Estudiantes universitarias nuligestas en edad fértil y su postura acerca de posibles vías del parto / Nuligest university students of childbearing age and their position about possible ways of delivery

Resumen Introducción: Tanto a nivel sudamericano como mundial, el incremento de la tasa de cesáreas electivas ha sido abrumante. Esto se considera un problema de salud pública, ya que el parto vaginal es la vía más fisiológica para el nacimiento y trae beneficios de salud para la madre y el recién nacido, tanto inmediatos como a futuro. Objetivo: Evaluar la postura de mujeres nuligestas en edad fértil acerca de las vías del parto a través de sus conocimientos, percepciones y preferencias. Método: Estudio de corte transversal. Se aplicó una encuesta a estudiantes universitarias para la recopilación de datos mediante SPSS, y análisis con prueba de diferencias de proporciones y de χ2. Resultados: 210 mujeres encuestadas. Un 80% de ellas desconoce la menor morbilidad infantil asociada a un parto vaginal, más de la mitad estima una ventaja de la cesárea que evite el dolor y un gran porcentaje desconoce los riesgos médicos asociados a la cesárea. Conclusiones: Existe un alto nivel de desconocimiento respecto a beneficios, riesgos y consecuencias de las diferentes vías del parto.

Abstract Introduction: Both in South America and worldwide, the increase in the rate of elective caesarean sections has been overwhelming. This is considered a public health problem, since vaginal delivery is the most physiological route for birth and brings health benefits for the mother and the newborn, immediately and in the future. Objective: To evaluate the position of nulliparous women of childbearing age regarding the delivery pathways through their knowledge, perceptions, and preferences. Method: Cross-sectional study with an analytical component. A survey was applied to university students for data collection through SPSS, and analysis was made with the difference of proportions and χ2 test. Results: 210 women surveyed; 80% of them are unaware of the lower infant morbidity associated with a vaginal delivery, more than a half estimate an advantage of a cesarean section that it avoids pain, and a large percentage are unaware of the medical risks associated with cesarean sections. Conclusions: There is a high level of ignorance regarding the benefits, risks and consequences of the different delivery routes.

Análise dos indicadores de saúde sexual e reprodutiva de adolescentes brasileiros, 2009, 2012 e 2015 / Analysis of sexual and reproductive health indicators of Brazilian adolescents, 2009, 2012 and 2015

RESUMO: Objetivo: Analisar indicadores de saúde sexual e reprodutiva de adolescentes com base nos dados da Pesquisa Nacional de Saúde do Escolar (PeNSE) em 2015, comparando-os aos de 2009 e 2012. Métodos: Estudo transversal que analisou dados de escolares do nono ano da PeNSE 2015, 2012 e 2009. Estimou-se a prevalência com intervalos de confiança de 95% para indicadores de iniciação sexual, uso do preservativo na última relação sexual, ter recebido orientação para gravidez, infecções sexualmente transmissíveis e preservativo grátis nas três edições. Prevalências dos indicadores de 2015 foram estimadas segundo sexo, dependência administrativa da escola e região. Utilizou-se o teste do χ2 de Pearson para diferenças estatísticas. Resultados: A prevalência de iniciação sexual apresentou queda, de 30,5% em 2009 para 27,5% em 2015, assim como do uso de preservativo, de 75,9 para 66,2%. Notou-se queda da orientação para prevenção de gravidez nas escolas públicas, de 81,1 para 79,3% e de preservativo gratuito nas escolas privadas, de 65,4 para 57,3%. Cerca de 30% relataram uso combinado de preservativo e outro método e 19,5% não fizeram uso de método algum. Observou-se que meninos apresentaram maior prevalência de iniciação sexual, maior número de parceiros e menor uso de preservativo. As regiões norte, nordeste e centro-oeste apresentaram pior desempenho dos indicadores. Conclusão: Evidenciou-se diminuição da iniciação sexual e do uso de preservativo entre adolescentes, maior vulnerabilidade às infecções sexualmente transmissíveis nos meninos e à gravidez entre as adolescentes de escolas públicas.

