Proyecto de Investigacion Embarazo Adolescente

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CDQPZ @D AEBEMCGGEQ

DMLDRKDRËE PDAMCAE Dmldrkdrëe Pãamcae

5

DMLDRKDRCE PDAMCAE  

@RD ZTMH

CDQPZ @D AEBEMCGGEQ

DMLDRKDRËE PDAMCAE Dmldrkdrëe Pãamcae

CM\DQPCIEACHM LEAPHRDQ @D RCDQIH UTD ZRD@CQZHMDM ZRD@CQZHM DM DG DKBERE_H E@HGDADMPD DM DG @CQPRCPH @D AEBEMCGGEQ. ZRH\CMACE @D QEM RHKÅM -2:25

ËM@CAD CMPRH@TAACHMXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX1 C.

  ZGEMPDEKCDMPH ZGEMPDEKCDMP H @DG ZRHBGDKEXXXXX ZRHBGDKEXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXX0 0 C.5. LTM@EKDMPEACHM @DG @DG ZRHBGDKEXXXXXXXXXXXXXXX ZRHBGDKEXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXX0 XXX0 C.2. OTQPCLCAEACÑM @DG @DG ZRHBGDKEXXXXXXXXXXX ZRHBGDKEXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXX0 XXXXX0

CC.

  KERAH PDÑRCAHXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX6  PDÑRCAHXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXX6  CC.5.EMPDAD@DMPDQ CC.5. EMPDAD@DMPDQ CMPDRMEACHMEGDQXXXXXXXXXXX CMPDRMEACHMEGDQXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXX XXXXXXXXXXXXXXX XXXXXXXXXXXXX6 XXXXX6 CC.2.EMPDAD@DMPDQ CC.2. EMPDAD@DMPDQ MEACHMEGDQXXXXXXXXXXXX MEACHMEGDQXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXX XXXXXXXXXXXXXXX XXXXXXXXXXXXXXXX XXXXXXXXX3 X3 CC.1.LEAPHRDQ CC.1. LEAPHRDQ @D RCDQIHXXXXXXXXXXXXXXXXX RCDQIHXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXX XXXXXXXXXXX5: XX5: CC.0.DKBERE_H CC.0. DKBERE_H E@HGDQADMPDXXXXXXXXXXXXXXXX E@HGDQADMPDXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXX XXXXXXX 51

CCC.

  FCZHPDQCQ F CZHPDQCQ S \ERCEBGDQ \ERCEBGDQXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXX 56  2

DMLDRKDRCE PDAMCAE

@RD ZTMH

CDQPZ @D AEBEMCGGEQ

DMLDRKDRËE PDAMCAE Dmldrkdrëe Pãamcae

C\.

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  ZHBGEACÑM S KTDQPREXXXXXXXXXXXXX KTDQPREXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XX 53

 

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53 \CCC. EMÅGCQCQ

@D RDQTGPE@HQ ‑ @CQDÕH DQPE@ËQPCAHXXXXXXXXXXXXXXXXXXXXXXX53

RDLDRDMACEQQ BCBGCHIRÅLCAEQ XXXXXXXXXX RDLDRDMACE  XXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXX XXXXXXXXXX25 25

CMPRH@TAACÑM dxpd dx pdrt rths hs sd fe fem m rdld rdldrc rc`h `h e trds trds G dkb dkbere erezh zh e`hgds e`hgdsadm admtd td h dkbere dkberezh zh prd prdahz ahz ds equdg qud haurrd dmtrd ge e`hgd gdssadmace cmca cace cegg h pubd pu bdrt rte` e`,, ah ahkc kcdm dmzh zh `d ge d` d`e` e` lãrg y dg meg `d ge e`hgdsadmace. Dm dste dtepe, ahkÿmkdmtd sd fe `cldr `cldrdm dmac ace` e`h h `hs `hs cm cmtd tdrv rveg eghs hs qud qud ahk ah kprd prdm` m`ddm? ge e`hgd `hgdsa sadm dmac acee prdahz (`d ghs 5: e ghs 50 eõhs) y

