Background:The sensitivity and specificity of the clinical audiological evaluation in newborns are debatable compared to neurophysiological methods of a hearing evaluation. This study aimed to determine the sensitivity and specificity of the cochleopalpebral reflex as a clinical test for hearing screening in newborns. Methods: A case-control study was designed. Newborns discharged from a neonatal intensive care unit (NICU) were included. Brainstem evoked auditory potentials were recorded. A wooden rattle was used to explore the cochleopalpebral reflex. The sensitivity and specificity of the cochleopalpebral reflex were calculated. Continuous data were analyzed with Student's t-test, with statistically significant p-values < 0.05. Results: We selected 450 newborns who were divided into two groups: group A, with bilateral sensory neural hearing loss (n = 150), and group B, with normal hearing (n = 300). Group A showed a significantly lower gestation age at birth (p = 0.005) compared to group B (32.5 ± 2.6 vs. 34.4 ± 3.5 weeks). In group A, the cochleopalpebral reflex's sensitivity was 80% using the wooden rattle. In group B, the specificity was 98%. Conclusions: The NICU discharged newborns' clinical hearing evaluation is not enough to exclude hearing loss. Although it may be the only diagnostic tool for hearing loss in some settings, its limitations should be considered.
Describir el neurodesarrollo de pacientes con cardiopatía congénita compleja (CCC) a quienes se les realizó cirugía cardiaca en el periodo neonatal. material y métodos: Mediante un estudio longitudinal, observacional y retrospectivo incluimos 14 pacientes, evaluando el neurodesarrollo por medio de la escala de desarrollo infantil Bayley II a la edad de 30 meses. Resultados: La edad promedio al momento de la cirugía de 19 días. La cardiopatía más frecuente fue coartación aórtica (43%). Del total, 29% tuvo desarrollo cognitivo bajo, desarrollo psicomotriz en el 50% anormal. Conclusiones: Los pacientes pediátricos con CCC después de la cirugía tienen alto riesgo de presentar déficit neurológico, con predominio en el área psicomotriz.
Background: Offspring of mothers with diabetes mellitus (DM) during pregnancy may be at high risk for developmental alterations. This study aimed to identify the effects of maternal pre-and gestational diabetes on the body mass index of infants and children at two, four, six, and eight years of age. Methods: We studied children of mothers with type 1, type 2, and gestational diabetes and a control group. Maternal and neonatal variables were analyzed for associations with children overweight/obesity. Results: Mothers with DM were older than controls (32 ± 6 vs. 22 ± 6 years, p < 0.001). The frequency of preeclampsia in mothers with DM was 28%. Gestational age and weight at birth were lower in infants from the groups of mothers with DM in comparison with controls (32.8 ± 3.1 vs. 36.4 ± 2.2 weeks, p < 0.001, and 1,637 ± 600 vs. 2,208 ± 518 g, p < 0.001, respectively). At 8 years of age, 47% of the offspring of mothers with DM type 2 had overweight/obesity (odds ratio (OR 8.25) 95% confidence interval (CI) 1.3-51, p = 0.01), while 27% of offspring of mothers with type 1 DM had overweight/obesity, and 10% of offspring of mothers with gestational diabetes presented overweight/obesity. Conclusions: Offspring of pre-gestational DM mothers have a higher risk to develop overweight/obesity, as was observed with follow-up until school age, for which they require continuous vigilance.
Background: High-risk birth is a public health problem that generates atypical parenting practices. This study aimed to identify these practices to construct and validate a scale to measure parenting factors and attitudes in children with high-risk birth parents. Methods: The instrument was applied to an intentional non-probabilistic sample of 701 parents of children with high-risk births (age range 17-64 years). The scale consists of 56 items, each with five Likert-type response options. Results: As a result of the factor analysis with Varimax rotation, the final version was divided into two subscales: factors and attitudes associated with parenting skills. In the first, with 36 items and six factors (low educational skills, overprotection, and permissive parenting, dissatisfaction with the parental role, stress in raising a child with a high-risk birth, tri-generational disapproval of the parental role, and positive support from the extended family), a Cronbach's alpha value of 0.90 was obtained, explaining 53.16 of the variance. In the second subscale, with 30 items grouped in four factors (parenting beliefs, negative coping with high-risk birth, self-validation in parenting, and parental resilience to the experience of high-risk birth parenting), a Cronbach's alpha of 0.82 was obtained, explaining 48.08 of the variance. Conclusions: We suggest that this scale be applied together with others that measure theoretically related variables.
Introducción: El gateo representa la primera forma de locomoción autónoma. Se han mencionado las implicaciones de la adquisición del gateo para lograr la marcha independiente y el control motor en el niño, pero son pocos los estudios relacionados con el gateo y sus efectos en el niño de alto riesgo biológico. Por eso se intentó conocer la relación entre la adquisición del gateo y la marcha independiente en una población de niños nacidos de alto riesgo en un programa de seguimiento pediátrico. Material y métodos: Estudio observacional, retrospectivo y descriptivo de una cohorte de niños de alto riesgo que acuden al seguimiento pediátrico, en el cual se revisó el periodo de adquisición del patrón de gateo y la marcha independiente. Resultados: Se integraron cuatro grupos: gateo normal, gateo limítrofe, gateo con retraso y gateo nulo. Se estudió a 558 lactantes; los grupos se integraron con gateo normal, 238 niños; gateo limítrofe, 96 lactantes; retraso en la adquisición del gateo, 207 niños; y gateo nulo, 17 niños. Por género, las niñas gatean mejor, con peso y edad gestacional mayores y predominio en los gateadores. La escala de Bayley señala mejores puntuaciones para los gateadores. En los niños con gateo normal, la marcha independiente se adquirió en el periodo normal a diferencia del grupo con retraso en el gateo en el cual la marcha independiente apareció con retraso. Conclusiones: En este estudio se identificó una relación entre la edad de inicio del gateo con la edad de adquisición de la marcha independiente, con mejor evolución en los niños gateadores.
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