Resultados de las consultas municipales de atención a la pareja infértil 2017-2020 / Results of the Municipal Consultations for Infertile Couple Care 2017-2020

Introducción: La infertilidad afecta hasta un 15 por ciento de las parejas en edad reproductiva en el mundo y es uno de los factores que inciden en la baja natalidad de Cuba. Antes del 2016 no existían consultas de infertilidad en todos los municipios y era bajo el número de embarazos logrados, lo que motivó la decisión de extenderlas a todos los municipios del país. Objetivo: Describir los resultados de las consultas municipales de infertilidad en los primeros cuatro años de su implementación (2017-2020). Métodos: Estudio observacional transversal de casos, atendidos en las 82 consultas municipales de infertilidad existentes antes del 2016 y después de su generalización a todos los municipios del país. Resultados: En las consultas municipales han sido atendidas 81,3 por ciento de las parejas infértiles que lo demandan, se incrementó el número de consultas ofrecidas de 24 215 en el año 2016 a 140 183 en el 2020. En ese período se elevó en 10 por ciento los embarazos obtenidos, 63,5 por ciento de los logrados en todos los niveles de atención. Conclusiones: Las consultas municipales incrementaron sus resultados entre el año 2017 al 2020 y los nacimientos obtenidos pueden ser considerados como una contribución del sector salud a reducir la baja natalidad que experimenta el país(AU)

Introduction: Infertility affects up to 15percent of couples of reproductive age in the world and is one of the factors affecting the low birth rate in Cuba. Before 2016, infertility consultations did not exist in all municipalities and the number of pregnancies achieved was low, which motivated the decision to extend them to all municipalities in the country. Aim: To describe the results of municipal infertility consultations in the first four years of their implementation (2017-2020). Methods: Cross-sectional observational study of cases, attended in the 82 municipal infertility consultations existing before 2016 and after their generalization to all municipalities in the country. Results: 81.3percent of the infertile couples requesting treatment were attended in the municipal consultations. The number of consultations offered increased from 24 215 in 2016 to 140 183 in 2020. In that period, pregnancies obtained increased by 10 percent, 63.5 percent of those achieved at all levels of care. Conclusions: Municipal consultations increased their results from 2017 to 2020 and the births obtained can be considered as a contribution of the health sector to reduce the low birth rate experienced by the country(AU)

La responsabilidad subjetiva en los derroteros del deseo de hijo / Subjective Responsibility in the Paths of the Desire for a Child

El presente escrito aborda la cuestión del proyecto monomarental, sus derroteros y periplos singulares. Al tiempo que en ellos se vislumbra un camino muchas veces compartido y repetido. La temática reviste una presencia estadística en aumento a nivel mundial que visibiliza cambios sociales, económicos y de derechos en la agenda femenina. El objetivo central del escrito radica en describir en primera persona las circunstancias que llevaron a Helen a recurrir a la ovodonación como método reproductivo y los duelos que dicho recorrido encierra. En síntesis, en la historia de Helen se vislumbra de modo paradigmático el encuentro con la imposibilidad del propio cuerpo reproductivo y la solución que ofrece la medicina; al tiempo que en otra cuerda, se trasluce la dimensión singular y clínica de las decisiones subjetivas por las que ella deberá responder

This paper addresses the question of the singleparent project, its paths and unique journeys. At the same time that in them a path many times shared and repeated is glimpsed. The issue has a growing statistical presence worldwide that makes visible social, economic and rights changes on the women's agenda. The central objective of the writing lies in describing in the first person the circumstances that led Helen to resort to egg donation as a reproductive method and the duels that this journey entails. In short, in Helen's story, the encounter with the impossibility of the reproductive body itself and the solution offered by medicine is glimpsed in a paradigmatic way; while on another string, the singular and clinical dimension of the subjective decisions for which she will have to answer shines through

Evaluación de la terapia de reproducción médicamente asistida en 9 años: estudio de cohorte retrospectivo / Medically assisted reproductive therapy assessment in 9 years: retrospective cohort study

