A case-control survey of 48 children with nonsyndromic cleft lip or palate showed a significant increase in prevalence of maternal use of topical corticosteroid preparations in the first trimester of pregnancy, compared to 58 controls born in the same hospital; the odds ratio was 13.154, 95% confidence interval 1.67-586, P = 0.0049 on Fisher's exact two-tail test. The results were statistically significant although the wide confidence interval reflected the small sample size. Although older epidemiological studies have not detected any association between systemic corticosteroid treatment and the combined incidence of all congenital malformations, experimental studies over several decades have shown that maternal corticosteroid exposure in several species of animals is specifically associated with oral clefts. This association has been confirmed by more specific case-control surveys where the cases were children with cleft lip or palate and the exposure was maternal systemic corticosteroid treatment in the first trimester. Only one previous survey also analyzed topical corticosteroids, and it demonstrated an increased odds ratio for cleft lip or palate. A national survey of children with cleft palate will be necessary to evaluate the results of this pilot study.
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La planificación familiar es una forma de pensar y vivir, adoptada voluntariamente por individuos y parejas, basada en conocimientos y actitudes de cara a promover la salud y el bienestar de la familia y de la comunidad. Este concepto hace alusión al derecho de las personas a regular su fertilidad; que, pensado desde esa óptica, se convierte fundamentalmente en un derecho sexual, pero que, a la vez, influye en el cumplimiento de los derechos reproductivos. Es un hecho que las condiciones de marginación, exclusión y pobreza, que enfrentan los pueblos indígenas obstaculizan el ejercicio de sus derechos sexuales y reproductivos. Sin embargo, existen factores culturales que incrementan esta problemática como son: los roles tradicionales de género y el no reconocimiento de los derechos de las mujeres a decidir sobre su cuerpo, su sexualidad y el número de hijos que desean tener. En Paraguay existen 112.848 habitantes aborígenes, 54.473 de ellos son mujeres, según el III Censo Nacional de Población y Vivienda para Pueblos Indígenas 2012.
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