Cuidados perinatales del prematuro moderado y tardío en España. Impacto de la pandemia por SARS-CoV-2 / Perinatal care of moderate and late preterm in Spain. Impact of the SARS-CoV-2 pandemic

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Predictive value of the Ages and Stages Questionnaire® for school performance and school intervention in late preterm- and term-born children.

BACKGROUND: The new health supervision guidelines emphasize the importance of surveillance or a formal developmental screening test at 4 years, one of the most used tests is Ages & Stages Questionnaire. Nevertheless, there is still not enough evidence whether these tools will be useful to predict future school performance (SP). OBJECTIVES: The objectives of this study were to evaluate the Ages & Stages Questionnaire 3rd edition 48-month interval (ASQ3-48) translated to Spanish for predicting the need for school intervention (SI) and poor SP at 8-9 years of age, in late preterm infants (LPIs) and term-born infants (Terms) and to compare the prevalence of SI and poor SP in the two groups. METHODS: Data were collected from a cohort of 75 LPIs and 58 Terms assessed with ASQ3-48 and with a further assessment of academic results at 8-9 years, through a standardized school test of the Education Department of Catalonia. SI data were obtained through a parent report. Area under the curve (AUC), sensitivity, specificity and predictive values were calculated, and logistic regression analysis was used. RESULTS: The prevalence of poor SP was 12.8%, without statistically significant differences between LPIs and Terms. LPIs had higher SI than Terms (29.3% vs. 10.3%, P = 0.001). AUC for poor SP was 0.73 and for receiving SI was 0.56 without differences between the two groups. The sensitivity of the ASQ3-48 for poor SP was 41%, for specificity 92%, and for receiving SI 14% and 89%, respectively. Poor SP was related to having positive screening in the ASQ3-48 (OR 6.5 [95% CI, 1.9-22.2]) while having received SI was related to late prematurity (OR 3.6 [95% CI, 1.3-9.6]). CONCLUSIONS: The ASQ3-48 shows acceptable predictive properties for poor SP but not for receiving SI. No differences were found in SP between LPI and Term cohorts, but LPIs are likelier to require SI.

Cognitive and Learning Outcomes in Late Preterm Infants at School Age: A Systematic Review.

Late preterm children born between 340/7 and 366/7 weeks' gestation account for ≈70% of prematurely born infants. There is growing concern about this population at risk of mild neurodevelopmental problems, learning disabilities and lower academic performance. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, this paper analyzes recent published evidence from 16selected studies involving late preterm children and control group assessments at preschool and/or school age, mainly focusing on cognitive functioning, language learning and academic achievement. The review identifies the assessment tools used in these studies (standardized tests, parental questionnaires and laboratory tasks) and the areas being evaluated from preschool (age 3 years) to primary school levels. Results reveal the presence of mild difficulties, pointing to suboptimal outcomes in areas such as executive function, short term verbal memory, literacy skills, attention and processing speed. Some difficulties are transient, but others persist, possibly compromising academic achievement, as suggested by the few studies reporting on higher risk for poor school performance. Given the increasing number of late preterm children in our society the review highlights the need to implement screening strategies to facilitate early risk detection and minimize the negative effects of this morbidity in childhood.

Test de PCR a SARS-CoV-2 persistentemente positivo. No siempre la detección del virus es COVID-19 / PCR test for SARS-CoV-2 persistently positive. Virus detection is not always COVID-19

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Reliability and agreement of ages and stages questionnaires®: Results in late preterm and term-born infants at 24 and 48 months.

AIM: To evaluate the reliability of the Ages and Stages Questionnaires (ASQ-3) 24 and 48 month intervals translated to Spanish by Brookes Publishing, and the agreement between both questionnaires, comparing late preterm (LPI) and term-born infants (terms). METHODS: Two cohort samples of healthy LPI and terms that were born in a private hospital in Barcelona, Spain. Internal consistency was analyzed by Cronbach's alpha scores and Pearson product- moment correlation between the domain scores and the overall score. The agreement was analyzed using Pearson's correlations between the two questionnaires, and the odds ratio (OR) for positive screening at 48 months, given a positive screen in 24 month assessment. RESULTS: A total of 473 evaluations were analyzed, representing 331 children. Cronbach's alpha scores for the motor domains on both intervals were low, but acceptable compared with the overall score; a strong positive correlation between the domain and overall score were obtained in the majority of the domains. The correlation between the 24 and 48 month total scores were positive, especially for LPI. Having at least 2 domains in the referral zone at 24 months was associated with an OR of 140 [95% CI 14.85; 3575.65] for positive screen at 48 months. CONCLUSION: The Spanish ASQ-3 24 and 48 month intervals appear to be a reliable for developmental screening and for the follow-up of children, especially for LPI. Having two or more domains in the referral zone at 24 months screening is a significant predictor of developmental delay risk at 48-month questionnaire.

