Función sexual femenina durante el período posparto / Female sexual function during the postpartum period

OBJETIVO: Analizar variables bio-psicosociales asociadas a la función sexual femenina en el período posparto. MÉTODOS: Estudio analítico, transversal y correlacional en 117 mujeres que se controlaron entre el tercer y cuarto mes posparto, en los Centros de Salud Familiar “Huequén” y “Alemania” del Servicio de Salud Araucanía Norte, Novena Región, Chile, 2009. A través de una entrevista se les aplicó un instrumento para la obtención de datos sociodemográficos y el índice de función sexual femenina, este último se aplicó a 53 mujeres que habían iniciado actividad sexual. Se utilizaron las pruebas de Chi cuadrado, Mann-Whitney, t de Student y test de Friedman. RESULTADOS: El promedio de índice de función sexual femenina fue de 22,1 puntos; (rango 34,8 y 7,0 puntos). El 73,6 % de las mujeres presentó disfunción sexual, El índice de función sexual femenina fue mayor en aquellas mujeres que iniciaron actividad sexual porque deseaban hacerlo, que aquellas que iniciaron porque su pareja insistió (P= 0,0210) El orgasmo fue el dominio con mayor porcentaje para disfunción sexual (83 %). El deseo sexual estuvo levemente disminuido en mujeres con lactancia materna exclusiva, y fue estadísticamente significativa en relación con otros tipos de lactancia (P=0,0560). El deseo (P=0,0182) y la excitación (P=0,0002) fue mayor en las mujeres que deseaban tener relaciones sexuales, en comparación con las que iniciaron actividad coital porque su pareja insistió. CONCLUSIÓN: La mujer en la etapa posparto presenta disfunción sexual relacionada con factores fisiológicos y emocionales.

OBJECTIVE: To analyze bio-psychosocial variables associated to female sexual function during post-partum period. METHOD: A cross-sectional, analytical and correlational study, in 117 women which were checked between their third and fourth month post-partum period, in the Family Health Centers “Hueque” and “Germany” Araucanía Health Service North Ninth Region, Chile, 2009. By means of an interview a measuring tool for socio-demographic data collection and Female Sexual Function Index, was applied to 53 women who had initiated sexual activity, were applied the Chi square Tests, Mann-Whitney, t de Student and the Friedman test. RESULTS: Average of female sexual function Index was 22.1 points; (34.8 and 7 points average). 73.6 % of women showed some degree of sexual dysfunction; there was a significant statistical difference among women who started their sexual relationship because they really wanted to do so compared to the ones who started sexual activity because their sexual partner insisted on doing so (P= 0.0210). Orgasm was the domain with the largest percentage of sexual dysfunction (83 %). Desire was decreased in women with breast-feeding practice only and it was statistically significant in relation to other types of feeding (P=0.0560). Desire (P=0.0182) and sexual arousal (P=0.0002) were deeper in women who wanted to have sexual relationships compared to the ones who started sex life because their partner pressed them to do so. CONCLUSION: Women during post-partum period show sexual dysfunction related to psychological and emotional factors.

Conocimientos, actitudes y comportamiento sexual en un grupo de adolescentes chilenos

Introducción: La sexualidad es una de las mayores preocupaciones para el adolescente, su familia y la sociedad. Objetivo: Determinar conocimientos, actitudes y conducta sexuales en un grupo de adolescentes chilenos. Material y métodos: Estudio descriptivo y cuantitativo realizado en la Octava Región de Chile en el año 2003. Se seleccionó una muestra de 398 alumnos de liceos municipales. Se analizaron variables como comportamiento sexual, conocimientos y actitudes sobre sexualidad. Para el análisis estadístico se utilizaron las pruebas de χ ² y Mann y Whitney. Resultados: La edad promedio de los adolescentes fue de 16.1 ± 1.3 años. Con un intervalo de 14 a 19 años. Vivía con ambos padres 72.9%, 76.4% señaló haber tenido educación sexual, más de 50% refiere haber recibido información sexual de padres, profesores, amigos y/o medios de comunicación. De los hombres, 89.8%; y 92.9%, de las mujeres, mencionaron conocer algún método anticonceptivo. Reconoció el preservativo 84.4% como método que previene el contagio de infecciones de transmisión sexual y VIH/SIDA. Declaró haber tenido relaciones sexuales 21.6%, la edad promedio de 15.1 ± 1.8 años. De quienes han iniciado actividad sexual, 53.5% reconoció no haber usado ningún método anticonceptivo en su primera relación. El número de parejas sexuales en el grupo estudiado alcanzó un promedio de 1.8 parejas. C onclusiones: A pesar de tener cierto grado de conocimiento sobre sexualidad, los adolescentes asumen conductas de riesgo para su salud sexual y reproductiva.

