[Factors associated with Streptococcus group B colonization in pregnant women in Los Altos, Chiapas]. / Factores asociados a la colonización por Streptococcus del grupo B en mujeres embarazadas de Los Altos, Chiapas.

OBJECTIVE: To estimate the prevalence and analyze the factors associated with group B Streptococcus (GBS) colonization in pregnant women of Los Altos, Chiapas, Mexico. MATERIAL AND METHODS: Between February and September 1999, a cross-sectional study was conducted among 910 women who sought delivery care at three public hospitals of San Cristobal de Las Casas, Chiapas. Vaginal and perianal samples were taken for GBS detection by bacteriological culture. Identification of groups and serotypes was performed using latex agglutination. The analysis of factors associated with colonization was done using chi-squared tests and log-linear modeling. RESULTS: GBS colonization was found in 8.6% (95% CI 6.8-10.5) of study subjects. Women with the greatest likelihood of colonization were those with > or = 5 pregnancies, residents of counties with high levels of poverty, working outside the home, and living in homes in which the head of household worked in agriculture (26.8%, OR = 7.25, 95% CI 1.83-28.67). CONCLUSIONS: In the study area, it is necessary that actions aiming to prevent and control infections by GBS be directed principally at those groups of women with the highest probability of colonization, in order to diminish the perinatal transmission of GBS.

[Impact of delivery care type on perinatal mortality in Tapachula, Chiapas, southern border of Mexico]. / Efectos del tipo de atención del parto en la mortalidad perinatal en Tapachula, Chiapas, frontera sur de México.

PURPOSE: To know and to explain the effects of the obstetrical assistance on the rate of perinatal mortality in a municipality of the state of Chiapas, Mexico which is distinguished by having a marginal rural zone, another one presenting an important agroindustrial and fishery development and the urban area. DESIGN: Transversal, epidemiological study. Some localities representing the three different geopolitic areas of the municipality were selected by probabilistic sampling. Field work was done from october 1996 to march 1997. PARTICIPANTS: Information was obtained by a probabilistic sampling survey of 1,382 pregnancies occurring from 1987 to 1996 in 670 women whose age range was between 15 to 49 years old. The unit of analysis was the set of alive newborns as well as dead newborns (stillbirth) from the 28th week of the gestation period until the first week of extrauterin life. RESULTS: The analysis showed a rate of perinatal mortality of 36.2 per 1000 alive newborns, the percentage of birth assistance by a midwife is of 40 percent while assistance by a relative of the pregnant, her husband or herself is that of 3.8%. The higher risks of increasing the mortality rate were found to be during the gestation period prior to or up to the 7th month (OR = 23.0, p < 0.05), for the lack of prenatal control (OR = 3.44, p < 0.05) and when birth assistance is provided by the woman's husband or a relative (OR = 3.31, p < 0.01). CONCLUSION: Empirical midwives are currently assisting up to the 43% of the pregnancies as far as prenatal control is concerned while they assist up to 40% of the actual deliveries, the later varying when moving to the core of the municipality. Statistically important differences in the rate of perinatal mortality were not found regardless of the type of assistance received prior to and during the actual delivery, by a midwife or a physician.

Efectos del tipo de atención del parto en la mortalidad perinatal en Tapachula, Chiapas, Frontera sur de México / The effects of birth assistance on the rate of perinatal mortality in tapachula, chiapas, south mexican border

Objetivo. Conocer la relación entre el tipo de atención de parto y mortalidad perinatal en el municipio de Tapachula, que se caracteriza por ser la región agropecuaria más importante de la frontera sur de México. Diseño. Estudio epidemiológico de corte transversal. La unidad de observación fue la familia y en ella las mujeres en edad fértil (15-49 años). Se consideró como muerte perinatal aquella defunción u óbito fetal que ocurrió entre la semana 28 de gestación y los 7 días de vida extrauterina; la información fue obtenida mediante historias de embarazos de octubre de 1996 a marzo de 1997. Participantes. Se recolectó información de 673 mujeres que registraron 1.382 embarazos de 1987 a 1996. Resultados. La tasa de mortalidad perinatal se calculó en 36,2 por mil embarazos y/o nacidos vivos, el porcentaje de partos atendidos por médico fue del 56,2 por ciento, por parteras del 40 por ciento y por algún familiar del 3,8 por ciento; la atención del parto en instituciones del sector salud fue del 55,5 por ciento y un 88,8 por ciento de los mismos recibió control de embarazo o prenatal. Se observó un gradiente de protección en la atención del parto médico/familiar RM, 0,30 (0,33-0,69); partera/familiar, RM, 0,16 (0,07-0,39), y de riesgo médico/partera, 1,84 (0,94-3,57). La falta de control prenatal no/sí fue un importante factor de riesgo, RM, 3,45 (1,93-6,17). Conclusiones. La falta de control prenatal es un determinante importante de la mortalidad perinatal. La atención del parto médico/partera no mostró diferencias significativas, por lo que en nuestros países se debe seguir apoyando (AU)

Efecto de las prácticas anticonceptivas sobre la fecundidad en la región fronteriza de Chiapas, México / The effect of contraception on fertillity in the border region of Chiapas, México