OBJETIVO: Describir las tasas de recién nacidos vivos (RNV) y embarazo de la terapia de reproducción médicamente asistida de baja complejidad del Centro de Reproducción Humana de la Universidad de Valparaíso, Chile. MÉTODO: Estudio retrospectivo de todos los ciclos de estimulación ovárica controlada con inseminación intrauterina (IIU) completados, entre los años 2011 y 2019. Se evaluaron las características clínicas basales y los resultados en IIU homólogas y heterólogas según el ciclo inseminado, la causa de infertilidad, el rango etario y el índice de masa corporal (IMC). El desenlace principal fue la tasa de RNV por ciclo inseminado. RESULTADOS: Se estudiaron 1415 ciclos en 700 parejas. La tasa acumulativa de RNV fue del 19,6%, un 18,3% en IIU homóloga y un 39,0% en IIU heteróloga. La tasa de RNV fue del 10,0% al primer ciclo, del 5,8% al segundo ciclo y del 3,7% al tercer o más ciclos. Al separar por IIU heteróloga, esta aumenta al 24,4% al primer ciclo y al 14,6% al segundo ciclo. La tasa de RNV es significativamente mejor en pacientes menores de 35 años (23,7%) y con IMC < 29 (20,8%). CONCLUSIONES: El tratamiento de baja complejidad en pacientes infértiles es una opción terapéutica vigente con una aceptable tasa de RNV por ciclo inseminado. Los resultados están influenciados por la edad y por el IMC.

OBJECTIVE: To describe the rates of live newborns (LNB) and pregnancy of the low complexity therapy of the Centre for Human Reproduction of Universidad de Valparaíso, Chile. METHOD: Retrospective study of all cycles of controlled ovarian stimulation with intrauterine insemination (IUI) completed between 2011-2019. The baseline clinical characteristics and results in homologous and heterologous IUI were evaluated according to inseminated cycle, cause of infertility, age range and body mass index (BMI). The main outcome was rate of LNB per inseminated cycle. RESULTS: 1415 cycles were studied in 700 couples. The cumulative rate of LNB was 19.6%, 18.3% in homologous IUI and 39.0% in heterologous IUI. The LNB rate was 10.0% at the first cycle, 5.8% at the second cycle, 3.7% at the third or more cycles. When separating by heterologous IUI, it increases to 24.4% in the first cycle and 14.6% in the second cycle. The LNB rate is significantly better in patients under 35 years of age (23.7%) and with a BMI less than 29 (20.8%). CONCLUSIONS: Treatment of low complexity in selected infertile patients is a current therapeutic option with an acceptable rate of LNB per inseminated cycle. The results are influenced by age and BMI.

Análisis descriptivo poblacional respecto a tasa de natalidad y edad materna en Chile entre 2015-2020 / Descriptive population analysis of the birth rate and maternal age in Chile between 2015 -2020

Introducción: A nivel mundial la tasa de natalidad desde las últimas décadas ha venido en declive, por lo que adquiere relevancia investigar sus cambios. Objetivos: Cuantificar la tendencia de nacimientos en Chile según rango etario de la madre y sexo biológico del recién nacido en el periodo 2015-2020. Metodología: Se realizó un estudio observacional y ecológico, con los datos obtenidos del banco mundial y DEIS, para la población y nacimientos respectivamente. Los datos se dividieron según las edades maternas en tres grupos: <18 años, 18-34 años y ≥ 35 años. No se requirió comité de ética debido a que no se interviene con personas. Los autores no presentan conflicto de interés. Resultados: Se observó una disminución de los nacimientos del 22,6%, pasando de 244.626 el 2015 a 189.250 el 2020. Los nacimientos en el grupo etario de madres menores a 18 años disminuyeron un 82,13%, reduciéndose de 17.505 a 3.129, el rango de edad materna correspondiente al segundo grupo de 18 a 34 años, ubicó la mayor cantidad de nacimientos, manteniéndose alrededor de un 77,75% (neto), el rango ≥ 35 años, presentó un alza de un 17%, aumentando de 34.648 nacimientos a 40.539. Discusión: En Chile hay un descenso en los nacimientos dado a que la maternidad se está postergando, lo cual puede deberse a la educación sexual implementada en el país y la mayor participación de mujeres en ámbito laboral, esto sugiere una transición de una demografía estable a una regresiva.