Impact of neonatal morbidity on the risk of developmental delay in late preterm infants.

BACKGROUND: Late preterm infants (LPI) have a higher risk of developmental delay (DD) than term-born infants. The association of perinatal complications with specific morbidity is not clear. AIM: (1) To compare the risk of DD at 4years of age between LPI who have presence or absence of any morbidity associated with the prematurity at birth, called complicated (cLPI) or uncomplicated (uLPI), and term-born infants, (2) to determine maternal and perinatal factors associated with risk of DD, and (3) to analyze, in LPI, the association between perinatal morbidity and risk of DD. METHODS: A retrospective cohort study including 163 LPI - 47 cLPI and 116 uLPI - and 158 term-born infants (Terms) was conducted. Parents completed the Ages & Stages Questionnaires®3rd Spanish version (ASQ3). Risk of DD was defined as the presence of any ASQ3 domain scoring below the mean minus 2 SD. Association between risk of DD and maternal and perinatal factors was analysed using a multivariate logistic model. Incidence of risk of DD was analysed according to specific morbidity. RESULTS: Compared to Terms, cLPI have a higher risk of DD in the communication domain. Respiratory pathology was associated with a higher risk in the communication domain. Caesarean delivery was the only maternal perinatal risk factor for DD, especially in gross motor domain. CONCLUSIONS: At the age of 4years cLPI, especially those with respiratory morbidity, had a higher risk of communication delay. Caesarean delivery was the only perinatal risk factor associated with risk of DD.

Valors de tensió arterial en nadons sans / Valores de tensión arterial en recién nacidos sanos / Blood pressure values in healthy newborns

Fonament: escassetat d'estudis sobre el valor de la tensió arterial en nounats sans. Objectiu: determinar els valors de tensió arterial en el pe-ríode neonatal immediat en nounats sans. Mètode: cohort de 4.496 nadons de 36 a 41 setmanes de gestació, entre gener de 2007 i desembre de 2010, sense malformacions congènites. Mesura de la tensió arterial sistòlica, diastòlica i mitjana per mètode oscil•lomètric al moment de l'ingrés a la sala de nadons, als 30-60 minuts de vida. Registre dels resultats en una base de dades amb els valors de pes en néixer i edat gestacional. Resultats: els valors de tensió arterial varien amb l'edat gestacional, amb increments significatius des de les 36 fins a les 41 setmanes, així com amb el pes en néixer. Conclusions.: és important establir patrons estàndard de tensió arterial en el període neonatal amb la finalitat de detectar anormalitats. L'edat i el pes en néixer influeixen en els resultats. La metodologia hi té un paper essencia

Fundamento. Escasez de estudios sobre el valor de la tensión arterial en recién nacidos sanos. Objetivo. Determinar los valores de tensión arterial en el período neonatal inmediato en recién nacidos sanos. Método. Cohorte de 4.496 recién nacidos de 36 a 41 semanas de gestación entre enero de 2007 y diciembre de 2010 sin malformaciones congénitas. Medición de la tensión arterial sistólica, diastólica y media por método oscilométrico a su ingreso en la nursería, a los 30-60 minutos de vida. Registro de los resultados en una base de datos junto a los valores de peso al nacer y edad gestacional. Resultados. Los valores de tensión arterial varían con la edad gestacional, con incrementos significativos desde las 36 a las 41 semanas, así como con el peso al nacer. Conclusiones. Es importante establecer patrones estándar de tensión arterial en el período neonatal. La edad y el peso al nacer influyen en los resultados. La metodología juega un papel esencial (AU)

Background. There is a paucity of studies on blood pressure values in healthy newborns. Objective. To determine the values of blood pressure in the immediate neonatal period in healthy newborns. Methods. A cohort of 4,496 newborn infants of 36 to 41 weeks of gestational age born between January 2007 and December 2010 were included in the study. Newborns with congenital malformations were excluded. Measurement of arterial blood pressure, including systolic, diastolic, and median, was performed using an oscillometric method at the time of admission to the nursery, which was within 30 to 60 minutes of life. The results were recorded in a database, along with the birth weight and gestational age. Results. The blood pressure values vary with gestational age, with significant increases from 36 to 41 weeks, and with birth weight. Conclusions. It is important to define the normal blood pressure patterns in the neonatal period. Gestational age, birth weight, and the method used may influence blood pressure readings (AU)