Objectives: To determine frequency and perinatal outcomes of underweight newborns at Tacna Hipolito Unanue Hospital. Design: Retrospective, epidemiological case-control. Setting: Hospital Hipolito Unanue of Tacna, Peru. Population: We analyzed data of 3 622 live births in singleton pregnancies weighing 2 500 to 2 999 g, born during years 2001 to 2010, compared with 24 556 controls 3 000 to 3 999 g. Interventions: Bivariate analysis, using OR with 95% confidence intervals. Perinatal Data System was used. Main outcome measures: Characteristics and perinatal outcomes. Results: The frequency of underweight newborns was 10,77 x 100 live births, with downward trend during the ten years. Low birth weight was associated with female sex, prematurity, depression at one minute and five minutes after birth. Adverse perinatal outcomes were higher morbidity (OR=1,54) and neonatal mortality (OR=4,54); ...

Newborn (RN) twin is at high risk for morbidity and mortality. It is classified with intrauterine growth curves (CCIU) single fetuses, but no Peruvian curves for this group. To determine the intrauterine growth of a selected group of Peruvian twins and compare RN unique patterns. MATERIALS AND METHODS: Descriptive, transversal study for 13 years (1992-2004) in the Hipolito Unanue Hospital in Tacna, Peru. 518 twins, 282 twins (54%) was selected without factors qie altered intrauterine growth. averages, standard deviation and percentiles 10, 50 and 90 of weight, height and head circumference was found for gestational age of 32-41 weeks, which were corrected with second order polynomial. Average percentile values and unique curvy compared RN, were considered significant when p <0.05. RESULTS: Of 36 909 live births, 518 were twins, which was selected 282. The most representative group was 38...

Introduction: Fetal macrosomia is a risk factor for metabolic disorder and obesity in childhood and adulthood. Objectives: To determine nutritional status and metabolic disorders of children with history of fetal macrosomia in Tacna. Design: Prospective, descriptive and longitudinal study. Institution: Hipolito Unanue Hospital, Tacna, Peru. Patients: Fifty children 8 to 10 year-old born at Hipolito Unanue Hospital of Tacna, with history of birth weight over 4 500 grams were studied. Children with chronic diseases predisposing to overweight or obesity were excluded. Interventions: The nutritional status was assessed by current body mass index (BMI) according to age using World Health Organization charts; blood pressure was measured in millimeters of mercury and fasting serum sample was obtained for enzymatic methods analysis to assess glucose, triglycerides, total cholesterol, HD...

LA SALUD EN TIEMPOS DE COVID 19

OBJECTIVE: To identify Peruvian perinatal mortality risk factors at both population level (ENDES) and hospital level (SIP) and to determine their predictive value. DESIGN:Epidemiologic, analytical, case-control study using information from both the National Survey of Demography and Health (ENDES) and the Perinatal Computer System (SIP) of 9 hospitals of the Ministry of Health corresponding to the year 2000. MATERIAL AND METHODS: The study included mothers with gestations more than 28 weeks or newborns weíght above 1000g. We used rate per thousand births, odds ratio (OR) with 95% confidence intervals, population attributable risk percentage (RAP%), logistical and curved regression ROC (receiving operating characteristic). RESULTS: The rate of perinatal mortality in Peru in the year 2000 was 23, 1 per thousand births according to ENDES, similar to the 22,9 rate of the hospital study. END...

Objectives: To determine incidence and risk factors for underweight newborns at Hospital Hipolito Unanue of Tacna. Design: Retrospective, epidemiological case-control study. Setting: Hospital Hipolito Unanue, Tacna, Peru. Population: During years 2 001 to 2 010 we analyzed data of 3 622 live births weighing 2 500 to 2 999 g, from single pregnancies, compared to 24 556 controls weighing 3 000 to 3 999 g. Interventions: We performed bivariate analysis using confidence intervals OR 95%, and multivariate analysis with logistic regression. Perinatal Data System was used. Main outcome measures: Risk factors. Results: The frequency of underweight newborns was 10,77 x 100 live births. Risk factors were illiterate mother (OR=1,98), unmarried (OR=1,41), student (OR=1,4), adolescent (OR=1,38), malnourished (OR=1,84), primiparous (OR=1,35), absence (OR=1,41) or inadequate prenatal care (OR=1,55), hy...