Introduction: The birth rate has been declining worldwide since the last decades, so it is important to investigate its changes. Objectives: To quantify the trend of births in Chile according to age range of the mother and biological sex of the newborn in the period 2015-2020. Methodology: An observational and ecological study was conducted, with data obtained from the World Bank and DEIS, for population and births respectively. Data were divided according to maternal ages into three groups: <18 years, 18-34 years and ≥ 35 years. No ethics committee was required due to the fact that we did not intervene with individuals. The authors have no conflict of interest. Results: A decrease in births of 22.6% was observed, from 244,626 in 2015 to 189,250 in 2020. Births in the age group of mothers under 18 years decreased by 82.13%, decreasing from 17,505 to 3,129, the maternal age range corresponding to the second group from 18 to 34 years, located the highest number of births, remaining around 77.75% (net), the range ≥ 35 years, presented a rise of 17%, increasing from 34. Discussion: In Chile there is a decrease in births due to the fact that motherhood is being postponed, which may be due to the sexual education implemented in the country and the greater participation of women in the labor market, suggesting a transition from a stable demography to a regressive one.

Feto-maternal outcomes of caesarean delivery in Federal Medical Centre, Asaba: a two year review

Background: The upward trend of caesarean section and its associated morbidity/mortality especially in low- and middle-income areas make regular appraisal of the procedure necessary. Objective: To evaluate caesarean section; its rate, indications, and maternal and fetal outcomes in Asaba. Methods: A retrospective study of all caesarean sections carried out at the obstetrics unit of the Federal Medical Centre, Asaba, between July 1, 2018, and June 31, 2020. Data was analyzed using SPSS version 20. Results: There were 2778 deliveries during the period, out of which 705 had caesarean sections, giving an overall caesarean section rate of 25.4%. There were 456 (64.7%) emergency caesarean sections. The commonest indication for caesarean section was repeat caesarean section 196 (27.8%), while cephalo-pelvic disproportion 87 (12.3%) was the commonest indication for emergency caesarean section. Majority of the babies had low APGAR score at 1min and 5mins, 126 (27.6%) and 50 (11.0%) from emergency than elective caesarean section 16 (6.4%) and 5 (2.0%) at 1min and 5mins respectively (x2=17.963, P<0.001). There were 31 (4.2%) perinatal deaths out of which majority 28 (6.1%) were from emergency caesarean sections (x2=9.412 P=0.002). The commonest post-operative complication was postpartum anemia (140 (19.9%) while caesarean section case fatality was 0.6%. Conclusion: This study showed a caesarean section rate of 25.4% with repeat caesarean section and Cephalopelvic disproportion being the most common indication for elective and emergency caesarean section respectively. Emergency caesarean section accounted for most of the cases and is associated with a higher risk of maternal and perinatal morbidity and mortality

Argentina's fertility regime (1980-2010): the end of the first demographic transition or an emergent second one? / O regime de fecundidade na Argentina (1980-2010): o fim da primeira transição demográfica ou uma segunda emergente? / El régimen de fecundidad en Argentina (1980-2010): ¿El final de la primera transición demográfica o una segunda emergente?

Abstract Argentina's fertility transition has exceptional characteristics. Compared to most Latin American countries, Argentina's fertility declined relatively early and, unlike fertility transitions in Western Europe, this decline did not lead to a high period of natural population growth. By the beginning of the twenty-first century, Argentina seemed to experience fertility stagnation despite women's increased formal education and labor force participation, and increased availability of contraceptives. Using the 1980, 1991, 2001, and 2010 Population Censuses, I demonstrate that fertility has continued its downward trend from 1980 to 2010. Changes in fertility behaviors are given by a decrease in the mean number of children per woman, but not by an increase in childlessness. However, there is evidence of postponement of childbearing. Results show that although Argentina is completing its first demographic transition, as it has not reached below-replacement fertility yet, this country could show signs of an emerging second demographic transition.

Resumo A transição da fecundidade na Argentina tem características excepcionais. Em comparação com a maioria dos países da América Latina, a fecundidade na Argentina diminuiu relativamente cedo e, diferentemente das transições de fecundidade na Europa Ocidental, esse declínio não levou a um período de alto crescimento natural da população. No início do século 21, a Argentina parecia experimentar uma estagnação da fecundidade, apesar do aumento da educação formal e da participação laboral das mulheres e de uma maior disponibilidade de contraceptivos. Utilizando os dados dos Censos Populacionais de 1980, 1991, 2001 e 2010, o presente trabalho mostra que a fecundidade continuou sua tendência de queda de 1980 a 2010. As mudanças no comportamento da fecundidade são dadas por uma diminuição no número médio de filhos por mulher, mas não por um aumento da nuliparidade. No entanto, há evidências de um adiamento da fecundidade. Os resultados mostram que, embora a Argentina esteja completando sua primeira transição demográfica, já que ainda não atingiu a fecundidade abaixo do nível de reposição, o país pode mostrar sinais de uma emergente segunda transição demográfica.

