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哥伦比亚早产和/或低出生体重青年成年人的围产期危险因素:一项关于听觉和视觉障碍的回顾性队列研究

Perinatal risk factors in ex-preterm and/or low birthweight Colombian young adults: a retrospective cohort study on auditory and visual impairments.

作者信息

Charpak Nathalie, Montealegre-Pomar Adriana, Rosero Lyda Teresa, Lince-Rivera Catalina, Cortés Darwin

机构信息

Kangaroo Foundation, Bogotá, Colombia.

Pontificia Universidad Javeriana, Bogotá, Colombia.

出版信息

Lancet Reg Health Am. 2024 Nov 5;39:100921. doi: 10.1016/j.lana.2024.100921. eCollection 2024 Nov.

Abstract

BACKGROUND

Advances in neonatal care have increased survival rates for premature or low birth weight (LBW) infants but raised concerns about long-term neurosensory and psychomotor challenges. : to investigate perinatal factors linked to visual and auditory problems in ex-preterm or LBW young adults, assessing their long-term quality of life.

METHODS

Participants from a 20-year-old randomised controlled trial comparing Kangaroo-Mother Care (KMC) to conventional care were re-enrolled. A group of 50 at term individuals without risk factors was assessed as a reference group.

FINDINGS

5.9% of participants had functional visual issues and 8.1% experienced hearing problems. Those with hearing or visual impairments had longer hospital stays and more neonatal complications. Correlations were found between Griffiths auditory sub-scale results at 6 months and long-term auditory outcomes. Only 27.5% of those with deafness had access to cochlear implants or hearing aids, resulting in lower IQ scores, learning difficulties, and increased risk of depression and self-harm. Participants with visual impairments exhibited lower IQ scores, self-esteem, and HOME test acceptance. However, they did not differ from the group with normal vision in terms of quality of life, depression, or attachment scores. All participants, whether they had issues or not, rated their quality of life higher than their parents did.

INTERPRETATION

Preterm or LBW infants with visual and hearing deficits are more likely to face cognitive and emotional challenges in adulthood. This study underscores the importance of a multidisciplinary approach to promptly address these vulnerabilities, reducing the risk of long-term neurodevelopmental and functional issues.

FUNDING

The Grand Challenge Canada, Fulbright Colciencias and Colombia Cientifica - Alianza, The World Bank, managed by the Colombian Administrative Department of Science, Technology and Innovation (COLCIENCIAS).

摘要

背景

新生儿护理的进步提高了早产或低体重(LBW)婴儿的存活率,但引发了对长期神经感觉和精神运动挑战的担忧。目的:调查与早产或低体重青年成人视觉和听觉问题相关的围产期因素,评估他们的长期生活质量。

方法

重新招募了来自一项为期20年的随机对照试验的参与者,该试验比较了袋鼠式护理(KMC)与传统护理。一组50名足月且无危险因素的个体被评估为参照组。

研究结果

5.9%的参与者存在功能性视觉问题,8.1%有听力问题。有听力或视觉障碍的人住院时间更长,新生儿并发症更多。发现6个月时的格里菲斯听觉子量表结果与长期听觉结果之间存在相关性。耳聋者中只有27.5%能够使用人工耳蜗或助听器,这导致智商得分较低、学习困难以及抑郁和自我伤害风险增加。有视觉障碍的参与者表现出较低的智商得分、自尊和家庭环境观察量表(HOME)得分。然而,他们在生活质量、抑郁或依恋得分方面与视力正常的组没有差异。所有参与者,无论是否有问题,对自己生活质量的评分都高于他们的父母。

解读

有视觉和听力缺陷的早产或低体重婴儿在成年后更有可能面临认知和情感挑战。本研究强调了多学科方法及时解决这些脆弱性的重要性,以降低长期神经发育和功能问题的风险。

资金来源

加拿大重大挑战项目、富布赖特科利encias和哥伦比亚科学联盟、世界银行,由哥伦比亚科学、技术和创新行政部门(COLCIENCIAS)管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c45d/11570731/212115218e57/gr1.jpg

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