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Prevalencia de prematuridad y factores de riesgo <= span style=3D'mso-spacerun:yes'> asociados en recién nacidos, ingresados = en el área de neonatología del Hospital Vicente Corral Moscoso, 2011-2015

 

 

Prevalence of prematurity and ri= sk factors in newborns admitted to the neonatology area, Hospital Vicente Corr= al Moscoso, 2011-2015

 

 

Fabián Alejandro Suin Guaraca.[1], Katiuska Vanessa Suriaga Ramírez.[2], Pamela Elisa Cordero Torres.3 & Héctor Fabián Siguencia Astudillo.4<= /sup>

=  

Recibido: 5-02-2020 / Revisado: 15-03-2020 /Aceptado: 04-04-2020/ Publicado: 05-06-20= 20

 

DOI: https://doi.= org/10.33262/anatomiadigital.v3i2.1..1255

&n= bsp;

Abstract.

Prematurity, worldwid= e, is the leading cause of neonatal mortality and morbidity, making it a real challenge for the Ecuadorian health system. The main objective of the research is to establish the prevalence of prematurity and its associated factors, in the Neonatology area of ​​the Vicente Corral Moscoso Hospital, between 2011-2015, applying an analytical, cross-sectional observational methodology, reviewing a number= of 447 clinical records of newborns, who met the inclusion criteria, statistically analyzing, reporting Odds ratio, with a confidence interval= of (95%) and accepting the pi value, the relevant bioethical foundations were applied, within the results it is given that the prevalence of prematurity was (29.4%), the percentage of adolescent mothers was ( 30.3%), (56.1%) h= ave secondary education, (36.4%) are married and (72.7%) spend the night in u= rban areas. The predominant sex of premature infants was male with (52.3%), (70.5%) were late preterm infants and 79.5% were small for gestational ag= e. The risk factors that show a statistical variation relationship were: age you= nger than 19 years old and older than 35 years old (OR: 1.71; CI: 1.12-2.59 p: 0.01), hypertensive disorders (OR: 1.81; CI: 1.08-3.03 p: 0.02 ), intrauterine growth restriction (OR: 4.89 CI: 3.17-7.55 p: 0.000), and multiple pregnancy (OR: 2.79; CI: 1.45-5.34 p: 0.001), concluding that the prevalence of prematurity was high, a relationship was found statistically significant with: age, hypertensive disorders, intrauterine growth retard= ation and multiple pregnancy

 

 

Keywords: Prematurity, Risk, Multiple pregnancy, neonatolo= gy

 

 <= /o:p>

Resumen.

La prematuridad, a nivel mundial constituye la primera causa de mortalidad y morbilidad neonatal, siendo por ello un verdadero reto para el sistema de salud Ecuatoriano, el objetivo principa= l de la investigación es el establecimiento de la prevalencia de prematuridad y sus factores asociados, en el área de Neonatología del Hospital Vicente Corral Moscoso, entre los años 2011-2015, aplicando una metodología analística, transversal observacional, revisando un número de 447 histori= as clínicas de neonatos, los cuales cumplieron los criterios de inclusión, analizando estadísticamente, reportándose Odds ratio, con un intervalo de confianza del (95%) y aceptando el pi value, se aplicaron los fundamentos bioéticos pertinentes, dentro de los resultados se da que la prevalencia de prematuridad fue del (29,4%), el porcentaje de madres adolescentes fue de (30,3%), el (56,1%) posee instrucción secundaria, (36,4%) son casadas y un (72,7%) pernoctan en zonas urbanas. El sexo predominante de los prematuros fue masculino con (52,3%), el (70,5%) fueron prematuros tardíos y el 79,5% pequeños para la edad gestacional.  Los factores de riesgo que muestran relación variación estadística fueron: ed= ad menor a 19 años y mayor 35 años ( OR:1.71 ; IC: 1.12-2.59 p: 0.01), trastornos hipertensivos (OR:1.81; IC: 1.08-3.03 p: 0.02), restricción de crecimiento intrauterino (OR:4.89 IC:3.17-7.55 p: 0.000), y embarazo múlt= iple (OR: 2.79; IC: 1.45-5.34 p: 0.001), concluyendo que la prevalencia de prematuridad fue elevada, se encontró relación estadísticamente significa= tiva con: edad, trastornos hipertensivos, retardo del crecimiento intrauterino= y embarazo múltiple

Palabras claves: Prematuridad, Riesgo, Embarazo múltiple, neonatología

Introducción.

