Tabla I. Análisis descriptivo de las variables analizadas en los dos grupos. |
|||
Prematuros tardíos |
Nacidos a término |
p |
|
Sexo |
Varones: 30 (68%) Mujeres: 14 (32%) |
Varones: 30 (68%) Mujeres: 14 (32%) |
1,000 |
Edad gestacional (semanas) |
34 semanas: 9 (20%) 35 semanas: 10 (23%) 36 semanas: 25 (57%) |
39 semanas: 37 (84%) 37 semanas: 2 (4,5%) 38 semanas: 5 (38%) |
|
Microcefalia |
6 (14%) |
0 |
0,010 |
Multiparidad |
Gemelar: 2 (9%) Parto único: 40 (91%) |
Gemelar: 0 Parto único: 44 (100%) |
0,040 |
Tipo de parto |
Eutócico: 24 (54%) Instrumental: 6 (14%) Cesárea: 14 (32%) |
Eutócico: 34 (77%) Instrumental: 3 (7%) Cesárea: 7 (16%) |
0,080 |
Reanimación |
No: 38 (86,4%) Sí: 6 (13,6%) |
No: 38 (86,4%) Sí: 6 (13,6%) |
1,000 |
Tipo de reanimación |
Aspiración de secreciones: 1 (2,3%) VPPI: 4 (9%) Oxigenoterapia con CPAP nasal: 1 (2,3%) |
Aspiración de secreciones: 1 (2,3%) VPPI: 5 (11,4%) |
0,700 |
Ingreso en neonatología |
No: 22 (50%) Sí: 22 (50%) |
No: 36 (82%) Sí: 8 (18%) |
0,002 |
Ictericia |
No: 30 (68%) Sí: 14 (32%) |
No: 41 (93%) Sí: 3 (7%) |
0,006 |
Hiperbilirrubinemia con fototerapia |
9 (64%) |
0 |
0,002 |
Hipoglucemia |
9 (20%) |
1 (2%) |
0,008 |
Distrés respiratorio |
10 (23%) |
2 (5%) |
0,010 |
Intolerancia digestiva, dificultades con la alimentación |
7 (17%) |
18 (42%) |
0,200 |
Lactancia materna |
Sí: 42 (95,5%) No: 2 (4,5%) |
Sí: 42 (95,5%) No: 2 (4,5%) |
1,000 |
Duración de la lactancia materna |
≤ 3 meses: 16 (38%) 4-6 meses: 12 (28,5%) > 6 meses: 14 (33,5%) |
< 3 meses: 7 (16%) 3-6 meses: 15 (36%) > 6 meses: 20 (48%) |
0,070 |
≤ 3 meses: 16 (38%) > 3 meses: 26 (62%) |
≤ 3 meses: 7 (16%) > 3 meses: 35 (84%) |
0,020 |
|
Alteración del desarrollo psicomotor |
1 (2%) |
0 |
0,300 |
Patología materna |
No: 34 (71%) Sí: 10 (29%) |
No: 35 (78%) Sí: 9 (22%) |
0,200 |
Tipo de patología materna |
Hipotiroidismo: 4 (8%) Preeclampsia: 7 (15%) Diabetes: 3 (6%) |
Hipotiroidismo: 4 (8%) Preeclampsia: 2 (4,5%) Diabetes: 2 (4,5%) |
1,000 0,080 0,500 |
CPAP: presión positiva continua en la vía aérea; VPPI: ventilación con presión positiva no invasiva. |
Tabla II. Comparación del test de Brunet-Lézine y del cuestionario ASQ-3 por sexo. |
|||
Varones |
Mujeres |
p |
|
Edad de desarrollo global |
23,2 ± 2,5 |
24,5 ± 2,6 |
0,020 |
Edad de desarrollo postural |
23,6 ± 2,4 |
23,3 ± 2,7 |
0,600 |
Edad de desarrollo oculomotriz |
23,5 ± 2,7 |
24,7 ± 3,0 |
0,020 |
Edad de desarrollo del lenguaje |
22,9 ± 4,1 |
25,0 ± 3,7 |
0,020 |
Edad de desarrollo de la sociabilidad |
23,7 ± 2,6 |
25,6 ± 2,4 |
0,003 |
Cociente de desarrollo global |
93,0 ± 9,2 |
99,1 ± 9,4 |
0,006 |
Cociente de desarrollo postural |
94,3 ± 10,0 |
94,4 ± 9,6 |
0,900 |
Cociente de desarrollo oculomotriz |
94,0 ± 10,3 |
100,0 ± 11,3 |
0,010 |
Cociente de desarrollo del lenguaje |
91,3 ± 15,5 |
100,8 ± 13,8 |
0,008 |
Cociente de desarrollo de la sociabilidad |
94,8 ± 10,2 |
103,5 ± 10,0 |
< 0,001 |
ASQ-3 comunicación |
48,5 ± 14,1 |
55,5 ± 7,2 |
0,010 |
ASQ-3 motor grueso |
53,1 ± 8,9 |
52,2 ± 9,3 |
0,600 |
ASQ-3 motor fino |
49,3 ± 7,1 |
48,3 ± 7,4 |
0,500 |
ASQ-3 resolución de problemas |
45,5 ± 10,6 |
45,3 ± 9,3 |
0,900 |
ASQ-3 socioindividual |
48,5 ± 10,5 |
54,4 ± 6,4 |
0,008 |
ASQ-3: Ages & Stages Questionnaires. |
Psychomotor development in late preterms at two years of age: a comparison with full-term newborn infants using two different instruments Introduction. Late preterm infants currently constitute 70% of preterm infant births. They present greater comorbidity, including neurodevelopment disorders, which may not manifest until the school age. Aim. To identify the existence of difficulties in the neurodevelopment at the age of two years. Subjects and methods. The psychomotor development was performed at two years of age in late preterm infants and term control group born at our center between January and September 2014, with Brunet-Lézine Revised test and Ages & Stages Questionnaires (ASQ-3) questionnaire. Results. 88 children were included. Late preterm infants had lower scores in the language area and postural developmental. Girls achieved better results than males at global developmental age, oculo-motor coordination, language area and sociability. The ASQ-3 questionnaire detected differences in communication and socio-individual. Prematurity and male sex were identified as an independent risk factor to present a developmental disorder, prematurity for language impairment and male sex for younger developmental age and language impairment. The correlation between language assessment with the Brunet-Lézine Revised test and the ASQ-3 questionnaire was good, with a Pearson correlation coefficient of 0.7 (p < 0.001), showing the usefulness of the questionnaire. Conclusions. Late preterm infants have a lower developmental age in the language area at two years. Prematurity and male sex are risk factors for developmental disorder. Language assessment with the ASQ-3 questionnaire may be a useful tool to detect disorders and intervene early. Key words. ASQ-3. Brunet-Lézine Revised. Language impairment. Late preterm infant. Neonatal morbidity. Neurodevelopment disorders. Psychomotor development. |