Resumen La transición de la fecundidad en Argentina tiene características excepcionales. Comparada con la mayoría de los países latinoamericanos, la fecundidad en Argentina disminuyó relativamente temprano y, a diferencia de las transiciones de fecundidad en Europa occidental, este descenso no condujo a un período de alto crecimiento natural de la población. A principios del siglo XXI, Argentina parecía experimentar un estancamiento de la fecundidad a pesar del aumento de la educación formal y de la participación laboral de las mujeres y de una mayor disponibilidad de anticonceptivos. Utilizando los Censos de Población de 1980, 1991, 2001 y 2010, demuestro que la fecundidad ha continuado su tendencia descendente desde 1980 hasta 2010. Los cambios en los comportamientos de fecundidad vienen dados por una disminución del número promedio de hijos por mujer, pero no por un aumento de la nuliparidad. Sin embargo, hay evidencia de un aplazamiento de la fecundidad. Los resultados muestran que, aunque Argentina está completando su primera transición demográfica, ya que aún no ha alcanzado una fecundidad por debajo del nivel de reemplazo, este país podría mostrar signos de una segunda transición demográfica emergente.

Provincial differentials of the effect of internal migration on teenage fertility in South Africa

This study investigated the association between internal migration and teenage fertility in South Africa. Data were from the 2007 and 2016 South African community surveys, N2007= 89800 and N2016=239733, age range 12 to 19, black teenagers= 81.5% and 89.4%, respectively. Results showed that between 2007 and 2016 internal migration levels decreased by 2% nationally, but increased for Gauteng, Western Cape and KwaZulu Natal provinces. Teenage fertility levels decreased in all provinces except the Northern Cape in the study period. In both years teenage fertility was observed at higher levels among girls that were older, heads of households, and who were in secondary schooling. Random-intercept multilevel binary logistic regression revealed that the risk of teenage fertility differed between more rural and urban provinces. In provinces that were predominantly rural the risk of teenage pregnancy increased as community-levels of internal migration increased while the risk decreased as internal migration increased in provinces that were predominantly urban. Findings suggest that the effects of internal migration on teenage pregnancy are largely dependent on the local context making it necessary to create interventions that are context-specific at sub-national levels.

Intrauterine insemination with donor sperm: only the number of motile spermatozoa inseminated influences both pregnancy and live-birth rates / 亚洲男科学杂志(英文版)

Intrauterine insemination with donor sperm (IUI-D) is an assisted reproductive technology (ART) offered to couples with definitive male infertility or risk of genetic disease transmission. Here, we sought to evaluate our practice in IUI-D and identify factors that influenced the success rate. We performed a retrospective, single-center study of all IUI-D procedures performed at Lille University Medical Center (Lille, France) between January 1, 2007, and December 31, 2017. Single and multivariate analyses with a mixed logistic model were used to identify factors associated with clinical pregnancies and live births. We included 322 couples and 1179 IUI-D procedures. The clinical pregnancy rate was 23.5%, and the live birth rate was 18.9% per IUI-D. In a multivariate analysis, the women's age was negatively associated with the live birth rate. The number of motile spermatozoa inseminated was the only factor associated with both clinical pregnancies and live births, with a chosen threshold of 0.75 million. The clinical pregnancy and live birth rates were, respectively, 17.3% and 13.0% below the number of motile spermatozoa inseminated threshold and 25.9% and 21.0% at or above the threshold (all P = 0.005). The number of motile spermatozoa inseminated was the only factor that significantly influenced both pregnancies and live-birth rates after IUI-D. Indeed, below a threshold of 0.75 million motile spermatozoa inseminated, those rates were significantly lower. Application of this number of motile spermatozoa inseminated threshold may help centers to allocate donations more effectively while maintaining reasonable waiting times for patients.

