Asociación entre la multiplicidad del embarazo y anomalías congénitas en el recién nacido: Estudio de casos-controles de base poblacional

Introducción: Los defectos congénitos son un problema de salud pública, anualmente se registran en Colombia alrededor de 3000 casos. Se estima que un 94% de los casos se presentan en países de bajos-medianos ingresos, como Colombia. Tienen una gran carga de morbimortalidad perinatal, causan 1 de cad...

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Autores:
Rubio Duarte, Andrés Felipe
Tipo de recurso:
Fecha de publicación:
2023
Institución:
Universidad Autónoma de Bucaramanga - UNAB
Repositorio:
Repositorio UNAB
Idioma:
spa
OAI Identifier:
oai:repository.unab.edu.co:20.500.12749/20350
Acceso en línea:
http://hdl.handle.net/20.500.12749/20350
https://doi.org/10.29375/tesis.20350
Palabra clave:
Multiple pregancy
Congenital anomaly
Newborn
Medical sciences
Human abnormalities
Abnormalities in the fetus
Multiple pregnancy
Pregnancy period
Ciencias médicas
Anormalidades humanas
Anormalidades en el feto
Embarazo múltiple
Periodo de embarazo
Embarazo múltiple
Anomalía congénita
Recién nacido
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License
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
id UNAB2_efd8064fa350be796720a4e2d07a4745
oai_identifier_str oai:repository.unab.edu.co:20.500.12749/20350
network_acronym_str UNAB2
network_name_str Repositorio UNAB
repository_id_str
dc.title.spa.fl_str_mv Asociación entre la multiplicidad del embarazo y anomalías congénitas en el recién nacido: Estudio de casos-controles de base poblacional
dc.title.translated.spa.fl_str_mv Association between pregnancy multiplicity and congenital anomalies in newborns: a Population-Based case-control study.
title Asociación entre la multiplicidad del embarazo y anomalías congénitas en el recién nacido: Estudio de casos-controles de base poblacional
spellingShingle Asociación entre la multiplicidad del embarazo y anomalías congénitas en el recién nacido: Estudio de casos-controles de base poblacional
Multiple pregancy
Congenital anomaly
Newborn
Medical sciences
Human abnormalities
Abnormalities in the fetus
Multiple pregnancy
Pregnancy period
Ciencias médicas
Anormalidades humanas
Anormalidades en el feto
Embarazo múltiple
Periodo de embarazo
Embarazo múltiple
Anomalía congénita
Recién nacido
title_short Asociación entre la multiplicidad del embarazo y anomalías congénitas en el recién nacido: Estudio de casos-controles de base poblacional
title_full Asociación entre la multiplicidad del embarazo y anomalías congénitas en el recién nacido: Estudio de casos-controles de base poblacional
title_fullStr Asociación entre la multiplicidad del embarazo y anomalías congénitas en el recién nacido: Estudio de casos-controles de base poblacional
title_full_unstemmed Asociación entre la multiplicidad del embarazo y anomalías congénitas en el recién nacido: Estudio de casos-controles de base poblacional
title_sort Asociación entre la multiplicidad del embarazo y anomalías congénitas en el recién nacido: Estudio de casos-controles de base poblacional
dc.creator.fl_str_mv Rubio Duarte, Andrés Felipe
dc.contributor.advisor.none.fl_str_mv Beltran Avendaño, Mónica Andrea
Herrera Galindo, Víctor Mauricio
dc.contributor.author.none.fl_str_mv Rubio Duarte, Andrés Felipe
dc.contributor.cvlac.spa.fl_str_mv Rubio Duarte, Andrés Felipe [0001774484]
Herrera Galindo, Víctor Mauricio [0000068020]
Beltrán Avendaño, Mónica Andrea [0000423319]
dc.contributor.googlescholar.spa.fl_str_mv Rubio Duarte, Andrés Felipe [WII30IAAAAJ&hl=es]
Herrera Galindo, Víctor Mauricio [es&oi=ao]
dc.contributor.orcid.spa.fl_str_mv Rubio Duarte, Andrés Felipe [0000-0001-9091-5367]
Beltrán Avendaño, Mónica Andrea [0000-0001-6973-9557]
dc.contributor.researchgate.spa.fl_str_mv Rubio Duarte, Andrés Felipe [Felipe-Rubio-Duarte]
Beltrán Avendaño, Mónica Andrea [Monica-Andrea-Beltran-Avendano-2194091127]
dc.contributor.apolounab.spa.fl_str_mv Herrera Galindo, Víctor Mauricio [víctor-mauricio-herrera-galindo]
Beltrán Avendaño, Mónica Andrea [mónica-andrea-beltrán-avendaño]
dc.subject.keywords.spa.fl_str_mv Multiple pregancy
