Ganancia inicial de peso del recién nacido de término hijo de madre adolescente / Early weight gain of infants born to adolescent mothers

RESUMEN

Introducción: el embarazo de la adolescente es frecuente en Chile; sus hijos pueden tener mayor riesgo de lactancia materna insuficiente de cuidados inadecuados y mal incremento ponderal. Objetivo: Estudiar la ganancia de peso durante el 1er mes de vida de recién nacidos (RN) hijos de madres adolescentes y su asociación con riesgo de ictericia, hospitalización y abandono de lactancia materna. Sujetos y métodos: Se estudiaron 40 RN de término, hijos de madres primíparas adolescentes < 19 anos, de estratos socioeconómicos bajos, adecuados para la edad gestacional (AEG), sin patología aguda o malformaciones, (GE; H/M 27/ 13) y se compararon con 36 RN de madres adultas primíparas (GC; H/M 19/17), de un hospital público de Santiago. Fueron controlados en atención primaria (peso, talla) con mediana a los 8 y 30 días en ambos grupos, se consultó por ictericia, lactancia materna y hospitalización. Resultados: Al 8° día la ganancia de peso fue GE -1,5 g/día (-107 vs +36) vs GC -5,7 g/d (-59 a +39) (NS), < al incremento esperado por OMS (14-21g/d), habían recuperado peso de nacimiento 52% de GE y 44% GC (NS). Al mes no hubo diferencias en el incremento diario (GE 31; -1,7 a 79 g/d, GC 28; -3 a 63 g/d NS), semejantes a estándares OMS (x 34g/día en hombres y 29g/día en mujeres). Al subdividir GE en grupos de madres de 15 a 16 y de 17 a 18 anos, se observó un mayor incremento diario el 1er mes en el grupo de 15 a 16 anos 38 g/d (9-79) vs 17 a 18 anos 25g/d (-1,7 a 57) (p< 0,02) y con el GC (p<0,02). No hubo diferencias en el riesgo de ictericia al 3° día GE12/40, GC 7/36 (NS), pero hubo diferencia al 8° día, GE 13/40, GC 2/36 (OR 8,2 IC1,7-39; p=0,003), sin mayor riesgo de hospitalización. Ambos grupos recibieron lactancia materna, con fórmula artificial en GE 8/40, GC 10/36 (NS). Conclusiones: Los hijos de madre adolescentes no presentan mayor riesgo de retraso en la recuperación de PN comparados con hijos de madres primíparas adultas, el sub-grupo de hijos de adolescentes de 15 a 16 anos tuvieron un mayor incremento de peso que el de 17 a 18 anos y el GC. Si bien el riesgo de ictericia al 8° día es mayor en el GE, este no constituyó un factor de hospitalización. Presentan buena adherencia a lactancia materna.

ABSTRACT

Background: Adolescent pregnancy is frequent in Chile, and their infants could present an increased risk of inadequate breast feeding and weight gain. Objectives: To assess the early weight gain in infants born to Chilean adolescent mothers and their association with breast feeding, risk ofjaundice and hospitalization. Subjects and methods: Fortyfull-term and adequatefor gestational age newborns (SG; M/F 27/13), born to healthy adolescent mothers (less than < 19 y at delivery) (SG) from low socioeconomic groups, were recruited in a public hospital in Santiago, Chile. They were paired with 36 born to healthy primiparous adult mothers (control group CG; M/F19/17); those born with low birth weight or congenital malformations were excluded. They were assessed at well baby clinics in primary care centers for weight, length, (median age 8 and 30 d.; breast feeding, jaundice and hospitalization were registered). Results: No significant differences were found in weight gain at 8th day of age (SG -15 g/d (-107 to +36); CG -5,7 g/d (-59 to +39) (NS), both lower than the weight increments of WHO standards (14-21 g/d); birth weight recovery was found in SG 52%% and CG 44% (NS). Neither a difference was found at 30 days (SG 31g/d (-1.7 to +79), CG 28 g/d (-3 to63); (NS), comparable to WHO standards (males 34 g/d; females 29 g/d). However, the sub-group of infants born to adolescent mothers 15-16 y. presented a greater weight gain than those to adolescents mothers 16-17 y. (38 g/d (9 to 79 vs 25 g/d ,-1,7 to + 57) than the CG (p<0.02). Formula breast feeding was provided to 8/40 in SG and 10/36 in CG (NS). No differences in jaundice was found at the 3rd day, but an increased rate was observed at the 8th day (SG 13/40 vs CG2/36) (OR 8.2; CI 1.7-39; p=0.003), without an increased risk of hospitalization. Conclusions: Infants born to Chilean adolescent mothers have a comparable weight gain to infants born to adult mothers, with a comparable time of birth weight recovery. Those born to mothers 15-16 years of age had a greater weight gain than those born to mothers 17-18 years or adult mothers. Jaundice to the 8° day was greater in the SG with no increased rate of hospitalization. They present a good rate of breast feeding.