ABSTRACT: Objective: To analyze sexual and reproductive health indicators of adolescents based on data from the National School-based Health Survey (PeNSE) in 2015, comparing them to the data from 2009 and 2012. Methods: Cross-sectional study that has analyzed data from 9th grade students from PeNSE 2015, 2012 and 2009. We estimated prevalence and 95% confidence intervals for the following indicators: sexual initiation, condom use in the last sexual intercourse, counseling for pregnancy, sexually transmitted infections and free condoms in the three rounds of the survey. Prevalence of all indicators accessed in 2015 was estimated according to sex, type of school and region. Pearson's χ2 test was used. Results: The prevalence of sexual initiation reported by adolescents has decreased from 30.5%, in 2009, to 27.5%, in 2015, as well as the use of condom in the last intercourse, from 75.9 to 66.2%, respectively. In respect to counseling, there was a reduction regarding pregnancy prevention in public schools, from 81.1 to 79.3% and in relation to free condom in private schools, from 65.4 to 57.3%. About 30% reported using both condom and another contraceptive method, and 19.5% did not use any method. Boys presented greater prevalence of sexual initiation, higher number of partners and reduced prevalence of condom use. Adolescents living in North, Northeast and Central-West regions presented worse indicators. Conclusion: There was a reduction in sexual initiation and condom use among Brazilian adolescents, boys were more vulnerable to sexually transmitted infections, and girls from public schools were more vulnerable to pregnancy.

Impact of Childbearing Decisions on Family Size of Korean Women with Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) predominantly affects women in their reproductive years and has a significant impact on childbearing. We investigated the influence of personal decision on family size among Korean women with SLE and factors that affect the decisions. A case-control study comparing childbearing history and decisions of 112 SLE patients and 135 controls was performed. Women with SLE participating in the Network for Lupus Clinical Research in South Korea and matching controls between ages of 18-45, who are/were married or living with a partner were included. Data regarding socio-demographics, reproductive history, and childbearing decisions were collected through a survey using a standardized questionnaire and medical record review. More women with SLE reported at least one pregnancy (85.7% vs. 71.9%, P = 0.009) or at least one live birth (85.7% vs. 71.9%, P = 0.003) compared with controls. Mean number of pregnancies was significantly higher (2.4 ± 1.6 vs. 1.4 ± 1.3, P < 0.001), and mean number of live births was significantly lower in women with SLE (1.2 ± 0.8 vs. 1.6 ± 0.8, P < 0.001). Significantly more women with SLE made the decision not to have children compared with controls (54.5% vs. 40.7%, P = 0.031), and health-related concerns were the major cause of the decision. Other socio-demographic factors did not influence the decision to limit childbearing in SLE women. The disease-related concerns had significant impact on family size and childbearing decisions among Korean women with SLE.

Efectividad del programa psicoeducativo de educación sexual y salud reproductiva / Effectiveness of the psychoeducational program of sexual education and reproductive health

Introducción: una conducta sexual adecuada basada en conocimientos sólidos sobre salud sexual y reproductiva contribuye a que los adolescentes posean una vida sexual satisfactoria. Objetivo: demostrar efectividad de la intervención psicoeducativa en féminas de la enseñanza secundaria, en un antes y un después. Métodos: estudio cuasi-experimental comparativo de valor metodológico desarrollado en las secundarias básicas urbanas de Cumanayagua, con un universo de 180 estudiantes femeninas pertenecientes al 9no grado. Se elaboró un cuestionario con las variables de interés por el método de encuesta, para caracterizar el comportamiento sexual manifiesto en sus relaciones con el medio social e identificar los conocimientos de las féminas de la enseñanza secundaria relacionados con la educación sexual y salud reproductiva, el cual se utilizó después de aplicado el programa. Se usaron técnicas afectivo-participativas, grupales, de análisis, de integración, de formación de grupo y de evaluación. Resultados: se logra elevar el conocimiento: del momento oportuno para iniciar las relaciones sexuales, de 18 por ciento a un 71 por ciento; acerca del riesgo del embarazo en la primera relación sexual, de 37 por ciento al 75 por ciento; riesgos del embarazo y el aborto, de 57 por ciento a un 71 pr ciento; identificación de las Infecciones de Transmisión Sexual y sus consecuencias de 27 por ciento al 75 pr ciento y de 26 por ciento al 83 por ciento respectivamente. De forma general se logra modificar, de forma creciente, el conocimiento en las categorías de: muy suficientes de un 13,9 por ciento a un 26,7 por ciento y suficientes de un 28,9 por ciento a un 53,9 por ciento y los insuficientes decrecen de un 57,2 por ciento a un 19,4 por ciento, siendo efectivo el programa en un 85,7 por ciento. Conclusiones: el nivel de conocimientos en los adolescentes sobre este tema fue bajo, por lo que mantienían un comportamiento riesgoso; lográndose mejoría después de las intervenciones educativas(AU)

