Objetivo: Evaluar la asociación entre la calidad del sueño y la depresión perinatal en gestantes que cursan entre la semana de gestación 12 y la semana de gestación 36 en un centro materno infantil de Lima . Materiales y Métodos: Estudio transversal analítico en gestantes atendidas en un centro de atención primaria entre agosto y diciembre del año 2019 . Los datos se recogieron mediante una encuesta auto aplicada. Se empleó el Índice de calidad del sueño de Pittsburgh (PSQI) para la evaluación de la calidad de sueño. La evaluación de la depresión perinatal fue con la escala de Depresión Postnatal de Edimburgo (EPDS). Para el análisis multivariado se utilizó la regresión de Poisson con varianzas robustas a fin de calcular las razones de prevalencia crudas y ajustadas y sus respectivos intervalos de confianza. Resultados: Se incluyeron 200 participantes. La mediana de la edad fue de 26 años (RIQ :22-32) y 111 (55.5%) gestaciones fueron no planificadas. El 52% presento una mala calidad de sueño y el riesgo de depresión perinatal fue del 31.5%. La mala calidad de sueño se asoció con una frecuencia significativamente mayor de depresión perinatal. ( RPa de 4.8 para aquellas con mala calidad de sueño que merece atención médica presentaron , RPa de 6.6 para aquellas con mala calidad de sueño que merece atención y tratamiento médico). Conclusiones : Existe una asociación entre la mala calidad del sueño y la depresión perinatal en gestantes entre las semanas 12 y 36 de gestación. Se debe promover investigaciones operativas a fin de evaluar si intervenciones para mejorar la calidad del sueño podrían tener un impacto positivo en la reducción de la depresión perinatal. / Objective: Evaluate the association between sleep quality and perinatal depression in pregnant women between the 12th week of gestation and the 36th week of gestation in a maternal and child center in Lima. Materials and Methods: Analytical cross-sectional study in pregnant women cared for in a primary care center between August and December 2019. The data were collected through a self-administered survey. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The evaluation of perinatal depression was with the Edinburgh Postnatal Depression Scale (EPDS). For the multivariate analysis, Poisson regression with robust variances was used to calculate the crude and adjusted prevalence ratios and their respective confidence intervals. Results: The sample was composed of 200 participants. The median age was 26 years (IQR: 22-32) and 111 (55.5%) pregnancies were unplanned. 52% presented a poor quality of sleep and the risk of perinatal depression was 31.5%. Poor quality of sleep was associated with a significantly higher frequency of perinatal depression. (RPa of 4.8 for those with poor quality of sleep that deserves medical attention and RPa of 6.6 for those with poor quality of sleep that deserves medical attention and treatment). Conclusion: There is an association between poor sleep quality and perinatal depression in pregnant women between weeks 12 and 36 of gestation. Operational research should be promoted to assess whether interventions to improve sleep quality could have a positive impact on reducing perinatal depression. / Tesis

En el presente informe, el autor analiza los problemas que se desprenden de los hechos señalados en la sentencia del Tribunal Constitucional. Entre estos, se encuentran la determinación del tipo de relación contractual existente entre la demandante y la entidad demandada, con énfasis en la dicotomía entre la contratación de naturaleza civil y laboral, y la existencia de un despido nulo, así como la delimitación de su tipología y posibles efectos ante una confusión o mal uso de la misma en la institución de la carga de la prueba. Para alcanzar el objetivo, se utilizan diversas fuentes doctrinarias, así como una pluralidad de instrumentos normativos, como la legislación nacional, la Constitución y el marco internacional referido a los Convenios de la Organización Internacional del Trabajo. Respecto de las conclusiones del trabajo, resulta posible afirmar la existencia de elementos de subordinación que acrediten la naturaleza laboral del contrato de la demandante; sin embargo, el análisis ofrecido en la sentencia es bastante acotado, toda vez que se limita a mencionar el elemento probatorio referido al horario de refrigerio, pero no desarrolla el nexo existente entre los hechos y el derecho ni brinda otros criterios para reforzar su postura. De igual forma, parece existir una confusión en las tipologías de despido nulo adscritas al caso, porque se determina la existencia de un despido discriminatorio por razón de sexo, a pesar de la existencia de regulación legislativa del despido por motivo de embarazo, lo cual deviene en efectos importantes en cargas probatorias. / In this report, the author analyses the problems arising from the facts stated in the judgment. Among these are the determination of the type of contractual relationship existing between the plaintiff and the defendant, with emphasis on the dichotomy between civil and labour contracting, and the existence of a null dismissal, as well as the delimitation of its typology and possible effects in the face of confusion or misuse in the institution of the burden of proof. In order to achieve this objective, various doctrinal sources are used, as well as a plurality of normative instruments, such as national legislation, the Constitution and the international framework referring to the Conventions of the International Labour Organisation. With regard to the conclusions of the work, it is possible to affirm the existence of elements of subordination that accredit the labour nature of the plaintiff's contract; however, the analysis offered in the judgement is quite limited, since it is limited to mentioning the evidentiary element referring to the refreshment schedule, but does not develop the existing link between the facts and the law, nor does it offer other criteria to reinforce its position. Similarly, there seems to be confusion in the typologies of null dismissal ascribed to the case, because it determines the existence of a discriminatory dismissal on grounds of sex, despite the existence of legislative regulation of dismissal on grounds of pregnancy, which results in significant effects on the burden of proof.