Introduction: The sexuality is one of the biggest concerns for the adolescent, his family and the society. Objective: To determine knowledge, attitudes and sexual behavior in a group of Chilean adolescents. Material and methods: A descriptive and quantitative study was carried out in the Eighth Region of Chile in the year 2003. A sample of 398 students of county's liceo was selected. Variables were analyzed as sexual behavior, knowledge and attitudes it has more than enough sexuality. For the statistical analysis we used the χ ² and Mann and Whitney tests. Results: The average of age for the adolescents was 16.1 ± 1.3 years. With and interval of 14 to 19 years. 72.9% lived with both parents, 76.4% had sexual education, more than 50% they refers to have received parents' sexual information from professors, friends and communication media, 89.8% of the men and 92.9% of the women mentioned to know some birth-control method. 84.4% recognized the preservative as method that prevents the sexually transmitted infections (STI) and HIV/AIDS. 21.6% declared to have had sexual relationships, the age 15.1 ± 1.8 year-old average. 53.5% that have begun sexual activity recognized not to have used any birth-control method in his first sexual relationship. The number of even sexual in the studied group it reached an average of 1.8 couples. Conclusions: In spite of having certain degree of knowledge it has more than enough sexuality, the adolescents assume behaviors of risk for their sexual and reproductive health.

Embarazo en la adolescencia y su relación con la deserción escolar / The relationship between teenage pregnancy and school desertion

Background: In Chile, the prevalence of teenage pregnancy is 17 percent. Aim: To assess relationship between adolescent pregnancy and school desertion. Patients and methods: At the Hospital Guillermo Grant Benavente's Departament of Obstetrics and Gynecology, in Concepción, Chile, 2001 a comparative, cross sectional and correlational study was conducted. The study group were pregnant adolescents who deserted from school system, divided in two subgroups: 86 adolescents who deserted before pregnancy and 130 who deserted during pregnancy. Results: Twenty percent of teenagers that deserted from school before pregnancy belonged to a sublevel of poverty, compared with 5 percent of those who deserted during pregnancy. Flunk was frequent in both but higher in girls that deserted before pregnancy (46.5 and 36.9 percent respectively, (p <0.001). Economic problems were the main cause of desertion before pregnancy (27.6 percent). Shame (41.6 percent) and obstetric complications (31.7 percent) were the main reasons for deserting during pregnancy. Seventy percent of adolescents who deserted before pregnancy had no educational, working or recreational activities. The parental educational level of both groups was low. Conclusions: There is a relationship between teenage pregnancy and school desertion. Adolescents who deserted from school before pregnancy are more vulnerable (Rev Méd Chile 2004; 132: 65-70).

Perfíl lipídico en recién nacidos con retardo del crecimiento intrauterino / Serum lipids in newborns with intrauterine growth retardation