Aplicación de la clasificación de Robson para el análisis de la tasa de cesárea en el Hospital Doctor Peset / Review of cesarean rate in Hospital Doctor Peset using the Robson classification

OBJECTIVE: To analyze the caesarean deliveries attended in our hospital, grouping them according to the Robson Classification System and to establish measures in order to reduce caesarean delivery rates. METHOD: Prospective study of all the deliveries attended at Hospital Doctor Peset in 2019 using the Robson classification. RESULTS: A total of 1113 births have been analyzed with a total cesarean section rate of 25.3%. The largest contribution to the total cesarean delivery rate with 34.4% was group 2A (nulliparous women with a single fetus in cephalic presentation, 37 weeks or more pregnant who started labor by induction). Secondly, group 5 (multiparous women with at least previous cesarean section, with single cephalic fetus, 37 weeks or more pregnant) which represents the 20.1% of the total. Inductions in nulliparas multiply the cesarean section rate by 3 compared to nulliparas that initiate labor spontaneously. CONCLUSIONS: Robsons classification is a tool that allows to easily classify and analyze the groups in which to implement measures to reduce the number of caesarean sections performed. Analyzing the induction indications and reviewing action protocols could suppose a substantial decrease in the caesarean section rate in our center.

OBJETIVO: Analizar las cesáreas realizadas en nuestro centro agrupándolas según la clasificación de Robson para establecer medidas que permitan reducir la tasa de cesáreas. MÉTODO: Auditoría prospectiva de los nacimientos asistidos en el Hospital Doctor Peset en el año 2019 mediante la clasificación de Robson. RESULTADOS: Se han analizado 1113 nacimientos con una tasa de cesárea del 25.3%. El grupo que más contribuyó al total de cesáreas realizadas, con un 34.4%, fue el 2A (nulíparas con feto único en presentación cefálica, de 37 semanas o más de embarazo, que iniciaron el parto mediante inducción). En segundo lugar, el grupo 5 (multíparas con al menos una cesárea previa, con un feto único en presentación cefálica, de 37 semanas o más de embarazo), con un 20.1%. Las inducciones en nulíparas multiplican por tres la tasa de cesárea respecto a las nulíparas que inician el trabajo de parto de manera espontánea. CONCLUSIONES: La clasificación de Robson es una herramienta que permite clasificar y analizar de manera sencilla los grupos en los que implantar medidas para reducir el número de cesáreas realizadas. Analizar las indicaciones de inducción y revisar los protocolos de actuación podría suponer una disminución sustancial en la tasa de cesáreas en nuestro centro.

Effect of housing system during pregnancy on reproductive parameters of sows / [Efeito do sistema de alojamento durante a gestação sobre os parâmetros reprodutivos de porcas]

The aim of this study was to evaluate the reproductive performance of sows in individual stalls (Stall) or group-housed into groups on days 3 to 5 (Pen5) or 38 to 42 (Pen42) after breeding. The reproductive data was collected from the operating system of the farm establishing the average of the weekly performances of the sows that gave birth, for four years, except for the Pen5 system, which was evaluated for three years. Statistical analyses were performed using SAS®, using MIXED (for quantitative traits), NPAR1WAY (for categorical traits) and LOGISTIC (binomial traits) procedures, using sows as a repeated measure. Sows in Stall system had piglets with higher birth weight them sows in the group-housed system (P<0.05), however the piglets born alive, total piglets weaned, average litter weight, and duration of farrowing were lower in this system than in the group-housed (P<0.0001). There was no difference between Pen5 and Stall systems for gestation period and mummified piglets. The Pen42 system had a higher percentage of mummified piglets and a shorter gestation period, when compared Pen5 and Stall systems (P<0.0001), and similar results to the Pen5 system for duration of farrowing, piglets born alive, stillbirths, total piglets weaned, average litter weight and birth weight (P<0.0001).(AU)