OBJECTIVE: To determine intrauterine fetal growth curves in a selected group of Peruvian newborns. DESIGN: Descriptive, transversal study. SETTING: Ministry of Health hospitals, Peru. PARTICIPANTS: Live newborns. INTERVENTIONS: We enrolled successive live newborns attended during 2005, using Centro Latinoamericano de Perinatologia’s (CLAPHPO/HWO) standard weight and measuring techniques, gestational age by last menstrual period, excluding both maternal and fetal pathology, and determining smoking and maternal malnutrition. We used median, standard deviation, 10, 50 and 90 weight, height and cephalic perimeter percentiles. Curves were drawn and smoothed using third degree polynomial adjustment by Excel program. MAIN OUTCOME MEASURES: Intrauterine growth curves according to weight, height and cephalic perimeter. RESULTS: During 2005, 99 439 infants were born at Ministry of Health’s 29 ...

The perinatal mortality indicates the level of development and quality of health of the people and to measure the health of the conceptus during the last two months of fetal life and the first 6 days after birth. Peru has marked structural contrasts in Latin America and the Caribbean. The greatest differences are in the maternal mortality ratio (2.3 times) and less is 5 years (2 times), the perinatal mortality rate similar to the Latin American average. In the last fifteen years the proportion of neonatal mortality has increased, reaching 55% of infant mortality. In the first month of life, infants die mainly from suffocation, respiratory distress, infection or congenital malformation. L00% of neonatal deaths in 2002, 41% was the result of complications during delivery and immediate newborn care: 33%, complications related to pregnancy: 16%, complications in the first week of life and 10...

OBJECTIVES: To quantify the increase in small for gestational age (SGA RN) to use the intrauterine growth curves of Tacna, and study their risk factors. MATERlAL AND METHODS: 15 739 infants in the Hipolito Unanue Hospital in Tacna were studied, from 1994 to 1999, using intrauterine growth curves (CIU) by weight, Lubchenco and Tacna, and identifying RN PEG further, which is called " new PEG ", studying its risk factors. The Perinatal Information System, odds ratio and chi square test was used. RESULTS: RN large for gestational age (RN GEG) decreased 15.6% to 9.5%, appropriate for gestational age (RN AEG) remained at 83.2% and 81.3% and RN PEG increased from 1.2% to 9.2%; This change was statistically significant. There were 1448 RN-PEG using our curve and 189 when using Lubchenco. The difference in 1259 RN (8% of the total population) corresponds to the "RN new PEG". Their risk factors we...

OBJECTIVE: To determine small for gestational age (SGA) newborns when using the Peruvian intrauterine growth curves and to study their risk for morbidity and mortality. DESIGN:Prospective, analytical, case-control study. SETTING:Peruvian Ministry of Health hospitals. PARTICIPANTS: Live newborns. INTERVENTIONS: Ninety-five thousand seven hundred and fifty-one neonates from 29 Peruvian Ministry of Health hospitals born during 2005 were classified by applying both Lubchenco and Peruvian weight intrauterine growth curves. Percentage distribution was compared and significant differences was considered when p < 0,05. We studied additional SGA (named new SGA) newborns risks for morbidity and mortality in comparison with adequate for gestational age (AGA) newborns, from week 37 through 42, using odds ratio with 95% confidence interval. Perinatal System Informatic Data was used. MAIN OUTCOME MEAS...

Objective: To determine fetal growth according to maternal parity, height and origin, and newborn’s sex. Design: Prospective, transversal study. Setting: Peruvian Ministry of Health hospitals. Participants: Live newborns. Interventions: Enrolment of successive live newborns (LNB) without intrauterine growth restriction in 29 Peruvian Ministry of Health hospitals during 2005. We compared male and female LNB average weights -children from either primiparae or multiparae born in the coast, mountains and jungles-, by student t, considering significant differences when p < 0,05. Maternal height was correlated with LNB’s weight, height, cephalic perimeter and gestational age. Main outcome measures: Influence of fetal sex, maternal parity, height and natural region on intrauterine growth curves. Results: Selected 50 568 LNB males presented average weight 19 to 41 g higher than females and m...

Objetivo: Determinar si la edad materna, escolaridad y paridad influyen en el peso del recién nacido en Hospitales del Ministerio de Salud del Perú. Material y Métodos: Estudio retrospectivo, transversal, en 56 196 recién nacidos vivos de embarazo único de 37 a 42 semanas de gestación, sin factores que alteren el peso al nacer, nacidos en 29 hospitales del Ministerio de Salud del Perú en el año 2008. Se utilizó la base de datos del Sistema informático Perinatal (SIP2000). Se analizó relación de peso al nacer con edad materna, escolaridad y paridad. Se calculó peso promedio, desviación estándar, percentil 50 y proporción de categorías de peso del recién nacido (bajo, insuficiente, adecuado y alto). Se aplicó chi cuadrado y t de Student, para determinar asociación y comparación de medias respectivamente, considerando significativo cuando p < 0,05. Resultados: 19,4% fue...