Introduction: Adequate sexual behavior based on sound knowledge on sexual and reproductive health helps adolescents to have satisfactory sexual life. Objective: To prove the effectiveness of psychoeducational intervention in high school female students before and after that intervention. Methods: Comparative quasi-experimental study with methodological value that was carried out in urban junior high schools of Cumanayagua municipality and the universe of study was one hundred and eighty 9th grade female students. A questionnaire was designed using the variables of interest by the survey-type method, in order to characterize the sexual behavior present in its relationships with the social setting and to identify the knowledge of junior high school female students associated with sexual education and reproductive health, which was applied after the program. Affective-participatory, group, analysis, integration, group formation and evaluation techniques were all used in this study. Results: It was possible to raise the level of knowledge about the right time to start the sexual relationship from 18 percent to 71 percent; about the risk of getting pregnant in the first sexual intercourse from 37 percent to 75 percent; pregnancy risks and abortion from 57 to 71 percent; identification of sexually transmitted infections and their consequences from 27 percent to 75 percent and 26 to 83 percent, respectively. The study managed to change in a significant way the knowledge in the following categories: highly sufficient from 13.9 to 26.7percent and sufficient from 28.9 percent to 53.9 percent whereas insufficient category decreased from 57.2 percent to 19.4 percent. The program reached 85.7 percent effectiveness. Conclusions: The level of knowledge shown by adolescents about this topic was low, that is the reason why they kept risky attitudes; after the educational interventions, their knowledge improved(AU)

El deseo de hijo en las parentalidades actuales: infertilidad y técnicas reproductivas / [The desire for a child in today parenthood: Infertility and reproductive techniques].

The advances in reproductive medicine have unprecedentedly expanded the possibilities to form a family. Today we can speak of a diversity of ways to access to parenthood. The paradigm of family formations has also changed following the diversity of parenting projects: heterosexual couples, blended families (post-divorce), couples formed by lesbians and gays and single parenting. The vicissitudes of "desire for a child" under current parenthood lead us to think about their scope in clinical reproductive disorders or infertility and new family configurations. One of the destinies of the desire for a child in women is the "passion for a child", the child at any cost. Thinking of the changes in parenthood in this field involves not only the desire to have a child in a woman, a man or a couple, but also the history of the origins in children. Especially with some of the reproductive techniques used, such as surrogacy and the donation of gametes-eggs (ovum and sperm). In these cases we are dealing with new articulations of blood ties, kinship and parenthood.

Intenciones reproductivas y factores asociados con los nacimientos no planeados, Paraguay, 1995-2008 / Reproductive intentions and factors related to unplanned births, Paraguay, 1995-2008