O objetivo deste estudo foi avaliar a performance reprodutiva de matrizes suínas alojadas individualmente (Individual) ou em grupos, nos dias 3 a 5 (Grupo 5) ou 38 a 42 (Grupo 42) após a inseminação. Os dados reprodutivos foram coletados do sistema operacional da granja, estabelecendo-se a média dos desempenhos semanais das matrizes que pariram por semana, durante quatro anos, exceto para o sistema Grupo 5, que foi avaliado por três anos. A análise estatística foi realizada com SAS®, usando-se os procedimentos MIXED (para variáveis quantitativas), NPAR1WAY (para variáveis categóricas) e LOGISTIC (para variáveis binomiais), tendo a matriz como uma medida repetida. As matrizes no sistema Individual tiveram leitões com maior média de peso ao nascer do que as matrizes nos sistemas de alojamento em grupo (P<0,05), porém os leitões nascidos vivos, o total de leitões nascidos, o peso médio da leitegada e a duração do parto foram menores no sistema Individual do que nos sistemas de alojamento em grupo (P<0,0001). Não houve diferença entre os sistemas Grupo 5 e Individual para o tempo de duração da gestação e o número de leitões mumificados. O sistema Grupo 42 apresentou maior porcentagem de leitões mumificados e menor período de gestação, quando comparado aos sistemas Grupo 5 e Individual (P<0,0001), e resultados semelhantes ao sistema Grupo 5 para duração do parto, leitões nascidos vivos, natimortos, total de leitões desmamados, peso médio da leitegada e peso ao nascer (P<0,0001).(AU)

Seasonal Variation by Race in the Male-to-Female Ratio at Birth in the United States

ABSTRACT Objective: In humans, males' births exceed females' births. This ratio is conventionally referred to as M/F and is used to denote male births divided by total births. This ratio is influenced by a large number of factors and has been shown to exhibit seasonality. This study was carried out in order to ascertain whether seasonal variation in M/F exists in the United States of America and whether such variations are influenced by race. Materials and Methods: Data on births by gender and race from 2003 to 2013 were obtained from Centres for Disease Control and Prevention Wonder section as four races: White, Black/African American, Asian/Pacific Islander and American Indian/Alaska Native. ANOVA and ARIMA tests were carried out. Results: This study analysed 45 103 146 live births (M/F 0.51182) over 2003 to 2013. M/F was highest in Asian/Pacific Islander (p < < 0.0001), followed by White (p = 0.002), American Indian/Alaska Native (p = 0.04) and Black/African American. Significant seasonality was present overall, with a peak in June, for Whites more than Black/African American. Conclusion: Parental stress lowers M/F, and lower M/F found in Black/African and American Indian/Alaskan births may be stress related. The dampened seasonality noted in Black/African American births may also be due to this phenomenon. More males were born in spring, as in other species, with interesting inter-racial differences.

Analysis of related factors affecting cumulative live birth rates of the first ovarian hyperstimulation in vitro fertilization or intracytoplasmic sperm injection cycle: a population-based study from 17,978 women in China / 中华医学杂志(英文版)

BACKGROUND@#More and more scholars have called for the cumulative live birth rate (CLBR) of a complete ovarian stimulation cycle as a key indicator for assisted reproductive technology. This research aims to study the CLBR of the first ovarian hyperstimulation cycles and analyze the related prognosis factors that might affect the CLBR.@*METHODS@#Our retrospective study included first in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycles performed between January 2013 to December 2014. A total of 17,978 couples of first ovarian hyperstimulation IVF/ICSI cycles were included. The study was followed up for 4 years to observe the CLBR. The multivariable logistic regression model was used to analyze the prognosis factor, P value of <0.05 was considered statistically significant.@*RESULTS@#The cumulative pregnancy rate was 58.14% (10,452/17,978), and the CLBR was 49.66% (8928/17,978). The female age was younger in the live birth group when compared with the non-live birth group (30.81 ± 4.05 vs. 33.09 ± 5.13, P < 0.001). The average duration of infertility was shorter than the non-live birth cohort (4.22 ± 3.11 vs. 5.06 ± 4.08, P < 0.001). The preliminary gonadotropin used and the total number of gonadotropin used were lower in the live birth group when compared with the non-live birth group (both P < 0.001). Meanwhile, the number of oocytes retrieved and transferrable embryos were both significantly higher in the live birth group (15.35 ± 7.98 vs. 11.35 ± 7.60, P < 0.001; 6.66 ± 5.19 vs. 3.62 ± 3.51, P < 0.001, respectively).@*CONCLUSIONS@#The women's age, body mass index, duration of infertility years, infertility factors, controlled ovarian hyperstimulation protocol, the number of acquired oocytes, and number of transferrable embryos are the prognosis factors that significantly affected the CLBR.

