Características sócio-demográficas e reprodutivas de adolescentes atendidas no pós-parto no Instituto da Criança da Universidade de São Paulo / Socio-demographic and reproductive characteristics of adolescent mothers who attended an inpatient clinic linked to the Adolescent Unit of a public hospital

Tendo em vista os problemas inerentes à gravidez na adolescência e a importância de direcionar ações de saúde para essa população a Unidade de Adolescentes do Instituto da Criança do Hospital das Clínicas da USP estendeu o atendimento, oferecendo atenção integral para mães adolescentes e seus filhos que freqüentaram o pré-natal na Disciplina de Obstetrícia da FMUSP. Este estudo visou identificar algumas características do modo de vida das mães adolescentes que freqüentam esse serviço. A população amostral foi constituída pelas 81 jovens que freqüentavam o ambulatório no período de estudo. Verificou-se que 76,5% delas não planejaram a gestação. Mesmo assim, com o apoio familiar e da instituição, planejavam mais filhos em data futura. A maioria delas convivia com o companheiro que, algumas vezes, assumiu também a chefia da família da adolescente. Grande parte delas, 54,3 % abandonou os estudos e, das 59 mães que trabalhavam, 38 deixaram de fazê-lo. As atividades de lazer foram modificadas e cerca de metade das jovens deixou de participar de qualquer atividade de lazer. O estudo permite ressaltar as repercussões da maternidade na vida das jovens e evidencia a importância do pré-natal e de serviços que proporcionem atendimento pós-parto, enfocando a saúde de uma forma global, beneficiando as adolescentes e seus filhos(AU)

Taking into account the inherent problems concerning adolescent pregnancy and the importance of implementing health actions targeted at that population, this paper aims to identify social characteristics of adolescent mothers who were followed up, during the prenatal period, by the Discipline of Obstetrics of the School of Medicine of the University of S„o Paulo, linked to the Adolescent Unit of Hospital das Cl¡nicas. The sample population was composed of the 81 mothers who attended that Unit during the study period. Information concerning personal characteristics was collected by a survey. It was verified that 76.5 percent of the young mothers had not intended to become pregnant, but with the support provided by the family and the institution, they were planning to have more babies in the future. The majority of them lived with their partner, who, in some cases, became the head of the adolescent's family. Of the 81 mothers, 39.5 percent did not complete elementary school; 54.3 percent quitted studying and 49 percent did not work. Their leisure activities changed and approximately half of the adolescents stopped participating in any leisure activity, during and after pregnancy. The study emphasizes the importance of prenatal and postnatal care in order to benefit those young women and their children.(AU)

Gonadal function in male adolescents and young males with juvenile onset systemic lupus erythematosus.

OBJECTIVE: To evaluate gonadal function in male adolescents and young men with juvenile onset systemic lupus erythematosus (SLE). METHODS: Four young men with SLE underwent clinical and laboratory evaluation, testicular ultrasound, follicle stimulating hormone, luteinizing hormone, prolactin, testosterone, and anti-sperm antibody determination. The semen analyses were performed according to the WHO guidelines and Kruger strict criteria. All patients were asked to provide 3 semen samples over a period of 2 months. A new sample was collected 6 months later. RESULTS: The median disease duration was 6.6 years. The median age at initial ejaculation was 13.5 years. All 4 patients had severe disease with renal involvement (WHO class IV or V). The SLICC/ACR damage index at the time of study entry ranged between 0 and 3. The patients' Tanner stage was P5G5; all reported normal erection and libido. Gonadal evaluation by thorough examination of the genitalia and ultrasound was normal. Anti-sperm antibodies were negative in all patients. Only one patient showed high FSH and LH levels. The initial and final semen evaluations of the 4 patients were abnormal (azoospermia, oligoastenoteratospermia, or teratospermia). One patient was receiving azathioprine and 2 were receiving cyclophosphamide at the time of study entry. CONCLUSION: Although these patients had normal sexual activity and normal external genitalia, their fertility was decreased based on the sperm abnormalities. Serial semen analyses in larger study populations will be necessary to clarify the degree and duration of sperm abnormalities in male patients with SLE in general.