[Neurologic evolution of premature infants following assisted ventilation, with and without bronchopulmonary dysplasia]. / Evolución neurológica del recién nacido pretérmino ventilado con y sin displasia broncopulmonar.

The aim of this work was to evaluate the influence of bronchopulmonary dysplasia on the neurological outcome of the preterm infant requiring assisted ventilation. Thirty-nine preterm infants requiring ventilation support during 72 hours or more were classified into two groups according to the presence or absence of bronchopulmonary dysplasia (BPD). In the BPD group (n = 11), only the incidence of mild cognitive deficits was significantly higher (36.4 % vs 0 %). Our results suggest that the neurological outcome of the infants with BPD is more closely associated with other neonatal events (intraventricular hemorrhage, periventricular leukomalacia, neonatal seizures, longer ventilation support, maximum serum bilirubin levels, low Apgar score at 10 minutes and poor intake of amino acids) than with the presence of BPD. The data of this study suggest that indomethacin reduces the risk of neurological deficits.

[Pathogenic factors in bronchopulmonary dysplasia]. / Factores patogénicos de la displasia broncopulmonar.

This paper analyses the main pathogenic and prognostic factors of BPD. A study was made of 60 premature babies who were ventilated for a period of more than 72 hours. The control group consisted of the 37 premature babies who did not develop BPD and the study group of the remaining 23 who, 28 days after birth, showed respiratory difficulties, a compatible radiography of the thorax and FiO2 requirements above 0.21. The severity of the BDP in the neonatal period was quantified by means of the clinical and radiological criteria of Toce and a special scale was applied to its evolutive aspects.

[Incidence and mortality of bronchopulmonary dysplasia]. / Incidencia y mortalidad de la displasia broncopulmonar.

In this paper an attempt is made to analyze the variations in the incidence and severity of bronchopulmonary dysplasia (BPD) in our environment. A review has been made of the clinical records of premature infants with a diagnosis of BPD from 1979 to 1989, both inclusive. The existence of BPD was accepted when, after assisted ventilation with intermittent positive pressure for a minimum of 72 hours, there were respiratory difficulties, a compatible radiography of the thorax and requirements of over 0.21 FiO2 on the 28th day of life. Between 1985 and 1989, the incidence of BPD was similar to that of the five previous years (38.3% versus 42.3%), but mortality decreased (21.7% versus 36.3%). Other epidemiological data worth noting are the appearance of BPD in 2.6 per 1000 live newborns, 9.6 per 1000 newborns kept in hospital and 15.9% of premature infants treated with ventilation. BPD was found in 73% of newborns weighing less than 1.000 g, 41% weighing between 1000 and 1.499 g and only 16% of those weighing over 1,499 g. BPD was found in all newborns of less than 28 weeks, in 38% of those between 28 and 30 weeks and only in 4% of those aged more than 30 weeks. BPD appeared specially after hyalline membrane disease (30.7%).

[Newborn infant of drug-addicted mother: maternal, perinatal, neonatal aspects, and neonatal abstinence syndrome]. / Recién nacido de madre adicta a las drogas: aspectos maternos, perinatológicos, neonatales y síndrome de abstinencia.

Maternal drug addiction has increased in an alarming way over the last ten years. Therefore, the withdrawal syndrome in the newborn has also increased. 53% of the newborns (of chemical dependent mother) studied from 1985 to 1989 in HCP have presented this syndrome. We have analysed: perinatal, neonatal and maternal factors, and their clinical features and treatment: There is a great incidence of perinatal asphyxia, acidosis, premature rupture of the fetal membranes, etc. The newborns are usually premature or of low birth weight for their gestational age. They present diverse pathology: syphilis, HBsAg +, HIV +, gonorrhea, congenital malformations, etc. The mothers are often prostitutes, belong to a low socioeconomic status, have had previous abortions and have had no control of the actual pregnancy, etc. The syndrome of abstinence presents with: jitteriness, sweating, high-pitched or continuous crying, vomits, diarrhea, and even seizures. The neurological and digestive manifestations are the most difficult to treat. The treatment consists of general measures (little stimulation dim light, etc.), phenobarbital, and chlorpromazine.

[Prognostic factors of neurosensory sequelae in extremely premature infants]. / Factores pronósticos de las secuelas neurosensoriales en el prematuro extremo.

Modern neonatal intensive care has led to a rise in the survival rate of very low birthweight infants (VLBW), but at the same time is a greater number of neurosensorial sequelae. In this study, 50 VLBW (weight less than 1,500 g) babies followed up for at least 12 months are analysed. 18% showed major sequelae (40% of those weighing less than 1,000 g, 12.5% of those weighing 1,000 g or more). The prognostic factors which were most important in the prediction of sequelae were: low birthweight, major irregularities in the EEG, the presence of sepsis, and prolonged ventilotherapy or antibiotherapy.

[Urinary tract infection in the newborn infant]. / Infección del tracto urinario en el recién nacido.

Twenty-eight cases of urinary tract infection in newborns with positive urinoculture and suggestive clinical symptomatology are reviewed. The incidence was 0.24%, being most frequent in preterm and postterm newborns. Male neonates was more affected. Failure to thrive, excessive weight loss, poor feeding, diarrhoea, vomiting and jaundice are the most relevant clinical signs. E. coli and Klebsiella are the most frequent organism isolated, followed by Enterobacter and Candida. The presence of metabolic acidosis and leukocituria using a bag technique were the most accurate laboratory data to suspect a urinary tract infection.