La prematuridad comprende un problema de salud pública, que se ha mantenido a través de los tiempos, afectando a los recién nacidos, de menos de 37 semanas completas de gestación contadas a partir del último día del periodo menstrual, esta problemática eleva el riesgo de adaptación en el recién nacido a la vida extrauterina, debido a la inmadurez anatomo-fisiológica, desembocando múltiples complicaciones respiratorias infecciosas y neurológicas, al momento del Nacimiento aumentando la morbili= dad infantil. (Salgue et al. 2009)

Mendoza, et al. (2016) y De Sousa et al. (2017) manifiestan que el resultado de la prematuridad, genera grandes costos económicos y sociales, vinculado por algunos factores demográficos y obstét= ricos como son el bajo nivel socioeconómico la edad materna el antecedente de par= to prematuro el sangrado vaginal en el segundo trimestre. En el Ecuador  el problema de mortalidad neonatal apor= ta cerca del 60%, en menores de un año y alrededor del 70% en menores de menos= de 28 días de nacidos, los cuales cuentan con bajo peso dentro de la edad gestacional representada por el 1% de nacimientos, contribuyendo con un 40%= de mortalidad infantiles (Afonso, 2017)=

En la actualidad se requiere contar con información actualizada de la prevalencia de nacimientos prematuros y los factores de riesgos asociados, por todo lo que significa el cuidado y atención de un ni= ño prematuro y su impacto sobre la vida de sus familiares y la sociedad dentro= de los aspectos sociales psicológicos económicos y de salud (Mendoza et al., 2= 015)

El manejo de la prematuridad constituye un verdade= ro desafío para las casas de salud del país debido a que el recién nacido prematuro por todas las condiciones presentadas necesita cuidados especializados los cuales requieren un amplio conocimiento y la intervención mediante múltiples procedimientos para proveer una aproximación razonable e= n lo que es el diagnóstico prevención evaluación y tratamiento con la finalidad = de que se contribuye a disminuir la morbilidad neonatal derivado de la prematurez (Guzmán y María 2016).

Lo que se busca dentro de la investigación como objetivo general es establecer una relación entre prematuridad y los factor= es de riesgo asociados de los recién nacidos ingresados en el área de neonatol= ogía del hospital Vicente Corral moscoso entre los años 2011 al 2015, y los  objetivos específicos están: en determi= nar las características sociodemográficas de la población en estudio caracteriz= ar a los recién nacidos prematuros según el sexo peso al nacer y edad de gestaci= ón por Ballard y  establecer la asocia= ción entre prematuridad y factores de riesgo como son: ruptura prematura de membranas, trastornos hipertensivos, retardo del crecimiento intrauterino, embarazo múltiple, IVU y controles prenatales insuficientes. Para realizar = el diagnóstico y el cálculo de las semanas de gestación se utiliza la última f= echa de menstruación la ecografía y al momento del nacimiento se aplica la prueb= a de Ballard, el mismo que constituye en un instrumento de fácil acceso valorando una serie de características físicas y neurológicas colocando como resultad= o en cada casilla según la edad gestacional la investigación de estas características para poder ser evaluado al resultado subjetivo.<= /span>

Consecuencias de la prematuridad, Romero, Carrera y Rodríguez (2012), expresan que a= l nacer en prematuridad trae consigo una serie de trastornos cuya severid= ad dependerá del número de semanas de gestación que se hayan cumplido por lo q= ue un recién nacido prematuro presenta diversas alteraciones propias de su inmadurez como la membrana hialina taquipnea hipoglucemia hiperbilirrubinem= ia alteraciones nutricionales y deshidratación. (Schonhau= lt, Perez y Astudillo 2012) El desarrollo cognitivo= y de la Salud Mental con la prematuridad causando un progreso anormal déficit de atención trastornos emocionales y del comportamiento afectan también al rendimiento académico, relación inversamente proporcional a la edad del gestacional del nacimiento (Schonhault, Perez y Astudillo 2012).

