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Rev Invest Clin 2006; 58 (5)
Idioma: Español
Referencias bibliográficas: 39
Paginas: 416-423
Archivo PDF: 62.07 Kb.
RESUMEN
Objetivo. Identificar los factores de riesgo asociados a lesiones originadas durante el nacimiento en recién nacidos.
Lugar. Servicio de Neonatología, Hospital General “Dr. Manuel Gea González”, SS.
Diseño. Casos y controles, prolectivo.
Pacientes. 129 casos y 134 controles.
Mediciones. Las variables estudiadas fueron,
a) maternas y del parto: edad, peso, talla, control prenatal, enfermedad previa o durante el embarazo, características del trabajo de parto, tipo de anestesia, aplicación de maniobras externas, uso de fórceps;
b) en el recién nacido: peso al nacer, edad gestacional, grado académico del médico que atendió el nacimiento y tipo de lesión.
Resultados. Los factores que se asociaron en forma independiente a la presentación de traumatismo al nacimiento fueron para
equimosis: anestesia general (RM 13.7, IC 95% = 3 – 62.6), presentación pélvica (RM 6.4, IC 95% =1.4 – 27.9 y edad gestacional ≤ 32 semanas (RM 6.4, IC 95% =1.3 – 31.1); para
laceración, nacimiento vaginal distócico o cesárea (RM 19, IC 95% = 4.4 – 81.1), y maniobras externas (RM 5.6, IC 95%= 1.5 – 21.6); para
cefalohematoma talla materna ≤ 1.54 m (RM 7.4, IC 95% = 2.3 – 23.7) y maniobras externas (RM 7.2, IC 95% = 2.2 – 23.7); para
caput succedaneum maniobras externas (RM 3.4, IC 95% = 1.5 – 7.7) y edad materna ≤ 19 o ≥ 36 años (RM 3.0, IC 95% = 1.4 – 6.4).
Conclusiones. Los factores de riesgo asociados a lesiones durante el nacimiento identificados en este estudio involucran tanto características maternas como del recién nacido y de la atención del parto.
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