Analysis of complexity in the characterization of maternal and child morbidity episodes
Keywords:
social epidemiology, complexity of health problems, maternal and child health, infections associated with health assistance, pre-eclampsia.Abstract
Introduction: The maternal and child health constitutes a very defined priority in the health system of Cuba, reason why the study of complex health problems is of unquestionable value.
Objective: To characterize women with infections associated with the health assistance or pre-eclampsia, from the paradigm of complexity.
Methods: A complex three phase investigation was carried out in Mariana Grajales Coello Provincial Gynecoobstetric Hospital in Santiago de Cuba that included a temporary series analysis and an observational, descriptive and cross-sectional study, for which 1 896 patients diagnosed with infections associated with the health assistance, from 2004 to 2017, and 140 pregnant women with pre-eclampsia, registered in the five year period 2013-2017 were selected, also, clinical, epidemiological, humoral, echographic and pathologic variables were considered. Temporary series analysis (seasonal factorization, spectral analysis and identification of the series components), of main components and neural network were carried out; at the same time that the specific seasonal and microbiological patterns were identified for the infections associated with health assistance.
Results: The age, obstetric history and fluctuations of blood pressure were important prediction factors related to pre-eclampsia, besides renal and hepatic failure as worsenings and/or complications of this clinical entity.
Conclusions: The use of multilevel analysis methods revealed the complex structure that is established between the clinical, epidemiological, social and environmental variables in connection with the infections associated with health assistance and pre-eclampsia, what was evidenced with the pathologic findings.
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