Objective To describe fetal and neonatal mortality due to congenital anomalies in Colombia. Methods We analyzed all fetal and neonatal deaths due to a congenital anomaly registered with the Colombian vital statistics system during 1999–2008. Results The registry included 213,293 fetal deaths and 7,216,727 live births. Of the live births, 77,738 (1.08%) resulted in neonatal deaths. Congenital anomalies were responsible for 7321 fetal deaths (3.4% of all fetal deaths) and 15,040 neonatal deaths (19.3% of all neonatal deaths). The fetal mortality rate due to congenital anomalies was 9.9 per 10,000 live births and fetal deaths; the neonatal mortality rate due to congenital anomalies was 20.8 per 10,000 live births. Mortality rates due to congenital anomalies remained relatively stable during the study period. The most frequent fatal congenital anomalies were congenital heart defects (32.0%), central nervous system anomalies (15.8%), and chromosomal anomalies (8.0%). Risk factors for fetal and neonatal death included: male or undetermined sex, living in villages or rural areas, mother's age >35 years, low and very low birthweight, and <28 weeks gestation at birth. Conclusions Congenital anomalies are an important cause of fetal and neonatal deaths in Colombia, but many of the anomalies may be preventable or treatable.
Introducción. Desde el 2003, en Colombia se desarrolla el Proyecto Nacional de Reducción de la Transmisión Madre Hijo de VIH, cuyo objetivo es prevenir la transmisión vertical de VIH mediante la incorporación de la prueba voluntaria de VIH durante el control prenatal, el tratamiento y la profilaxis antirretroviral en la gestante infectada y el niño expuesto, el parto por cesárea y la sustitución de la leche materna. Objetivo. Describir los resultados de la implementación de la estrategia de prevención de la transmisión madre hijo [2003][2004][2005]. Materiales y métodos. Se hizo el estudio descriptivo de la cobertura alcanzada, la probabilidad de transmisión vertical y los factores asociados y prevalencias registradas en cada departamento. Se exploró la probabilidad de transmisión según tratamiento y se identificaron las diferencias por regiones. Resultados. El proyecto se implementó en 757 municipios (68%), en los cuales se realizó la prueba de VIH a 200.853 gestantes, y se detectaron 377 infectadas (0,19%), con mayor seropositividad en la región Caribe, en Quindío y en Santander. Se completó el seguimiento a 285 mujeres y sus hijos, y se registraron 12 casos en niños. La probabilidad de transmisión con el suministro oportuno del protocolo (n=170) fue de 1,78% (IC95%: 0,37 a 5,13%). Los factores relacionados con la transmisión fueron: carga viral inicial mayor de 10.000/mm 3 , ausencia de control prenatal y captación tardía en el embarazo. No se encontraron diferencias estadísticas entre los esquemas antirretrovirales utilizados. La región Caribe tuvo menor cobertura del control prenatal y mayor captación tardía. Conclusiones. La reducción de la transmisión madre hijo de VIH es una intervención preventiva eficaz que favorece el fortalecimiento de los servicios de control prenatal. El sostenimiento de la estrategia con cobertura nacional debe ser una meta de los gobiernos nacional y regionales y de las entidades aseguradoras.Palabras clave: virus de inmunodeficiencia humana, transmisión vertical de enfermedad, prevención y control, atención prenatal, diagnóstico prenatal, terapia antirretroviral altamente activa. Reduction of VIH mother-to-child transmission in Colombia, two years of experience, 2003-2005Introduction. A national initiative on reduction of HIV mother-to-child-transmission is being implemented since 2003 in Colombia, including HIV counseled and voluntary testing as part of the routine antenatal care, comprehensive care with ARV treatment to HIV-positive pregnant women and their infected children, caesarian delivery, and replacement of breast milk. Objective. To describe the achievements in the implementation of the prevention strategy of mother-to-child HIV transmission, 2003HIV transmission, -2005. Materials and methods. The implementation procedures of the Project are described, as well as the coverage percentages achieved, the prevention of vertical transmission and its associated factors, and the six-month prevalence by geographical departments. The probability of transmission adjusted to the...
Background: Multiple studies have described increased risk of severe coronavirus disease among pregnant women compared to nonpregnant women. The risk in middle-income countries where the distributions of age groups and preexisting conditions may differ is less known. Objectives:To determine whether pregnant women with SARS-CoV-2 infection are at increased risk for severe COVID-19 compared to nonpregnant women in Colombia. Methods: We analysed national surveillance data from Colombia, of women aged 15-44 years with laboratory-confirmed infection with SARS-CoV-2 by molecular or antigen testing, from 6 March 2020 to 12 December 2020. An enhanced follow-up of pregnant women with COVID-19 was established to monitor pregnancy and birth outcomes.Results: Of 371,363 women aged 15-44 years with laboratory-confirmed SARS-CoV-2 infection, 1.5% (n = 5614) were reported as pregnant; among those, 2610 (46.5%) were considered a complete pregnancy for reporting purposes at the time of analysis. Hospitalisation (23.9%) and death (1.3%) occurred more frequently among pregnant symptomatic women compared to nonpregnant symptomatic women (2.9% and 0.3%, respectively). Compared to nonpregnant symptomatic women, pregnant symptomatic women were at increased risk of hospitalisation (adjusted risk ratio [RR] 2.19, 95% confidence interval [CI] 2.07, 2.32) and death (RR 1.82, 95% CI 1.60, 2.07), after adjusting for age, type of health insurance and presence of certain underlying medical conditions. Among complete pregnancies, 55 (2.1%) were pregnancy losses, 72 (2.8%) resulted in term low birthweight infants and 375 (14.4%) were preterm deliveries.Conclusions: Although pregnant women were infrequently reported with laboratoryconfirmed SARS-CoV-2 infection, pregnant symptomatic women with COVID-19 were at increased risk for hospitalisation and death compared to nonpregnant symptomatic
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