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Revista Cubana de Pediatría

versión impresa ISSN 0034-7531

Resumen

MENDOZA TASCON, Luís Alfonso et al. Gestational age-associated morbidity in late preterm neonates. Rev Cubana Pediatr [online]. 2012, vol.84, n.4, pp.345-356. ISSN 0034-7531.

Objective: to compare the short-term morbidity, the number of interventions, the length of stay at hospital and the incurred costs between 34-weeks neonates and over-34 weeks newborns, who had been admitted to the neonatal intensive care units of Fundacion Hospital San Jose de Buga in Colombia from September 19th 2005 to September 18th 2011. Methods: retrospective cohort study in forty 34-weeks newborns and one hundred twenty nine 35-36 weeks neonates. Maternal and neonatal factors as well as applied therapies were evaluated. The analysis covered summary statistics and bivariate analysis. For finding association, the relative risk with 95 % confidence interval, and the Pearson's chi square test of independence were used. Results: respiratory morbidity was found in 32.5 % of patients, jaundice in 29 %, gastrointestinal morbidity in 13.6 %, metabolic morbidity in 13.6 %, cardiac morbidity in 1.8 %, hematological morbidity in 1.2 % and hypothermia and sepsis were seen in 1.2 % of patients. Renal failure affected 0.6 % of neonates, without statistical difference between the groups. There was statistically significant difference (p< 0,05) for fasting time (over 2 days), parenteral nutrition and time of oxygen therapy (more than 2 and 5 days, respectively), time of mechanical ventilation and long stays at hospital (over 7 days); the 34-weeks neonates were the most affected in terms of morbidity. Weight, size and head perimeter figures at birth and at discharge from the hospital were lower in the 34 weeks group, whereas the delayed intrauterine growth was greater in the 35 and 36 weeks neonates (26,4 vs. 7,5 %; RR: 1,3; IC 95 %: 1,1-1,5; p< 0,05). The care of 34 week neonates at hospital is, therefore, 1.6 and 0.6 times more expensive than that of 35 and 36-weeks newborns. Conclusions: the late preterm infant should be considered as immature with morbidity and mortality risks. The incidence of jaundice, respiratory, gastrointestinal and metabolic morbidities is high; however, the 34-week newborns require more interventions than the 35 and 36 weeks neonates.

Palabras clave : late preterm infant; short-term morbidity; birthweight.

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