Background: The X syndrome, related to coronary disease in adults, could be possibly programmed priory to delivery, in children with intrauterine growth retardation. Aim: To measure serum lipids in newborns with symmetrical or asymmetrical intrauterine growth retardation. Patients and methods: One hundred thirty five newborns with intrauterine growth retardation and 116 normal term newborns, with 38 to 41 gestational weeks, were studied. Total, HDL, and LDL cholesterol, triglycerides and apoproteins. A1 and B were measured in imbilical cord blood samples. Results: No differences in total, HDL, LDL cholesterol, apoproteins A1 and B were observed between the study groups. Triglycerides were higher in newborns with intrauterine growth retardation, compared to normal term newborns (45 ñ 27 and 36 ñ 19 mg/dl respectively, p<0,001). Differences in serum triglyceride levels respect to controls were observed in both male and female newborns with asymmetrical growth retardation. Likewise the differences respect to controls were observed in newborns with mild or severe but not with moderate growth retardation. Conclusions: Newborns with intrauterine growth retardation have higher triglyceride levels than normal term newborns

Impacto del sindrome hipertensivo del embarazao en el retardo del crecimiento intrauterino / Impact of hypertensive disease of pregnancy on intrauterine growth retardation

Background: Intrauterine growth retardation, associated to hypertensive disease of pregnancy, is responsible for a higher perinatal mortality and morbidity. Aim: To assess obstetrical, perinatal and neonatal features of intrauterine growth retardation associated to hypertensive disease of pregnancy. Patients and methods: One hundred thirty seven newborns with intrauterine growth retardation, whose mothers had hypertensive disease of pregnancy, were compared to 165 similar newborns but whose mothers did not have the disease. Results: The incidence of intrauterine growth retardation associated to hypertensive disease of pregnancy was 45.4 percent. Maternal obesity at the start and end of pregnancy, a pregestational weight over 65 kg and a weight increment of more than 20 kg during pregnancy were risk factors for hypertensive disease of pregnancy with relative risks of 1.76, 1.62, 1.62 and 2.09 respectively. Relative risks for cesarean section and prematurity were also higher among women with hypertensive disease of pregnancy. Intrauterine growth retardation associated to maternal hypertension was symmetrical and severe in 37.9 percent of newborns. All seven neonatal deaths occurred in newborns with severe retardation. Conclusions: Neonatal and perinatal morbidity and mortality are higher in newborns with intrauterine growth retardation. Hypertensive disease of pregnancy was associated with a twice higher incidence of asymmetrical intrauterine growth retardation

Pérfil lipídico en sangre de cordón de recién nacidos normales y con alguna patología fetal y/o materna / Lipid profile in cord blood of normal newborns with some fetal and/or maternal pathology

Se realizaron determinaciones lipídicas en sangre de cordón de recién nacidos (RN) de ambos sexos, normales (n = 30) y con morbilidad neonatal o materna (n = 67), obtenida inmediatamente después del parto. Se consideró como RN sano una edad gestacional entre 38 y 41 semanas, peso > 2.500 g, Apgar > 7, así como ausencia de morbilidad perinatal, malformaciones congénitas y patología materna, como hipertensión arterial o diabetes. Las patologías consideradas fueron: grandes para edad gestacional, pretérmino, hipertensión materna, Apgar < 7, gemelos de pretérmino y otras. Al comparar los promedios de CT en los RN de pretérmino,Apgar < 7 con los RN normales (73 ñ 29; 73 ñ 24; 59 ñ 14 mg/dl) se encontró una diferencia significativa (p < 0.05). Para los promedios de los RN con HTA materna más pretérmino y gemelos de pretérmino (100 ñ 7; 104 ñ 26 mg/dl) la diferencia estadística fue mayor (p < 0,001). En estos dos últimos grupos, también se encontró diferencia significativa para el C-LDL (p < 0.001) (52 ñ 14; 64 ñ 24 mg/dl) comparado con RN normales (27 ñ 10 mg/dl). En los TG, fueron significativamente diferentes los promedios de los RN con HTA materna más pretérmino (58 ñ 51 mg/dl) y los con Apgar < 7 (45 ñ 47 mg/dl) comparados con RN normales (25 ñ 13 mg/dl) (p < 0,001 y p < 0,05 respectivamente). Siendo la hipercolesterolemia familiar el trastorno de las lipoproteínas más frecuente reconocido en la niñez,es importante su detección a edad temprana, así como saber diferenciarla de los niveles altos de colesterol, producto de alguna patología fetal o materna