A nivel del sistema nervioso central presenta un proceso madurativo en el último trimestre de gestación y en el primer mes l= uego del nacimiento con esta problemática el prematuro presentar alteraciones estructurales manifestándose con una disminución en la sustancia gris corti= cal, provocando trastornos a nivel cognitivo dificultades en razón de la memoria= la atención el razonamiento el aprendizaje la conducta y el rendimiento escola= r se conoce además que dichos problemas conductuales pueden acarrear conductas antisociales ansiedad y depresión en edades adultas (V= aldes et al (2015)

Factores asociados a la prematuridad: <= span lang=3DES-EC style=3D'font-size:12.0pt;line-height:115%;font-family:"Times = New Roman",serif; mso-ansi-language:ES-EC'>están la edad materna, los controles prenatales, rotura prematura de membranas, IVU, trastornos hipertensivos del embarazo, restricción del crecimiento intrauterino y embarazo múltiple.

Edad materna, Rodríguez y Rossell (2013) expresan que la = edad en que una mujer se convierte en madre pasando por el proceso del cuidado d= e su embarazo y en el producto de su gestación.  Mendoza et al., (2015), concluyen en su estudio que el ser madres menores de 19 años hubo un odds radio de 1,57, relacionando con la prematuridad

Controles prenatales, el Ministerio de Salud Pública (2015), Reyes y Khiara (2017) expresan, que un control adecuado duran= te todo el embarazo resulta de Vital importancia para que esté culmina de la m= ejor manera y en el tiempo determinado considerando 13 controles óptimos gestacionales y un mínimo de 5, la disminución de los mismos podría estar relacionado con un nacimiento prematuro. Mendoza et al., (2015), demostraron que una mala adherencia a los controles prenatales actúo como riesgo de prematuridad

Rotura prematura de membranas, el Ministerio de Salud Pública (2015), Schonhault, Perez y Astud= illo (2012) expresan que la rotura de membranas cori amnióticas, Se presentan an= tes de que se inicie la labor del parto estimulado por varios problemas como son los inflamatorios e infeccioso presentando riesgo de morbilidad en la madre= y el niño desencadenando Además del parto prematuro.

Infección de vías urinarias (IVU), Varios autores, entre estos Guadalupe y Oshiro (2015) demuestran la relación entre la infecci= ón de vías urinarias con la prematuridad Al igual que presenta relación directa c= on la infección del tracto urinario.

Trastornos hipertensivos del embarazo, la preclamsia, eclampsia y síndrome de HELLP, Son reconocidas de esta problemática amenazando la vida de la madre razón por la cual se debe interrumpir el inmediato el embarazo inmediatamente llegando a= ser una causa de nacimiento prematuro. (Silva et al y García et al, 2016).

Mendoza et al., (2016) encontró una relación estadística significativa entre los trastornos hipertensivos y la prematuri= dad Claros y Mendoza (2015) menciona entre sus investigaciones que encontró una relación entre prematuridad y preeclampsia eclampsia.

Restricción del crecimiento intrauterino, está influenciada por alteraciones que afectan directamente a la circulación y actividad de la placenta repercutiendo en el desarrollo y crecimiento fetal y en la condición de salud de la madre pudie= ndo desencadenar un nacimiento prematuro (Pimiento y Beltrán 2015).<= /span>

Mendoza et al., (2015) menciona en su en su estudi= o la relación entre esta condición y la prematuridad Por otra parte Arteaga et a= l., (2013) manifiesta en sus estudios que atendió a 313 neonatos diagnosticados= con prematuridad de quién es un 14.7% fueron diagnosticados con restricción del crecimiento intrauterino.

Embarazo múltiple, El contar con dos o más fetos durante el período de gestación es un factor determinante relacionado con la prematuridad la cual= se puede presentar en un 50% de estos embarazos antes de las 27 semanas ya es = un 30% menos de 32 semanas en nacimientos triples, Leal et al., (2016) y Ahuma= da y Barrios (2016) demostraron que el embarazo múltiple, está relacionado con la prematuridad y el embarazo gemelar.

