Cuidados centrados en el desarrollo en unidades de neonatología de México, 2015. Encuesta a través de redes sociales / Developmental centered care in Neonatology Units of Mexico, 2015. Inquiry through social networks

Resumen ANTECEDENTES: los cuidados centrados en el desarrollo tienen por objeto favorecer el desarrollo neurosensorial y emocional del recién nacido, disminuir el estrés asociado con la atención neonatal, el dolor relacionado con pruebas diagnósticas y los tratamientos invasores. OBJETIVO: describir el grado de implementación de los cuidados centrados en el desarrollo en las unidades de cuidados intensivos neonatales de México. MATERIALES Y MÉTODOS: estudio transversal, observacional y descriptivo. Por medios electrónicos se envió a personal que labora en unidades de cuidados intensivos neonatales, que atienden a más de 50 menores de 1500 g cada año, un cuestionario enfocado a los cuidados centrados en el desarrollo. RESULTADOS: de las 39 unidades de cuidados intensivos neonatales incluidas: 31% usó cobertores para proteger a las incubadoras de la luz, 10% recurrió a algún método de medición del ruido y 36% aplicó escalas del dolor. El tiempo de acceso de los padres a la unidad fue de 2-3 horas al día (56%). El 13% disponía de sala para padres dentro de la unidad, 36% permitían el método canguro. CONCLUSIONES: se observó falta de estrategias para elevar la cobertura de cuidados centrados en el desarrollo en las UCIN, mejorar la educación de los padres respecto a las medidas utilizadas en este programa y lograr que los cuidados centrados en el desarrollo sean aplicados en todas las regiones debido a su bajo costo y gran beneficio.

Abstract BACKGROUND: The objective of Developmental Centered Care (DCC) is to favor the neurosensorial and emotional development of the newborn and to decrease the stress associated to neonatal care and the pain related to diagnostic tests and invasive treatments. OBJECTIVE: To describe the implementation extent of the DCC in the Neonatal Intensive Care Units (NICU) in Mexico. MATERIALS AND METHODS: Cross sectional, observational and descriptive study. A questionnaire focused on DCC was sent via online to personnel working in NICUs that attend more than 50 children weighting less than 1.500 gr every year. RESULTS: A total of 39 NICUs were studied: 31% use covers as a mean of protection from light, 10% use methods of noise measurement, 36% employ pain assessment scales. The access of the parents to the units is 2-3 hours per day (56%); 13% of the units have a room exclusively for parents available inside the unit, and 36% allow the Kangaroo Care Method to be performed. CONCLUSION: A lack of strategies is noted to raise the coverage of these care methods in the NICUs, to improve the education of the parents respecting the measures used in this program, and to achieve that the DCC is applied in every region due to its low cost and great benefit.

Asociación VACTERL-H con agenesia tibial. ¿Expansión del fenotipo clínico? / VACTERL-H association with tibial agenesis. Expansion of the clinical phenotype?

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[The prevalence and risk factors of cleft lip and cleft palate in 2 hospitals in the city of Guadalajara, Jalisco, Mexico]. / Prevalencia y factores de riesgo de labio y paladar hendido en dos hospitales, en la Ciudad de Guadalajara, Jalisco, México.

OBJECTIVE: The purpose of this article is to determine the prevalence of the cleft lip and palate and its association with some risking factors. MATERIAL AND METHODS: A retrospective, observational and analytic study, of 44 newborn infants with cleft lip and palate and their controls, in 33,461 consecutive births, with 20 weeks or more, and birth weight more than 500 g, since November of 1988 to June of 1991. The information were obtained from the database of the Congenital External Malformation Register, done by the University of Guadalajara, in four hospitals. The prevalence of the cleft lip and palate was calculated. Of the variables studied their association was searched with congenital malformation in 2 x 2 tables, calculating, its chi square, confidence interval, and old ratio. RESULTS: The prevalence of the cleft lip and palate was of 13.2 x 10,000 births. By categories: cleft lip 2.7 x 10,000, cleft lip and palate 7.8 x 10,000 and cleft palate 2.7 x 10,000. The only statistics differences with control group were the association with antecedent of other malformation in the family and methrorrague during pregnancy. CONCLUSIONS: The found prevalence is similar to the one informed in the literature, with some differences by categories. The association with antecedent of another malformation in the family, support the role of the hereditary role in the multifactorial etiology.