Background: Group B Streptococcus (GBS) remains a leading cause of neonatal sepsis in high-income contexts, despite declines due to intrapartum antibiotic prophylaxis (IAP). Recent evidence suggests higher incidence in Africa, where IAP is rare. We investigated the global incidence of infant invasive GBS disease and the associated serotypes, updating previous estimates. Methods: We conducted systematic literature reviews (PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Literature [LILACS], World Health Organization Library Information System [WHOLIS], and Scopus) and sought unpublished data regarding invasive GBS disease in infants aged 0-89 days. We conducted random-effects meta-analyses of incidence, case fatality risk (CFR), and serotype prevalence. Results: We identified 135 studies with data on incidence (n = 90), CFR (n = 64), or serotype (n = 45). The pooled incidence of invasive GBS disease in infants was 0.49 per 1000 live births (95% confidence interval [CI], .43-.56), and was highest in Africa (1.12) and lowest in Asia (0.30). Early-onset disease incidence was 0.41 (95% CI, .36-.47); late-onset disease incidence was 0.26 (95% CI, .21-.30). CFR was 8.4% (95% CI, 6.6%-10.2%). Serotype III (61.5%) dominated, with 97% of cases caused by serotypes Ia, Ib, II, III, and V. Conclusions: The incidence of infant GBS disease remains high in some regions, particularly Africa. We likely underestimated incidence in some contexts, due to limitations in case ascertainment and specimen collection and processing. Burden in Asia requires further investigation.

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Infant Group B Streptococcal Disease Incidence and Serotypes Worldwide: Systematic Review and Meta-analyses.

Introduction: It is well known that extreme age pregnancy can affect the newborn, maternal age blaming of some perinatal complications, however there are few studies that investigate the pregnancies in this age group so it will be investigated in this study what happens in pregnancies of teenage mothers in a Lima Hospital. Material and Methods: Through a cross-sectional retrospective descriptive observational study attempted to determine perinatal complications in newborns of adolescent mothers (10 -19 years) in the National Hipolito Unanue Hospital.20112012. We worked with a statistical significance level p <0.05. Getting the cumulative percentage We used SPSS version 17. Results: There were a total of 392 births in adolescents with a mean age of 18.6 years, 2.6% of them (10) belonging to early adolescence. Preterm delivery occurred in 9.18%, the rate of cesarean section was 27.3%, 22.4% of infants weighing between 2500g and 3999g and 2500g less than 7.9%, was also obtained by often the following conditions, suspected early neonatal sepsis 62 (47.3%), jaundice pathological 41 (31.2%), bowel obstruction 16 (12.2%), congenital anomalies 8 (6.1%), hydrocephalus 4 (3%), moderate depression 24 (6%) severe depression 16 (4%). Conclusions: In this study of all infants born to teenage mothers, 30% had low birth weight (<2500 g), 47% showed clinical signs of suspected early neonatal sepsis and 31% attended with pathologic jaundice, 6% moderate depression, 4% severe depression.

Tesis para optar el título profesional de médico cirujano

Objetivo: Determinar la prevalencia de actividad sexual (AS) y factores asociados del debut sexual en adolescentes escolarizados de una ciudad colombiana. Metodos: Estudio observacional, de corte transversal, con 947 estudiantes de 14 a 19 anos. Las asociaciones se determinaron mediante Odds Ratio con 95% de intervalo de confianza. Para el analisis multivariado se empleo regresion logistica. Resultados: La prevalencia de AS fue 52,8%. La mediana de edad de inicio fue 15 anos (RI: 14-16). Las variables asociadas al inicio temprano de la AS para el nivel individual fueron: sexo masculino, aprobacion y actitudes permisivas hacia el sexo del adolescente, consumo de licor, tabaco y drogas. Para el nivel familiar fueron: madre no da educacion sexual al hijo, hermano/a que en la adolescencia hayan sido padre/madre, aprobacion y actitudes permisivas de los padres hacia el sexo en la adolescencia. Para el nivel socio-cultural fueron: como factores de riesgo el pertenecer a los estratos socioeconomicos 1 y 2, aprobacion y actitudes permisivas de los pares o grupo de amigos del adolescente a la AS en la adolescencia, y como factor protector el haber recibido educacion en anticoncepcion por personas diferentes a los padres, como equipos de educacion en colegios o personal de salud. Conclusion: Factores individuales como sexo masculino, propia toma de decisiones, papel que desempena la madre en la educacion sexual de sus hijos y la influencia de pares o amigos en la toma de decisiones, se asociaron con el inicio temprano de la AS entre adolescentes.