Metodología.

La investigación este tipo analítica, visual de prevalencia y corte transversal, realizada en la provincia de Azuay, correspondiente a la zona 6 de salud del Ecuador dentro el área de neonatol= ogía del Hospital Vicente Corral Moscoso. La unidad de análisis correspon= de a los neonatos ingresados Durante los años 2011 al 2015 en el área de neonatología constituida por universo de estudio de 2698 en neonatos. Para realizar el cálculo muestral se utilizó como base los supuestos de prevalencia de prematuridad del 11.4%, expresado por Marín metal (2006), que posee una confiabilidad del 97% un error del 3% obteniendo una muestra míni= ma de 447 neonatos Posteriormente se estratifica por años quedando constituida como podemos observar en la tabla N.1

Tabla 1. Estratificación por años de los neonatos

Años <= /b>

Población

Porcentaje

Muestra

2011

430

16

72

2012

532

20

89

2013

541

20

89

2014

678

25

112

2015

517

19

85

Total =

2698

100

447

 

Fuente: Elaboración propia.

Dentro de Los criterios de inclusión se bas= aron las historias clínicas de neonatos ingresados en el área de neonatología del hospital Vicente Corral moscoso entre el período comprendido del año 2011 al año 2015, asimismo los criterios de exclusión nos demuestran que las historias clínicas con datos incompletos no entran dentro del análisis investigativo.

Las variables utilizadas en el estudio comprenden variables sociodemográficas como son la etnia edad instrucción estado civil y residencia permanente de la madre. La variable dependient= e comprende la prematuridad, las variables independientes están ruptura prematur= a de membranas, retardo del crecimiento intrauterino, número de controles prenatales, trastornos hipertensivos de la gestación, periodo intergenésico, IVU, y embarazo múltiple

Se valoró y cuantificó mediante el método a= nalítico, visual, la técnica desarrollada se dio mediante la recolección de datos utilizando un cuestionario con las variables evaluadas y definidas por los investigadores. Dentro de los instrumentos están la información recolectada mediante el formulario elaborado por los investigadores constan= do de varias secciones la primera concerniente a los datos sociodemográficos, = la segunda y tercera sección recopilo datos sobre los factores asociados propuestos en esta investigación.

Dentro de los aspectos éticos, la informaci= ón se recopiló con total confidencialidad, contando abiertamente con la autorización del comité de bioética de la Universidad de Cuenca, así como también de las autoridades competentes del hospital, procediendo a codificar los formularios con una numeración de tres dígitos iniciados desde el 001 h= asta el 447.

Dentro de los procedimientos implementados está la= autorización vigente luego de la aprobación del protocolo por parte del comité de ética = de la Universidad de Cuenca aprobada y validada mediante un oficio de gestión = documental contando con una supervisión del Dr. Fabián Sigüenza en calidad de director.

El análisis y tabulación de datos se realizó mediante el programa de Microsoft Excel para luego ser analizados en el paq= uete estadístico SPSS v. 15, presentando los resultados en tablas personalizadas, para las variables cualitativas se utilizó frecuencias y porcentajes (f %) y para las variables cuantitativas que corresponde a la media y desviación estándar ( , DS). Aplicando la prueba de chi cuadrado para determinar= la asociación entre la prematuridad y los factores de riesgo con un intervalo = de confianza del 95% aceptando así la hipótesis alterna si el valor de pi valor resulta inferior al 0.05

Resultados.