Made available in DSpace on 2016-01-26T12:51:15Z (GMT). No. of bitstreams: 1 katiajairagalisteu_dissert.pdf: 6806647 bytes, checksum: ab1b8f140157ecb1f877fc0e8939bf8b (MD5) Previous issue date: 2007-06-22 / The aim of our study was to assess toxoplasmosis frequency and its risk factors in pregnant women and their newborns from São Paulo State Northwest region. From two thousand and a hundred pregnant women, 232 patients were screened in the referral outpatient clinics of two Health Units in São José do Rio Preto, between June 2005 and March 2006. Serological analysis was performed by the IgG indirect hemagglutination assay. The 133 positive pregnant women were also evaluated by the IgG-avidity test followed by ELISA assays for IgM and IgG for their newborns. The transmission risk factors were accomplished by interview. The independence among rates was determined by the Chi-Square method and odds ratio test with a 5% significance level. The obtained data showed 57.3% of IgG reagent pregnant women, all of them providing highly IgG-avidity results. The newborns showed positivity to IgG but they were all negative to IgM. Our data suggest that the transmission of this protozoan occurs in the studied area. However, we could not demonstrate congenital transmission. Ingestion of water from public reservoirs and unpasteurized milk were considered to be risk factors to toxoplasmosis in the Northwest region of São Paulo State. Due to the Toxoplasma gondii ascertained transmission, serological accompaniment of pregnant women it is highly recommended. / Os objetivos deste trabalho foram avaliar a freqüência de toxoplasmose e os fatores de risco associados em grávidas e seus neonatos do Noroeste Paulista. Das 2.100 gestantes atendidas em ambulatórios de referência nas duas Unidades de Saúde de São José do Rio Preto, no período de junho de 2005 a março de 2006, foram triadas 232 mulheres grávidas e realizado exame sorológico para a pesquisa de IgG por meio do teste de Hemaglutinação indireta. Destas, 133 grávidas forneceram resultado positivo, as quais foram também avaliadas pelo teste de avidez para IgG. Posteriormente, os neonatos foram investigados quanto a presença de IgM e IgG pelo teste de ELISA. O levantamento dos fatores de risco na transmissão da toxoplasmose foi realizado por entrevista. A independência entre as proporções foi determinada pelo método do teste Qui-Quadrado e o teste de razão de chances. O nível de significância adotado foi de 5%. Os resultados demonstraram que 57,3% eram IgG reagentes. Todas as grávidas positivas apresentaram alta avidez para IgG. Os recém-nascidos mostraram positividade para IgG, entretanto, foi observada negatividade para a pesquisa de IgM. A transmissão do protozoário ocorre na região, no entanto, a transmissão congênita não foi evidenciada. A água de consumo e o leite não-pasteurizado estão associados a essa infecção no Noroeste Paulista. O acompanhamento sorológico para o T. gondii, durante todo o pré-natal, é de extrema importância.

