[Neurologic development of children at age two who had been treated at a neonatal intensive care unit]. / El neurodesarrollo a los dos años de vida de neonatos tratados en una unidad de cuidados intensivos neonatales.

The principal objective of this study was to evaluate, at 2 years of age, the neurological development of a group of children who had been treated in the neonatal intensive care unit (NICU) of the National Institute of Perinatology of Mexico. All the children born between 1 January 1992 and 31 December 1993 who had entered the NICU and stayed for 3 or more days were studied from the neurological, psychological, auditory, linguistic, motor, and neuromuscular standpoint. This group included 134 patients, who had had an average gestational age of 32 weeks and an average birth-weight of 1,677 g. They had stayed in the hospital an average of 51 days, and 75% of them had undergone artificial respiration. In the examination done at age 2, 66.5% of the children were normal and 8.2% had serious impairments. There were statistically significant associations between their neurological condition and the days of artificial respiration (P < 0.0001), the days spent in the NICU (P < 0.000004), and the gestational age in weeks (P < 0.03). There was no association between the children's sex and the results of the assessments. The study results showed a decrease in neural abnormalities in comparison with the results obtained in similar studies 10 years earlier.

[Subependymal/intraventricular hemorrhage in preterm newborn infants. Neurodevelopmental course during the first year of life]. / Hemorragia subependimaria/intraventricular en neonatos pretérmino. Evolución del neurodesarrollo durante el primer año de vida.

Subependymal/intraventricular hemorrhage (SE/IVH) is the most frequently encountered type of hemorrhage in the neonatal period. Premature infants often develop SE/IVH which remains is one of most serious neonatal events. We studied a group of 96 premature newborn infants: half of which were diagnosed with SE/IVH. We evaluated the babies at six and 12 months of age which++ a battery of neurobehavioral exams, including neurological, psychological, motor an audiological test. In 52 of infants with SE/IVH showed some type of neurobehavioral abnormality, compared with 13% of non-SE/IVH infants. In 56% of SE/IVH infants had neurological abnormalities at 12 months (P < 0.0001) difference with non-SE/IVH), predominantly in areas of muscle tone and reflex. Motor abnormalities were encountered in 42% of SE/IVH children, and in 4% of non-SE/IVH children at 12 months. Psychometric abnormalities at 12 months were noted in 53% of the SE/IVH group. Hypocusis were noted in 38% of the SE/IVH group and in 15% of the non-SE/IVH group.

[A follow-up during the first year of life of newborn infants with very low weight at birth]. / Seguimiento durante el primer año de vida, de neonatos con muy bajo peso al nacer.

Groups of low-weight neonates, especially those under 1,500 g, discharged from the Intensive Care Unit, have a greater frequency of having psychoneurologic, audiologic, language and ophthalmologic scars in comparison with those neonates who suffered no complications. These frequencies vary considerably depending on different authors, the type of sequela and the duration of the follow-up. It is difficult to identify early on, which of these children will be affected in his later development. The currently used prognostic indexes have shown the importance of combining the child's psychoneurologic and biologic evolution as well as his surrounding environmental factors. Thirty-eight newborns were studied. Each weighted 1,500 g or less and were discharged from the Neonatal Intensive Care Unit. All of the patients were subsequently evaluated by specialists in Neurology, Psychology, Social Communication, Neuromotor Rehabilitation and Ophthalmology at 3, 6, 9 and 12 months of age (37 weeks) and included in a study conducted by the Program for Pediatric Follow-up at the National Institute of Perinatology. In general, the number of abnormalities found in each of the specialties during the first months of life was notorious, which later decreased as the child got older. For example, Neurology found abnormalities at 3 months in a proportion of 0.61 and at 12 months, it decreased to 0.19 (P less than 0.001). During neuromotor stimulation something similar was seen at three months a proportion of 0.39 abnormalities were recorded while at 12 months this decreased to 0.18. The human communication tests showed a proportion of 0.32 at 3 months and 0.10 at 12 months (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Effects of early multimodal stimulation on preterm newborn infants]. / Efectos de la estimulación multimodal temprana en neonatos pretérmino.

During the last trimester of pregnancy, newborns are deprived of both maternal biorhythms, tactile, kinesthetic and auditory stimulation which characterize the intrauterine environment. The purpose of this study is to determine if supplemental multimodal stimulation improves neurobehavioral performance, increases weight gain and shortens hospital stay. Nine neonates with the following characteristics were included in an early multimodal stimulation program: 1) gestational age less than or equal to 34 weeks, 2) feeding through orogastric tubing, 3) hemodynamically stable, with no signs of hemorrhaging, infections, or any suggestion of neurological damage, convulsions or congenital malformations. A control group with the same characteristics was also included in the study. Risk factors for each patient were evaluated and their evolution was closely watched while still in the hospital. Both the postural reflexes and neurobehavioral performance were assessed at the time the child left the hospital and a month afterwards. Statistically significant differences were found in the neurobehavioral performance and postural reflexes of those included in the study group.