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Factores asociados al inicio de la actividad sexual en adolescentes de Tuluá, Colombia

Background: Sexually transmitted infections and pregnancy in adolescents are acknowledged public health problems in many countries. Although it is known that the proper use of condoms allows avoiding these health problems, their use in Chile is still limited, for unknown reasons. Objective: Based on planned behavioural theory, the aim was to validate a behaviour model regarding condom use by measuring the influence of the variables that predict this use among Chilean university students. Methods: A cross-sectional descriptive study was carried out in October 2016 among 151 Chilean university students belonging to the health and engineering areas. The information was collected through a self-administered survey. The sample was divided into two groups: stable and not stable relationships. Partial least squares (PLS) regression was used for the analysis. Results: It was possible to explain the condom use of the students by 57%. The attitude was the main variable related to the intention of using condoms, together with the perceived behavioural control. Additionally, there are statistically significant differences in the variables that predict condom use among students with stable relations compared to those without a stable relationship. Conclusions: The planned behavioural theory is useful for predicting condom use behaviour when students have a stable partner.

Predicting Condom Use among Undergraduate Students Based on the Theory of Planned Behaviour, Coquimbo, Chile, 2016

This article presents the revision and analysis of several studies that address the categories behaviors and unsafe sex to engage in a reflection of the main findings under the gender perspective. On this basis, points of divergence and convergence of research were established, leading to a reflective dialogue that suggests the recognition of social and historically constituted power relations, their impact on social reality and the relationship between contemporary men and women. Finally conclusions are presented reflecting meanings attributed to femininity, masculinity, body and sexuality, which is exposed as an invitation to consider the approach to address intervention programs that promote health and reproductive rights of young people.

http://www.scielo.org.co/pdf/psdc/v31n2/v31n2a08.pdf

Prácticas y conductas sexuales de riesgo en jóvenes: una perspectiva de género

SUMMARY Background: Adolescent pregnancy is a public health problem because of the consequences for mother and child. Objective: To determine the characteristics and risks in adolescent mothers and their children's (anthropometry, birth status, morbidity and mortality) compared with a group of older mothers 20-34 years and control their children. Methods: Prospective cohort study with 379 children and 928 adult female adolescents. Data were analyzed using median, mean and dispersion measures, tests unpaired t-test or Wilcoxon rank-sum (Mann-Whitney test), ANOVA or Kruskal-Wallis, Chi2 or Fisher's exact, relative risk and attributable risk percentage exposure with confidence intervals of 95%. Results: Among adolescents there were more single mothers (25.6%), lower education and social health insurance (25.9%) (p<0.05). In early adolescents were more cases of preeclampsia (26.3%) and preterm labor (10.5%). Among teenage mothers, 30.9% of the children were premature, and had more heart disease, bacterial infections, syphilis, and congenital cleft lip and palate and higher mortality when compared with children of older mothers (p<0.05). Conclusions: Teenage motherhood carries greater health risks to themselves and their children, increasing

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Hijo de madre adolescente: riesgos, morbilidad y mortalidad neonatal

Antecedentes: El inicio de Ia actividad sexual en adolescentes, esta asociada a pobre planificacion familiar (PF), mayor tasa de fecundidad y riesgo de adquisicion de enfermedades de transmision sexual (ETS). Objetivo: Evaluar el impacto sobre la fecundidad, planificacion familiar y lesiones de cuello uterino en una poblacion de adolescentes y jovenes, que iniciaron actividad sexual en la adolescencia. Metodo: Estudio de cohorte retrospectiva. Incluyo 845 adolescentes y jovenes que iniciaron actividad sexual en la adolescencia y que consultaron a una Institucion Prestadora de Servicios de Salud en Tulua, Colombia. El analisis incluyo estadisticas descriptivas, analisis de riesgo relativo (RR) y atribuible a la exposicion (RAexp) expresado en porcentaje, como indicadores de asociacion. Resultados: Hubo 203 adolescentes y 642 jovenes. El promedio de edad de inicio de la actividad sexual fue 16 anos (±1,6 anos). El 49% no realizaba PF, 34,7% tenia ≥1 hijo y 6,9% alguna lesion en cuello uterino. Hubo asociacion entre actividad sexual en la adolescencia temprana y tener un hijo, al compararlo con el inicio de la actividad sexual en la adolescencia media (RR: 1,6; IC 95%: 1,2-2,1. RAexp0/35,7%; IC 95%: 13,3-52,4%) y tardia (RR: 2; IC 95%: 1,5-2,6. RAexp0/49%; IC 95%: 31,7-62%). Conclusiones: Nuestros resultados confirman el inicio precoz de la actividad sexual en adolescentes, el bajo uso de anticonceptivos y el riesgo de lesiones cervicales. Programas educativos conducentes al retraso del inicio de la actividad sexual, el uso de metodos anticonceptivos efectivos y de barrera, permitiran reducir las cifras encontradas en este estudio.

