Journal article Open Access

Factores gestacionales en el desarrollo de enfermedades desmineralizantes óseas del infante: Revisión sistemática

Vásquez-Serrano, Carlos Daniel; Ruiz-Andrade, Andrea

RESUMEN

La salud ósea comienza durante la etapa fetal y exige cubrir una cantidad adecuada de nutrientes in útero para la mineralización, asegurando un crecimiento óptimo en el organismo del recién nacido. Las enfermedades metabólicas óseas del neonato surgen como una complicación propia de la prematuridad, a causa de una privatización de los depósitos minerales que incrementan principalmente durante el tercer trimestre de gestación. Sin embargo, debido a la complejidad en la fisiología de la formación y remodelación ósea, es importante reconocer otros factores relacionados en el desarrollo de enfermedades desmineralizantes óseas. Se concretó la búsqueda de información en las plataformas Academic Search Premier, PubMed y MEDLINE acerca de los principales desencadenantes durante el periodo gestacional que han demostrado mayor asociación con la incidencia de estas patologías, bajo el cumplimiento de criterios de selección (anterioridad máxima de 5 años, importancia de la hipótesis con el enfoque del estudio, sin sesgos de padecer patologías óseas congénitas, validez demostrada por una correcta asociación estadística y calidad medida con herramientas proporcionadas por el programa de habilidades en lectura crítica español [CASPe]). Se encontró que las alteraciones en la densidad ósea caracterizadas por una reducción de la porción inorgánica del hueso, pueden ser propiciadas por una restricción de estimulación mecánica y de crecimiento intrauterino, al igual que factores modificables inducidos por la futura madre como déficit alimenticio, consumo de tabaco, uso de tratamientos farmacológicos específicos, infecciones, así como la presencia de un descontrol glucémico y otras alteraciones metabólicas.

 

 

ABSTRACT

Bone health begins during the fetal stage and requires an adequate amount of intrauterine nutrients for mineralization, ensuring optimal growth in the newborn's organism. Bone metabolic diseases of the newborn arise as a complication of prematury, because of a privatization of mineral deposits that increase mainly during the third trimester of pregnancy. However, due to the complexity in the physiology of bone formation and remodeling, it is important to recognize other factors in the development of bone demineralizing diseases. The search for information on the Academic Search Premier, PubMed, MEDLINE platforms about the main triggers during the gestational period that have shown greater association with the incidence of these pathologies was completed, under the fulfillment of selection criteria (maximum prior to last 5 years, importance of the hypothesis with the project approach, without biases of suffering congenital bone pathologies, validity demonstrated by a correct statisticial association and quality measured with tools provided by Spanish critical reading skills program [CASPe]). It was found that alterations in bone density characterized by a reduction in the inorganic portion of bone, can be caused by a restriction of mechanical stimulation and intrauterine growth, as well as modifiable factors induced by the future mother, such as nutritional deficit, tobacco consumption, use of specific pharmacological treatments, infections, as well as the presence of a glycemic uncontrol and other metabolic alterations.

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