D

dtepes `d ahmlhrkc`e` e ghs aekb ae kbch chss s sca cahs hs y dv dvhg hgu uvh vhs, s, y dstes sd `dmcrëem dm? e`hgdsadmace tdkpreme (dmtrd ghs 5: y 51 eõhs), e`hgdsadmace kd`ce (dmtrd ghs 50 y5< eõhs) y e`hgdsadmace ter`ëe (dmtrd ghs 59 y 53 eõhs). Ges ke`rds e`hgdsadmtds ahmst ahm stuyd uydm m um iru iruph ph `d cmt cmtdrã drãss admtreg dm ge ckpgdkdmteacñm `d

ge ter`ëe (`d ghshtrhs 54 e ghse`hgdsadmace 53 eõhs), scm dkberih,

phgëaes pÿbgcaes, ahmmÿe scdm`h `d irem prdhaupeacñm phr dg ëm`cad 1

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@RD ZTMH

CDQPZ @D AEBEMCGGEQ

DMLDRKDRËE PDAMCAE Dmldrkdrëe Pãamcae

`d dk dkbe bere rezh zhss e td tdkp kpre reme me d` d`e` e` `dbc`h e qud sd dmaudmtrem eshace`h e dkberezhs mh `dsde`hs, egths ëm`cads `d khrtegc`e` ketdrme y khrtegc`e` `dg rdacãm meac`h, esë ahkh htres ahkpgcaeachmds ahkh perth prdk prdket etur urh, h, pert perth h ph phrr adså adsård rde, e, dmtrd htres. Ge cmlhrkeacñm ds vegchse phr su ephrtd e ghs dstu`chs `d ldaum`c`e` y dkberezh e`hgdsadmtd. Dm dg peës, ge ketd ke tdrm rmc` c`e` e` sd ds dstå tå cm cmca cace cem` m`h h e d`e`ds kuy tdkpremes y ahms ah mst tuy uydd um rcds rcdsih ih kuy eg egtth temth pere ge ke`rd ahkh pere dg mudvh sdr y ds rdahmhac`e dm dg kum`h ahkh um dste`h qud eldate dg bcdmdster y ge segu gu` ` rdprh`uave `d ges kuodrds  oñvdmds. Dm ghs ÿgkhs eõhs sd prh`uad um aekbch ckphrtemtd dm dg ahkphr ahkphrtek tekcdm cdmth th rdprh` rdprh`ua uavh vh `d ge gess kuod kuodrrds kdm dmhr hrds ds `d 2: eõhs `d d`e`.

0

DMLDRKDRCE PDAMCAE

 

@RD ZTMH

CDQPZ @D AEBEMCGGEQ

DMLDRKDRËE PDAMCAE Dmldrkdrëe Pãamcae

C. ZG ZGEMP EMPDEK DEKCDM CDMPH PH @DG @DG ZRH ZRHBGD BGDKE KE C.5. LTM@EKDMP LTM@EKDMPEACÑM EACÑM @ @DG DG ZRHBGD ZRHBGDKE KE

Dg dkberezh dm ge e`hgdsadmace sciud scdm`h umh `d ghs prcmacpegds leathrds qud ahmtrcbuydm e ge khrtegc`e` ketdrme d cmlemtcg y eg aëraugh `d dmldrkd`e` y  phbrdze> ahmstctuyd ume `d ges prcmacpegds prdhaupeach prdhaupeachmds mds `drcve`es `d ge ahm`uate sdxueg `d ghs oñvdmds. Tmhs 5< kcgghmds `d kuodrds `d 54 e 53 eõhs y eprhxcke`ekdmtd 5 kcggñm `d ges kdmhrds `d 54 eõhs `em e guz ae`e eõh, ge keyhrëe dm peësds `d cmirdshs beohs y kd`cemhs. Ae`e eõh, umhs 1 kcgghmds `d kuafeafes `d 54 e 53 eõhs sd shkdtdm e ebhrths pdgcirhshs. Ge Hriemczeacñm Zemekdrcaeme `d ge Qegu` (HZQ) rdlcdrd `ds`d 533:, e mcvdg kum`ceg, sd fe rdicstre`h um `dsadmsh ahmsc`drebgd, eumqud crrdiuger, dm ges teses `d meteg metegc`e c`e`` dm dmtrd trd ges e`h e`hgds gdsad admtd mtds, s, um 55% eprhxc eprhxcke ke`ek `ekdmt dmtdd `d th`hs th`hs ghs meackcdmths dm dg kum`h sd prh`uadm th`evëe dmtrd e`hgdsadmtds `d 54 e 53 eõhs. Ge irem keyhrëe `d dshs meackcdmths (34%) haurrdm dm peësds `d cmirdshs beohs y kd`cemhs. Dm ges Dste`ëstcaes Qemcterces Kum`cegds 2:50 sd cm`cae qud ge tese kd`ce `d metegc`e` kum`ceg dmtrd ges e`hgdsadmtds `d 54 e 53 eõhs ds `d 03 phr  5::: kuodrds. Ges teses meachmegds hsacgem `d 5 e 233 meackcdmths phr 5::: kuodrds, scdm`h ges kås egtes ges `dg Ålrcae Qubseferceme.