Congenital anomaly
Newborn
Medical sciences
Human abnormalities
Abnormalities in the fetus
Multiple pregnancy
Pregnancy period
topic Multiple pregancy
Congenital anomaly
Newborn
Medical sciences
Human abnormalities
Abnormalities in the fetus
Multiple pregnancy
Pregnancy period
Ciencias médicas
Anormalidades humanas
Anormalidades en el feto
Embarazo múltiple
Periodo de embarazo
Embarazo múltiple
Anomalía congénita
Recién nacido
dc.subject.lemb.spa.fl_str_mv Ciencias médicas
Anormalidades humanas
Anormalidades en el feto
Embarazo múltiple
Periodo de embarazo
dc.subject.proposal.spa.fl_str_mv Embarazo múltiple
Anomalía congénita
Recién nacido
description Introducción: Los defectos congénitos son un problema de salud pública, anualmente se registran en Colombia alrededor de 3000 casos. Se estima que un 94% de los casos se presentan en países de bajos-medianos ingresos, como Colombia. Tienen una gran carga de morbimortalidad perinatal, causan 1 de cada 5 muertes en recién nacidos. El embarazo múltiple también tiene un impacto negativo en la salud de la gestante y el recién nacido, incrementando el riesgo de aborto, óbito fetal, parto prematuro, trastornos hipertensivos asociados al embarazo y muerte perinatal. La presencia de defectos congénitos en el embarazo múltiple puede aumentar la morbimortalidad materna y perinatal. Metodología: Estudio tipo casos-controles basado en datos secundarios anonimizados de registros de la ficha de notificación para defectos congénitos del Sistema Nacional de Vigilancia Epidemiológica (SIVIGILA) en el periodo 2016-2021. Los casos fueron todos los recién nacidos elegibles con diagnóstico de anomalía congénita utilizando la Clasificación Internacional de Enfermedades 10ª edición CIE- 10; los controles fueron los recién nacidos vivos registrados en el Departamento Nacional de Estadística (DANE), nacidos en el mismo año y municipio del caso, escogidos aleatoriamente en relación 1:1. Inicialmente fue realizado un análisis descriptivo. Se estimó la prevalencia para el periodo a nivel nacional y por departamentos de todas las anomalías congénitas y para los siguientes grupos: cardiovascular, neurológica, genitales, labio leporino y paladar hendido. El denominador para el cálculo corresponde a la totalidad de nacidos vivos, registrados en el DANE, a nivel nacional y por departamentos. Se graficaron en un mapa geográfico mediante el uso de GeoDa®. Posteriormente se realizó una descripción de los casos y controles en función de la multiplicidad del embarazo y grupo etario materno. Los casos fueron caracterizados de acuerdo al número de anomalías registradas y el grupo CIE-10 al cual pertenecen. Se construyó un modelo de regresión logística condicionada por municipio de residencia y año de registro, estimando el OR con un IC95% de la asociación entre el embarazo múltiple y las anomalías congénitas, estimando el efecto confusor de la edad materna, tratada como variable discreta. El análisis fue realizado en el programa estadístico R. Resultados: Para el periodo de estudio hubo un total de 3,213,606 nacidos vivos reportados ante el DANE y 34,108 casos de anomalías congénitas tipo malformación reportados en el SIVIGILA, con una prevalencia general de 106.1 (IC95%: 105-107.3) casos por cada 10,000 nacidos vivos (nv). Las anomalías cardiovasculares, del sistema urinario, neurológicas y el labio-paladar hendido tienen una mayor prevalencia en la región andina y el centro del país; los departamentos de Santander, Antioquia y Boyacá concentran la mayor prevalencia de este grupo de anomalías. Se parearon un 95.8% de los casos. La prevalencia de embarazo múltiple fue de 2.8%, siendo más frecuente en los recién nacidos con anomalía congénita (4.2%) que en los controles (1.4%) siendo esta una diferencia estadísticamente significativa (p<0.05). El resultado del modelo de regresión logística condicional estima una mayor probabilidad de cualquier anomalía congénita en el embarazo múltiple con respecto al embarazo único (OR=3.16, IC95%: 2.8-3.5), relación que se mantiene luego de incorporar el grupo etario materno en el modelo (OR=3.09, IC95%: 2.8-3.4), siendo la de mayor