RESUMEN
Introdução: A gravidez na adolescência, tanto no Brasil como em diversos países do mundo, representa um problema de saúde pública, evidenciado pelo crescente índice de gestações precoces e incidência de intercorrências obstétricas e neonatais. O objetivo deste estudo foi comparar as características maternas das mães adolescentes, resultados perinatais, via de parto e dados sobre os seus recém-nascidos em relação às mães adultas. Métodos: Estudo transversal retrospectivo realizado com mães cadastradas no Sistema de Informações sobre Nascidos Vivos-Sinasc em Caruaru-PE, em 2006 e 2007. Resultados: Das 10.653 mães estudadas, 2.540 eram adolescentes. Registraram--se 32,0% de partos em mães adolescentes com 8 a 11 anos de estudo; 30,3% viviam em união consensual; fizeram sete consultas ou mais de pré-natal (51,4%); suas crianças nasceram de parto cesáreo (37,7%), prematuras (7,4%), de baixo peso (9,6%) e Ápgar no 5º minuto ≤ 7(0,7%). Ao comparar com mães adultas, observou-se que mães adolescentes possuem maior probabilidade de estar sem companheiros (OR 1,47; IC95% 1,33-1,61); apresentam risco aumentado para prematuridade (OR 1,39 IC95% 1,16-1,66) e baixo peso ao nascer (OR 1,36; IC95% 1,16-1,59) e o Ápgar no 5º minuto ≤ 7 (0,7%), duas vezes maior (OR 2,09; IC95%: 1,13-3,86). Adolescentes com mais de sete consultas apresentam desvantagem sob a forma de risco (OR 1,5; IC95% 1,37-1,64) quando comparadas as adultas, assim como o parto cesáreo apresenta-se como fator de proteção (OR 0,49; IC95% 0,45-0,54) às adolescentes. Conclusão: A gravidez na adolescência está associada à ausência de companheiro, prematuridade, baixo peso ao nascer e Apgar igual ou menor que sete no 5º minuto.
Introduction: Adolescent pregnancy in Brazil and in several countries of the world represents a public health problem, as evidenced by the increasing rate of early pregnancies and the incidence of obstetric and neonatal complications. The aim of this was to compare the maternal characteristics of adolescent mothers, perinatal outcomes, mode of delivery, and data on their newborns as compared to adult mothers. Methods: A retrospective cross-sectional study of mothers enrolled in the Information System on Live Births in Caruaru (SINASC-PE), in 2006 and 2007. Results: Of the 10,653 women studied, 2,540 were teenagers. We found 32.0% of births among teenage mothers with 8-11 years of schooling; 30.3% lived in consensual union, 51.4% made seven or more prenatal care visits, and their children were born by cesarean section (37.7%), were premature (7.4%), had low birth weight (9.6%) and had Apgar score at 5 minutes ≤ 7 (0.7%). As compared to adult mothers, adolescent mothers were found to be more likely to be without partners (OR 1.47, 95% CI 1.33 to 1.61), at increased risk for pre-term birth (OR 1.39 95% CI 1.16 to 1.66) and have newborns with low birth weight (OR 1.36, 95% CI 1.16 to 1.59) and 5th minute Apgar score ≤ 7 (0.7%), two times higher (OR 2.09; 95% CI: 1.13 to 3.86). Adolescents with over seven prenatal care visits are at a disadvantage concerning risk (OR 1.5, 95% CI 1.37 to 1.64) as compared to adults, just like cesarean delivery appears as a protective factor (OR 0, 49, 95% CI 0.45 to 0.54) for adolescents. Conclusion: Adolescent pregnancy is associated with the absence of a partner, prematurity, low birth weight and Apgar score ≤ 7 at 5 minutes.
Asunto(s)
Humanos , Femenino , Embarazo , Adolescente , Embarazo en Adolescencia , Recién Nacido de Bajo Peso , Estudios Retrospectivos/métodos , Estudios Transversales/métodos , Factores de RiesgoRESUMEN
We have estimated the risk of transmitting HIV infection from a unit of HIV seronegative blood collected in Los Angeles and Orange Counties, CA from March 1985 through February 1987. Our method consisted of lookback investigations and anti-HIV testing of living recipients of HIV seronegative units donated by persons who later tested HIV seropositive at the time of a subsequent donation. During these investigations we have documented 3 cases of HIV transmission from HIV seronegative blood; using several assumptions, and extrapolating from this data, we have calculated that the risk of HIV transmission from an HIV seronegative unit was 1 in 51,000 to 1 in 102,000 (with a best guess of 1 in 68,000). We believe that our model can be applied in other geographic regions in an ongoing fashion in order to update our estimates of HIV transmission from HIV seronegative blood.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/transmisión , Seropositividad para VIH/complicaciones , Humanos , Estudios Retrospectivos/métodos , Factores de RiesgoRESUMEN
We describe a medical information system tailored to the operational needs of the Gynecologic and Infertility Clinic at The Johns Hopkins Hospital. It is used for patient registration and scheduling, medical and surgical record keeping, and research investigation. Data entered include a complete medical history, diagnoses, procedures performed and their outcomes, surgical pathologic study, follow-up notes, phone consultations, and laboratory findings. Data are coded individually and can be retrieved and presented in a standard or user-specific report format. The Reproductive Endocrinology Medical Information System (REMIS) was implemented over 6 months from January to June 1984. To date, 8000 new patient registrations and 3600 outpatient visits have been entered. There are approximately 100 new patient entries and 240 return visit entries per month. Preliminary evaluation of the system based on the effect on quality care, use by each user group, and research applicability demonstrates that the REMIS provides clinicians with more complete, organized, and accessible patient records to serve as an effective adjunct to clinical operations.
Asunto(s)
Endocrinología , Sistemas en Línea , Servicio Ambulatorio en Hospital/organización & administración , Reproducción , Citas y Horarios , Computadores , Femenino , Hospitales con más de 500 Camas , Humanos , Infertilidad Femenina/terapia , Maryland , Registros Médicos , Estudios Prospectivos/métodos , Proyectos de Investigación , Estudios Retrospectivos/métodos , Programas InformáticosRESUMEN
Prospective controlled studies give the most reliable background for clinical decisions. To use them correctly, however, many strict premises have to be fulfilled that are often impossible in practice. If no research is conducted in these cases, however, that means disastrous dependence on one method. The main application of retrospective analyses is therefore in the sense of a second-best solution. Furthermore, retrospective consideration is a genuine necessity for medical research if you are interested in the critical reflection of your own work and in dealing with new problems.
Asunto(s)
Estudios Prospectivos/métodos , Estudios Retrospectivos/métodos , Humanos , Distribución Aleatoria , Procedimientos Quirúrgicos OperativosRESUMEN
The example of a historic comparative study on the value of the application of inhibitions on thrombocyte aggregation (inhibition of thrombocyte function) was used to prove how important such data can be. Mistakes can also be discovered. Clinical comparisons can only be made when investigations have been made using a planned form to note anamnesis and other data. Special pre-illness history, the findings and course of the illness are not noted on a planned form. These conditions also allow an opinion to be formed from retrospective study of a case. The results help to build a prospective and randomized work.