Factores asociados a la fecundidad adicional no deseada: análisis de una encuesta nacional en Perú / Factors associated with unwanted additional fertility: secondary analysis of a national survey in Peru

Resumen Objetivos: Determinar la asociación entre los factores sociodemográficos y reproductivos con la fecundidad adicional no deseada (FAND) en el Perú. Materiales y métodos: Se realizó un estudio observacional, analítico transversal, a partir de la Encuesta Demográfica y de Salud Familiar (ENDES) 2018 en el Perú. La FAND es una variable que se creó a partir de la diferencia numérica entre la fecundidad obtenida y la fecundidad deseada. La variable FAND, se creó a partir de la diferencia numérica entre la fecundidad obtenida y la fecundidad deseada y se agrupó en dos categorías donde la diferencia numérica positiva correspondió a la presencia de FAND. Se realizó una regresión de Poisson, tanto cruda como ajustada. Resultados: Se analizaron los datos de 6944 mujeres entre 40 y 49 años, con una edad promedio de 44,3 años. Se halló una prevalencia de FAND de 72,5% (IC95%: 70,4%-74,4%). En el modelo ajustado, se observó que pertenecer al quintil superior de riqueza (RPa 0,80; IC95%: 0,69-0,93) disminuía la probabilidad de FAND con respecto al quintil intermedio. Por otro lado, provenir del ámbito rural (RPa 1,07; IC95%: 1,01-1,14), aumenta la probabilidad de FAND con respecto al provenir del ámbito urbano. Conclusiones: La prevalencia de FAND en mujeres peruanas de 40 a 49 años que participaron de la ENDES 2018 es alta. Provenir del área rural aumenta la probabilidad de FAND; y pertenecer al quintil superior de riqueza, la disminuye.

Abstract Objectives: To determine the association between sociodemographic and reproductive factors with unwanted additional fertility (UAF) in Peru. Materials and methods: We carried out an observational, cross-sectional analytical study based on the 2018 Demographic and Family Health Survey (DHS) in Peru. The UAF variable was defined as the numerical difference between the general fertility rate and the total fertility rate. This variable was divided into 2 categories, UAF was considered when the numerical difference was positive. The Poisson regression was used, both crude and adjusted. Results: We analyzed data from 6,944 women with an average age of 44.3 years (range, 40 to 49). The prevalence of UAF was found to be 72.5% (95% CI: 70.4%-74.4%). In the adjusted model, patients in the top wealth quintile (aPR 0.80; 95% CI: 0.69-0.93) were found to have a lower probability of having unwanted pregnancies when compared to those in the middle quintile. On the other hand, patients from rural areas (aPR 1.07; 95% CI: 1.01-1.14) had a higher probability of having unwanted pregnancies when compared to those from urban áreas. Conclusions: The prevalence of UAF in Peruvian women between 40 and 49 years old who participated in the 2018 DHS is high. Patients from rural areas have a higher probability of having unwanted pregnancies, and those in the top wealth quintile have a lower probability.

Influence of transcervical infusion of seminal plasma on the farrowing rate and litter size in artificially inseminated sows / [Influência da infusão transcervical de plasma seminal na taxa de partos e tamanho da ninhada em porcos inseminados artificialmente]

Recent studies have focused on the use of seminal plasma to increase sow fertility after classical intracervical artificial insemination (AI). The aim of the present study was to investigate the influence of seminal plasma infusion, prior to the application of conventional AI dose, on the fertility rate in sows. A total of 114 sows were treated with intrauterine infusion of 30ml seminal plasma (SP), while 114 control sows were infused by physiological solution (PS), immediately before the application of conventional AI dose. The experiment was conducted at one commercial pig farm in Serbia, which is comprised of 1,500 sows in the breeding herd. Intrauterine infusion of seminal plasma produced significantly (P<0.05) higher farrowing rate (93.8%) and significantly (P<0.01) more live-born piglets per litter (12.27), compared with the control sows (83.33% farrowing rate and 10.48 piglets). The present results show that intrauterine infusion of seminal plasma can be a useful tool for increasing the fertility rate in artificially inseminated sows, under the conditions of practical intensive pig production.(AU)