magnitud la observada para el grupo de anomalías no clasificadas (OR=10.9, IC95%: 4.9-24.3), sistema respiratorio (OR=3.88, IC95%: 1.8-8.6), cardiovascular (OR=3.69, IC95%: 2.9-4.6) y las anomalías genitales (OR=3.32, IC95%: 1.9-5.8). Conclusiones: El embarazo múltiple se asocia a una mayor probabilidad de anomalías congénitas en el recién nacido, independiente del grupo de anomalía y la edad materna. La probabilidad de anomalía congénita en embarazo múltiple aumenta proporcional a la edad materna. Los resultados son concordantes con estudios en población asiática y americana. La distribución de las anomalías congénitas en Colombia es heterogénea con una mayor tasa en la región Andina y centro para cardiopatías, anomalías del sistema nervioso, urinario, neurológico y labio-paladar hendido.
publishDate 2023
dc.date.accessioned.none.fl_str_mv 2023-06-28T16:48:54Z
dc.date.available.none.fl_str_mv 2023-06-28T16:48:54Z
dc.date.issued.none.fl_str_mv 2023-05-15
dc.type.eng.fl_str_mv Thesis
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.local.spa.fl_str_mv Tesis
dc.type.hasversion.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/TM
status_str acceptedVersion
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/20.500.12749/20350
dc.identifier.instname.spa.fl_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional UNAB
dc.identifier.repourl.spa.fl_str_mv repourl:https://repository.unab.edu.co
dc.identifier.doi.none.fl_str_mv https://doi.org/10.29375/tesis.20350
url http://hdl.handle.net/20.500.12749/20350
https://doi.org/10.29375/tesis.20350
identifier_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
reponame:Repositorio Institucional UNAB
repourl:https://repository.unab.edu.co
dc.language.iso.spa.fl_str_mv spa
language spa
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spelling Beltran Avendaño, Mónica Andrea053bd7db-1f3d-40cf-86e3-b4cf7cdc846cHerrera Galindo, Víctor Mauricio82736c90-93c9-4f26-86c7-0c8ae52dea2fRubio Duarte, Andrés Felipe7dc5f2c3-96fb-4a91-a1c4-155026f20463Rubio Duarte, Andrés Felipe [0001774484]Herrera Galindo, Víctor Mauricio [0000068020]Beltrán Avendaño, Mónica Andrea [0000423319]Rubio Duarte, Andrés Felipe [WII30IAAAAJ&hl=es]Herrera Galindo, Víctor Mauricio [es&oi=ao]Rubio Duarte, Andrés Felipe [0000-0001-9091-5367]Beltrán Avendaño, Mónica Andrea [0000-0001-6973-9557]Rubio Duarte, Andrés Felipe [Felipe-Rubio-Duarte]Beltrán Avendaño, Mónica Andrea [Monica-Andrea-Beltran-Avendano-2194091127]Herrera Galindo, Víctor Mauricio [víctor-mauricio-herrera-galindo]Beltrán Avendaño, Mónica Andrea [mónica-andrea-beltrán-avendaño]ColombiaUNAB Campus Bucaramanga2023-06-28T16:48:54Z2023-06-28T16:48:54Z2023-05-15http://hdl.handle.net/20.500.12749/20350instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.cohttps://doi.org/10.29375/tesis.20350Introducción: Los defectos congénitos son un problema de salud pública, anualmente se registran en Colombia alrededor de 3000 casos. Se estima que un 94% de los casos se presentan en países de bajos-medianos ingresos, como Colombia. Tienen una gran carga de morbimortalidad perinatal, causan 1 de cada 5 muertes en recién nacidos. El embarazo múltiple también tiene un impacto negativo en la salud de la gestante y el recién nacido, incrementando el riesgo de aborto, óbito fetal, parto prematuro, trastornos hipertensivos asociados al embarazo y muerte perinatal. La presencia de defectos congénitos en el embarazo múltiple puede aumentar la morbimortalidad materna y perinatal. Metodología: Estudio tipo casos-controles basado en datos secundarios anonimizados de registros de la ficha de notificación para defectos congénitos del Sistema Nacional de Vigilancia Epidemiológica (SIVIGILA) en el periodo 2016-2021. Los casos fueron todos los recién nacidos elegibles con diagnóstico de anomalía congénita utilizando la Clasificación Internacional de Enfermedades 10ª edición CIE- 10; los controles fueron los recién nacidos vivos registrados en el Departamento Nacional de Estadística (DANE), nacidos en el mismo año y municipio del caso, escogidos aleatoriamente en relación 1:1. Inicialmente fue realizado un análisis descriptivo. Se estimó la