Producto del análisis de la problemática en salud materno infantil en el país, los especialistas en el área perinatal, concluimos la necesidad de elaborar una herramienta importante para contribuir a la disminución de la morbimortalidad perinatal, principal problema de salud pública nacional. Este libro es una herramienta en perinatología útil para el diagnóstico clínico, dirigido a médicos, estudiantes de medicina y demas profesionales de la salud del área materno infantil. Es un breve bosquejo de las circunstancias y cuidados neonatales que se presentan en fotos clínicas de las diferentes experiencias hospitalarias de nuestro país.

Este libro sobre crecimiento intrauterino y neonatal en el Perú y sus implicancias en salud pública, es el resultado de una estrecha cooperación entre las Facultades de Medicina de la Universidad Nacional Jorge Basadre Grohmann de Tacna y la Universidad Nacional Mayor de San Marcos, con el financiamiento del Instituto Nacional de Salud para estudios de crecimiento intrauterino en el Perú. El propósito es presentar patrones de crecimiento intrauterino propios del país para una adecuada clasificación del estado nutricional de nuestros recién nacidos y su consecuente prevención de la malnutrición intrauterina y crecimiento postnatal del recién nacido de muy bajo peso.

Objetivos. Conocer la incidencia, supervivencia y factores de riesgo del recién nacido con extremo bajo peso (RNEBP) en el Hospital Hipólito Unanue, de Tacna (HHUT). Pacientes y Método. Estudio retrospectivo analítico de casos y controles. Se analizaron a todos los nacidos vivos de embarazo único, con peso al nacer menor de 1000 g, nacidos durante los años 2000 a 2014 en el HHUT. Se evaluó la incidencia y supervivencia por 100 nacidos vivos y se analizaron los factores de riesgo. Los casos fueron todos los recién nacidos con peso < 1000 g y los controles, todos los recién nacidos con peso entre 2500 y 3999 g. Se calculó el odds ratio (OR), con un intervalo de confianza del 95%. La información se obtuvo de la base de datos del Sistema Informático Perinatal. Resultados. De 49 979 recién nacidos vivos, 191 tuvieron peso < 1000 g; la incidencia de RNEBP fue 0,38 por 10...

Objetivo: Determinar la frecuencia, tasa de cesárea y riesgos de morbimortalidad del recién nacido a término precoz (RNTP). Material y métodos: Estudio observacional, retrospectivo, analítico. Se incluyó a neonatos únicos vivos a término, nacidos en el hospital Hipólito Unanue de Tacna durante los años 2000 a 2014 (n=45332). Se comparó a los nacidos a termino precoz de 37 a 38 6/7 semanas (n=11276), y los nacidos a termino completo de 39 a 41 6/7 semanas (n=34056). Se utilizó frecuencia y tasa por 100 nacidos vivos, odds ratio (OR) con  intervalos de confianza al 95% (IC 95%), regresión logarítmica y prueba “t” para muestrasindependientes. Se utilizó la base de datos del Sistema Informático Perinatal. Resultados: La frecuencia de nacidos a término precoz fue 22,5 por 100 nacidos vivos, con un crecimiento logarítmico significativo (p=0,03). Representó 24,9% de todo...

El conocimiento de la mortalidad perinatal es un hecho de gran importancia, por que nos proporciona una imagen del nivel de desarrollo y calidad de salud de los pueblos. Además, permite medir el estado de salud del producto de la concepción durante los dos últimos meses de vida intrauterina y los primeros 6 días de vida extrauterina. 

Cinco formas de proteger al personal de salud durante la crisis del COVID-19

LA SALUD EN TIEMPOS DE COVID 19

The perinatal mortality indicates the level of development and quality of health of the people and to measure the health of the conceptus during the last two months of fetal life and the first 6 days after birth. Peru has marked structural contrasts in Latin America and the Caribbean. The greatest differences are in the maternal mortality ratio (2.3 times) and less is 5 years (2 times), the perinatal mortality rate similar to the Latin American average. In the last fifteen years the proportion of neonatal mortality has increased, reaching 55% of infant mortality. In the first month of life, infants die mainly from suffocation, respiratory distress, infection or congenital malformation. L00% of neonatal deaths in 2002, 41% was the result of complications during delivery and immediate newborn care: 33%, complications related to pregnancy: 16%, complications in the first week of life and 10...