Situación funcional y calidad de vida de adultos que nacieron prematuros con peso menor de 1500 g en un hospital terciario entre los años 1987 y 2000

  1. Botella López, Vanesa
Supervised by:
  1. Vicente María Bosch Giménez Director
  2. Lucía Sanguino López Director

Defence university: Universidad de Murcia

Fecha de defensa: 18 October 2024

Committee:
  1. Julio Pérez López Chair
  2. Francisco Sánchez Ferrer Secretary
  3. Mercedes Juste Ruiz Committee member

Type: Thesis

Sustainable development goals

Abstract

Introduction: Improvements in obstetric care and advances in neonatology have led to an increase in the survival of very preterm newborns. During their admission they present numerous complications, which would suggest a worse prognosis in adulthood. Hypothesis: Prematurity and associated pathology during the neonatal period are related to functional situation and perceived quality of life in adulthood. Main objective: To relate the functional situation and the perceived quality of life in relation to health in adulthood (HRQoL), with prematurity, pathology associated with it and with the most relevant procedures during admission to neonatology, in the group of premature newborns (PTNB) weighing less than or equal to 1500 g. Material and Method: Observational, descriptive, analytical, retrospective and cross-sectional study. The study included premature newborns in the General Hospital of Alicante or transferred to this hospital with less than 24 hours of life, weighing less than 1500 g, and born between 1987 and 2000. PTNBs with major malformations, those transferred to their hospital of origin before of 2 weeks of life, and those subjects without administrative or untraceable data. For the collection of variables, medical records from the admission to neonatology and the follow-up consultation in neonatology and clinical psychology at 6 years were reviewed. In adulthood, they are invited to participate in a telematic survey that consists of 2 parts, the first on the functional situation and the second part on the perceived quality of life in relation to health (HRQoL) (version 2 of the SF 36 health questionnaire). Results: A total of 303 subjects were included. There were no differences in the baseline situation between participants and non-participants. The mean gestational age and weight were 29 weeks and 1169 g, respectively; 45.9% were men and 54.1% were women. At 5-6 years, 13.8% had been diagnosed with infantile cerebral palsy, 10.3% had intellectual disability, and 26% had Conners questionnaire scores compatible with Attention-Deficit/Hyperactivity Disorder. At the time of the survey, the subjects were between 23 and 36 years old. More than half of them had achieved studies higher than compulsory education and up to 36% had completed university studies. 56.8% were independent, 23.8% reported chronic illness and the majority had not required admission in the last year (95%). The mental health component was rated worse than the physical component. The lowest rated item was vitality and when comparing the scores with the Spanish population values, they scored better in all health items except emotional role and social function. The variables that had the greatest impact on both functional status and HRQoL were gestational age, birth weight and sex, as variables of the neonatal period, and IQ and performance reported by teachers from the assessment at 5-6 years. Conclusion: the adults born prematurely in our study can make an adequate transition to adulthood: most of them have a level of education higher than compulsory education, they live independently and during the time of young adulthood they do not have more chronic diseases or a higher rate of hospital admissions. Regarding HRQoL, they present worse scores in the mental health component than in the physical component, but they do not present differences, and they even score better in most of the health items.