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Apgar bajo al nacer y convulsiones neonatales: Desarrollo motor grueso en el primer a?o de vida

Keywords: infanib test, neonatal seizures, high-risk infant follow-up, neurodevelopment.

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Abstract:

objective: to assess the putative association between 5 minutes apgar score, neonatal seizures and neurodevelopmental delay (infanib test) performed at 1 year of corrected age. design: historic cohort. setting: a first level hospital in cali, colombia (1989 to 1997); subjects came from a low socioeconomic stratum population. study subjects: a total of 287 infants who completed the 1 year follow up program were included. interventions: not applicable main outcome measures: incidence (cumulative and density) of neuromotor abnormalities (abnormal infanib test) at 1 year of age. results: compliance with program visits was 80%. thirty nine (13.6%) infants presented low 5 minutes apgar score. thirty six (12.5%) infants presented neonatal seizures, associated mainly with neonatal asphyxia and hypoglicemia. forty seven infants had an abnormal infanib test (cumulative incidence 16.4% and incidence density 1.3 new cases per 100 infants-year). a significant association between neonatal seizures and an abnormal infanib was found (rr crude 2.39 ic 95% 1.37-4.16). low 5 minutes apgar score is not an effect modifier neither a confounder of the association between neonatal seizures and an abnormal infanib. exploring the presence or absence of effect modification only bacterial meningitis, demonstrated a role as confounder for the association between seizures and infanib results. conclusions: both neonatal seizures and bacterial meningitis were independently associated with abnormal infanib results. neonatal seizures are not only an important risk factor (adjusted rr = 2.51 ic 95% 1.10-5.72), but an easily identifiable one that can help the physician taking the medical history to identify patients at high risk for neuromotor abnormalities during the first year of life.

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