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      Patrón de riesgo en la gestante adolescente primípara: un problema latente Translated title: Risk pattern in primiparous pregnant adolescent: a latent problem

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          Abstract

          El objetivo de esta investigación fue identificar en la adolescente primípara y su hijo un eventual patrón de riesgo, considerando las características de atención médica integral que recibe esta población en el país. Se realizó un estudio transversal y retrospectivo, de tipo casos y controles, integrado por una muestra de 207 unidades de análisis (69 casos y 138 controles), de 1 290 embarazadas en total. Entre las variables evaluadas figuraron: abortos provocados previos (= 2); afecciones diagnosticadas, asociadas con el embarazo; eventos dependientes de la gestación y otras. En el análisis estadístico se aplicó la razón de productos cruzados (RPC) u odds ratio (OR), con un intervalo de confianza (IC) de 95 %, así como la prueba de Ji al cuadrado, con p = 0,05 o menor. Las variables de asociación significativa y carácter causal fueron: anemias deficitarias en segundo y tercer trimestres, infección genital en primer trimestre y amenaza de parto pretérmino, en tanto los abortos (= 2) y las enfermedades del feto mostraron significación en sus asociaciones y carácter protector. Se identificó un patrón de riesgo de limitada complejidad para su manejo, con amplias opciones de modificación antes y después de la concepción y sin impacto negativo sobre la mortalidad maternoperinatal.

          Translated abstract

          The objective of this research was to identify a possible risk pattern in the primiparous adolescent and her child, taking into account the characteristics of comprehensive health care that this population receives in the country. A cross-sectional and retrospective case-control study was conducted in a sample of 207 analysis units (69 cases and 138 controls), of 1 290 pregnant women in total. Among the evaluated variables were earlier induced abortions (± 2); diagnosed conditions associated with pregnancy; pregnancy-dependent events and others. In the statistical analysis the odds ratio (OR) was used with a 95 % confidence interval (CI), as well as the chi-square test with p = 0,05 or lower. Variables of significant association and causal character were deficiency anemia in second and third trimesters, genital infection in first trimester and preterm labor, while abortions (± 2) and fetal diseases showed significance in their associations and protective character. A risk pattern of limited complexity for its use was identified, with extensive modification options before and after conception, and without negative impact on maternal perinatal mortality.

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          Most cited references23

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          Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: Cross-sectional study.

          This study was undertaken to determine whether adolescent pregnancy is associated with increased risks of adverse pregnancy outcomes. We studied 854,377 Latin American women who were younger than 25 years during 1985 through 2003 using information recorded in the Perinatal Information System database of the Latin American Center for Perinatology and Human Development, Montevideo, Uruguay. Adjusted odds ratios were obtained through logistic regression analysis. After an adjustment for 16 major confounding factors, adolescents aged 15 years or younger had higher risks for maternal death, early neonatal death, and anemia compared with women aged 20 to 24 years. Moreover, all age groups of adolescents had higher risks for postpartum hemorrhage, puerperal endometritis, operative vaginal delivery, episiotomy, low birth weight, preterm delivery, and small-for-gestational-age infants. All adolescent mothers had lower risks for cesarean delivery, third-trimester bleeding, and gestational diabetes. In Latin America, adolescent pregnancy is independently associated with increased risks of adverse pregnancy outcomes.
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            Adolescents and youth in developing countries: Health and development issues in context.

            Adolescence is a period of transition, marked by physical, psychological, and cognitive changes underpin by biological factors. Today's generation of young people - the largest in history - is approaching adulthood in a world vastly different from previous generations; AIDS, globalisation, urbanisation, electronic communication, migration, and economic challenges have radically transformed the landscape. Transition to productive and healthy adults is further shaped by societal context, including gender and socialisation process. With the evidence that young people are not as healthy as they seem, addressing the health and development issues of young people, more than ever before, need concerted and holistic approach. Such approach must take the entire lifecycle of the young person as well as the social environment into context. This is particularly critical in developing countries, where three major factors converge - comparatively higher proportion of young people in the population, disproportionately high burden of youth-related health problems, and greater resources challenge. Copyright 2010 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
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              Mortalidad materna y perinatal en adolescentes

              Se analizan las tasas de mortalidad materna y perinatal, durante la adolescencia, comparándola con lo planteado en la literatura internacional mediante los datos que aparecen en la Oficina Nacional de Estadísticas y en los Anuarios de la Dirección Nacional de Estadísticas del MINSAP. Se estudiaron 1 559 398 nacimientos ocurridos en 10 años, de los cuales el 16,2 % fueron en mujeres menores de 20 años; se indica que este porcentaje es más bajo que en los países latinoamericanos comprendidos en el estudio de Demographic and Health Surveys. La tasa de mortalidad materna fue inferior en las adolescentes que en el grupo de mujeres de todas las edades. Igualmente la tasa de mortalidad perinatal I se mostró ligeramente inferior al grupo de mujeres de todas las edades, en contraposición con lo que se plantea en la literatura internacional, lo cual evidencia la atención especial que recibe la adolescente en Cuba.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                san
                MEDISAN
                MEDISAN
                Centro Provincial de Ciencias Médicas, Santiago de Cuba (Santiago de Cuba )
                1029-3019
                December 2011
                : 15
                : 12
                : 1720-1728
                Affiliations
                [1 ] Hospital Ginecoobstétrico Docente Tamara Bunke Bider Cuba
                Article
                S1029-30192011001200006
                c8657b22-7e91-4511-b81c-ee5d40b241f2

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Cuba

                Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=1029-3019&lng=en
                Categories
                MEDICINE, GENERAL & INTERNAL

                Internal medicine
                pregnancy,adolescence,risk pattern,maternity hospital,embarazo,adolescencia,patrón de riesgo,hospital materno

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