Restricción del crecimiento extrauterino y su asociación con el neurodesarrollo en recién nacidos muy prematuros: Una revisión sistemática con metaanálisis
DOI:
https://doi.org/10.14306/renhyd.30.1.2551Palabras clave:
Nacimiento prematuro, Crecimiento, Trastornos del neurodesarrollo, AntropometríaResumen
Introducción: El parto prematuro constituye una condición de alto riesgo para alteraciones del neurodesarrollo. La restricción del crecimiento extrauterino (RCEU) ha sido propuesta como predictor temprano de estos desenlaces; sin embargo, los resultados son variables en función de los estándares y definiciones empleadas. El objetivo de este estudio fue evaluar la asociación entre la RCEU en peso y perímetro cefálico (PC) y el neurodesarrollo entre los 18 y 24 meses de edad corregida en recién nacidos muy prematuros.
Metodología: Se realizó una revisión sistemática y un metaanálisis de estudios publicados desde enero de 2016 hasta enero 2026 en MEDLINE/PubMed, Web of Science, Scopus, ScienceDirect y Springer Nature. Se incluyeron estudios en recién nacidos <32 semanas de edad gestacional que evaluaron la asociación entre la RCEU en peso y PC (disminución ≥1 ±0,2 puntuación z de acuerdo con INTERGROWTH-21st) y el neurodesarrollo mediante la escala Baley II/III o Griffith. El metaanálisis se realizó utilizando modelos de efectos aleatorios de DerSimonian-Laird. El riesgo de sesgo se evaluó mediante la herramienta ROBINS-E.
Resultados: Ocho estudios se incluyeron en la síntesis cualitativa y seis en el metaanálisis, con un total de 6286 lactantes evaluados mediante peso y 3747 mediante PC. La RCEU en peso se asoció con mayores probabilidades de alteraciones del neurodesarrollo (OR = 1,7; IC 95%: 1,1–2,7), mientras que la RCEU en PC mostró una asociación similar (OR = 1,8; IC 95%: 1,0–3,3).
Conclusión: La RCEU según estándares INTERGROWTH-21st en peso y PC se asocia con mayor riesgo de alteraciones del neurodesarrollo en lactantes muy prematuros, aunque el número limitado de estudios restringe la generalización de los resultados.
Financiación: Programa de Becas Nacionales para Estudios de Posgrado de la Secretaría de Ciencia, Humanidades, Tecnología e Innovación (SECIHTI), número de registro 4042646.
Registro del protocolo: https://osf.io/j2exd/
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Derechos de autor 2020 Miguel Ángel Hernández Real, Carmen Sánchez Pérez , María Esther Irigoyen Camacho, Flora Zárate Mondragón, Alicia Correa Ramírez
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