OBJETIVO: Describir las intenciones reproductivas de las mujeres paraguayas entre 1995 y 2008 y determinar las características asociadas con los embarazos no deseados e inoportunos. MÉTODOS:. Estudio descriptivo exploratorio basado en datos secundarios de las encuestas nacionales de demografía y salud reproductiva de 1995, 2004 y 2008. Se analizaron los cambios en las características sociodemográficas de las mujeres, el uso de métodos anticonceptivos y la fecundidad, así como de la proporción de nacimientos deseados, inoportunos y no deseados. Mediante dos modelos de regresión logística multifactorial se determinaron las características asociadas con los embarazos no deseados o inoportunos. RESULTADOS: En 2008, la tercera parte (33,3%) de los nacimientos no fueron planeados (25,6% inoportunos y 7,7% no deseados). La edad estuvo asociada de forma directa y significativa al deseo de postergar el último nacimiento; el nivel de escolaridad se asoció inversamente con la posibilidad de tener nacimientos inoportunos; y residir en áreas urbanas, con los nacimientos no deseados. El no estar casada o unida a una pareja estable estuvo asociado con considerar el último nacimiento como no deseado o inoportuno, tanto en las mujeres solteras como en las separadas, divorciadas o viudas. CONCLUSIONES: A pesar del mejoramiento del nivel de escolaridad de las mujeres, su mayor incorporación al trabajo remunerado, el aumento del uso de métodos anticonceptivos y la disminución de la fecundidad, todavía existen grupos de mujeres que no pueden satisfacer sus ideales reproductivos y están expuestas a embarazos no deseados o inoportunos.

OBJECTIVE: To describe the reproductive intentions of Paraguayan women over the period from 1995 to 2008 and determine the characteristics associated with unwanted and mistimed pregnancies. METHODS: An exploratory, descriptive study was conducted using secondary data from national demographic and reproductive health surveys from 1995, 2004, and 2008. The study examined the socio-demographic characteristics of the women, the use of contraceptive methods, and fertility, as well as the proportion of wanted, mistimed, and unwanted births. Using two multifactorial logistic regression models, the characteristics associated with unwanted or mistimed pregnancies were determined. RESULTS: In 2008, one-third (33.3%) of the births were unplanned (25.6% mistimed and 7.7% unwanted). Age was directly and significantly associated with the woman having wanted to postpone her most recent birth; level of schooling was inversely related to the possibility of having mistimed births; and living in urban areas was associated with unwanted births. Not being married or in a stable relationship was associated with regarding the most recent birth as unwanted or mistimed, not only among single women, but also among those separated, divorced, and widowed. CONCLUSIONS: Despite improvements in women's levels of schooling, their increasing access to paid employment, the growing use of contraceptive methods, and reductions in fertility, there are still groups of women who are unable to fulfill their reproductive intentions and are at risk of having unwanted or mistimed pregnancies.

Duas mães?: mulheres lésbicas e maternidade / Two moms?: lesbians and motherhood

Em nossa sociedade, a relação heterossexual ainda parece ser a única possibilidade legitimada para formação de um casal ou até mesmo de uma família. Porém, é cada vez maior o número de pessoas que desafia os discursos normativos presentes e busca a constituição de parcerias afetivo-sexuais com outras de seu próprio sexo, muitas vezes associando essas parcerias à experiência da parentalidade, seja com filhos biológicos ou adotivos. Com as crescentes discussões sobre os direitos sexuais reprodutivos e com o surgimento de novos arranjos familiares, entre eles o formado por casais homossexuais, começa-se a desconstruir o modelo ideal de família nuclear e abre-se caminho para discussão de temas como a maternidade lésbica. Este trabalho pretende contribuir com o debate da homoparentalidade, procurando demonstrar as especificidades existentes entre essas mulheres e suas formas de construir sua cidadania íntima dentro do contexto heteronormativo da sociedade brasileira. Para tanto, foi traçado o seguinte objetivo geral: compreender as concepções sobre a parentalidade de mulheres lésbicas que buscam a gravidez por meio de doadores de sêmen, sejam eles conhecidos ou desconhecidos. O estudo proposto baseia-se nos pressupostos da pesquisa qualitativa, como forma de privilegiar os discursos dos sujeitos como fonte de informação. Doze mulheres lésbicas aceitaram participar do estudo e foram entrevistadas entre os anos de 2009 e 2011. Os dados foram transcritos, organizados e analisados. A partir dos resultados, foi possível perceber que a vivência da maternidade por parte das mulheres lésbicas depende de fatores diversos como o histórico-cultural, o social, o jurídico-legal, o econômico e os relacionados às políticas públicas, além, é claro, da história de vida de cada uma dessas mulheres. Desta forma, para a mulher assumir a homossexualidade em uma sociedade heteronormativa e, ao mesmo tempo, optar pela maternidade, é necessário percorrer um árduo caminho, onde uma das saídas parece ser a luta pela cidadania plena e consolidação dos direitos humanos. Isto aponta para a importância de se abordar o tema em estudos e discussões acadêmicas com outras esferas da política pública e da vida social, incluindo a saúde pública.