EN la tabla 2, se presenta la distribución de 447 = recién nacidos del área de neonatología del Hospital Vicente Corral Moscoso, según= las características sociodemográficas del año 2011-2015

Tabla 2. Distribución recién nacidos HVCM

 

Fre= cuencia

Por= centaje

EDA= D

=3D o <19 = años

110=

24.= 6

20 = a 24 años

137=

30.= 6

25 = a 29 años

87<= o:p>

19.= 5

30 = a 34 años

63<= o:p>

14.= 1

35 = años o más

50<= o:p>

11.= 2

Tot= al

447=

100=

ETN= IA

Bla= nca

1

0.2=

Neg= ra

3

0.7=

Mes= tiza

435=

97.= 3

Ind= ígena

7

1.6=

Otr= a

1

0.2=

Tot= al

447=

100=

INS= TRUCCIÓN

Pri= maria

119=

26.= 6

Sec= undaria

291=

65.= 1

Uni= versitario

32<= o:p>

7.2=

Otr= os

5

1.1=

Tot= al

447=

100=

EST= ADO CIVIL

Sol= tera

110=

24.= 6

Cas= ada

179=

40<= o:p>

Div= orciada

1

0.2=

Viu= da

1

0.2=

Uni= ón libre

156=

34.= 9

Tot= al

447=

100=

RES= IDENCIA

Urb= ana

359=

80.= 3

Rur= al

88<= o:p>

19.= 7

Tot= al

447=

100=

 

Fuente: Hospital Vicente Corral Moscoso.

 

La tabla 2, muestra datos sociodemográficos donde = la mayor parte de las madres de los neonatos están en un Rango de edad de 20 a= 24 años con el 30.6% seguidas de las adolescentes con un 24.6% y las mujeres d= e 25 a 29 años presentaron una frecuencia del 19.5%. El 97.3% auto identificándo= se como mestizas el 1.6% como indígenas el 65.1% culminó sus estudios secundar= ios el 26.6% la primaria un 40% Indicó que su estado civil casada un 34.9% unión libre el 24.6% soltera la residencia urbana predominó con el 80.3% y la residencia rural con 19.7%

Tabla 3. Prevalencia de prematuridad en 447 pacientes del Área de Neonatología del Hospital Vice= nte Corral Moscoso. 2011-2015.<= /span>

&nb= sp;

Fre= cuencia

Por= centaje

PRE= MATURIDAD

Sí<= o:p>

132=

29.= 5

No =

315=

70.= 5

Tot= al

447=

100=

 

Fuente: Elaboraci= ón propia.

En la tabla número 3 observamos que la prevalencia= de prematuridad en el área de neonatología del hospital Vicente Corral moscoso está entre los años 2011 a 2015 con un 29.5%, concordando con cifras expues= tas por Leal et al.(2016), quienes concluyeron= una prevalencia de 11.5% en su estudio realizado en gestantes de una población brasileña;  al igual que Mendoza Ta= scón et al., en  Colombia quienes report= aron un 11,4% (9), a su vez Azevedo et at., presentaron cifras inferiores de prematuridad con un 8% en Minas Gerais-Brasil , estudio realizado por Guimarães et al. (2008)

Tabla 4. Distribución de 132 recién nacidos prematuros Área de Neonatología del Hospital Vicente Corral Moscoso. 2011-2015, características sociodemográficas.

&nb= sp;

Pre= maturidad

 

Fre= cuencia

Por= centaje

 

EDA= D

=3D o <19 = años

40<= o:p>

30.= 3

 

20 = a 24 años

36<= o:p>

27.= 3

 

25 = a 29 años

19<= o:p>

14.= 4

 

30 = a 34 años

18<= o:p>

13.= 6

 

35 = años o más

19<= o:p>

14.= 4

 

Tot= al

132=

100=

 

ETN= IA

Neg= ra

1

0.8=

 

Mes= tiza

125=

94.= 7

 

Ind= ígena

6

4.5=

 

Tot= al

132=

100=

 

INS= TRUCCIÓN

Pri= maria

46<= o:p>

34.= 8

 

Sec= undaria

74<= o:p>

56.= 1

 

Uni= versitario

10<= o:p>

7.6=

 

Otr= os

2

1.5=

 

Tot= al

132=

100=

 

EST= ADO CIVIL

Sol= tera

43<= o:p>

32.= 6

 

Cas= ada

48<= o:p>

36.= 4

 

Uni= ón libre

41<= o:p>

31.= 1

 

Tot= al

132=

100=

 

RES= IDENCIA

Urb= ana

96<= o:p>

72.= 7

 

Rur= al

36<= o:p>

27.= 3

 

Tot= al

132=

100=

 

 

Fuente: Elaboraci= ón propia.

