Publication: Seguimiento a los 24 meses de edad corregida de una cohorte de niños con peso al nacimiento menor de 1500 gramos en el Hospital Clínico San Carlos
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2017-09-08
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Universidad Complutense de Madrid
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Abstract
Sabemos que el recién nacido pretérmino de muy bajo peso al nacimiento es un paciente complejo, muchas veces con presencia de patología intercurrente grave, que puede dejar secuelas ya en este periodo o bien ser una situación que genera potencial secuelar evolutivo, que incidirá en los primeros meses-años en la alteración del desarrollo neuromotor y neurosensorial, dejando menos evidencia de la alteración neurocognitiva que se desarrolla biológicamente en plenitud en años posteriores. Dentro de las comorbilidades neonatales que se han destacado como relevantes en su potencial de génesis de secuelas del desarrollo destacan la displasia broncopulmonar, la enterocolitis necrotizante, las sepsis precoz y tardías, la hemorragia intraventricular grave, la leucomalacia periventricular quística y la retinopatía del prematuro. Todas ellas se dan en un contexto favorecido por la propia prematuridad, siendo su incidencia y, muchas veces también su gravedad, inversamente proporcional a la edad gestacional del recién nacido. Otro hecho importante en este periodo neonatal y que tiene repercusión en la evolución tras el alta hospitalaria es la restricción de crecimiento postnatal que tienen la mayoría de los RN pretérmino, evidenciado por un z-score más bajo al alta neonatal que al nacimiento en muchos casos...
We know that during neonatal intensive care unit (NICU) admission, the very low birth weight infant (VLBWI) often develops severe morbidity. This may produce sequelae in this early period or in the long term, which will impact the neuromotor and neurosensory development of the patient and the final outcome. There is often less evidence of neurocognitive impairment in the early years that will biologically develop completely in later years. Among the neonatal morbidities that have been highlighted as relevant because of their potential to impact neurodevelopment are bronchopulmonary dysplasia, necrotizing enterocolitis, early and late-onset sepsis, severe intraventricular hemorrhage, cystic periventricular leukomalacia and retinopathy of prematurity. All of them take place in a context favored by prematurity itself, and its incidence and severity are usually inversely proportional to the gestational age of the newborn. Another important fact in the neonatal period, that also has an impact on post discharge evolution, is the postnatal growth restriction of most preterm infants, evidenced by a lower z-score at discharge than right after birth...
We know that during neonatal intensive care unit (NICU) admission, the very low birth weight infant (VLBWI) often develops severe morbidity. This may produce sequelae in this early period or in the long term, which will impact the neuromotor and neurosensory development of the patient and the final outcome. There is often less evidence of neurocognitive impairment in the early years that will biologically develop completely in later years. Among the neonatal morbidities that have been highlighted as relevant because of their potential to impact neurodevelopment are bronchopulmonary dysplasia, necrotizing enterocolitis, early and late-onset sepsis, severe intraventricular hemorrhage, cystic periventricular leukomalacia and retinopathy of prematurity. All of them take place in a context favored by prematurity itself, and its incidence and severity are usually inversely proportional to the gestational age of the newborn. Another important fact in the neonatal period, that also has an impact on post discharge evolution, is the postnatal growth restriction of most preterm infants, evidenced by a lower z-score at discharge than right after birth...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Pediatría, leída el 25/01/2016