Práticas contraceptivas e gestão da heterossexualidade: agência individual, contextos relacionais e gênero / Contraceptive practices and management of heterosexuality: individual agency, relational contexts and gender

A tese versa sobre as grandes questões relativas à contracepção no Brasil. Integra um esforço por analisar condutas referentes à contracepção, segundo lógicas que priorizam a situacionalidade e a relacionalidade de tais fenômenos. As estratégias para gerir a fecundidade são constitutivas da sexualidade heterossexual. Mulheres e homens podem usar ou não contracepção; as razões dessa conduta extrapolam aspectos concernentes a informação e acesso. Busca-se compreender as práticas contraceptivas a partir do processo do aprendizado das lógicas relacionais e de gênero, em diferentes momentos dos percursos biográficos: o início da trajetória afetivo-sexual, os contextos de irrupção de uma gravidez e o encerramento da potencialidade reprodutiva, por meio da esterilização contraceptiva. Este compósito demandou a utilização de materiais empíricos distintos para a construção e análise das etapas eleitas dos percursos biográficos. Enfoca-se, primeiramente, o momento da passagem à sexualidade com parceiro. Problematiza-se a idéia de relaxamento das práticas contraceptivas, a partir da iniciação sexual, concepção corrente na literatura nacional em função do descrécimo de uso de preservativo em relações sexuais posteriores. Aborda-se, em, seguida, as atitudes e as questões presentes no processo de construção da prática contraceptiva, no momento em que a vida sexual se torna regular. A proposição da perspectiva da gestão contraceptiva sublinha as posições dos protagonistas, marcadas pelo gênero. Por último, analise-se as circunstâncias biográficas e os cenários relacionais da esterilização contraceptiva, a qual emerge como uma estratégia de estabilização ou de consolidação de um percurso contraceptivo/ reprodutivo. O debate em torno da contracepção no Brasil apresenta a tendência a enfatizar a determinação social para explicar as gestações imprevistas...

Ambiente de desenvolvimento e início da vida reprodutiva em mulheres Brasileiras / Environment of development and the start of Brazilian women's reproductive life

Modelos teóricos inspirados na teoria da história de vida têm avaliado padrões de reprodução humanos em países desenvolvidos, com resultados ainda não conclusivos. Em vista das condições de vida na população brasileira, foram investigadas relações entre marcos da carreira reprodutiva feminina, condições ambientais e variáveis psicossociais relacionadas às condições de criação. Foram entrevistadas 606 mulheres em seis estados. Os resultados apóiam a teoria da história de vida, mostrando associações entre condições de vida na infância e início da vida sexual e da reprodução, mas não com a idade da menarca. Sugerimos que diferentes marcadores da vida reprodutiva podem estar sob controle de diferentes fenômenos e que a diversidade de condições da população brasileira oferece contextos alternativos para testar hipóteses.

Several models inspired by the life history theory have assessed the patterns of human reproduction in developed countries with promising but inconclusive results. Considering the diversity of life conditions in Brazil, we investigated the relationship between the time of main events in female reproductive life, environmental conditions and psychosocial variables related to child-rearing. We interviewed 606 women in six different states in Brazil. Results corroborate the life history theory, showing associations among the investigated factors, especially between life conditions during childhood and the beginning of sexual life and reproduction, but not to sexual maturity. We suggest that landmarks in reproductive life, although related, can be under the influence of several phenomena. Diversity of life conditions in Brazil offers alternative contexts to hypotheses testing.