De acuerdo con las características sociodemográficas las madres que tuvieron recién nacidos prematuros comprenden un 30.3% las cuales fueron adolescente= s el 27.3% sus edades oscilan entre 20 a 24 años el 94.7% identificándose con la etnia mestiza el 56.1% fueron distribución secundaria el 36.4% casadas el 3= 2.6% solteras y el 72.7% tienen residencia urbana versus un 27.3% residencia en áreas rurales.

Tabla 5. Distribución de 132 recién nacidos prematuros, recién nacidos prematuros Área de Neonatología del Hospital Vic= ente Corral Moscoso. 2011-2015, según sexo, edad gestacional y peso

&nb= sp;

&nb= sp;

Rec= ién Nacidos Prematuros

Fre= cuencia

Por= centaje

SEX= O

Hom= bre

69<= o:p>

52.= 3

Muj= er

63<= o:p>

47.= 7

Tot= al

132=

100=

CLA= SIFICACIÓN POR EDAD GESTACIONAL

Muy prematuros

15<= o:p>

11.= 4

Pre= maturos moderados

24<= o:p>

18.= 2

Pre= maturos tardíos

93<= o:p>

70.= 5

Tot= al

132=

100=

PES= O CON RELACIÓN A EDAD GESTACIONAL

Peq= ueño para la edad gestacional

105=

79.= 5

Ade= cuado para la edad gestacional

26<= o:p>

19.= 7

Gra= nde para la edad gestacional

1

0.8=

Tot= al

132=

100=

 

Fuente: Elaboraci= ón propia.

En la tabla número 5 evidenciamos la distribución de los recién nacidos premat= uros de acuerdo al sexo donde predominan los neonatos varones con un 52.3% los neonatos femeninos 47.7% en cuanto a la edad gestacional los prematuros tar= díos comprenden un 70.5% ,los moderados un 18.2% y el 11.4% fue para los muy prematuros, en cuanto a la relación del peso con edad gestacional el 79.5%,= fue pequeño y el 19.7%, adecuado para la edad gestacional.

Tabla 6. Distribución de 447 recién nacidos del Área de Neonatología del Hospital Vicente Corral Moscoso según factores asociados a prematuridad. 2011-2015.

Pre= maturidad

&nb= sp;

&nb= sp;

&nb= sp;

&nb= sp;

Sí =

No =

OR =

IC =

&nb= sp;

Val= or p

F

%

F

%

Eda= d

<19 = o > 35 años

59<= o:p>

44.= 7

101=

32.= 1

1.7= 1

1.1= 2

2.5= 9

0.0= 1

No<= o:p>

73<= o:p>

55.= 3

214=

67.= 9

&nb= sp;

&nb= sp;

&nb= sp;

&nb= sp;

Con= troles prenatales

>= ; 5 controles

51<= o:p>

38.= 6

124=

39.= 4

0.9= 7

0.6= 3

1.4= 7

0.8= 8

<= ; 5 controles

81<= o:p>

61.= 4

191=

60.= 6

&nb= sp;

&nb= sp;

&nb= sp;

&nb= sp;

RPM=

Sí<= o:p>

25<= o:p>

18.= 9

39<= o:p>

12.= 4

1.6= 5

0.9= 5

2.8= 6

0.0= 7

No<= o:p>

107=

81.= 1

276=

87.= 6

&nb= sp;

&nb= sp;

&nb= sp;

&nb= sp;

IVU=

Sí<= o:p>

61<= o:p>

46.= 2

137=

43.= 5

1.1= 1

0.7= 4

1.6= 7

0.5= 9

No<= o:p>

71<= o:p>

53.= 8

178=

56.= 5

&nb= sp;

&nb= sp;

&nb= sp;

&nb= sp;

Tra= stornos hipertensivos

Sí<= o:p>

30<= o:p>

22.= 7

44<= o:p>

14.= 0

1.8= 1

1.0= 8

3.0= 3

0.0= 2

No<= o:p>

102=

77.= 3

271=

86.= 0

&nb= sp;

