This qualitative study reports the findings from 6 focus groups conducted at a clinic in Southern Mexico with caregivers of morbidly obese children. This study was developed with the purpose of gaining a further understanding of caregivers' perceived role in addressing their children's obesity within the family context and identifying topics that could be considered when providing health care in similar sociocultural environments. We identified that although caregivers acknowledge the role of modifiable factors in obesity prevention and treatment, they held beliefs about determinism in obesity. In addition, diet was the more frequently identified means of reducing the impact of obesity. The importance of role modeling and promoting healthy behaviors in the family context are topics that could be addressed in clinical practice.

Background In Mexico, the COVID-19 pandemic led to preventative measures such as confinement and social interaction limitations that paradoxically may have aggravated healthcare access disparities for pregnant women and accentuated health system weaknesses addressing high-risk patients’ pregnancies. Our objective is to estimate the maternal mortality ratio in 1 year and analyze the clinical course of pregnant women hospitalized due to acute respiratory distress syndrome and COVID-19. Methods A retrospective surveillance study of the national maternal mortality was performed from February 2020–February 2021 in Mexico related to COVID-19 cases in pregnant women, including their outcomes. Comparisons were made between patients who died and those who survived to identify prognostic factors and underlying health conditions distribution. Results Maternal Mortality Ratio increased by 56.8% in the studied period, confirmed COVID-19 was the cause of 22.93% of cases. Additionally, unconfirmed cases represented 4.5% of all maternal deaths. Among hospitalized pregnant women with Acute Respiratory Distress Syndrome consistent with COVID-19, smoking and cardiovascular diseases were more common among patients who faced a fatal outcome. They were also more common in the age group of < 19 or > 38. In addition, pneumonia was associated with asthma and immune impairment, while diabetes and increased BMI increased the odds for death (Odds Ratio 2.30 and 1.70, respectively). Conclusions Maternal Mortality Ratio in Mexico increased over 60% in 1 year during the pandemic; COVID-19 was linked to 25.4% of maternal deaths in the studied period. Lethality among pregnant women with a diagnosis of COVID-19 was 2.8%, and while asthma and immune impairment increased propensity for developing pneumonia, obesity and diabetes increased the odds for in-hospital death. Measures are needed to improve access to coordinated well-organized healthcare to reduce maternal deaths related to COVID-19 and pandemic collateral effects.

Obesity affects quality of life and increases the risk of morbidity and mortality. Mexico, a middle-income country, has a high prevalence of overweight and obesity among urban children. Merida is the most populated and growing city in southern Mexico with a mixed Mayan and non-Maya population. Local urbanization and access to industrialized foods have impacted the eating habits and physical activity of children, increasing the risk of overweight and obesity. This study aimed to contribute to the existing literature on the global prevalence of overweight and obesity and examined the association of parental income, ethnicity and nutritional status with body mass index (BMI) and height in primary school children in Merida. The heights and weights of 3243 children aged 6-12 from sixteen randomly selected schools in the city were collected between April and December 2012. Multinomial logistic regression models were used to examine differences in the prevalence of BMI and height categories (based on WHO reference values) by ethnicity and income levels. Of the total students, 1648 (50.9%) were overweight or obese. Stunting was found in 227 children (7%), while 755 (23.3%) were defined as having short stature. Combined stunting and overweight/obesity was found in 301 students (9.3%) and twelve (0.4%) were classified as stunted and of low weight. Having two Mayan surnames was inversely associated with having adequate height (OR=0.69, p<0.05) and the presence of two Maya surnames in children increased the odds of short stature and stunting. Children from lower income families had twice the odds of being stunted and obese. Overweight, obesity and short stature were frequent among the studied children. A significant proportion of Meridan children could face an increased risk of developing cardiovascular disease and its associated negative economic and social outcomes unless healthier habits are adopted. Action is needed to reduce the prevalence of obesity among southern Mexican families of all ethnic groups, particularly those of lower income.

RESUMENEl síndrome de HELLP es una complicación multisistémica del embarazo que se distingue por el trastorno hipertensivo más la triada: hemólisis microangiopática, elevación de enzimas hepáticas y disminución del conteo de plaquetas. Está asociado con la aparición de graves complicaciones perinatales e incremento de la mortalidad materna. Ocurre en 0,5 a 0,9% de todos los embarazos y en 10 a 20% de las pacientes con preeclampsia-eclampsia. Complicaciones obstétricas como ésta deben sospecharse de manera temprana para poderlas atender de manera oportuna y así prevenir situaciones potencialmente fatales tanto para la madre como para el feto. Es por ello, que deben integrarse adecuadamente los signos y síntomas, comprendiendo el reto diagnóstico que este síndrome puede significar.ABSTRACT HELLP syndrome is a severe systemic complication in pregnancy characterized by hypertensive disorder added to the clinical profile that includes: microangiopathic hemolysis, elevation of liver enzymes, and decreased platelet count. It is associated with the appearance of serious perinatal complications and increased maternal mortality. It occurs in 0.5 to 0.9% of all pregnancies and in 10 to 20% of patients with pre-eclampsia/eclampsia. Obstetric complications such as this syndrome need to be suspected in clinical practice, to prevent fatal outcomes for both, the mother and the fetus. Therefore, clinical manifestations should be identified early to approach challenges that the diagnosis may pose.

This study’s objective is to analyze the incidence, lethality, hospitalization, and confirmation of COVID-19 cases in Mexico. Sentinel surveillance for COVID-19 cases in Mexico began after the confirmation of the first patient with community transmission. Methods: This epidemiologic, cross-sectional study includes all clinically suspected, and laboratory-confirmed cases nationwide from the beginning of the outbreak to 21 April 2020. State-cluster demographic data and health indicators were analyzed in reference to epidemiologic measures, with logistic regressions for the dependent variables of incidence, confirmation, and lethality. Results: The national incidence was 13.89/100,000 inhabitants with a 6.52% overall lethality and a confirmed-case mortality of 11.1%. The incidence variation significantly correlated with migration, but not urbanization. Pediatric patients were less prone to be tested (OR = −3.92), while geriatric individuals were a priority. State lethality positively correlated with the proportion of the population assisted at public hospitals and correlated inversely to the number of hospitals and clinics in the state. Conclusions: Migration strongly correlated with incidence; elderly patients had lower odds of being hospitalized but were likely to die. Patients aged <15 were less prone to be laboratory-confirmed. Case confirmation was not performed in all hospitalized patients, but 72.15% of hospitalized patients had favorable outcomes to date.