哥伦比亚早产儿和/或低出生体重儿的围产期风险因素：关于听觉和视觉障碍的回顾性队列研究

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas Pub Date : 2024-11-01 DOI:10.1016/j.lana.2024.100921

Nathalie Charpak , Adriana Montealegre-Pomar , Lyda Teresa Rosero , Catalina Lince-Rivera , Darwin Cortés

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引用次数: 0

摘要

背景：新生儿护理的进步提高了早产儿或低出生体重儿（LBW）的存活率，但也引发了对长期神经感觉和精神运动挑战的担忧。目标：调查与早产儿或低出生体重儿的视觉和听觉问题有关的围产期因素，评估他们的长期生活质量。方法：重新登记一项对比了袋鼠妈妈护理（Kangaroo-Mother Care，KMC）和传统护理的 20 年随机对照试验的参与者。结果5.9%的参与者有功能性视力问题，8.1%的参与者有听力问题。有听力或视力障碍者的住院时间更长，新生儿并发症也更多。6个月时的格里菲斯听力分量表结果与长期听力结果之间存在相关性。只有27.5%的耳聋患者可以使用人工耳蜗或助听器，这导致他们的智商分数较低，学习困难，抑郁和自残的风险增加。视力受损者的智商分数、自尊心和家庭测试接受度都较低。然而，在生活质量、抑郁或依恋评分方面，他们与视力正常的群体并无差异。所有参与者，无论他们是否有问题，对自己生活质量的评价都高于他们的父母。释义有视力和听力缺陷的早产儿或低体重儿在成年后更有可能面临认知和情感方面的挑战。这项研究强调了采用多学科方法及时解决这些问题的重要性，从而降低出现长期神经发育和功能问题的风险。资金来源加拿大大挑战、富布赖特-哥伦比亚和哥伦比亚科学-联盟、世界银行，由哥伦比亚科学、技术和创新管理部（COLCIENCIAS）管理。

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Perinatal risk factors in ex-preterm and/or low birthweight Colombian young adults: a retrospective cohort study on auditory and visual impairments

Background

Advances in neonatal care have increased survival rates for premature or low birth weight (LBW) infants but raised concerns about long-term neurosensory and psychomotor challenges. Objective: to investigate perinatal factors linked to visual and auditory problems in ex-preterm or LBW young adults, assessing their long-term quality of life.

Methods

Participants from a 20-year-old randomised controlled trial comparing Kangaroo-Mother Care (KMC) to conventional care were re-enrolled. A group of 50 at term individuals without risk factors was assessed as a reference group.

Findings

5.9% of participants had functional visual issues and 8.1% experienced hearing problems. Those with hearing or visual impairments had longer hospital stays and more neonatal complications. Correlations were found between Griffiths auditory sub-scale results at 6 months and long-term auditory outcomes. Only 27.5% of those with deafness had access to cochlear implants or hearing aids, resulting in lower IQ scores, learning difficulties, and increased risk of depression and self-harm. Participants with visual impairments exhibited lower IQ scores, self-esteem, and HOME test acceptance. However, they did not differ from the group with normal vision in terms of quality of life, depression, or attachment scores. All participants, whether they had issues or not, rated their quality of life higher than their parents did.

Interpretation

Preterm or LBW infants with visual and hearing deficits are more likely to face cognitive and emotional challenges in adulthood. This study underscores the importance of a multidisciplinary approach to promptly address these vulnerabilities, reducing the risk of long-term neurodevelopmental and functional issues.

Funding

The Grand Challenge Canada, Fulbright Colciencias and Colombia Cientifica – Alianza, The World Bank, managed by the Colombian Administrative Department of Science, Technology and Innovation (COLCIENCIAS).

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来源期刊

Lancet Regional Health-Americas Multiple-

CiteScore

8.00

自引率

0.00%

发文量

期刊介绍： The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.