Estudio descriptivo y comparativo de las complicaciones a corto-medio plazo y de la demanda asistencial urgente de los prematuros tardíos en un hospital comarcal

Abstract

Background: preterm birth has increased over the last decades in developed countres; the principal contribution to this increase has been from "late pretem" infants, born at 34+0+36+6 weeks gestation. They are physiologically and metabolically immature and they are at a higher risk of morbidity and mortality. Objective: to evaluate the late preterm characteristics and its morbidity compared with term infants at Guadalajara University Hospital. Methods: it was performed a prospective and descriptive study of two cohorts of infants: late preterm born between January 2008 and March 2010 and term infants. The morbidity was registered during the first two years of life. Results: in the study period 306 late preterm were born at Guadalajara University Hospital and 283 were included in our study. Late preterm was associated with high maternal age and twin pregnancy. 164 were admitted to the neonatal care unit and the most frequent causes were low weight (31,4 %) and inmediate respiratory distress syndrome (29,3%). Since 8,4% were admitted for observation based exclusively in their immturity. We have observed a higher risk for morbidities in smaller gestational ages and they gad significantly higher morbidity compared with the term infants in all the situations: admission rate, readmission rate and the number of consults in the emergency pediatric department were higher, too. The predominant pathology was respiratory in all age ranges. Conclusions: late preterm consume a great amount of resources and require often logn-term hospitalisations in the neonatal period that could be sustituted by specific programmes of care and attention in the maternity. In other side, late preterm infants have higher morbidity than term infants in the first two years of live, mainly within the first six month