Discursos normativos sobre o desejo de ter filhos / Discursos normativos sobre el deseo de tener hijos / Normative discourses on the desire to have children

São apresentadas reflexões acerca dos discursos normativos sobre sexualidade, família e reprodução difundidos pelos saberes médico e jurídico na sociedade contemporânea. Partiu-se do pressuposto de que nos atuais discursos acerca do desejo de filhos coexistem transformações e permanências de valores e práticas, traduzidas em reivindicações no plano dos direitos sexuais e reprodutivos, com novas demandas no âmbito das políticas públicas e de saúde. O atual valor atribuído à família tem por base o modelo de família conjugal moderna, o que pode ser observado em meio às transformações ocorridas nas relações familiares e das identidades sexuais. A partir de uma nova configuração de valores, a expectativa de paternidade e de maternidade tornou-se, em parte, um valor da relação homossexual. No entanto, a despeito das transformações no âmbito das relações familiares e das identidades sociais, a centralidade do casal heterossexual prevalece no discurso médico e jurídico acerca do desejo de filhos.

Reflections on normative discourses on sexuality, family and reproduction are shown, promoted by medical and juridical knowledge in modern society. This study was based on the assumption that changes and maintenance of values and practices coexist in the current discourses on the desire to have children, expressed as claims in the dimension of sexual and reproductive rights, with new demands in the sphere of public and health policies. The current value attributed to family is founded on the model of modern conjugal family, which can be observed in the changes that have occurred in family relations and sexual identities. Based on a new configuration of values, the expectation of paternity and maternity has partly become a value of the homosexual relationship. However, despite changes in the sphere of family relations and social identities, the centrality of the heterosexual couple prevails in the medical and juridical discourse on the desire to have children.

Son presentadas reflexiones acerca de los discursos normativos sobre sexualidad, familia y reproducción difundidos por los conocimientos médico y jurídico en la sociedad contemporánea. Se partió del supuesto de que en los actuales discursos acerca del deseo de hijos coexisten transformaciones y permanencias de valores y prácticas, traducidas en reivindicaciones en el plano de los derechos sexuales y reproductivos, con nuevas demandas en el ámbito de las políticas públicas y de salud. El actual valor atribuido a la familia tiene por base el modelo de familia conyugal moderna, lo que puede ser observado en medio de las transformaciones ocurridas en las relaciones familiares y de las identidades sexuales. A partir de una nueva configuración de valores, la expectativa de paternidad y de maternidad se tornó, en parte, un valor de la relación homosexual. Sin embargo, ignorando las transformaciones en el ámbito de las relaciones familiares y de las identidades sociales, la centralidad de la pareja heterosexual prevalece en el discurso médico y jurídico acerca del deseo de hijos.

Perceptions of gender and tuberculosis in a south Indian urban community.

BACKGROUND: The Revised National Tuberculosis Control Programme (RNTCP) in India advocating Directly Observed Treatment-Short course (DOTS) detects nearly three times more male than female TB patients. The reasons for this difference are unclear. An understanding of the community's health beliefs, perceptions on the disease and behaviour towards TB patients may throw some light on this issue. MATERIAL AND METHODS: A qualitative study using focus group discussions was conducted among men and women of younger and older age groups from lower income neighbourhoods. The information obtained was grouped into themes which included, understanding of TB, vulnerability, access to health care and social responses. Gender differences in community perceptions on TB seem to be critical in issues related to marriage. RESULTS: The stigma of TB is more visible in women than men when it comes to marriage. Men and children were perceived to get preferential attention by their families during illness. While the younger age group, irrespective of gender, accessed care from private providers, the older group preferred a government facility. Awareness of TB was acceptable but it seemed more associated as a respiratory disease and the common symptom associated with TB was cough. CONCLUSION: This study highlights the need for gender specific intervention strategies to enhance better access of TB services.

