Asociación entre las patologías puerperales de mama y el abandono de la lactancia materna en el Hospital Local del Norte

dc.contributor.advisorOrtiz Serrano, Ricardo
dc.contributor.advisorCastellanos Domínguez, Yeny Zulay
dc.contributor.apolounabOrtiz Serrano, Ricardo [ricardo-ortiz-serrano]spa
dc.contributor.apolounabCastellanos Domínguez, Yeny Zulay [yeny-zulay-castellanos-domínguez]spa
dc.contributor.authorSepúlveda Sierra, Angélica María
dc.contributor.cvlacCastellanos Domínguez, Yeny Zulay [0001363740]spa
dc.contributor.googlescholarCastellanos Domínguez, Yeny Zulay [es&oi=ao]spa
dc.contributor.orcidOrtiz Serrano, Ricardo [0009-0004-4859-5952]spa
dc.contributor.orcidCastellanos Domínguez, Yeny Zulay [0000-0001-5881-1998]spa
dc.contributor.researchgroupGrupo de Estudio Genético de Enfermedades Complejasspa
dc.contributor.researchgroupGrupo de Investigaciones Clínicasspa
dc.coverage.campusUNAB Campus Bucaramangaspa
dc.coverage.spatialBucaramanga (Santander, Colombia)spa
dc.coverage.temporalDiciembre de 2019 y Junio de 2021spa
dc.date.accessioned2023-11-16T16:57:20Z
dc.date.available2023-11-16T16:57:20Z
dc.date.issued2023-11-01
dc.degree.nameEspecialista en Ginecología y Obstetriciaspa
dc.description.abstractIntroducción: La lactancia materna es el proceso fisiológico que posibilita el primer alimento natural del ser humano en su primera etapa de vida. Cubre todas las necesidades nutricionales que garantizan su crecimiento y desarrollo normal. Se han identificado los beneficios que brinda en cuanto al neurodesarrollo, a la disminución de enfermedades infecciosas, a la prevención de enfermedades crónicas en la adultez y en la salud materna. Sin embargo, merece una atención seria, creciente y significativa, pues a pesar del conocimiento sobre sus beneficios, en Colombia para el 2015 solo 36,2% de los lactantes menores de 6 meses tuvieron lactancia materna exclusiva (LME). Los motivos de la interrupción son complejos y variados: se involucran factores sociales, psicológicos y físicos. Por esto, surge el propósito de este estudio de identificar y entender cómo los problemas de mama y otros factores afectan la lactancia materna, en especial la LME. Para que los profesionales de la salud logren promoverla adecuadamente y jueguen un papel fundamental en la promoción, protección y apoyo de dicha práctica. Objetivo: Evaluar la asociación entre las patologías de mama y el abandono de la lactancia materna dentro de los tres meses postparto en pacientes atendidas en el Hospital Local del Norte. Materiales y Métodos: Se planteó este estudio analítico de cohorte prospectiva en el Hospital Local del Norte, para examinar la asociación entre las patologías de mama relacionadas con la lactancia y posibles factores que puedan estar influyendo en el abandono de la LME. Resultados: Se resalta el elevado abandono de la LME (38,4%) en los tres primeros meses de vida del lactante. Las patologías de mama se asociaron a la ablactación temprana, pero no de forma significativa. Con significancia estadística se destacan: la edad materna menor a 25 años, ser soltera, primigestante o secundigestante, la falta de educación respecto a los beneficios de la lactancia, las complicaciones de no lactar, la técnica de la lactancia, el antecedente de alimentación complementaria antes de 6 meses en anterior hijo, el no antecedente de lactancia, el uso del biberón al egreso hospitalario y el sentirse nerviosa o presentar llanto con el abandono de la LME. Conclusiones: No se encontró una asociación estadísticamente significativa entre las patologías de mama y el abandono de la LME en los tres primeros meses de vida del lactante. Se presentó baja incidencia de las patologías de mama, lo que es cuestionable y susceptible de sesgo de recuerdo. La edad menor de 24 años y el uso de biberón predicen el abandono de la LME según el modelo multivariado.spa
dc.description.abstractenglishBackground: Breastfeeding is a physiological process, which provides the first natural nourishment during the early stages of life. It covers all the nutritional needs that assures the normal growth and development of the infant. Breastfeeding benefits have been identified in neurodevelopment, reduction of infectious diseases, prevention of chronic diseases in adulthood and maternal health. However, it deserves serious, growing and significant attention, because despite the identified benefits, in Colombia in 2015 only 36.2% of infants under 6 months had been breastfeeding exclusively. The reasons for discontinuation of breastfeeding are complex and varied, as social, psychological, and physical factors play a role. Due to this, arises the purpose of this study, to identify and understand how the maternal problems and other factors affect exclusive breastfeeding (EBF), with the goal that health care professionals promote adequately and play a fundamental role in the promotion, protection, and support of exclusive breastfeeding. Objective: To evaluate the association between breast pathologies and the abandonment of breastfeeding within three months postpartum of patients attended at the Hospital Local del Norte. Methods: An analytical prospective cohort study was proposed at the Hospital