During the first 24 hours of admission, STAMP screening tool was applied. For its validation, results were compared with those obtained from a nutritional assessment performed by specialist staff, which included clinical, anthropometric and body composition data., Results: A sample of 250 children was studied. Nutritional assessment identified 64 patients (25.6%) under risk, 40 of whom were malnourished (16%). STAMP classified 48.4% of the patients as being under nutritional risk. This tool showed 75% sensitivity and 60.8% specificity when identifying patients under risk according to nutritional assessment. It showed 90% sensitivity and 59.5% specificity when identifying malnourished patients., Comments: Malnutrition was less frequent than that reported in other European countries, although diagnosis technique was different. STAMP is a simple and useful tool for nutritional screening, avoiding the need to assess all patients on admission in order to identify those under nutritional risk.

Introduction: One in every four women smoke at the beginning of the pregnancy in Spain; of these, 25-50% give up smoking during gestation and most of them smoke again after childbirth. Maternal smoking has harmful effects on babies, such as low birth-weight with its resulting morbidity. The objective of this study is to compare the anthropometric and socio-cultural characteristics between newborns from smoking motheŕs and those from non- smoking ones., Materials and Methods: Smoking habits and the socio-cultural characteristics were assessed from a sample of 1499 pregnant women, as well as their newborn anthropometric variables of their newborn babies during 2009 in the Aragon region of Spain., Results: In the sample of 1499 pregnant women the prevalence of smoking during pregnancy was 19.6%; among the Spanish women, 23% of them smoked during the gestation compared with only 11% in women from other countries. The smoker mothers were younger and they had a lower educational level than the non smoker ones; however, there were no statistical differences between their anthropometric characteristics. Newborns from smoker women in Aragon had a lower weigh at delivery (3155 vs. 3295 grams: p<.001) and a relative risk of low weight at birth for their gestational age of 2.1 (95% CI: 1.35 - 2.97). The length and the rest of newborn anthropometric variables were also affected., Conclusion: The prevalence of smoking during gestation is high in Aragon. The mothers who smoke are younger and have different socio-cultural characteristics compared with non-smoker mothers. Maternal smoking habits have a harmful effect on newborn nutritional status, representing an avoidable risk of low weight at birth., (Copyright © 2011 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.)

Introduction: Maternal nutritional status is an important factor of adequate intrauterine growth and neonatal weight. The aim of this study is to evaluate the relationship between pre-gestational BMI (Body Mass Index) and breastfeeding duration, as well as infant anthropometric measurements during their first six months of life., Materials and Methods: Anthropometric measurements and the type of feeding were evaluated in a representative sample of 1,547 newborns from our population during 2009, according to their maternal BMI, and also in a sub-cohort of 759 infants followed up to 6 months of life., Results: A total of 72.9% of women had a normal weight, 18.7% were overweight and 8.4% obese. Women with a BMI ≥ 25 kg/m(2) had lower weight gain during pregnancy (P < .001), lower socioeconomic and cultural level (P < .001), and their infants had higher weight at delivery (P=.003) and at 6 months of life, with no differences in body length. Newborn weight increased in relation to maternal BMI, but over 35 kg/m(2) it decreased progressively (P < .001). Breastfeeding prevalence in obese women was 58.5% at hospital postpartum discharge, and 8.6% at six months of life; as opposed to 70.8% and 13.9%, respectively in women with normal BMI., Conclusions: In our sample, maternal obesity is associated with a low socioeconomic and cultural level, higher infant weight at delivery and at 6 months of life, and less prevalence of exclusive breastfeeding; all of them nutritional risk factors in the short and long term., (Copyright © 2010 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.)