Objetivos: Conocer las experiencias de maternidad en mujeres peruanas adultas del nivel socioeconómico medio-alto que fueron madres en su adolescencia. Material y método: Estudio cualitativo desarrollado con 9 mujeres peruanas adultas que fueron madres en su adolescencia y cuyas edades estuvieron comprendidas entre los 42 a 46 años. Se aplicó la estrategia de la entrevista no estructurada y la información recolectada fue analizada utilizando la técnica del análisis temático. Resultados: Los principales hallazgos revelan que las participantes construyen en la actualidad una imagen de madres resilientes, protectoras y valientes. Esto se ha logrado, según refieren, porque en el proceso del embarazo y la crianza de sus hijos vivenciaron acontecimientos que cambiaron su vida: se casaron, dejaron de estudiar y tuvieron que asumir, en algunos casos, el rol de la figura paterna. Por otra parte, las mujeres reconocen que pensamientos y emociones como la inseguridad, desconfianza y tristeza han estado presentes en el inicio de su maternidad y fueron importantes para afrontar el cuidado de sus hijos. Conclusiones: Ser madre en la adolescencia, aún en contextos socioeconómicos medio y alto, está sujeta a dificultades personales y familiares. A pesar de estas circunstancias, las mujeres que participaron en el estudio han enfrentado la maternidad en su adolescencia y construyeron una figura de madres resilientes. En el inicio de la maternidad se reconocen pensamientos y emociones que fueron afrontándose en la medida que se construía el vínculo del cuidado con sus hijos. / Aim: Become aware of the maternity experiences of Peruvian adult women of the medium-high socioeconomic level who become mothers in their adolescence. Material y method: Qualitative research conducted on 9 Peruvian adult women who became mothers in their adolescence whose age ranged from 42 to 46 years. The unstructured interview strategy was applied, and the findings were analyzed using the thematic analysis technique. Results: The main findings reveal that the participants currently build an image of resilient, protective and courageous mothers. This has been achieved, according to them, because during pregnancy and their offspring upbringing they experienced events that changed their lives: they got married as well as the need to interrupt their studies and assume in some of the cases the role of both parents in the absence of a father figure. Otherwise, women identify that thoughts and emotions such as insecurity, mistrust and sadness had been since the beginning of their maternity and were important to cope with the care of their children. Conclusions: Even in medium and high socioeconomic contexts, being a mother in adolescence mean to confront emotional, family and professional difficulties. Despite the circumstances, the women who participated in the study had been coping with maternity in their adolescence and they built a resilient mother figure. At the beginning of their maternity thoughts and emotions were recognized as women had been coping with it while they were building a family bond care with their children. / Tesis

Introducción: Al tener una disfunción del suelo pélvico aumentan las probabilidades de desarrollar incontinencia urinaria o prolapso genital. Estas condiciones, a su vez, podrían generar una infección del tracto urinario (ITU). En la población de mujeres embarazadas, la disfunción del suelo pélvico ocurre principalmente por la carga de peso del vientre, el cual podría ser una causa de la ITU. Objetivo: Determinar la asociación entre la disfunción del suelo pélvico y la ocurrencia de la ITU en gestantes. Métodos: Estudio observacional de tipo transversal analítico. La población fueron gestantes entre 18 a 35 años de 5 centros de salud en Lima. La disfunción del suelo pélvico se evaluó con el cuestionario The Pelvic Floor Inventories Leiden (PeLFIs) dividiéndose en 3 componentes: sensación de flacidez, patrón de orina e incontinencia urinaria. La ITU se midió incluyendo una sección en el cuestionario abarcando 3 preguntas. Las variables edad, actividad física, ocupación y peso fueron incluidas en la sección de preguntas generales dentro del cuestionario. Resultados: En total fueron 146 gestantes encuestadas que cumplieron criterios de selección. La prevalencia de ITU durante el embarazo fue de 42.5%. Las gestantes con ITU durante el embarazo tienen un puntaje mayor en los componentes de sensación de flacidez (p=0.036), patrón de orina (p=0.001) e incontinencia urinaria (p=0.011). Conclusión: Luego de ajustar las variables confusoras se determinó que existe asociación entre los 3 componentes de disfunción del suelo pélvico y la ITU, ya que la mayoría de las gestantes tuvieron tratamientos contra la ITU para no perjudicar su embarazo. / Introduction: Upon occurrence of a pelvic floor dysfunction, the chances of developing urinary incontinence or vaginal prolapse increase. Such conditions, in turn, may lead to a urinary tract infection (UTI). In pregnant women, the pelvic floor dysfunction mainly occurs due to the weight of the womb, which could be a cause of the UTI. Objective: To determine the association between the pelvic floor dysfunction and the occurrence of UTI in pregnant women. Methods: Observational research of analytical cross-sectional type. The population included pregnant women between 18 to 35 years old from 5 health centers of Lima. The pelvic floor dysfunction was assessed through the questionnaire “The Pelvic Floor Inventories Leiden” (PelFIs), and it was divided into three components: vaginal swelling, urination pattern, and urinary incontinence. The UTI was measured based on three questions in a section of the questionnaire. Variables such as age, physical activity, occupation, and weight were included in the section of general questions within the questionnaire. Results: A total of 146 pregnant women surveyed met the selection criteria. The prevalence of UTI during pregnancy was 42.5 %. The pregnant women suffering from UTI during the pregnancy period show a higher score in the components of vaginal swelling (p=0.036), urination pattern (p=0.001), and urinary incontinence (p=0.011). Conclusion: After adjusting the confounding variables, it was determined that there is no association between the three components of the pelvic floor dysfunction and the UTI since most of the pregnant women followed treatments against UTI to avoid any harm during pregnancy. / Tesis