Resumen

MARTELL, Miguel et al. Asociación entre morbilidad neonatal y desarrollo en pretérminos a la edad escolar. Arch. Pediatr. Urug. [online]. 2007, vol.78, n.2, pp.99-109. ISSN 1688-1249.

Summary The aim of the study is the relationship between the morbility of very low birthweight newborns which required neonatal intensive care and their cognitive abilities during school. Material and method: this is a prospective cohort reconstruction study with a sample of 18 newborns whose birthweight was lower than 1.250 g. It was compared with a control group (term newborns with adequate birthweight), paired by their socioeconomic status. During the neonatal period in the intensive care unit morbility and neonatal severity were assessed using SNAP and NTISS from the first day with weekly controls, until delivery day. Two postnatal evaluations were done: pre-school assessment (between 3 and 4 years old) and at school age (between 8 and 9 years old). In the first evaluation the Denver scale was used to evaluate their neurodevelopment. A health classification system which can detect the health state of a child (MASH) was also used. During school-age the WISC-III scale which evaluates cognitive abilities was applied. In both periods weigth, height and craneal perimeter were measured. The relationship between the number of pathologies and cognitive scale was studied with a linear regression. Results: the average cognitive capacity (CIG) was 87,5±14,3 in the preterm group and 104,3±12,18 in the control group, showing a significant difference (p<0,003). The most frequent pathology was sepsis (47,8%). Pathology decreases cognitive score in 10 points (CI 95% = between 5 and 14), with a determinant coeficient: r² = 0,60 (p<0,05). Children who had three or more diseases developed severe neurodevelopment retardation. The severity of illness was significantly higher between 3 and 4 weeks of life. Conclusions: we found a significant relationship between neonatal complications and school outcomes in very low birth weight (<1.250 g).The newborn care in the intensive care units must aim at avoiding these complications, especially infectious diseases. Neonatal care implies a big responsibility for those who are in charge of the infrastructure and supervisision of the well-fucntioning of the units. Health carers should bare in mind that every complication will affect between 5 and 14 points the cognitive capacity at school.

Palabras clave : INFANT, VERY LOW BIRTH WEIGHT; INFANT, PREMATURE; MORBIDITY; CHILD DEVELOPMENT; COGNITION.

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