[Design and evaluation of an educational course for mothers of pregnant adolescents]. / Diseño y evaluación de un curso educativo dirigido a madres de adolescentes embarazadas.

This article is the continuation of a previous investigation about educational necessities in perinatal health of pregnant adolescent mothers. Now we present the design and evaluation of an Educational Course for that group. The theoretical mark of the Course corresponds to the education of adults, under the focus of the grupal learning. The content included gineco obstetrics topics, prevention of perinatal risks and the analysis of the social and cultural enviroment. As evaluation instrument, a self-applicable questionnaire of thirteen open questions was built on four aspects: family dynamics, utility of the course, utility of the information and behavior of the pregnant adolescents. A sample of 101 mothers of pregnant adolescents participated of the study from January 1999 to May 2000. The results indicate that the family dynamics was modified favorably in 88% of the cases soon after the attendance of mothers like adolescents to their respective courses, although some factors related with the father show a lack of commitment about the family situation. The 100% of the mothers considered important the attendance to the course because it is an educational instrument, so much for pregnant daughters as for themselves. The Course propitiated the exchange of preventive information between them in 87% of the cases. 97% of the mothers informed changes in their daughter's attitudes soon after her attendance to the course.

[Evaluation of an educational course for pregnant adolescents]. / Evaluación de un curso educativo sobre la etapa gestacional exclusivo para adolescentes embarazadas.

The pregnancy among adolescent women in Mexico is close than half million by year, this problem could be attended through health education in the Mexican medical care system. Since 1995 the Instituto Nacional de Perinatologia has a free training program only for adolescents designed to improve the health care medical procedures and reduces some perinatals health risks. This paper shows the structural design, functioning strategies and results of its application. Through a pre codificated 48 item list, were analyzed transversally the clinical records of 234 adolescents engraved themselves to the course. Two groups were formed: the "A" group with the patients attended at least to three sessions (106) and the group "B" with the ones who did not (128). The data analysis was made by contrasting each item between the groups using the appropriate statistical tests. The group "A" had greater average in scholarship, the moreover socioeconomic characteristics and gynecoobstetric background did not show significant differences. Group "B" had a higher proportion of adolescent with aggregated pathology to the pregnancy. We too observed significant differences in the proportions of complications during the pregnancy evolution and in the postpartum period. The acceptance on the pregnancy by the adolescent, her family and by her couple also showed significant differences. The average weight of the newborns were greater statistically in the "A" group. The proportions of family planning methods acceptance was higher in the same group, who has too shorter intra-hospitalary stay. This evaluation shows good fitness with the adolescents education expectatives and performance and favorable associations with some perinatals health risks.

[Neurologic development of children at age two who had been treated at a neonatal intensive care unit]. / El neurodesarrollo a los dos años de vida de neonatos tratados en una unidad de cuidados intensivos neonatales.

The principal objective of this study was to evaluate, at 2 years of age, the neurological development of a group of children who had been treated in the neonatal intensive care unit (NICU) of the National Institute of Perinatology of Mexico. All the children born between 1 January 1992 and 31 December 1993 who had entered the NICU and stayed for 3 or more days were studied from the neurological, psychological, auditory, linguistic, motor, and neuromuscular standpoint. This group included 134 patients, who had had an average gestational age of 32 weeks and an average birth-weight of 1,677 g. They had stayed in the hospital an average of 51 days, and 75% of them had undergone artificial respiration. In the examination done at age 2, 66.5% of the children were normal and 8.2% had serious impairments. There were statistically significant associations between their neurological condition and the days of artificial respiration (P < 0.0001), the days spent in the NICU (P < 0.000004), and the gestational age in weeks (P < 0.03). There was no association between the children's sex and the results of the assessments. The study results showed a decrease in neural abnormalities in comparison with the results obtained in similar studies 10 years earlier.

[Factors related to the recognition of alarm signals during pregnancy]. / Factores relacionados con el reconocimiento de signos de alarma durante el embarazo.

INTRODUCTION: The medical literature has noted the relationship between perinatal morbidity and mortality and cultural factors for more than twenty years. During this time, however, rates of diseases such as hypertension, which complicate pregnancy and delivery, threatened preterm delivery and premature rupture of the membranes have decrease little. These conditions required other, complementary actions such as health education. The purpose of this research was to explore existing knowledge about warning signs during pregnancy in a population using third level medical facilities as the first step in designing an educational program. MATERIAL AND METHODS: We applied a 17 item multiple choice questionnaire regarding alarm sings during pregnancy to a group of 100 pregnant women. The sample was classified into six groups according to the age of the patient and the presence of aggregate risk. The analysis focused on the proportion of correct responses, applying different statistical tests according to the nature of the variables. RESULTS: In stepwise multiple regression, years of education explained 8.1% of the variance of correct responses, the number of pregnancies 5.5%, and gestational age 6.6%. The ANOVA of the complete regression was significant (F = 9.41; df = 99; p < 0.001) with a standard error of 2.23 ans a final adjusted r = 0.45. The number of consultations was positively associated with gestational age but had no relationships with correct responses. Groups with the greatest information deficits were adolescents and patients of adequate reproductive age with low reproductive risk. CONCLUSIONS: Patients with the least obvious alarm signs failed the most items in the alarm sing questionaire. The educational relationship between the physician and the patient should be more carefully explored. We are in agreement with other authors that educational level of patients is a determining to the attitude and knowledge of the population towards its own health.