&nb= sp;

&nb= sp;

&nb= sp;

RCI= U

Sí<= o:p>

83<= o:p>

62.= 9

81<= o:p>

25.= 7

4.8= 9

3.1= 7

7.5= 5

0.0= 0

No<= o:p>

49<= o:p>

37.= 1

234=

74.= 3

&nb= sp;

&nb= sp;

&nb= sp;

&nb= sp;

Múl= tiple

Sí<= o:p>

21<= o:p>

15.= 9

20<= o:p>

6.3=

2.7= 9

1.4= 5

5.3= 4

0.0= 01

No<= o:p>

111=

84.= 1

295=

93.= 7

&nb= sp;

&nb= sp;

&nb= sp;

&nb= sp;

 

Fuente: Elaboraci= ón propia.

<= span style=3D'font-size:12.0pt;line-height:115%;font-family:"Times New Roman",se= rif'>Con respecto de la relación de factores de riesgo asociados, se concluyó que: la edad menor a 19 años y mayor a 35 (OR:1.71 ; IC: 1.12-2.59 p: 0.01 ), los t= rastornos hipertensivos (OR:1.81; IC: 1.08-3.03 p:0.02 ), la restricción de crecimien= to intrauterino (OR:4.89 IC:3.17-7.55 p: 0.000), y el embarazo múltiple (OR: 2= .79; IC: 1.45-5.34 p: 0.001), los cuales obtuvieron una relación estadísticamente significativa con prematuridad. Sin embargo, no se encontró esta relación c= on variables como: número de controles prenatales, ruptura prematura de membra= nas, IVU.

<= span class=3DA11>En cuanto al aspecto de la edad materna, de los datos resultantes la relación entre la Edad materna y prematuridad de las madres menores de 19 años y may= ores de 35 años tuvieron una relación estadísticamente significativa (OR: 1.71 I= C: 1.12-2-59 p: <0,001), concordando con Azevedo et al (2015), donde madres menores de 15 años, fueron consideradas como grupo de riesgo presentado un = (OR 1.22 IC. 95% 1.01-1.49 p: < 0.029), Mendoza et al (2016) menciono la raz= ón de momios de 1.57 IC: 1.29-1.87 p <0.001, cuyos grupos de edad entre 13 = y 19 años y madres entre 14 a 19 y 35 a 50 años presentaron un OR de 4.2 IC 2.77= -6.40 p < 0.001.

<= span class=3DA11>El aspecto de controles prenatales, se encontró una relación estadísticamente significativa con el numero de controles prenat= ales (menores a 5) (OR de 0.97, IC de 0.63-1.47 p=3D0.88), mientras que Mendoza = et al (2016)., evidenciaron que la mala adherencia a controles prenatales present= ó un OR 1.55 IC 1.29-1.87, p: < 0.001.

En cuanto al retardo del crecimiento intrauterino, Mendoza et al (2016)., demostrando mediante estudi= os de casos y controles en una población de 11811 madres gestantes Qué es la restricción de crecimiento intrauterino se relaciona directamente con factor para el nacimiento prematuro (OR 1.91 IC 1.09-3.32 p < 0.023), empatizando= con nuestra investigación la cual dio como resultado  el OR 4.89 IC 3.17-7.55 p 0.000, quedan= do comprobado estadísticamente que va en asocio con la prematuridad.

El embarazo múltiple analizado con los estudios de Leal et al (2016), En Brasil con 23940 madres indicaron que el embarazo múltiple fue un factor fuerte asociado a la prematuridad, (OR 16.42 IC 10.56-25.53). En concordancia con nuestra investigación, puesto que encontramos una relación estadísticamente significativa con embarazo múltiple y prematuridad (OR 2.79 IC 1.45-5.34 p 0.001)=

En la ruptura prematura de membranas, no se encuentra relación entre RPM y pre= maturos (OR 1.65 IC 0.95-2.86 p 0.07), contrariamente con los estudios realizados p= or Rodríguez, Ramos y Hernández (2013) encontrando relación estadísticamente significativa entre la variable a investigar y el parto prematuro (OR 1.67 = IC 1.25-2.24 p < 0.0005).

