Dificultades en el desarrollo, aprendizaje y comportamiento de prematuros moderados y tardíos: revisión de la evidencia.
Introduction: Over the past decades, in Chile, as well as in some developed countries, an increase of birth rate of moderate preterm (MPT), infants born at 32 to 33 weeks gestational age (GE) and late preterm (LPT), infants born at 34 to 36 weeks GE, has been observed. The purpose of this paper is t...
| Publicado en: | Contacto Científico Clínica Alemana Vol. 4; no. 2; pp. 61 - 70 |
|---|---|
| Autor principal: | |
| Formato: | Artículo |
| Publicado: |
Clinica Alemana de Santiago
2014
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| Sumario: | Introduction: Over the past decades, in Chile, as well as in some developed countries, an increase of birth rate of moderate preterm (MPT), infants born at 32 to 33 weeks gestational age (GE) and late preterm (LPT), infants born at 34 to 36 weeks GE, has been observed. The purpose of this paper is to evaluate the evidence regarding the risk of long term difficulties in children born MPT and LPT. Main article: Moderate and late preterm infants have double risk of developmental delay, learning difficulties and behavioral problems than children born full term, but with confidence intervals close to 1 which decrease after adjustment by other perinatal risk factors. There is a higher MPT and LPT risk in children born with low GE, admitted to Neonatal Intensive Care, those born small for gestational age, male gender and with higher social vulnerability. Conclusions: Children born MPT and LPT have a small additional risk of long term complications, especially those with higher perinatal and social risk factors. A critical review of the published evidence and the development of prospective studies to have high quality evidence that respond to current controversies are necessary. Introducción: En las últimas décadas, tanto en Chile como en países desarrollados, se ha experimentado un aumento de los nacimientos prematuros moderados (PM) y tardíos (PT) (32 a 33 y 34 a 36 semanas de edad gestacional (EG)). El objetivo es evaluar la evidencia respecto al riesgo a largo plazo que tienen los PM y PT. Desarrollo: Los PM/PT tendrían hasta el doble de riesgo de dificultades en su desarrollo psicomotor, aprendizaje, cognición, comportamiento y salud mental, que los niños que nacen a término, pero con intervalos de confianza que pasan cerca de la unidad y se estrechan al ajustar por factores perinatales confundentes. Se describe un mayor riesgo en los PM/PT de menor EG, con hospitalizaciones en Unidades de Cuidados intensivos Neonatales, gemelares, pequeños para la edad gestacional, género masculino y de mayor vulnerabilidad social. Conclusiones: los PM y PT tienen un pequeño riesgo adicional de presentar problemas a largo plazo, que podría estar concentrado en aquellos que reúnen condiciones de mayor riesgo perinatal o social. Se invita a dar una mirada crítica a la evidencia publicada y diseñar cohortes prospectivas que permitan dar respuesta a las controversias planteadas. |
|---|