Local del Norte, to examine the association between breast pathologies related to lactation and possible factors that may be influencing EBF abandonment. Results: The high abandonment of exclusive breastfeeding of 38.4% in the first three months of the infant's life is highlighted. Breast pathologies were associated with early weaning but were not statistically significant. The following were statistically significant when it came factors leading to the abandonment of exclusive breastfeeding: maternal age under 25 years, being single, first or second pregnancy, lack of education regarding the benefits of breastfeeding, complications of not breastfeeding, education on how to properly breastfeed, history of complementary feeding before 6 months in a previous child, use of the bottle at hospital discharge, and feeling nervous or crying with the abandonment of EBF. Conclusions: There was not a statistically significant association between breast pathologies and EBF abandonment in the first three months of the infant's life. A low incidence of breast pathologies was present, which is questionable and susceptible to recall bias. The age under 24 years and use of the bottle predict EBF abandonment according to the multivariate model.spa
dc.description.degreelevelEspecializaciónspa
dc.description.learningmodalityModalidad Presencialspa
dc.description.tableofcontents1. RESUMEN.................................................................................................................. 9 1.1. SUMMARY ............................................................................................................. 10 2. INTRODUCCIÓN ...................................................................................................... 11 3. PLANTEAMIENTO DEL PROBLEMA ....................................................................... 13 4. JUSTIFICACIÓN .........................................................................................................17 5. MARCO TEÓRICO ................................................................................................... 20 5.1. Definición de lactancia materna ...................................................................... 20 5.2. Epidemiología ..................................................................................................... 23 5.3. Fisiología de la lactancia..................................................................................... 25 5.4. Factores asociados con la continuidad de la lactancia .................................26 5.5. Factores asociados con el abandono de la lactancia .................................... 27 5.6. Contraindicaciones de la lactancia materna .................................................. 27 5.7. Promoción de la lactancia materna ................................................................ 29 6. PATOLOGÍAS ASOCIADAS CON LA LACTANCIA MATERNA .............................. 30 6.1. Trauma de pezón ............................................................................................... 30 6.2. Dolor en el pezón .............................................................................................. 30 6.3. Congestión mamaria ........................................................................................ 32 6.4. Mastitis ............................................................................................................... 33 6.5. Absceso mamario ............................................................................................. 39 7. PREVENCIÓN DE LAS PATOLOGÍAS MAMARIAS ............................................... 40 8. ESTADO DEL ARTE ................................................................................................ 41 9. OBJETIVOS ............................................................................................................. 45 9.1. Objetivo principal .............................................................................................. 45 9.2. Objetivos específicos ........................................................................................ 45 10. METODOLOGÍA PROPUESTA ............................................................................ 46 10.1. Pregunta de investigación ............................................................................. 46 10.2. Tipo de estudio................................................................................................ 46 10.3. Población ......................................................................................................... 46 10.3.1. Muestra ........................................................................................................ 46 10.3.2. Tamaño de la muestra ............................................................................... 46 10.3.3. Tipo de muestreo ....................................................................................... 47 10.4. Criterios de selección .................................................................................... 47 6 10.4.1. Criterios de inclusión ................................................................................. 