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Neurodesenvolvimento em fetos leves para a idade gestacional de termo
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Objetivo: Nascer leve para a idade gestacional (LIG) pode estar associado a piores desempenhos do neurodesenvolvimento comparativamente ao nascimento com peso adequado para a idade gestacional (AIG). O objetivo deste trabalho é avaliar a existência de scores inferiores no neurodesenvolvimento em crianças LIG de termo, através de uma revisão da literatura existente.
Métodos: Os estudos sobre o neurodesenvolvimento foram identificados a partir de uma base de dados eletrónica (PubMed), tendo sido excluídos os fetos pré-termo. LIG foi definido como ter um peso inferior ao percentil 10 e uma fluxometria umbilical normal.
Resultados: De um total de 182 estudos encontrados, apenas 21 foram incluídos. As definições de LIG foram variadas. Os dados não puderam ser sintetizados numa meta-análise devido à heterogeneidade entre os estudos. Crianças LIG mostraram diferenças no sistema nervoso central (SNC), que se correlacionaram com anormalidades do neurodesenvolvimento futuras. Conclusão: Alguns fetos LIG, sem sinais de insuficiência placentária, são verdadeiras formas de restrição de crescimento fetal (RCF) com graus subtis de dano neurológico. É necessário reconhecer estas alterações precocemente no sentido de alterar o prognóstico destas crianças.
Objective: Being small for gestational age (SGA) may be associated with poorer neurodevelopmental outcomes compared to being appropriate for gestational age (AGA). The aim of this paper was to evaluate the existence of decrease in neurodevelopmental scores in SGA infants born at term from a review of the existing literature. Methods: Studies of neurodevelopment in SGA babies were identified from a search of the internet scientific databases (PubMed). Studies that included preterm births were excluded. SGA was defined as birth weight below the 10th centile for gestation without abnormal umbilical artery doppler ultrasound. Results: From 182 studies retrieved, 21 studies were included. Definitions of SGA were variable. Data could not be synthetized in meta-analyses due to heterogeneity between studies. Infant born small for gestational age show brain differences, which are correlated with later neurodevelopmental abnormalities. Conclusion: Some SGA fetuses without placental insufficiency signs are true forms of FGR and may have subtle degrees of neurological damage. It is necessary to recognize these changes early in order to change the prognosis of these children.
Objective: Being small for gestational age (SGA) may be associated with poorer neurodevelopmental outcomes compared to being appropriate for gestational age (AGA). The aim of this paper was to evaluate the existence of decrease in neurodevelopmental scores in SGA infants born at term from a review of the existing literature. Methods: Studies of neurodevelopment in SGA babies were identified from a search of the internet scientific databases (PubMed). Studies that included preterm births were excluded. SGA was defined as birth weight below the 10th centile for gestation without abnormal umbilical artery doppler ultrasound. Results: From 182 studies retrieved, 21 studies were included. Definitions of SGA were variable. Data could not be synthetized in meta-analyses due to heterogeneity between studies. Infant born small for gestational age show brain differences, which are correlated with later neurodevelopmental abnormalities. Conclusion: Some SGA fetuses without placental insufficiency signs are true forms of FGR and may have subtle degrees of neurological damage. It is necessary to recognize these changes early in order to change the prognosis of these children.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016
Palavras-chave
Transtornos do neurodesenvolvimento Idade gestacional Peso fetal Obstetrícia Ginecologia