<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1029-3019</journal-id>
<journal-title><![CDATA[MEDISAN]]></journal-title>
<abbrev-journal-title><![CDATA[MEDISAN]]></abbrev-journal-title>
<issn>1029-3019</issn>
<publisher>
<publisher-name><![CDATA[Centro Provincial de Información de Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1029-30192020000300455</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Análisis de complejidad en la caracterización de episodios de morbilidad materno-infantil]]></article-title>
<article-title xml:lang="en"><![CDATA[Analysis of complexity in the characterization of maternal and child morbidity episodes]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Palú Orozco]]></surname>
<given-names><![CDATA[Adrián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Orozco González]]></surname>
<given-names><![CDATA[María Iluminada]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castellanos Abad]]></surname>
<given-names><![CDATA[Eriakna]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cruz Elegia]]></surname>
<given-names><![CDATA[Marcia María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas Centro Provincial de Higiene, Epidemiología y Microbiología ]]></institution>
<addr-line><![CDATA[Santiago de Cuba ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Ciencias Médicas Unidad Municipal de Higiene, Epidemiología y Microbiología ]]></institution>
<addr-line><![CDATA[Santiago de Cuba ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Provincial Ginecoobstétrico Mariana Grajales Coello  ]]></institution>
<addr-line><![CDATA[Santiago de Cuba ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<volume>24</volume>
<numero>3</numero>
<fpage>455</fpage>
<lpage>472</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1029-30192020000300455&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1029-30192020000300455&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1029-30192020000300455&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  La salud materno-infantil constituye una prioridad bien definida en el sistema sanitario de Cuba, por lo que el estudio de problemas sanitarios complejos resulta de incuestionable valor.  Objetivo:  Caracterizar a féminas con infecciones asociadas a la asistencia sanitaria o preeclampsia, desde el paradigma de la complejidad.  Métodos:  Se desarrolló una investigación compleja trietápica en el Hospital Provincial Ginecoobstétrico Mariana Grajales Coello de Santiago de Cuba, que incluyó un análisis de serie temporal y un estudio observacional, descriptivo y transversal, para lo cual se tomaron 1 896 pacientes diagnosticadas con infecciones asociadas a la asistencia sanitaria, desde el año 2004 al 2017, y 140 gestantes con preeclampsia, registradas en el quinquenio 2013-2017; además, se consideraron variables clínicas, epidemiológicas, humorales, ecográficas y anatomopatológicas. Se efectuaron análisis de series temporales (descomposición estacional, análisis espectral e identificación de componentes de la serie), de componentes principales y de redes neuronales; a la vez que se identificaron los patrones estacionales específicos y microbiológicos para las infecciones asociadas a la asistencia sanitaria.  Resultados:  La edad, la historia obstétrica y las fluctuaciones de la tensión arterial resultaron ser factores predictores de importancia relacionados con la preeclampsia, además de los fallos renal y hepático como agravamientos y/o complicaciones de dicha entidad clínica.  Conclusiones:  La utilización de métodos de análisis multinivel reveló el complejo entramado que se establece entre las variables clínicas, epidemiológicas, sociales y ambientales en relación con las infecciones asociadas a la asistencia sanitaria y la preeclampsia, lo que se evidenció con los hallazgos anatomopatológicos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  The maternal and child health constitutes a very defined priority in the health system of Cuba, reason why the study of complex health problems is of unquestionable value.  Objective:  To characterize women with infections associated with the health assistance or pre-eclampsia, from the paradigm of complexity.  Methods:  A complex three phase investigation was carried out in Mariana Grajales Coello Provincial Gynecoobstetric Hospital in Santiago de Cuba that included a temporary series analysis and an observational, descriptive and cross-sectional study, for which 1 896 patients diagnosed with infections associated with the health assistance, from 2004 to 2017, and 140 pregnant women with pre-eclampsia, registered in the five year period 2013-2017 were selected, also, clinical, epidemiological, humoral, echographic and pathologic variables were considered. Temporary series analysis (seasonal factorization, spectral analysis and identification of the series components), of main components and neural network were carried out; at the same time that the specific seasonal and microbiological patterns were identified for the infections associated with health assistance.  Results:  The age, obstetric history and fluctuations of blood pressure were important prediction factors related to pre-eclampsia, besides renal and hepatic failure as worsenings and/or complications of this clinical entity.  Conclusions:  The use of multilevel analysis methods revealed the complex structure that is established between the clinical, epidemiological, social and environmental variables in connection with the infections associated with health assistance and pre-eclampsia, what was evidenced with the pathologic findings.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[epidemiología social]]></kwd>
<kwd lng="es"><![CDATA[complejidad de problemas sanitarios]]></kwd>
<kwd lng="es"><![CDATA[salud materno-infantil]]></kwd>
<kwd lng="es"><![CDATA[infecciones asociadas a la asistencia sanitaria]]></kwd>
<kwd lng="es"><![CDATA[preeclampsia]]></kwd>
<kwd lng="en"><![CDATA[social epidemiology]]></kwd>
<kwd lng="en"><![CDATA[complexity of health problems]]></kwd>
<kwd lng="en"><![CDATA[maternal and child health]]></kwd>
<kwd lng="en"><![CDATA[infections associated with health assistance]]></kwd>
<kwd lng="en"><![CDATA[pre-eclampsia]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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