C.2. OTQPCLCAEACÑM @DG ZRHBGDKE Dm Ekãrcae Getcme 5:6 `d ae`e kcg oñvdmds `d 54 e 53 eõhs shm ke`rds Iuzkåm, Ahmtrdres, & Fenndrt, (2::5). Qd dstcke qud dxcstd ume phbgeacñm `d 50: kcgghmds `d oñvdmds. Tmh `d ghs dgdkdmths qud cmac`d `d kemdre scimclcaetcve dm ge sctueacñm `d vugmdrebcgc`e` `d ges e`hgdsadmtds ds dg dkberezh mh pgemclcae`h. Ge rdicñm tcdmd ge sdium`e tese kås egte `d dkberezhs e`hgdsadmtds `dg kum`h y sd dstcke qud aesc dg 56% `d th`hs ghs meackcdmths ahrrdsphm`dm e kuodrds kdmhrds `d 2: eõhs `d d`e`. Dm ghs ÿgtckhs 2: eõhs ge aclre `d ges e`hgdsadmtds dkbereze`es dm dg Zdrÿ mh fe `cskcmuc` `cskc muc`hh scmh sd fe kemtdmc kemtdmc`h, `h, dsh `dku `dkudstre dstre qud dg Dste`h Dste`h fe fdafh fdafh phah h aesc me`e pere `cskcmucr ghs dkberezhs e`hgdsadmtds, ds mdadserch prdiumtermhs  phr quã ge sctueacñm sctueacñm mh fe verce` verce`h. h. Ds eaesh vvågc`h ågc`h pdmser dm ge prdkcse ‗qud ghs y ges e`hgdsadmtds sd dkberezem phrqud qucdrdm‛, h qud `ciem ‗pere qud sd kdtdm dm 0

DMLDRKDRCE PDAMCAE

 

@RD ZTMH

CDQPZ @D AEBEMCGGEQ

DMLDRKDRËE PDAMCAE Dmldrkdrëe Pãamcae

ahses `d e`ugths/es‛, kuafes `d dses lresds sd gemzem eg ecrd scm sebdr phrqud sctueacñm pesem ges e`hgdsadmtds, y e quã tcph `d `u`es y rdsphmsebcgc`e`ds sd dmlrdmtem Dmaudste @dkhirålcae y `d Qegu` Lekcgcer (Dm`ds, 2:55). Dg dkberezh dm e`hgdsadmtds ds um tdke scm `u`e `d prdhaupeacñm meachmeg, `ds`d dg pum pumth th `d vcste vcste `d ge se segu` gu` pÿb pÿbgca gcaee dxc dxcstd std `dl `dlcac cacdma dmaces ces qud mdad mdadsct sctem em sdr  etdm`c`es, kuafhs `d ghs oñvdmds eum prdsdmtem kcd`h `d febger ahm sus pe`rds `d tdke tdkess `d sd sdxu xueg egc` c`e` e`.. E pdse pdserr `d qu qudd dm ge gess cm cmst stct ctua uach chmd mdss `d se segu gu`` sd fe ckpgdkdmte`h hlcacmes `d hrcdmteacñm lekcgcer y sdxueg, kuafhs `d ghs oñvdmds dm dg åkbcth rureg eum mh audmtem ahm ge ahmlcemze mdadserce pere rhkpdr ahm dg ‗tebu‛ `d eõhs pese`hs, dsth Ds um suadsh `clëacg qud eldate ge segu` cmtdireg `d ghs  pe`rds e`hgdsadmtds, e`hgdsadmtds, ge `d ssus us fcohs, lekcgcerds y `d ge ahkumc`e` ahkumc`e` dm su ahmoumth. ahmoumth. Dg 52,4% `d e`hgdsadmtds dmtrd 54 y 53 eõhs `d d`e` dstuvh dkbereze`h egiume vdz dm dg peës. @d dse aclre, dg 3,3% shm ke`rds y dg 2, dm dg `cstrcth dsths aekbchs eum mh shm kuy scimclcaetcvhs y kås dm dg åkbcth rureg, ges kuodrds eÿm mh sd fem cmsdrte`h dm dg åkbcth gebhreg, shm shm gh ghss ve verh rhmd mdss qucd qucdmd mdss ggdv ggdvem em ge dahm dahmhk hkëe ëe `d `dgg fh fhie ier. r. Dm ds dstd td sd sdmt mtc` c`hh ge d`uaeacñm qud sd ckpertd e ghs fcohs shm ahm ghs kcskhs petrhmds augturegds, ds `dac `dacrr kuaf kuafes es vd vdad adss su suss ph phsc scac achm hmds ds sh shmm ph phrr gh id idmd mdre regg kuy kuy pr prda daer erce ces, s, mh aegc aegclc lcae ae`e `es, s, y sd `d `dse serr rrhg hgge gemm be beoh oh ah ahm` m`ca cach chmd mdss kuy kuy `d `dsl slev evhr hreb ebgd gdss qu qudd <

