Restricción de crecimiento aumenta el riesgo de displasia broncopulmonar, muerte y sepsis en gemelos de 30 o menos semanas de gestación
| Autor: | Debora Sabatelli, Angélica Domínguez, Beatriz Milet, Patricia Mena |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Concordance síndrome de dificultad respiratoria Intrauterine growth restriction displasia broncopulmonar sepsis 03 medical and health sciences 0302 clinical medicine medicine 030212 general & internal medicine Neonatology mortalidad neonatal Gemelos discordantes Pregnancy Neonatal sepsis Obstetrics business.industry Case-control study restricción de crecimiento intrauterino prematurez medicine.disease 030104 developmental biology Bronchopulmonary dysplasia Pediatrics Perinatology and Child Health Gestation enfermedad de membrana hialina business |
| Zdroj: | Revista chilena de pediatría v.90 n.1 2019 SciELO Chile CONICYT Chile instacron:CONICYT |
| ISSN: | 0370-4106 |
| DOI: | 10.32641/rchped.v90i1.840 |
| Popis: | Introduction: Multiple factors influence the risk of morbidity and mortality of premature infants with intrauterine growth restriction (IUGR). The comparison of twins with different intrauterine growth allows evaluating the effect of the restriction, excluding maternal factors and prenatal management. Our objective was to assess the effect of IUGR on acute and chronic morbidity, and mortality of extreme preterm twins. Patients and Method: Twins weighing less than 1500 grams and gestation equal to or less than 30 weeks, of the Neocosur Network. Separate analyses were performed on concordant twin pairs, and on mild and severe discordant twins, evaluating the effect of IUGR on morbidity and mortality. A multivariate analysis was performed in order to establish the impact of this effect. Results: 459 twin pairs, 227 concordant twins, 110 of mild discordance, and 122 of severe discordance. Among the concordant ones, there was only a difference in oxygen uptake at 36 weeks. In those of mild discordance, the smaller twin presented a lower frequency of hyaline membrane disease and required fewer doses of surfactant, but had a higher risk of bronchopulmonary dysplasia (BPD) or death. In severe discordant twins, the smaller one presented higher mortality, sepsis, use and permanence in mechanical ventilation, despite the lower frequency of hyaline membrane disease. In multiple regression analysis, the combined risk of BPD or death was higher in the smaller twin and of severe discordance. Conclusion: In discordant twins, the acute respiratory pathology was more frequent in the larger one, although the risk of BPD or death was higher in the one with IUGR. |
| Databáze: | OpenAIRE |
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