Prematuridad y aprendizajes escolares. Un estudio longitudinal hasta los 11 años

Resumo

Preterm birth remains one of the world's greatest perinatal health problems. There is no other neonatal condition, which occurs so frequently and carries such a high risk to development. The causes of premature birth are not simple, they encompass a wide and complex causal range, which may help explain the wide heterogeneity in development and long-term learning. Despite all the improvements obtained in recent decades in the care and follow-up of preterm infants, there is still no clear evidence of a reduction in neurodevelopmental problems or long-term learning, except in those cases where follow-up or intervention continues until school age. But even in these cases, the preterm population cannot match their full-term counterparts. For this reason, follow-up studies up to school age should be remarkably important. OBJECTIVE The general objective of this doctoral thesis is to assess the physical development, general intellectual abilities, and levels of achievement in basic reading learning in a group of school-age children who were born with less than 37 weeks of gestation METHODOLOGY The methodology chosen for this study is that of a longitudinal design with a quasi-experimental method of descriptive type. The initial sample was randomly selected among children born preterm at the Hospital Universitario Virgen de la Arrixaca in Murcia between November 2000 and October 2002. In the present work 29 children were evaluated, of the 38 who completed the follow-up until 36 months, when they reached the age of 9-11 years. RESULTS and CONCLUSIONS -The variables of height and weight at birth are insufficient to predict subsequent increases in height and weight. -The level of perinatal risk seems to influence, among groups with low and high perinatal risk, in height and weight at 9-11 years of preterm infants. -Perinatal history, valued with PERI, appears to have a long-term influence on posterior weight, but not on height or body mass index -BSID-II scores may help predict composite scores on the WISC-IV Scale at the school stage. -The positive prognostic value among the scores obtained with the BSID-II and those attained at school age seems to increase their reliability as the child's age increases, which would lead us to insist on the need for a follow-up of the preterm born child that covers a period longer than a year and a half and, if possible, until the beginning of Primary Education or until the First Stage of Primary Education is completed. -The level of perinatal risk seems to mark a trend in the results, but it does not indicate significant differences that would allow us to conclude its influence on cognitive and attentional variables in the long term. -Perinatal risk levels appear to be clinically relevant to decoding skills and are significantly related to children's reading speed, but do not appear to be determinant in reading comprehension. -The level of decoding achieved by preterm infants appears to be significantly related to working memory and processing speed. -The level of achievement attained in reading speed does not appear to be determined by the intellectual capacity of the child. -There seems to be a tendency in the data to relate children's reading comprehension with the composite scores of the WISC-IV Scale, verbal comprehension, perceptual reasoning, working memory and Total IQ, but the relationship only seems to be statistically significant with the latter.