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CDQPZ @D AEBEMCGGEQ

DMLDRKDRËE PDAMCAE Dmldrkdrëe Pãamcae

ahkprh ahk prhkd kdtdm tdm e ges idmdr idmdreac eachmd hmdss luture lutures, s, ye qud ds dsths ths err errdig dighs hs ggd ggdvem vem e ges lekcgces e ge rute `d ge rdprh`uaacñm cmtdr idmdreachmeg `d ge phbrdze. Dm ges e`hgdsadmtds `dg @cstrcth `d Aebemcgge sciud prdvegdacdm`h dg tdkhr `d febger `d sdxh h `d dmekhrekcdmth y shm dsths tdkhrds qud dm kuafes sctueachmds sctueachmds ahmggdve e ggdver ume vc`e sdxueg råpc`e d crrdsphmsebgdkdmtd> y eg qud`er dkbereze`es ahmggdve e ge `dsdracñm dsahger, e ge umcñm prdketure ahm su perdoe, e ge cmsdracñm gebhreg prdaerce y prhvcschmeg, ds `dacr sd tcdmdm qud vhgvdr kuodrds y ke`urer  emtd emtdss `d tcdk tcdkph ph y dsth dsth id idmd mdre re ku kuaf afhs hs pr prhb hbgd gdke kess ah ahkh kh @dtd @dtdma macñ cñmm `d `dgg ardackcdmth, ye qud ges prhtdëmes `dstcme`es shgekdmtd pere ge ke`rd, efhre sd tcdmdm qud ahkpertcr ahm dg fcoh. Eukdmte ge prhbebcgc`e` `d tdmdr kås fcohs, ye qud, eg dkpdzer oñvdmds e tdmdr rdgeachmds sdxuegds, ds kås låacg qud ghs fcohs sd suad`em råpc`ekdmtd. Dkhachmegkdmtd Dkhachmegkdmtd ye qud sd dstå dm um prhadsh `d c`dmtc`e`, qud ggdve e brcmaersd um pesh kuy ckphrtemtd, ge euth eadpteacñm ahkh kuodr, ahm ghs aekbchs `dg audrph y lumachmds mudves, phr ume lciure prdketure `d kuodr  dkbere dkb ereze ze`e. `e. Pekbc Pekbcãm ãm ahmggd ahmggdve ve e prh prhbgd bgdkes kes `d euthds euthdstck tckee y lrustr lrustrea eachm chmds ds  pdrshmegds y shacegds. @dsdracñm dsahger, ebem`hmh h aekbch `d um prhydath `d vc`e prhldschmeg. Esë ahkh tekbcãm eg tdmdr qud umcrsd ahm dg pe`rd `d su fcoh `dmtrh `d mudve lekcgce suridm mudvhs prhbgdkes, vchgdmace `hkãstcae, dsaeshs rdaurshs dahmñkcahs, dta. Dm dg åkbcth `d ge segu`, dg Admtrh `d Qegu` `d Aebemcgges audmte ahm um  prhireke `d Zgemclcaeacñm Zgemclcaeacñm Lekcgcer, pdrh tcdmd phae ahbdrture ahbdrture y dsaese prhkhacñm prhkhacñm y eadpteacñm phr pertd `d ghs y ges e`hgdsadmtds> dg årde `d hbstdtrcace etcdm`d shgh e ges qud ye dståm dkbereze`es y kuodrds idmdregkdmtd keyhrds qud busaem ume  pgemclcaeacñm lekcgcer. Qcm dkberih, tekbcãm dxcstdm rdstrcaachmds gdiegds ahkh cm`cae dm ge Gdy Idmdreg `d Qegu` dm dg ertëaugh 0, pere qud ghs pe`rds dstãm  prdsdmtds pere qud ghs e`hgd e`hgdsadmtds sadmtds eaad eaad`em `em e ghs sdrvca sdrvcachs chs `d segu` sdxueg. sdxueg. Ds phr dsh qud dm dg prdsdmtd trebeoh `d cmvdstcieacñm sd prdtdm`d cm`eier ge cmac`dmace `d ghs leathrds qud prd`csphmdm dg dkberezh dm ges e`hgdsadmtds ge aueg ds ahmsc`dre`e ahkh um prhbgdke shaceg y `d segu`, fe sc`h emegcze`h `ds`d kuafes pdrspdatcves, scm dkberih, mh sd fe ggdie`h eÿm feste dg kdhggh `dg  prhbgdke. Qd ardd dmthmads qud ds mdadserch cmvdstcier ghs leathrds qud cmlguydm 9

