Publication: Análisis evolutivo de las secuelas neurocognitivas en los niños nacidos con una edad gestacional inferior a 32 semanas y/o peso al nacer menos de 1500 gramos
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2017-02-27
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Universidad Complutense de Madrid
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Abstract
Los avances clínicos y de investigación llevados a cabo en los últimos años no han impedido que los índices de prematuridad continúen aumentando en los países desarrollados. La importancia de conocer mejor este tipo de nacimientos radica tanto en la supervivencia de los neonatos como en la gran preocupación por su morbilidad. Las secuelas sensoriales y neurológicas son frecuentes y conocidas por los profesionales sanitarios, sin embargo las alteraciones neurocognitivas que sufren estos niños y que parecen ser inversamente proporcionales a la edad gestacional y peso al nacer han adquirido una notable trascendencia. Los trastornos del neurodesarrollo se consideran alteraciones vinculadas a la maduración cerebral. Por ello, se inician en la infancia y se expresan de forma diferente en distintas etapas del crecimiento. Son alteraciones que evolucionan de acuerdo con la formación del sistema nervioso central y que regulan las funciones motoras, sensitivas, cognitivas y emocionales que permiten la adaptación al medio. Los niños nacidos de forma prematura son vulnerables a padecer trastornos del neurodesarrollo por contar con un cerebro inmaduro y un tipo especifico de vascularización que la hace especialmente sensible a sufrir lesiones cerebrales. Además la maduración cerebral en un ambiente extrauterino puede ser objeto de importantes modificaciones lo que podría derivar en anomalías cerebrales no estructurales que contribuirían a explicar los problemas cognitivos, conductuales y emocionales que pueden aparecer en los niños nacidos con una edad gestacional menor a 37 semanas y/o peso inferior a 2.500 gramos...
The clinical advancement and research made in recent years did not prevent premature birth rates, which continue to increase in developed countries. The importance to understand better this type of birth inhabits so much in the survival of newborns, which is a great concern for morbidity. Sensory and neurologic consequences are common and known by the health professionals, however the neurocognitive disorders are suffered by these children and they seem to be inversely proportional to the gestational age and birth weight that have acquired considerable importance. The ‘neurodevelopmental’ disorders are considered to be disorders linked to brain maturation. Therefore, they begin in the childhood and are revealed differently in different stages of growth. The disorders, which evolve according to the formation of the central nervous system and which regulates the motor (driving force), sensitive, cognitive and emotional functions that allow adaptation to the environment. Children born with premature form are vulnerable to suffer ‘neurodevelopmental’ disorders by having an immature brain and a specific type of vascularization making it especially sensitive to suffer brain injuries and also brain maturation in an ectopic environment which could be subject to substantial changes leading to non-structural brain abnormalities that could help to explain the cognitive, behavioral and emotional problems that can occur in the infants born at a gestational age less than 37 weeks and / or less than 2500 grams In order to improve knowledge about the clinical and prognostic characteristics of this population, there have been emerged monitoring programs with the objective of multidisciplinary therapeutic approach towards these children, and that the Monitoring Program of the University Hospital ‘12 de Octubre’ has been a pioneer, encouraging the foundation of this study...
The clinical advancement and research made in recent years did not prevent premature birth rates, which continue to increase in developed countries. The importance to understand better this type of birth inhabits so much in the survival of newborns, which is a great concern for morbidity. Sensory and neurologic consequences are common and known by the health professionals, however the neurocognitive disorders are suffered by these children and they seem to be inversely proportional to the gestational age and birth weight that have acquired considerable importance. The ‘neurodevelopmental’ disorders are considered to be disorders linked to brain maturation. Therefore, they begin in the childhood and are revealed differently in different stages of growth. The disorders, which evolve according to the formation of the central nervous system and which regulates the motor (driving force), sensitive, cognitive and emotional functions that allow adaptation to the environment. Children born with premature form are vulnerable to suffer ‘neurodevelopmental’ disorders by having an immature brain and a specific type of vascularization making it especially sensitive to suffer brain injuries and also brain maturation in an ectopic environment which could be subject to substantial changes leading to non-structural brain abnormalities that could help to explain the cognitive, behavioral and emotional problems that can occur in the infants born at a gestational age less than 37 weeks and / or less than 2500 grams In order to improve knowledge about the clinical and prognostic characteristics of this population, there have been emerged monitoring programs with the objective of multidisciplinary therapeutic approach towards these children, and that the Monitoring Program of the University Hospital ‘12 de Octubre’ has been a pioneer, encouraging the foundation of this study...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Psiquiatría, leída el 05-02-2016