Background: There is a growing evidence of the impact of the current European economic crisis on health. In Spain since 2008 there have been increasing levels of impoverishment and inequality, and important cuts in social services, including per capita spending on healthcare. Aim:The objective is to evaluate the impact of the economic crisis on underweight at birth in Spain. Results and conclusions:Results demonstrate a significant increase in the prevalence of underweight at birth as from 2008. All maternal-foetal categories were affected, including those which showed the lowest prevalence before the crisis. In the full adjusted logistic regression, year-on-year GDP per capita remains predictive on underweight at birth risk, in such a way that the fall in GDP between 2007 and 2012 determined an increase of the OR of underweight at birth by 6.63%. Previous trends in maternal socio-demographic profile and a direct impact of the crisis are discussed to explain the trends described.

Results support the consideration of establishing parity and type of delivery-specific birthweight references. These new charts enable a better evaluation of the impact of the demographic, reproductive and obstetric trends currently in Spain on fetal growth.

results confirm the persistence of social inequalities in perinatal health described prior to the economic crisis, as well as a possibly negative effect of the recession between 2007 and 2015. Results also confirm that disparities in LBW are more clearly associated with the educational level of mothers than with their occupation.

Considering these data together with those available for other demographic and socioeconomic variables, before and after the period studied, we can conclude that the division by districts represents an effective stratification in the biological living standard of the population of the city of Madrid. These results constitute a first intra-urban approximation using height to the debate on inequality and biological living standards in Spain during the 20th Century.

Objective. To evaluate the trends in low birthweight (LBW) in Spain by parity during the 1996-2016 period. Method. Using data from the National Vital Statistics, joinpoint regression analysis was used to identify the timing of significant changes in the prevalence of LBW. The maternal-foetal characteristics as well unadjusted and adjusted relative risk (RR) of being born with LBW were compared between the established time periods. Results. The prevalence of LBW among live births to primiparous Spanish mothers increased from 5.1% to 6.87% in 2008 and then stabilized at maximum values, while among live births to multiparous mothers LBW increased from 4% to a maximum of 5.20% and then significantly reduced. Conclusions. There was a differential effect of the economic crisis on LBW according to parity, the negative impact being higher and more sustained among primiparous mothers. There may have been a social selection among mothers for pregnancies among those with lowest risks for LBW, more intense among multiparous mothers.

To be female appears to be a benefit under conditions of prematurity and high altitude. The increased incidence of prematurity due to altitude increase may reflect an adaptive advantage of preterm birth under these conditions.

Inhaled morphine has been used to treat dyspnea in a variety of clinical settings. There are, however, no reports of its use in treating patients with end‐stage lung disease due to cystic fibrosis (CF). We report on the use of inhaled morphine sulfate in a 13‐year‐old boy with CF, advanced lung disease, and acute respiratory failure. Therapy was effective in reducing his subjective feeling of air hunger and improving his BORG score. His sole significant adverse effect was headache after 2 days of treatment at 4‐hourly intervals. Pediatr Pulmonol. 2000; 30:257–259. © 2000 Wiley‐Liss, Inc.

Objectives: Cohort variation in adult height expresses both the impact of socio-economic change on human biology in a wide temporal perspective and social inequalities within populations. We aimed to test the use of joinpoint regressions to identify periods in which changes in height trends were statistically significant. Methods: Data correspond to the height recorded in Madrid City (Spain) for 65 313 conscripts between 1936 and 1974 (cohorts from 1915 to 1953), a period of social and political turmoil. Secular trends in height were analyzed in eight districts with contrasting socio-economic conditions, grouped in two categories, lower-class and middle-and upper-class. Trends in height were evaluated by quadratic regressions and by joinpoint regressions to identify the cut-off years when trends changed significantly.Results: Height increased in both socio-economic categories of districts, more among conscripts from the lower-class ones. However, results clearly show differences in trends according to district of residence. Whereas the increase in height in conscripts from the middle-and upper-class districts was steady, it was slower in those from the lower classes, with declines in height during the Civil War and first years of the Franco dictatorship. Conclusions: Joinpoint analysis reveals the association between urban living conditions and adult height, and that the disparities intensified during critical historical periods of Spain.