prevalencia para el periodo a nivel nacional y por departamentos de todas las anomalías congénitas y para los siguientes grupos: cardiovascular, neurológica, genitales, labio leporino y paladar hendido. El denominador para el cálculo corresponde a la totalidad de nacidos vivos, registrados en el DANE, a nivel nacional y por departamentos. Se graficaron en un mapa geográfico mediante el uso de GeoDa®. Posteriormente se realizó una descripción de los casos y controles en función de la multiplicidad del embarazo y grupo etario materno. Los casos fueron caracterizados de acuerdo al número de anomalías registradas y el grupo CIE-10 al cual pertenecen. Se construyó un modelo de regresión logística condicionada por municipio de residencia y año de registro, estimando el OR con un IC95% de la asociación entre el embarazo múltiple y las anomalías congénitas, estimando el efecto confusor de la edad materna, tratada como variable discreta. El análisis fue realizado en el programa estadístico R. Resultados: Para el periodo de estudio hubo un total de 3,213,606 nacidos vivos reportados ante el DANE y 34,108 casos de anomalías congénitas tipo malformación reportados en el SIVIGILA, con una prevalencia general de 106.1 (IC95%: 105-107.3) casos por cada 10,000 nacidos vivos (nv). Las anomalías cardiovasculares, del sistema urinario, neurológicas y el labio-paladar hendido tienen una mayor prevalencia en la región andina y el centro del país; los departamentos de Santander, Antioquia y Boyacá concentran la mayor prevalencia de este grupo de anomalías. Se parearon un 95.8% de los casos. La prevalencia de embarazo múltiple fue de 2.8%, siendo más frecuente en los recién nacidos con anomalía congénita (4.2%) que en los controles (1.4%) siendo esta una diferencia estadísticamente significativa (p<0.05). El resultado del modelo de regresión logística condicional estima una mayor probabilidad de cualquier anomalía congénita en el embarazo múltiple con respecto al embarazo único (OR=3.16, IC95%: 2.8-3.5), relación que se mantiene luego de incorporar el grupo etario materno en el modelo (OR=3.09, IC95%: 2.8-3.4), siendo la de mayor magnitud la observada para el grupo de anomalías no clasificadas (OR=10.9, IC95%: 4.9-24.3), sistema respiratorio (OR=3.88, IC95%: 1.8-8.6), cardiovascular (OR=3.69, IC95%: 2.9-4.6) y las anomalías genitales (OR=3.32, IC95%: 1.9-5.8). Conclusiones: El embarazo múltiple se asocia a una mayor probabilidad de anomalías congénitas en el recién nacido, independiente del grupo de anomalía y la edad materna. La probabilidad de anomalía congénita en embarazo múltiple aumenta proporcional a la edad materna. Los resultados son concordantes con estudios en población asiática y americana. La distribución de las anomalías congénitas en Colombia es heterogénea con una mayor tasa en la región Andina y centro para cardiopatías, anomalías del sistema nervioso, urinario, neurológico y labio-paladar hendido.MaestríaIntroduction: Congenital defects are a public health problem, with approximately 3,000 cases reported annually in Colombia. It is estimated that 94% of cases occur in low-to-middle-income countries like Colombia. They impose a significant burden of perinatal morbidity and mortality, accounting for 1 in 5 deaths among newborns. Multiple pregnancies also have a negative impact on the health of both the mother and the newborn, increasing the risk of abortion, fetal death, preterm birth, pregnancy-associated hypertensive disorders, and perinatal death. The presence of congenital defects in multiple pregnancies can further increase maternal and perinatal morbidity and mortality. Methodology: A case-control study was conducted based on anonymized secondary data from the Congenital Defect Notification Form of the National Epidemiological Surveillance System (SIVIGILA) for the period 2016-2021. Cases included all eligible newborns diagnosed with a congenital anomaly using the 10th edition of the International Classification of Diseases (ICD-10), while controls were live births registered in the National Department of Statistics (DANE), born in the same year and municipality as the cases, randomly