Los trastornos hipertensivos de la gestación, en la población de estudio dan resultados de  OR 1.81 IC 95 % 1.08-3.03 p 0.02 en relación con nacer prematuro, estudios que concuerdan con Ahumada y Barrios (2016) en los estudios realizados en la ciudad de Lima, Perú, dentro de los estudios de caso y controles reveló que la preeclampsia= es realmente un factor asociado a prematuridad (OR 1.9 p < 0.005).

La infección de vías urinarias en nuestra investigación, si las madres  padecen una infecció= n de tracto urinario en la gestación no se determinó como un factor relacionado a parto prematuro (OR 1.11 IC 0.74-1.67 p 0.59), en contrapunto con la investigación realizada por Rodríguez et al (2013), si encontraron relación  estadísticamente signific= ativa entre la infección de vías urinarias y la prematuridad (OR 3.63 IC al 9%% 2.67-4.92 p < 0.0001)

Conclusiones.

·         La mayoría de las madres del estu= dio, se auto consideraron como mestizas, ubicándose en el rango de edad entre 20= a 24 años, seguidas de las madres adolescentes, además se conoció qué más de = la mitad de las mujeres poseen instrucción secundaria y su residencia está en = la zona urbana.

·         Dentro del análisis del estudio se conoce que la prevalencia de prematuridad en los neonatos fue de 29.5%.

·         En cuanto al análisis estadístico= , no se encontraron relación con las variables: número de controles prenatales, ruptura prematura de las membranas e infección de las vías urinarias, la relación que presenta una variación estadística significativa se da con la prematuridad y factores como edad del menor a 19 años y mayores a 35 años, trastornos hipertensivos, restricción del crecimiento intrauterino y embara= zo múltiple.

·         Dentro de las características que= se pueden Resaltar de los recién nacidos prematuros fueron que más de la mitad= son de sexo masculino, en cuanto a la edad gestacional los neonatos tardíos alcanzaron un 70.5% y en contraposición con la relación del peso con edad gestacional fue de 79.5%

 

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            <= /b>

 

PARA CITAR EL ARTÍCULO INDEXADO.

 

 

<= span style=3D'font-size:10.5pt;line-height:115%;font-family:"Helvetica",sans-ser= if; color:#333333;background:white'>Suin Guaraca, F. A., Suriaga Ramírez, K. V., Cordero Torres, P. E., & Siguencia Astudill= o, H. F. (2020). Prevalencia de prematuridad y factores de riesgo asociados en re= cién nacidos, ingresados en el área de neonatología del Hospital Vicente Corral Moscoso, 2011-2015. Anatomía Digital3(2.1.), 18-3= 1. https://doi.org/10.33262/anatomiadigital.v3i2.1.1255

 

 


 

 

 

El artículo que se publica es de exclusiva responsabilidad de los autores y no necesariamente reflejan el pensamiento de la Revista Anatomía Digital.

 

El artículo qu= eda en propiedad de la revista y, por tanto, su publicación parcial y/o total en otro medio tiene que ser autorizado por el director de la Revista Anatomía Digital.

 

 

 

 

 



[1] Red Complementaria de Salud, Cuenca Ecuador. alejandrosuin@hotmail.com, ORCID ID 0000-0002-8093-0413.

[2] Red Complementaria de Salud, Cuenca Ecuador, katulina11@gmail.com, ORCID ID 0000-0001-6158-3092

3 Unidad Provincial del Seguro Social Campesino Morona Santiago Ecuador, pamitacordero_26@hotmail.com, ORCID ID 0000-0002-3672-1374

4 Tratante área de Neonatología Hospit= al Vicente corral Moscoso. fabian.siguencia@u= cuenca.edu.ec, ORCID ID 0000-0001-5719-0878<= /p>

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www.anatomiadigital.org

                                                 =                                                                       ISSN: 2697-3391

                                                 =                                           Vol. 3, N°2.1, p. 18-31, julio, 20 20

 

Investigación Social               =                                                                                             =                                Página 10<= /span>

 

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