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Introducción. La maternidad en la adolescencia implica un conjunto de desafíos clínicos y sociales, especialmente en contextos de ingresos medios y bajos, donde se vincula a mayores tasas de complicaciones obstétricas, repercusiones psicosociales y dificultades en el acceso a servicios integrales de salud sexual y reproductiva. Objetivo. Analizar la evolución de la prevalencia de parto en adolescentes en un hospital público de la provincia de Buenos Aires entre 2018 y 2023. Metodología. Estudio observacional, cuantitativo, de corte transversal seriado. Se analizaron 17.888 registros de partos del Sistema Informático Perinatal del Hospital Materno Neonatal Nuestra Señora de Pilar. Las variables analizadas incluyeron tipo de parto, infecciones diagnosticadas y peso al nacer. Se utilizó estadística descriptiva y exploración analítica de asociación entre el evento primario y las co-variables. Resultados. La prevalencia de parto adolescente osciló entre 19,55% (2018) y 12,68% (2023), con una tendencia descendente. La mayor proporción ocurrió en la adolescencia tardía (17–19 años). El parto vaginal fue más frecuente que la cesárea. Las infecciones más comunes fueron toxoplasmosis y sífilis. Se observó una asociación significativa entre parto adolescente y bajo peso al nacer (22,5% vs. 6,59% en adultas, p=0,000). Discusión. El parto adolescente se mantuvo como un fenómeno prevalente en el hospital público estudiado. Los hallazgos motivaron mejoras institucionales en el registro de datos y la atención de parturientas adolescentes. Se destaca la importancia de implementar estrategias de prevención y acceso efectivo a la salud sexual y reproductiva.
ABSTRACT
Introduction. Adolescent motherhood entails a range of clinical and social challenges, particularly in middle- and low-income settings, where it is associated with higher rates of obstetric complications, psychosocial repercussions, and limited access to comprehensive sexual and reproductive health services. Objective. To analyze the trends in adolescent birth prevalence at a public hospital in the Province of Buenos Aires between 2018 and 2023. Methodology. Observational, quantitative, serial cross-sectional study. A total of 17,888 birth records from the Perinatal Information System of the Nuestra Señora de Pilar Maternal and Neonatal Hospital were analyzed. The variables included type of delivery, diagnosed infections, and birth weight. Descriptive statistics and analytical exploration of associations between the primary event and covariates were performed. Results. The prevalence of adolescent births ranged from 19.55% (2018) to 12.68% (2023), showing a downward trend. The highest proportion was observed in late adolescence (17–19 years). Vaginal delivery was more frequent than caesarean section. The most common infections were toxoplasmosis and syphilis. A significant association was found between adolescent birth and low birth weight (22.5% vs. 6.59% in adults, p=0.000). Discussion. Adolescent childbirth remained a prevalent phenomenon in the public hospital studied. The findings led to institutional improvements in data recording and care for adolescent mothers. The importance of implementing prevention strategies and ensuring effective access to sexual and reproductive health services is underscored.
This study aimed to estimate reductions in travel-related carbon dioxide (CO2) emissions, travel time and distance resulting from a telemedicine service for patients with chronic conditions, and to assess its potential to contribute to more equitable access to specialised care in Northeast Brazil.
Cross-sectional study.
Primary healthcare units in the Northeast region of Brazil.
Patients between birth and 104 years of age with chronic conditions who received video-based teleconsultations between June 2022 and November 2023.
The primary outcome was the reduction in travel-related carbon emissions due to avoided in-person referrals. Secondary outcomes included travel time and travel distance savings. Round-trip distances between primary healthcare units and referral centres were estimated using geolocation data. CO2 emissions were calculated using the Greenhouse Gas (GHG) Protocol adapted to Brazil (Brazilian GHG Protocol Programme), focusing on Scope 3 emissions from patient travel.
A total of 4642 teleconsultations were conducted with 4106 patients. Of these, 4021 (86.6%) avoided in-person referrals, resulting in estimated savings of 226 900 miles in travel distance and 488 584 min in travel time. The estimated CO2 emissions avoided totalled 21 593 kg (21 930 kg CO2 equivalent), with a mean of 5.37 kg (SD±5.5) per teleconsultation (5.4 kg CO2 equivalent ; SD±5.5). Greater travel distance savings were observed among patients living in municipalities with lower Municipal Human Development Index (mean 92.3±104.2 miles vs 17.3±8.4 miles; p
Telemedicine use in Northeast Brazil significantly reduced patient travel, leading to substantial savings in CO2 emissions. These savings were more pronounced for patients in smaller, less developed municipalities. By reducing the need for travel, telemedicine can improve access to healthcare for remote or underserved populations, while also supporting environmental sustainability.
Scoping reviews, mapping reviews and evidence and gap maps (collectively known as ‘big picture reviews’) in health continue to gain popularity within the evidence ecosystem. These big-picture reviews are beneficial for policy-makers, guideline developers and researchers within the field of health for understanding the available evidence, characteristics, concepts and research gaps, which are often needed to support the development of policies, guidelines and practice. However, these reviews often face criticism related to poor and inconsistent methodological conduct and reporting. There is a need to understand which areas of these reviews require further methodological clarification and exploration. The aim of this project is to develop a research agenda for scoping reviews, mapping reviews and evidence and gap maps in health by identifying and prioritising specific research questions related to methodological uncertainties.
A modified e-Delphi process will be adopted. Participants (anticipated N=100) will include patients, clinicians, the public, researchers and others invested in creating a strategic research agenda for these reviews. This Delphi will be completed in four consecutive stages, including a survey collecting the methodological uncertainties for each of the big picture reviews, the development of research questions based on that survey and two further surveys and four workshops to prioritise the research questions.
This study was approved by the University of Adelaide Human Research Ethics Committee (H-2024-188). The results will be communicated through open-access peer-reviewed publications and conferences. Videos and infographics will be developed and placed on the JBI (previously Joanna Briggs Institute) Scoping Review Network webpage.
Objetivo principal: comprender la percepción de las enfermeras sobre la experiencia de asistencia ofrecida a la lactancia materna en el puerperio inmediato. Metodología: estudio de abordaje cualitativo, apoyado en etnografía, basado en etno-enfermería. La investigación se realizó en la maternidad de un hospital ubicado en el sur de Minas Gerais, con siete enfermeras que desarrollan prácticas de atención relacionadas con la mujer en el puerperio inmediato. Resultados principales: surgieron ocho categorías temáticas y sus respectivas sub-categorías: Lactancia materna y beneficios; ¡El parto normal ayuda! ¡El parto por cesárea se interpone! Práctica en asistencia a la lactancia materna; Atención prenatal y hospitalaria; Pautas; Lactancia materna en el puerperio inmediato; Dificultades enfrentadas durante la lactancia materna y percepción de la importancia del rol de la enfermería. Conclusión principal: las enfermeras, a pesar de tener práctica y conocimientos, se dan cuenta de que los cuidados de enfermería aún son deficientes, señalando muchas barreras que dificultan la práctica de la lactancia materna.
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