Objetivo. Estimar el efecto de las prácticas anticonceptivas sobre la fecundidad en la región fronteriza de Chiapas, México. Material y métodos. Durante 1994 se realizó un estudio epidemiológico de corte transversal en una muestra representativa de 1 560 mujeres no indígenas de 15 a 49 años en la región fronteriza de Chiapas. Se estimaron la prevalencia de uso de métodos anticinceptivos y las tasas globales de fecundidad (TGF) por tamaño de la localidad de residencia (rurales, intermedias y urbanas). Se comparó la TGF entre las mujeres nunca usuarias y alguna vez usuarias de métodos anticonceptivos. Resultados. La TGF estimada para la región fue de 3.67 y varió de 4.14 para áreas rurales a 3.36 para áreas urbanas. No se observaron diferencias en la TGF (3.74 y 3.88) ni el promedio de hijos nacidos vivos (3.47 y 3.48) entre usuarios alguna vez y nunca usuarias de métodos anticonceptivos. Conclusiones. El mayor efecto de las prácticas anticonceptivas en la fecundidad se observó en áreas rurales. El uso tardió de métodos anticonceptivos, así como la edad de unión más temprana entre las usuarias son factores que influyen para dar por resultado un escaso efecto en la fecundidad

Objetive.To estimate the effect of contraception on fertility in the border region of Chiapas, Mexico. Materials and methods. In 1994 an epidemiological cross-sectional study was carried out on a representative sample of 1 560 non-indigenous women between ages 15 and 49 in the border region of Chiapas. The prevalence of contraception practices and the total fertility rates (TER) were obtained and stratified by rural, intermediate and urban communities. TER were compared between women who had never used contraceptives and those who had used them. Results. The estimated TFR was 3.67 and varied from 4.14 in rural areas to 3.36 in urban areas. There were no differences in the TFR (3.74 and 3.88) nor in the average live births (3.47 and 3.48) between women who had never used contraceptives and those who had used them. Conclusions. The major effect of contraception on fertility was observed in rural areas. Factors which influence the small impact of contraception on fertility include the late use of these methods and the early age of first union among users.

[The effect of contraception on fertility in the border region of Chiapas, Mexico]. / Effecto de las prácticas anticonceptivas sobre la fecundidad en la región fronteriza de Chiapas, México.

OBJECTIVE: To estimate the effect of contraception on fertility in the border region of Chiapas, Mexico. MATERIALS AND METHODS: In 1994 an epidemiological cross-sectional study was carried out on a representative sample of 1,560 non-indigenous women between ages 15 and 49 in the border region of Chiapas. The prevalence of contraception practices and the total fertility rates (TFR) were obtained and stratified by rural, intermediate and urban communities. TFR were compared between women who had never used contraceptives and those who had used them. RESULTS: The estimated TFR was 3.67 and varied from 4.14 in rural areas to 3.36 in urban areas. There were no differences in the TFR (3.74 and 3.88) nor in the average live births (3.47 and 3.48) between women who had never used contraceptives and those who had used them. CONCLUSIONS: The major effect of contraception on fertility was observed in rural areas. Factors which influence the small impact of contraception on fertility include the late use of these methods and the early age of first union among users.

PIP: The objective of this study was to estimate the effect of contraception on fertility in the border region of Chiapas, Mexico. In 1994, an epidemiological cross-sectional study was carried out on a representative sample of 1560 nonindigenous women between the ages of 15 and 49 years in the border region of Chiapas. The prevalence of contraception practices and the total fertility rates (TFR) were obtained and stratified by rural, intermediate, and urban communities. TFR were compared between women who had never used contraceptives and those who had used them. The estimated TFR was 3.67 and varied from 4.14 in rural areas to 3.36 in urban areas. There were no differences in the TFR (3.74 and 3.88) nor in the average live births (3.47 and 3.48) between women who had never used contraceptives and those who had used them. The major effect of contraception on fertility was observed in rural areas. Factors which influence the small impact of contraception on fertility include the late use of these methods and the early age of first union among users. (author's)

[Factors related to drug use by adolescents in urban areas of Mexico]. / Factores asociados al consumo de drogas en adolescentes de áreas urbanas de México.

This is a retrospective study on teenagers from 14 to 17 years of age based on data from the National Survey on Drug Addiction conducted in 1988. The aim of this study was to discover the factors linked to drug consumption among Mexican urban teenagers. This paper reports prevalence rates (PR), raw and adjusted by gender as well as Cornfield's intervals (CI) of 95 per cent. For women, factors linked to drug use were: alcohol consumption (PR6.5, CI:1.5-28.3); father drug user (PR 3.2, CI:1.1-9.5). For men, factors linked to drug use were: age (PR 3.2; CI: 1.5-7.4); non religious practice (PR 2.7, CI: 1.2-6.4); acquaintances who are users of marihuana, cocaine or heroine-opium (PR 12.2, 6.6 and 7.0 respectively); and if the father, a brother or another relative are drug users (PR 4.1, 7.1 and 3.5 respectively). These findings show important gender differences in drug consumption patterns and linked factors. This paper brings out useful information for a complete understanding of this problem in Mexico.

[Child abuse in Tlaxcala: a case-control study]. / El niño maltratado en Tlaxcala: estudio de casos.

A longitudinal, retrospective and descriptive study about child abuse was carried out in the Hospitals of the Tlaxcala Secretariat of Health, Mexico. The information was obtained from hospitalized children's charts between January first and November 30, 1991. The charts included were those belonging to zero to 14 year old children with injuries, poisoning, and II-III degrees of malnutrition. Four child-abuse criteria were established: physical, sexual, non organic malnutrition and mixed (physical and non organic malnutrition). Two control groups were defined. Different patterns were observed between accidental and non accidental injuries, malnutrition and poisoning among the case and the control groups. The study provides useful information for the integral diagnosis of child abuse in hospitalized children.