Prematuro tardíodesarrollo ponderoestatural y psicomotor durante el primer año de vida: morbimortalidad neonatal y en el primer año de vida

Résumé

Late preterm: growth and neuro-psychomotor development in the first year. Neonatal and infant morbidity and mortality. Objetive Analyze growth development, nutritional status and neuro-psychomotor development in late preterm as compared full-term infants. To describe the incidence of late preterm births. To describe neonatal and infant morbidity and examine the incidence of clinical complications in this group. Analyze changes in body composition by anthropometric parameters and body electrical impedance analysis at 6 and 12 months in late preterm and full-term infants. Methods Prospective cohort study of late preterm group as compared full-term infants. Babies with major congenital anomalies were excluded. Demographic and gestational characteristics, neonatal and infant morbidity were compared between full-term and late preterm infants at 1, 6 and 12 months of corrected age. Psychomotor development was assessed by Denver II screening test. Growth and body composition were assessed by anthropometric measurements and electrical impedance analysis. Data analysis was performed with the SPSS¿ versión 21 Software. The chi-squared test was used to compared categorical variables. For continuous variables, t-tests and one-way analysis of variance were used to compare means. Multivariable analyses were carried out using lineal regression. Differences were considered statistically significant when p < 0,05. Conclusions -Growth development in late preterm infants is similar to full-term infants, so we have to accept the null hypothesis -The percentage of fat mass is higher in late preterm infants, but there is not statistically significant difference. More studies are needed to investigate whether the high fat mass in late preterm may increase the risk of metabolic syndrome. -Higher postnatal weight gain for 6 months of life positively affects in fat mass content at one year of life. So, we argue that a rapid weight gain is not favourable during that time. -Late preterm infants had language delay as compared with full-term infants. The Denver II screening test is a simple, quick and useful tool to detect impaired psychomotor development. This test may be helpful for routine pediatric developmental screening in children with high risk for developmental delay. -Neonatal and infant mordibity in late preterm infants is higher than full-term infants. -The late preterm birth rate was 3.8 % in our Health area (67.8 % of all preterm births). -It is important that physicians continue to become aware of the indication of ending pregnancy based on scientific evidence. So, this will reduce the infant morbidity and mortality and its future impact in the health.