Gómez Esteban Concepción, Sánchez Carrión Juan J, García Selgas Fernando J, Segovia Guisado José M
Complutense University of Madrid, Madrid, Spain.
Glob Pediatr Health. 2017 Sep 28;4:2333794X17733372. doi: 10.1177/2333794X17733372. eCollection 2017.
. Preterm birth has a major impact on growth, and very preterm birth is associated with disabilities in numerous developmental domains. This article describes and quantifies morbidities in a sample of 1200 ≤1500-g births in Spain between 1993 and 2011 based on parent information, and it highlights several variables that influence these morbidities. Multiple method surveys using computer-assisted telephones interviewing and computer-assisted web interviewing methods. Sample design was intentional. Most subjects were contacted via their referral hospitals. Data collection was done from April 2013 to June 2014. Prior to the survey, extensive qualitative fieldwork was conducted, including nonparticipant observation in neonatal units and the design and analysis of discussion groups and interviews with professionals and families, including preterm adolescents. A total of 44.2% of the sample were experiencing morbidity (mean: 1.788 morbidities per child). The most prevalent types were learning difficulties (34.4%) and attention deficit/hyperactivity disorder (31.5%). The most influential variables were male gender, age, lower birthweight, private hospital admission for birth, scarcity of health resources in the family's residential area, non-Spanish maternal birthplace, and emotional distress in the primary carer. Overall, the total percentage of very low birth weight children with morbidities has decreased moderately between 1993 and 2011, thanks to major socio-sanitary improvements during this period. Biological and medical variables, rather than family factors, explain more accurately the presence of morbidities in children with birth weight ≤1500 g.
早产对生长有重大影响,极早产与众多发育领域的残疾有关。本文根据家长提供的信息,描述并量化了1993年至2011年间西班牙1200名至1500克出生体重儿样本中的发病率,并强调了影响这些发病率的几个变量。采用计算机辅助电话访谈和计算机辅助网络访谈方法进行多方法调查。样本设计是有目的的。大多数受试者是通过他们的转诊医院联系的。数据收集于2013年4月至2014年6月进行。在调查之前,进行了广泛的定性实地调查,包括在新生儿病房的非参与观察以及讨论小组的设计和分析,以及对包括早产青少年在内的专业人员和家庭的访谈。样本中共有44.2%的儿童患有疾病(平均每名儿童患1.788种疾病)。最常见的类型是学习困难(34.4%)和注意力缺陷/多动障碍(31.5%)。最具影响力的变量是男性性别、年龄、低出生体重、私立医院出生、家庭居住地区卫生资源稀缺、母亲非西班牙出生地以及主要照顾者的情绪困扰。总体而言,由于这一时期社会卫生状况的重大改善,1993年至2011年间极低出生体重儿患疾病的总百分比有所适度下降。生物和医学变量而非家庭因素更准确地解释了出生体重≤1500克儿童疾病的存在情况。