selected in a 1:1 ratio. Initially, a descriptive analysis was performed. The prevalence for the entire period was estimated at the national level and by department for all congenital anomalies and the following groups: cardiovascular, neurological, genital, cleft lip, and cleft palate. The denominator for the calculation corresponded to the total number of live births registered in DANE, nationally and by department. GeoDa® software was used to graphically represent the data on a geographic map. Subsequently, cases and controls were described according to the multiplicity of pregnancy and maternal age group. The cases were characterized based on the number of registered anomalies and their corresponding ICD-10 group. A conditional logistic regression model was constructed by municipality of residence and year of registration, estimating the odds ratio (OR) with a 95% confidence interval (CI) for the association between multiple pregnancy and congenital anomalies, considering maternal age as a discrete variable. The analysis was conducted using the R statistical software. Results: During the study period, a total of 3,213,606 live births were reported to DANE, and 34,108 cases of congenital anomalies were reported in SIVIGILA, resulting in a general prevalence of 106.1 (95% CI: 105-107.3) cases per 10,000 live births. Cardiovascular, urinary system, neurological, and cleft lip/palate anomalies had a higher prevalence in the Andean region and central Colombia. The departments of Santander, Antioquia, and Boyacá had the highest prevalence of these anomaly groups. A total of 95.8% of the cases were matched with controls. The prevalence of multiple pregnancies was 2.8%, being more frequent in newborns with congenital anomalies (4.2%) than in controls (1.4%), with a statistically significant difference (p<0.05). The conditional logistic regression model estimated a higher probability of any congenital anomaly in multiple pregnancies compared to singleton pregnancies (OR=3.16, 95% CI: 2.8-3.5). This association remained significant after incorporating maternal age group into the model (OR=3.09, 95% CI: 2.8-3.4). The highest magnitude of association was observed for the group of unclassified anomalies (OR=10.9, 95% CI: 4.9-24.3), followed by respiratory system (OR=3.88, 95% CI: 1.8-8.6), cardiovascular (OR=3.69, 95% CI: 2.9-4.6), and genital anomalies (OR=3.32, 95% CI: 1.9-5.8). Conclusions: Multiple pregnancy is associated with a higher probability of congenital anomalies in newborns, regardless of the anomaly group or maternal age. The probability of congenital anomalies in multiple pregnancies increases proportionally with maternal age. The results are consistent with studies conducted in Asian and American populations. The distribution of congenital anomalies in Colombia is heterogeneous, with higher rates in the Andean and central regions for heart defects, nervous system abnormalities, urinary system anomalies, neurological anomalies, and cleft lip/palate.Modalidad Presencialapplication/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)Atribución-NoComercial-SinDerivadas 2.5 Colombiahttp://purl.org/coar/access_right/c_abf2Asociación entre la multiplicidad del embarazo y anomalías congénitas en el recién nacido: Estudio de casos-controles de base poblacionalAssociation between pregnancy multiplicity and congenital anomalies in newborns: a Population-Based case-control study.Thesisinfo:eu-repo/semantics/masterThesisTesisinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/redcol/resource_type/TMMagíster en Métodos para la Producción y Aplicación de Conocimiento Científico en SaludUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludMaestría en Métodos para la Producción y Aplicación de Conocimiento Científico en SaludMultiple pregancyCongenital anomalyNewbornMedical sciencesHuman abnormalitiesAbnormalities in the fetusMultiple pregnancyPregnancy periodCiencias médicasAnormalidades humanasAnormalidades en el fetoEmbarazo múltiplePeriodo de embarazoEmbarazo múltipleAnomalía congénitaRecién nacidoWorld Health Orgnaization. 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