Resumen

MORAES, Mario; PIMIENTA, Mónica  y  MADERA, Nolberto. Morbilidad en pretérminos tardíos: estudio prospectivo caso control multicéntrico. Arch. Pediatr. Urug. [online]. 2009, vol.80, n.3, pp.196-202. ISSN 1688-1249.

Summary Introduction: in 2005 WHO established the recommendation called late preterm or premature late to those born between 34 weeks 0 days and 36 weeks 7 days. There is abundant literature documenting a significant increase in morbidity and mortality between 34 and 37 weeks but this is an underestimation of its importance because the survival of these children is high and minor complications in premature ends. Objectives: 1) determine the incidence of respiratory and metabolic complications in late preterm. 2) To examine whether the complications of newborns with gestational age 37 weeks is greater than at 39-40 weeks. Methods: we conducted a prospective case-control study in four maternity centers. The cases were divided into two populations of 34 to 36 weeks and 37 completed weeks. Were taken as controls subsequent event following event in the same service with 39 and 40 weeks. Results: the study included 86 cases and controls in CHPR, 36 of the city of Salto and 43 of Maldonado with a population of 165 cases and 165 controls (n = 330). 34 weeks were 12 cases, 35 weeks 23 cases, 36 weeks 35 cases, 37 weeks 93 cases. In the control population of 12 cases (7.27%) respiratory distress was due to TTN. In the late preterm noted 19 cases of respiratory distress (26.3%) of whom 17 (23.6%) were transient tachypnea, one case of hyaline membrane disease and one case of severe pulmonary hypertension (1.38%). The incidence of respiratory distress syndrome was statistically significant difference in late preterm OR 4.57 (1,95-10,82) but not at 37 weeks. In 24 late preterm metabolic disorders was observed (33.3%) and 5 in the control group (3%) OR 16 95% (5,40-50). At 37 weeks was observed in 8 (8.6%) OR 3.01 95% (0,86-10). Hypoglycemia in the late preterm was significant difference in term infants, p = 0.0001. OR 13.15 (2,60-89) but not at 37 weeks.OR 14.91 (1,73-335). Jaundice was presented with increased incidence of the term p: 0.003. OR 8.78 (1,61-62). There were no deaths in the study period. Conclusions: late preterm infants have a higher incidence of respiratory and metabolic disorders at 39-40 weeks. Hypothermia, hypoglycemia, and jaundice are common complications in this group. At 37 weeks the disease twice that observed at 39-40 weeks.

Palabras clave : RESPIRATION DISORDERS;  METABOLIC DISEASES; INFANT, PREMATURE, DISEASES; INFANT, NEWBORN.

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