Fertility and fecundity of an outpatient sample with schizophrenia

OBJECTIVE: To determine reproductive rates among patients with schizophrenia who attended the outpatient clinic at the Universidade Federal de São Paulo. METHOD: All patients with schizophrenia completed a semi-standardized questionnaire, and data from the Brazilian census was used for comparing population rates. RESULTS: 167 patients completed the questionnaires and of these 33 (19.8 percent) were or had been married and 32 reported being a parent. The fertility rate (number of individuals who had had at least one child divided by the total number of individuals) was 19.4 percent (25 percent for females, 15.8 percent for males, p = 0.14). Fecundity rate was 1.75 for males and 1.69 for females (p = 0.85). A logistic regression analysis identified an association between the later date of the onset of illness and higher rate of marriage (p = 0.003). Gender and the interaction between gender and marital status were significant predictors for fertility (p < 0.05 and p = 0.024, respectively). CONCLUSIONS: Patients with schizophrenia showed lower rates for marital status, fertility and fecundity when compared to standard population rates. However, many patients will become parents during their life time. Therefore, it is imperative to develop services that fulfill their needs, mainly in Brazil, a middle-income country, where resources are scarce and there is no policy for dealing with this reality.

OBJETIVO: Determinar as taxas de reprodução de pacientes com esquizofrenia em uma clínica de atendimento ambulatorial da Universidade Federal de São Paulo. MÉTODO: Todos os pacientes com diagnóstico de esquizofrenia preencheram um questionário semi-padronizado. Dados do censo Brasileiro foram utilizados para comparação com taxas populacionais. RESULTADOS: 167 pacientes completaram o questionário, dos quais 33 (19,8 por cento) foram alguma vez casados e 32 tiveram filhos. A taxa de fertilidade (indivíduos que tiveram ao menos um filho pelo total de indivíduos) foi de 19,4 por cento (15,8 por cento para homens, 25 por cento para mulheres, p = 0,14). A taxa de fecundidade foi de 1,75 para homens e 1,69 para mulheres (p = 0,85). Análise de regressão logística identificou associação entre idade de início da doença mais tardio com maior taxa de casamento (p = 0,003). Gênero e interação entre gênero e situação conjugal foram significantes preditores para fertilidade (p < 0,05 e p = 0,024; respectivamente). CONCLUSÕES: Pacientes com esquizofrenia mostraram menores taxas de casamento, fertilidade e fecundidade quando comparados com taxas populacionais. Contudo, muitos pacientes com esquizofrenia terão filhos durante a vida e há carência de serviços de saúde que atendam às necessidades destes indivíduos, principalmente no Brasil, um país de renda média, onde os recursos são escassos e não existem políticas que abordem esta realidade.

Reproductive health awareness of school-going, unmarried, rural adolescents.

OBJECTIVE: In 1996, India included Adolescent Health in Reproductive and Child Heatlh Programme. This Task-Force Study was planned to test the awareness level of adolescents regarding various reproductive health issues and to identify lacunae in knowledge, particularly in legal minimum age of marriage, number of children, male preference, contraceptive practices, about STIs /AIDS etc. METHODS: It was a multicentre study, done in rural co-education/higher secondary schools of 22 districts located in 14 states through Human Reproductive Research Centre (HRRC's) of the Indian Council of Medical Research (ICMR). A sample of 8453 school going adolescents (aged 10-19 years) was surveyed by means of open ended, self-administered questionnaires maintaining confidentiality. RESULTS: Mean age of adolescents was 14.3 +/- 3.4 years. Awareness of legal minimum age of marriage was present in more than half of adolescents. Attitude towards marriage beyond 21 years in boys and 18 years in girls was favorable. Mean number of children desired was 2.2 +/- 1.4. However, number of children desired by boys (2.2+/-1.6) was significantly more (p< 0.000) than those desired by girls (2.0+/-1.1). More boys (23.7%) than girls (9.4%) wanted three or more children with male preference. Only 19.8% of adolescents were aware of at least one method of contraception. Only two-fifth (39.5%) were aware of AIDS and less than one-fifth (18%) were aware of STDs and most of them thought it is same as AIDS. Awareness of at least one method of immunization was present in three-fifth (60.1%) of students. It was least for DPT (13.5%) and most (55%) were aware of polio only. Awareness of all Reproductive Health matters was more in boys than girls and more in late teens (15-19) than earlier teens (10-14). CONCLUSION: The study showed tremendous lacunae in awareness of all Reproductive Health (RH) matters. There is a need for evolving information, education, and communication strategies to focus on raising awareness on RH and gender related issues. A sociocultural research is needed to find the right kind of sexual health services for young girls and boys.