Frecuencia de control prenatal inadecuado y de factores asociados a su ocurrencia. RESUMENObjetivo: Determinar la frecuencia de pacientes con control prenatal (CPN) inadecuado y los factores asociados a dicho evento. Material y métodos: Se realizó un estudio descriptivo transversal donde se entrevistó a puérperas en el Hospital Nacional Cayetano Heredia entre agosto 2010 y enero 2011, y se revisó la historia clínica y carnet materno perinatal (CLAP). Se definió CPN inadecuado al incumplimiento del número mínimo y cronograma de visitas propuesto por el Ministerio de Salud. Se compararon factores epidemiológicos, maternos y socioeconómicos entre grupos de gestantes con CPN adecuado e inadecuado.Resultados: Se incluyeron 384 puérperas, 66,05% recibieron 6 ó más controles prenatales y sólo 7,36% tuvo CPN adecuado. Ciento cuarenta y cinco puérperas tuvieron su primer CPN antes de las 12 semanas. Los factores que se presentaron con mayor frecuencia en el grupo de CPN inadecuado fueron paridad mayor a 2 (p=0,02) y no planificación de la gestación (p=0,003). Conclusiones: El porcentaje de CPN inadecuado fue elevado. El CPN inadecuado se asoció con paridad mayor a 2 y gestación no planificada. (Rev Med Hered 2011;22:169-175).PALABRAS CLAVE: Atención prenatal, factores de riesgo, embarazo. SUMMARYObjective: To determine the frequency of patients with inadequate prenatal care (PNC) and the factors associated with this event. Material and methods: A cross-sectional, descriptive study and data was obtained interviewing the mothers, reviewing clinical records and Maternal Perinatal Card between August 2010 and January 2011 at the Hospital Nacional Cayetano Heredia. We defined inadequate PNC as the failure of the minimum number of visits and schedule proposed by the Ministry of Health. We compared epidemiological, maternal and socioeconomic factors in groups with adequate PNC and non-adequate PNC. Results: We included 384 women, 66.05% received 6 or more prenatal controls and only 7.36% had an adequate PNC. 145 women had her first PNC before the 12 weeks of pregnancy. The factors with more frequency in the non-adequate PNC was a maternal parity more than 2 (p=0.02) and a non-planning pregnancy (p=0.003). Conclusions: The rate of non-adequate PNC was high. Having a maternal parity more than 2 and a non-planning pregnancy were associated with non-adequate PNC. (Rev Med Hered 2011;22:169-175).

Neuroticism is characterized by emotional instability and the tendency to experience negative emotions such as anger, anxiety and depressed mood. Subjects with borderline personality disorder (BPD) present this personality dimension as a temperamental core trait. There has been proposed that neuroticism can appropriately describe the most important characteristics of BPD. The polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) has been implicated in depression, anxiety and suicide. It is estimated that 5-HTTLPR polymorphism account to 7 to 9% of inherited variance of neuroticism in personality. The aim of this study is to evaluate the association between neuroticism and 5-HTTLPR polymorphism in BPD. We evaluate personality with NEO PI R inventory in 104 BPD subjects (76 female/28 male) that did not meet criteria for axis I diagnoses and other personality disorders. The genetic analysis of 5-HTTLPR were performed determining the presence of long and short alleles, subjects were grouped in long/long (LL) and S-carriers (LS+SS). Statistical analysis were tested with parametric and correlation method with Stata10. We found significant difference in neuroticism between the genotype groups (F = 8.57, p = 0.0004) and lower levels of neuroticism in LL than S-carriers. Female have higher neuroticism than male. 5-HTTLPR polymorphism explains 18.02% of inherited variance in neuroticism. The S-carriers had 11.9 times higher risk of presenting elevated neuroticism compared with LL. We conclude that there are relation between 5-HTTLPR polymorphism and neuroticism in BPD. These results should contribute to the genetic study of BPD.

Brain derived neurotrophic factor (BDNF) is the most widely distributed and highly expressed neurotrophin in the CNS. BDNF gene have been associated with increased risk psychiatric disorders. It has been described interaction between BDNF and serotonin system at a neural and genetic level. Neuroticism as a personality trait relevant in borderline personality disorder (BPD) has genetic inheritance and is associated with serotonergic dysfunction. Has been reported that BDNF Val66Met variant is associated with neuroticism in general population. The aim of this study is to test the association between Val66Met and neuroticism and evaluate if the presence of Val66Met allele interacts with polymorphism in promoter region of serotonin transporter gene (5-HTTLPR) for develop neuroticism in BPD. We evaluate personality with NEO PI R in 104 BPD subjects that did not meet criteria for axis I diagnoses and other personality disorders. Genetic analysis of BDNF was performed determining the presence of Val/Val Val/Met and Met/Met BDNF variants. 5-HTTLPR was performed determining the presence of L and S 5-HTTLPR alleles. Statistical analysis were tested with parametric and correlation method with Stata10. We did not found differences in neuroticism between BDNF variants, but when controlled by BDNF alleles we found that Met/Met modulate the expression of 5-HTTLPR, with S-carriers (LS+SS) having higher neuroticism than LL (F = 6.36, p = 0.0031). We found no differences in expression of 5-HTTLPR in other BDNF variants. We conclude that BDNF have a differential modulating effect of 5-HTTLPR in neuroticism in BPD.