[Gestational disorders]. / Morbilidad gestacional.

We present the results of an interview of 375 pregnant women which explores their gestational risk diagnoses, the types and frequencies of complaints. Five groups of 75 patients each were formed from this random sample corresponding to 30, 32, 34, 36 and 38 weeks of pregnancy respectively. We too analyze the patients' opinions about their own morbidity, the repercussion on activities of daily life and self-medication. The interview included the actions taken on their own account to deal with complaints during pregnancy, as well as to establish the relationships between these actions and medical attention they received. A total of 1534 complaints were recorded from the entire group, the mean per patient were four with a range from one to six. The reported from the entire group, the mean per patient were four with a range from one to six. The reported complaints did not caused medical consultation and were totally different with the respective risk diagnoses. Our results show that patients almost always accept their symptoms as a normal part of pregnancy, even when arise from pathology. Almost 70% of the patients view their symptoms as normal despite the fact that they produce difficulties of daily life in 41%, and that they temporarily block these activities in 19%. Around 10% of the patients admit self-medication. Over 50 types of actions were self-initiated, 1371 for the entire group as a whole. Around 95% of the complaints considered abnormal received no medical attention. We presented a series of thoughts on the effectiveness of popular practices and the possibility of integrating some of them into medical practice.(ABSTRACT TRUNCATED AT 250 WORDS)

[Sexuality and reproduction. A questionnaire at the basic secondary educational level]. / Sexualidad y reproducción. Una encuesta en el nivel de Educación Media Básica.

A 50 question survey was administered to 362 junior high school students in order to determine the level of sexual education. The objectives were to determine the themes of most interest to the students, to establish the precise participation of the school in sexual education, to define quality in teachers and to find possible differences in knowledge and attitudes according to school grade and sex. As expected, age but not sex, differed according to grades. Parents participated in the sexual education in their children in 50% of the sample; the high level of education of the majority of this group of parents will permit the development of additional programs for their participation in school related programs for sexual education. Sexual attitudes among students did not differ according to school grade. The percentage of responses about sexuality and reproduction that corresponded to materials in the curriculum was low; eighth grade students showed superior knowledge about theory, ninth grade students were superior in knowledge of more practical aspects. The principal sources of sexual education in this group were parents and teachers, 81% of the students reported having received some sexual education in the school, 51.4% as part of natural sciences course material and 12% as part of the eight grade course in social and human relations. We suggest a strategy of presenting progressively more complex materials of sexual education by grade in order to influence not only sexual attitudes but preventive sexual practices as well.

[The neurological and psychomotor evolution at 2 years of age of newborn infants who underwent assisted ventilation]. / Evolución neurológica y psicomotora a los dos años de vida de recién nacidos que fueron sometidos a ventilación asistida.

It is important to evaluate the development of neonates submitted to assisted ventilation since it is one of the most commonly used procedures in patients with respiratory failure. A group of 50 neonates who had been submitted to assisted ventilation were studied and compared to another group of 50 children with the same inclusion criteria, except for the fact that they had not needed ventilation. They were each evaluated since birth and thereafter every two months during their first year of life and every three months in the second year. The Amiel Tison Neurological Assessment was used to evaluate the children during the first year while the Mayo Clinic General Neurological Exploration adapted for nursing children was applied during the following year. In assessing psychomotor development, the Brunette Lezine Scale, standardized for Mexican children, was used. For practical purposes, a sample of the results obtained during the second year are presented while some pertinent variables are commented on. For those included in the ventilated group, results show a higher frequency of hyaline membrane disease (27 cases), intraventricular hemorrhage (19), pneumonia (18), and arterious duct persistence (13). The control group showed the following frequencies, respectively: 0, 4, 5, and 4 cases. The ventilation group was found to have a statistically significant higher relative risk rate (P less than 0.05) and a higher risk for neurologic sequelae (P less than 0.001) when compared to the control group. Asphyxia and hemorrhaging were factors associated and present in the ventilated group (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Community education in perinatal health]. / Educacion comunitaria en salud perinatal

PIP: The National Institute of Perinatology develops educational programs for the population using its services in order to promote positive behavior related to reproduction. One of the most frequently observed problems during prenatal control is patient abandonment of the services offered by health institutions. We present an investigation of the relationship between the educational program for pregnant women offered by the Institute and compliance with prenatal care. A group of 215 patients elected to participate in the educational program. The program consisted of themes on the evolution and culmination of the pregnancy, preparation for nursing, nutrition, developmental milestones, and dental health. Another group was selected at the same time, equal in size to the first but without participation in the course, as a control group. Both groups contained patients categorized in the 3 perinatal risk groups accepted by the Institute.^ieng