Estudos recentes concentraram no uso de plasma seminal para aumentar a fertilidade de porcos após inseminação artificial intracervical clássica (AI). O objetivo do presente estudo foi investigar a influência da infusão de plasma seminal, antes da aplicação da dose de AI convencional, na taxa de fertilidade de porcas. 114 porcas foram tratadas com infusão intrauterina de 30ml plasma seminal, e 114 porcas de controle receberam infusão de solução fisiológica (PS) imediatamente antes da aplicação da dose convencional de AI. O experimento foi realizado em uma fazenda de porcos comercial na Serbia, que é composta de 1.500 porcas no rebanho de reprodução. A infusão intrauterina de plasma seminal produziu uma taxa de fertilidade (93,8%) significativamente maior (P<0.05), e significativamente mais (P<0.01) leitões nascidos vivos por ninhada (12,27) comparado com as porcas de controle (83,33% taxa de fertilidade e 10,48 leitões). Os resultados mostram que infusão intrauterina com plasma seminal pode ser uma ferramenta útil para aumentar a taxa de fertilidade em porcas inseminadas artificialmente, sob as condições de prática de produção intensiva de porcos.(AU)

Salud sexual y reproductiva en la Ciudad de Buenos Aires: Situación y respuesta 2019 / Sexual and reproductive health in the City of Buenos Aires: Situation and response 2019

Actualización de los avances ocurridos durante el año 2019, relacionados con las acciones de la Coordinación Salud Sexual, Sida e ITS, del Ministerio de Salud del Gobierno de la Ciudad de Buenos Aires, destinada principalmente al equipo de salud involucrado en la política de salud sexual y reproductiva de la Ciudad. Continúa el modelo de análisis del informe 2016-2018, basado en las dimensiones: Determinantes (elementos que dan cuenta del contexto en el que se desarrolla la respuesta ), Población (indicadores que permiten caracterizar la población objetivo de la política pública), Acciones Programáticas (desarrollo institucional del Programa), y Utilización de los servicios (encuentro entre el sistema de salud y las personas usuarias). Incluye un documento anexo que presenta, a modo de Resumen Ejecutivo, una tabla que permite observar el comportamiento de algunos indicadores seleccionados para los años 2016-2019.

Envelhecimento populacional e financiamento público: análise do Rio Grande do Sul utilizando um modelo multissetorial / Population aging and public financing: an analysis of Rio Grande do Sul using a multisectoral model / Envejecimiento de la población y financiación pública: un análisis de Rio Grande do Sul utilizando un modelo multisectorial

Os efeitos econômicos do envelhecimento populacional é um tema ainda pouco estudado em países em desenvolvimento. No contexto brasileiro, o Rio Grande do Sul é um dos estados com maiores taxas de envelhecimento populacional. Esta mudança demográfica altera o perfil do consumo da economia, influenciando outras variáveis relacionadas. O objetivo deste trabalho é analisar os impactos das mudanças demográficas na arrecadação de impostos sobre consumo no Rio Grande do Sul. Para isso, utilizou-se um modelo de insumo-produto regional. Os resultados mostram que o envelhecimento populacional gera um perfil de consumo que reduz a carga destes impostos na economia.

The economic effects of population ageing are rarely addressed in developing countries. In the Brazilian context, Rio Grande do Sul is one of the states with the higher rates of population ageing. This demographic change modifies the economy's consumption pattern, affecting other related variables. The aim of this paper is to analyze the impact of the demographic changes in consumption taxes revenues in Rio Grande do Sul. To that end, a regional input-output model is used. The results show that the aging population generates a consumption profile that reduces the burden of these taxes on the economy.

Los efectos económicos del envejecimiento de la población son un tema todavía poco estudiado en los países en desarrollo. En el contexto brasileño, Rio Grande do Sul es uno de los estados con mayores tasas de envejecimiento de la población. Este cambio demográfico altera el perfil de consumo de la economía e influye en otras variables relacionadas. El objetivo de este trabajo es analizar los impactos de los cambios demográficos en la recaudación de los impuestos al consumo en Rio Grande do Sul. Para esto, se utiliza un modelo regional de insumos y productos. Los resultados muestran que el envejecimiento de la población genera un perfil de consumo que reduce la carga de estos impuestos en la economía.