47 10.4.2. Criterios de exclusión ................................................................................ 47 10.5. Variables del estudio .................................................................................... 48 10.6. Procedimientos del estudio......................................................................... 48 10.6.1. Estrategia de contacto de la cohorte ...................................................... 50 10.7. Plan de análisis ............................................................................................. 51 10.7.1. Análisis univariado .................................................................................... 51 10.7.2. Análisis bivariado ...................................................................................... 51 10.7.3. Análisis multivariado ................................................................................ 52 10.7.4. Análisis de pérdidas ................................................................................. 52 11. CONSIDERACIONES ÉTICAS ........................................................................... 53 12. RESULTADOS ................................................................................................... 55 12.1. Construcción de la cohorte ....................................................................... 55 12.2. Descripción de la cohorte- Análisis Univariado ................................ ..... 55 12.3. Análisis bivariado ........................................................................................ 62 12.4. Análisis multivariado ................................................................................... 70 12.5. Análisis de las pérdidas del seguimiento .................................................. 73 13. DISCUSIÓN ........................................................................................................ 77 14. LIMITACIONES .................................................................................................. 85 15. CONCLUSIONES ............................................................................................... 86 16. RECOMENDACIONES ....................................................................................... 87 17. REFERENCIAS BIBLIOGRÁFICAS ..................................................................... 88 18. ANEXOS ......................................................................................................... ... 99 18.1. Anexo 1. Tabla de operacionalización de las variables. ......................... 99 18.2. Anexo 2. Consentimiento Informado ........................................................ 106 18.3. Anexo 3. Instrumento parte 1 .................................................................... 110 18.4. Anexo 4. Instrumento parte 2 .................................................................... 113spa
dc.format.mimetypeapplication/pdfspa
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNABspa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.identifier.urihttp://hdl.handle.net/20.500.12749/22780
dc.language.isospaspa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.publisher.programEspecialización en Ginecología y Obstetriciaspa
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dc.relation.uriapolohttps://apolo.unab.edu.co/en/persons/ricardo-ortiz-serranospa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.rights.localAbierto (Texto Completo)spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.subject.keywordsExclusive breastfeedingspa
dc.subject.keywordsBreastfeedingspa
dc.subject.keywordsRisk factorsspa
dc.subject.keywordsAbandonmentspa
dc.subject.keywordsBreastfeeding difficultiesspa
dc.subject.keywordsNipple traumaspa
dc.subject.keywordsCracked nipplespa
dc.subject.keywordsEngorgementspa
dc.subject.keywordsAbscess breastspa
dc.subject.keywordsGynecologyspa
dc.subject.keywordsObstetricsspa
dc.subject.keywordsMedical sciencesspa
dc.subject.keywordsChild nutritionspa
dc.subject.keywordsParenteral feeding of childrenspa
dc.subject.keywordsChildren growthspa
dc.subject.lembGinecologíaspa
dc.subject.lembObstetriciaspa
dc.subject.lembCiencias médicasspa
dc.subject.lembNutrición infantilspa
dc.subject.lembAlimentación parenteral de niñosspa
dc.subject.lembNiños crecimientospa
dc.subject.proposalLactancia materna exclusivaspa
dc.subject.proposalLactancia maternaspa
dc.subject.proposalFactores de riesgospa
dc.subject.proposalAbandonospa
dc.subject.proposalDificultades de la lactanciaspa
dc.subject.proposalTrauma de pezónspa
dc.subject.proposalDolor en pezónspa
dc.subject.proposalPezón agrietadospa
dc.subject.proposalCongestión mamariaspa
dc.subject.proposalMastitisspa
dc.subject.proposalAbsceso de mamaspa
dc.titleAsociación entre las patologías puerperales de mama y el abandono de la lactancia materna en el Hospital Local del Nortespa
dc.title.translatedAssociation between puerperal breast pathologies and the abandonment of breastfeeding at the Hospital Local del Nortespa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aaspa
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.type.localTesisspa
dc.type.redcolhttp://purl.org/redcol/resource_type/TM

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