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| Id: | 8695
| | Autor: | Tejada, Romina; Huayanay, Leandro; Gutiérrez, César; Velásquez, Carlos; Loarte, César. | | Título: | Asociación entre el estado de infección por VIH y complicaciones infecciosas poscesárea electiva^ies / Association between HIV infection status and infectious complications after cesarean section elective
| | Fuente: | Rev. peru. med. exp. salud publica;29(4):444-451, oct.- dic. 2012. ^btab.
| | Resumen: | Objetivos. Determinar la asociación entre VIH y complicaciones infecciosas (CI) después de una cesárea electiva. Materiales y métodos. Estudio de cohortes no concurrentes; se revisaron las historias clínicas de 237 cesáreas electivas en gestantes VIH reactivas atendidas en el Instituto Nacional Materno Perinatal de Perú, realizadas entre 2004 a 2012. Estas fueron pareadas por cirujano y fecha de cesárea con 237 gestantes VIH no reactivas. Se recogieron datos sociodemográficos, clínicos, características de la cesárea y relacionados a la infección por el VIH. Las CI se evaluaron según las recomendaciones del NHI Consensus Development Task Force. Se realizó el análisis bivariado con un nivel de significación del 5 por ciento y el cálculo del Odds Ratio (OR) con intervalo de confianza (IC) al 95 por ciento . Se construyó un modelo de regresión logística condicional. Resultados. El 13,9 por ciento de mujeres VIH positivas presentaron CI y 9,7 por ciento del grupo control (OR: 1,5 IC95 por ciento [0,9-2,7]); las expuestas (mujeres con VIH) tuvieron mayor probabilidad de tener una infección del tracto urinario (ITU) que las no expuestas (ORa: 4,5 IC95 por ciento [1,4-14,5]). Se encontró asociación entre CI y el tipo de incisión (ORa: 2,3 IC95 por ciento [1,1-4,5]) y el tiempo de hospitalización (6 frente a 3 días, p mayor 0,001). Conclusiones. Las mujeres VIH positivas sin tratamiento antirretroviral tuvieron mayor riesgo de CI; aunque no se observó mayor riesgo global de CI en expuestas después de una cesárea electiva. El principal factor de riesgo asociado a una CI poscesárea electiva en mujeres VIH positivas fue el tipo de incisión. (AU)^iesObjectives: To determine the connection between HIV and infectious complications (IC) after an elective C-section. Materials and methods. A non-concurrent cohort study was conducted, in which the clinical records of 237 elective C-sections on HIV-positive pregnant women who gave birth at the Instituto Nacional Materno Perinatal (National Maternal Perinatal Institute) between 2004 and 2012 were revised. The records were matched by surgeon and C-section date, with 237 HIV-negative pregnant women. Socio-demographic and clinical data were collected, along with characteristics of the C-section and data related to the HIV infection. IC were evaluated according to the NIH Consensus Development Task Force. The descriptive analysis and the bivariate analysis were carried out with a significance level of 5 percent for the hypothesis tests and the calculation of the Odds Ratio (OR) with a confidence interval (CI) at 95 percent. A conditional logistic regression model was built. Results. IC were present in 13.9 percent of HIV-positive women and 9.7 percent of the control group (OR: 1.5 CI95 percent [0.9-2.7]); those who were exposed (women with HIV) were more likely to have a urinary tract infection (UTI) than those who were not exposed (ORa: 4.5 CI95% [1.4-14.5]). A connection was found between the IC and the type of incision (ORa: 2.3 CI95 percent [1.1-4.5]) and time of hospitalization (6 versus 3 days, p mayor 0.001). Conclusions. Exposed women did not register a greater global risk of IC after an elective C-section; however, they were, indeed, more likely to get a UTI. Those HIV-positive women who were not receiving antiretroviral treatment were in greater risk of IC. The main risk factors associated with a post C-section IC in HIV-positive women were the type of incision, as well as the surgery time with the UTI. (AU)^ien.
| | Descriptores: | VIH
Complicaciones Infecciosas del Embarazo
Complicaciones Postoperatorias
- Embarazo
Cesárea
Estudios de Cohortes
| | Límites: | Humanos
Femenino
Embarazo
| | Medio Electrónico: | http://www.ins.gob.pe/insvirtual/images/artrevista/pdf/rpmesp2012.v29.n4.a5.pdf / es
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