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Actividad sexual en adolescencia temprana: problema de salud pública en una ciudad colombiana

Objective:  To evaluate factors present on newborn admission to a neonatal intensive care and associated with a prolonged hospital stay.  Patients and Method:  Non-matched case-control study, with 555 infants, 111 with more than 7 days of hospital stay and 444 who stayed hospitalized between 1 and 7 days, between 2005 and 2010. Pre hospitalization maternal factors (age, pregnancy, health insurance, education, prenatal care, marital status, history of preeclampsia, prolonged rupture of membranes, chorioamnionitis infection) and neonatal ones (age at admission, gestational age, birth weight, gender, delivery practice, route of admission, Apgar and type of resuscitation) that were associated with prolonged hospital stay were analyzed. Analyses were conducted using STATA 11.0 and logistic regression in the multivariate analysis.  Results:  Maternal factors such as prenatal care with less than 5 doctor visits (AOR 2.7, 95% CI 1.3-5.5), lack of social health insurance (AOR 1.9, 95% CI 1.4-29), pregnant three or more times (AOR 1.7, 95% CI 1.1-2.7), neonatal birth weight under 2,000 g (AOR 4.2, 95% CI 1.9-9.5), need for cardiopulmonary resuscitation (AOR 4.2, 95% CI 2-9.1), gestational age less than 36 weeks (AOR 3.9, 95% CI 2-7.7) and admission to the neonatal unit through emergency room or referral from another hospital (AOR 2.8, 95% CI 1.7-4.6) were associated with hospital stays longer than 7 days.  Conclusions:  In-hospital complications that affect a prolonged stay at the health center were social health insurance, maternal education and prenatal care, and these should be considered in the evaluation of the hospital care quality indicators.

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Factores asociados a estancia hospitalaria prolongada en neonatos

A diagnostic predictive scale for urinary tract infection in febrile infants without an apparent focus Introduction: Urinary tract infection (UTI) is the most frequent bacterial infection in infants with nonspecific clinical manifestations. Objective: To validate a predictive scale for UTI in febrile infants without apparent source and hospitalized in a neonatal unit. Patients and Method: A nested case-control study was conduc-ted on 158 infants with febrile UTI, culture-confirmed, and on 346 febrile infants without apparent focus in whom UTI was ruled out, and also, hospitalized in a neonatal unit. The analysis was performed using Stata® 11. Associations were determined using odds ratio (OR) with 95% confidence interval. To find the predictive scale, multivariate analysis was performed using logistic regression and establishing major and minor criteria according to regression coefficient. Yield was calculated by sensitivity, specificity and area under ROC curve. The new predictive scale was validated by 108 new febrile neonates. Results: The major criteria to predict UTI were abnormal urinalysis and Gram positive cells without centrifugation, and among the minor criteria, male, age at time of fever, previous neonatal hospitalization, abnormal temperature (38.5°C or more, persistent fever, hypothermia) and 1.7 mg/dL C reactive protein or higher, resulting positive with the presence of one mayor or three minor criteria. It showed good performance with 100% sensitivity (CI 95%:98.3-100%), 92.3% specificity (CI 95%: 85.8-98.9%) and 0.962 area under ROC (95% CI: 0.932-0.991) when validated on 108 new febrile neonates without focus. Conclusions: The new predictive scale allows predicting UTI with good yield in infants with fever without an identified source.(Key words: Fever of unknown origin; neonate; urinary tract infection; predictive scale).Rev Chil Pediatr 2014; 85 (1): 52-63

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Escala predictiva diagnóstica de infección urinaria en neonatos febriles sin foco aparente

Introduction:  Hyaline membrane disease is an important cause of neonatal mortality. The objective of this research is to evaluate the efficacy of three different exogenous surfactants in premature infants.  Patients and Method:  A retrospective cohort analysis in 93 preterm infants  ≥  24 weeks and birth weight  ≥  500 g was performed, 31 infants for each surfactant. Exposure consisted of the 1st dose of bovactant (Alveofact ® ) 50 mg/kg, beractant (Survanta ® ) 100 mg/kg initially, and poractant alfa (Curosurf ® ) 200 mg/kg. The variables included duration of mechanical ventilation, duration of oxygen therapy, hospital stay, need for second dose of surfactant, adverse events surfactant administration and prematurity complications. Mortality and bronchopulmonary dysplasia (BPD) were evaluated. Statistical analysis was performed using Stata ®  11.0,  X 2  or Fisher exact test for qualitative variables and ALNOVA or Kruskal-Wallis tests for quantitative and association relative risk, all with 95% confidence level.  Results:  There were no gender, weight and gestational age differences at birth among the three groups. No statistically significant differences were found regarding duration of mechanical ventilation, duration of oxygen therapy, administration of a second dose of surfactant, hospital stay and complications among the three groups. Adverse events related to surfactant administration occurred for beractant and poractant alpha. There were 30 (32.3%) deaths, 8 (25.8%) associated to bovactant, 10 (32.3%) to beractant and 12 (38.7%) to poractant alpha (p > 0.05). Mortality and/or BDP occurred in 10 (32.2%) infants who received bovactant, 10 (32.2%) beractant and 14 (45.2%) with poractant alpha (p > 0.05).  Conclusions:  The primary and secondary outcomes among the three surfactants tested were similar, taking into account the limitations of the work.

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Martha Arias G

Papers

Hijo de madre adolescente: riesgos, morbilidad y mortalidad neonatal

Actividad sexual en adolescencia temprana: problema de salud pública en una ciudad colombiana

Factores asociados a estancia hospitalaria prolongada en neonatos

Escala predictiva diagnóstica de infección urinaria en neonatos febriles sin foco aparente

Eficacia de tres tipos de surfactante exógeno en prematuros con enfermedad de membrana hialina