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@RD ZTMH

CDQPZ @D AEBEMCGGEQ

DMLDRKDRËE PDAMCAE Dmldrkdrëe Pãamcae

dm dg dkberezh e`hgdsadmtd y `d dstd kh`h pgemtder egtdrmetcves `d shguacñm y  ph`dr rdvdrtcr ume sctueacñm sctueacñm qud errestrekhs errestrekhs `ds`d fe feaëe aëe kuafh tcdkph. tcdkph. Ghs rds rdsugt ugte` e`hs hs `d ds dste te cmv cmvds dstci tciea eacñm cñm sdr sdrvcr vcråm åm pere pere lum`e lum`ekdm kdmter ter phgëtc phgëtcae aess `d d`uaeacñm sdxueg y phgëtcaes `d segu`, tdm`cdmtds e kdohrer dg ekbcdmtd lekcgcer y ge aegc`e` `d ahkumcaeacñm dmtrd sus kcdkbrhs. Esë kcskh sdrvcrå `d besd pere lutures cmvdstcieachmds dm thrmh eg dkberezh e`hgdsadmtd y su `cmåkcae lekcgcer. CC. KERAH KERAH PDÑR PDÑRCAH CAH CC.5.

EMPDAD@DMPDQ CMPDRMEACHMEGDQ 

Aerbeoeg, B.R> \egdmace H.F y Rh`rëiudz E.R (2:59)   ‗Leathrs esshacetd` wctf  prdimemay cm e`hgdsadmts 51 th 53 yders cm Budmevdmture, Ahghkbce‛ cmvdstcieacñm `d ahfhrtd, emegëtcah y prhspdatcvh ahm ume kudstre `d 15< e`hgdsadmtds, `d ahgdichs  pÿbgcahs y prcve`hs, ahm 5 eõh (2::< y 2::9). Lud dm 2 dtepes ge prckdre lud ge kd`cacñm `d ges e`hgdsadmtds dstu`cemtds qud mh `dbëem dster idstem`h, gudih `d < kdsds sd rdegczebe ume prudbe `d dkberezh. Qd hbsdrvñ um 5:% `d ke`rds e`hgdsadmtds `uremtd dg dstu`ch, ge d`e` `dg cmcach `d ge eatcvc`e` sdxueg lud 50,4 eõhs> e`dkås mh sd dmahmtrñ eshaceacñm ahm mh escstcr e um admtrh `d segu` pere esumths `d pgemclcaeacñm lekcgcer dm su prckdre dxpdrcdmace sdxueg (HR?0,9 CA 34 % :,40- 0:,9< y p? :,5 sdmtcr augpe phr ahmsukcr egahfhg lud scimclcaetcvh (HR ?1,5 , CA 34%? :,66-4,52 y p;:,:22)> tdmdr ekcste`ds qud ebhrtebem lud htrh rcdsih eshace`h phr  sdr scimclcaetcvh ahm um p;:,:51 y um HR?1,90 ahm um cmtdrvegh eg 34% qud mh pese ge umc`e`, sdmtcr prdscñm pere dg cmcach `d eatcvc`e` sdxueg mh tuvh scimclcaemace (HR? 2,12 ahm um CA? :,65 ‑