ABSTRACT
RESUMEN Fundamento: El afrontamiento de la maternidad en la adolescencia tiene serias implicaciones para la vida de la madre y su descendencia. Es un proceso en el que influyen diversos factores sociales, culturales, económicos y biológicos. Objetivo: describir la relación entre factores socioculturales y la decisión del tipo de parto en adolescentes ecuatorianas. Métodos: estudio descriptivo, de corte transversal. Se estudiaron 574 adolescentes de la ciudad de Machala, Ecuador, en el año 2016, aplicando una encuesta personal. Se estableció en este grupo de adolescentes la relación entre la decisión del tipo de parto con las variables edad, residencia, paridad, religión e instrucción; y se definió la asociación estadística derivada de estas relaciones. Resultados: la mayor preferencia fue hacia el parto transpelviano, con un 82,4 %. El 70,2 % de las féminas perteneció a áreas urbanas, y el 66,2 % de ellas no tenía partos previos. La mayoría de las jóvenes decidió tener un parto transpelviano, a pesar del razonamiento expuesto referente a diferentes factores socioculturales. Hubo relación estadística significativa entre el razonamiento y la decisión. Conclusión: los aspectos socioculturales abordados no influyen en la toma de la decisión del tipo de parto que desean las adolescentes ecuatorianas; más bien, su decisión puede orientar hacia problemas de otra índole. Solo las creencias religiosas y el razonamiento que sirvió de base a la elección, se manifestaron como factores influyentes.
ABSTRACT Foundation: Confronting motherhood in adolescence has serious implications for the life of the mother and her descendant. It is a process influenced by various social, cultural, economic and biological factors. Objective: to describe the relationship between sociocultural factors and the decision of the type of delivery in Ecuadorian adolescents. Methods: cross- descriptive, study. A number of 574 adolescents were studied from the city of Machala, Ecuador, in 2016, applying a personal survey. The relationship between the decision of the type of delivery with the variables age, residence, parity, religion and instruction was established in this group of adolescents; and the statistical association derived from these relationships was defined. Results: the greater preference was towards trans-pelvic childbirth, with 82.4%. 70.2% of the adolescents belonged to urban areas, and 66.2% of them did not have previous births. The majority of them decided to have a trans-pelvic childbirth, despite the reasoning given regarding different sociocultural factors. There was a significant statistical relationship between the reasoning and the decision. Conclusion: the sociocultural aspects addressed do not influence the decision of the desired type of delivery; rather, their decision may lead to problems of another kind. Only religious beliefs and reasoning that served as the basis for the election were manifested as influential factors.
ABSTRACT
Abstract Background: Cardiovascular diseases are the leading cause of mortality and long-term disability worldwide. Various studies have suggested a protective effect of lactation in reducing the risk of cardiovascular diseases. Objective: This study was designed to assess the effects of pregnancy and lactation on the vulnerability of the myocardium to an ischemic insult. Methods: Eighteen female rats were randomly divided into three groups: ischemia-reperfusion (IR), in which the hearts of virgin rats underwent IR (n = 6); lactating, in which the rats nursed their pups for 3 weeks and the maternal hearts were then submitted to IR (n = 6); and non-lactating, in which the pups were separated after birth and the maternal hearts were submitted to IR (n = 6). Outcome measures included heart rate (HR), left ventricular developed pressure (LVDP), rate pressure product (RPP), ratio of the infarct size to the area at risk (IS/AAR %), and ventricular arrhythmias - premature ventricular contraction (PVC) and ventricular tachycardia (VT). Results: The IS/AAR was markedly decreased in the lactating group when compared with the non-lactating group (13.2 ± 2.5 versus 39.7 ± 3.5, p < 0.001) and the IR group (13.2 ± 2.5 versus 34.0 ± 4.7, p < 0.05). The evaluation of IR-induced ventricular arrhythmias indicated that the number of compound PVCs during ischemia, and the number and duration of VTs during ischemia and in the first 5 minutes of reperfusion in the non-lactating group were significantly (p < 0.05) higher than those in the lactating and IR groups. Conclusion: Lactation induced early-onset cardioprotective effects, while rats that were not allowed to nurse their pups were more susceptible to myocardial IR injury.
Resumo Fundamento: As doenças cardiovasculares são a principal causa de mortalidade e invalidez a longo prazo a nível mundial. Diversos estudos têm sugerido um efeito protetor da lactação na redução do risco para doenças cardiovasculares. Objetivo: Este estudo foi desenvolvido para avaliar os efeitos da gestação e da lactação sobre a vulnerabilidade do miocárdio ao insulto isquêmico. Métodos: Dezoito ratas foram divididas aleatoriamente em três grupos: isquemia-reperfusão (IR), no qual os corações de ratas virgens foram submetidos à IR (n = 6); lactantes, no qual as ratas amamentaram seus filhotes por 3 semanas e os corações maternos foram, em seguida, submetidos à IR (n = 6); e não lactantes, no qual os filhotes foram separados após o nascimento e os corações maternos foram submetidos à IR (n = 6). As medidas de desfecho incluíram frequência cardíaca (FC), pressão desenvolvida no ventrículo esquerdo (PDVE), duplo produto (DP), razão do tamanho do infarto sobre a área sob risco (TI/ASR %) e arritmias ventriculares - contração ventricular prematura (CVP) e taquicardia ventricular (TV). Resultados: O TI/ASR foi substancialmente menor no grupo de lactantes quando comparado ao grupo de não lactantes (13,2 ± 2,5 versus 39,7 ± 3,5, p < 0,001) e ao grupo IR (13,2 ± 2,5 versus 34,0 ± 4,7, p < 0,05). A avaliação das arritmias ventriculares induzidas pela IR indicou que o número de CVPs compostas na isquemia, e o número e a duração das TVs na isquemia e nos primeiros 5 minutos de reperfusão no grupo de não lactantes foram significativamente (p < 0,05) mais elevados do que os encontrados nos grupos IR e de lactantes. Conclusão: A lactação induziu o aparecimento precoce de efeitos cardioprotetores, enquanto ratas que não foram permitidas a amamentar seus filhotes se mostraram mais suscetíveis à lesão miocárdica por IR.
