Browsing by Author "Coo, Soledad"
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Item Adapting to Adversity: Effects of COVID-19 on Parenting in Chile(2022) Perez Ewert, J. Carola; Aldoney, Daniela; Vivanco-Carlevari, Anastassia; Coo, Soledad; Guzmán, Eugenio J.; Silva, Jaime R.The pandemic outbreak in March 2020 and its associated sanitary regulations and restrictions triggered an abrupt and significant change for society in general and for families’ organization in particular. In Chile, the Santiago Metropolitan District was under a strict lockdown that involved the closure of the entire educational system. From a systemic-family stress perspective, the impact of these changes might have consequences not only for each individual family member, but for the parental dynamic and, consequently, for children’s well-being. This paper presents the results of a followup study showing changes in self-reported parental depression and the perceived home organization of mothers and fathers assessed at three different moments: before the pandemic, at the initial outbreak, and after 1 month of strict lockdown. Relevant moderators were explored using linear mixed models to understand the within-subject changes in mothers’ and fathers’ self-reports across the different assessment times. Financial strain, personality traits of self-criticism and dependency, previous parent– child quality interaction, recent major stressful events, and number of children are highlighted as relevant factors that moderate changes in home chaos and parental mental health perception. Significant risks and protective factors are described for fathers and mothers. The use of pre-pandemic measures as baseline levels enabled the identification of personal and family characteristics that were related to better outcomes. The results help increase our understanding of the sanitary regulations’ impacts on the family system and identify vulnerability indicators that should be considered.Item An explanatory model of parental sensitivity in the mother–father–infant triad(2022) Olhaberry, Marcia Paola; León, María José; Coo, Soledad; Barrientos, Mauricio; Pérez, J.CarolaQuality of early family interactions has been associated with child development, bonding, and mental health. Childhood adversity, stress, and depression impact parenting, affecting the quality of the interaction within the mother-father-child triad. The aim of the present study was to analyze the influence of parents’ adverse childhood experiences, depressive symptoms, and parental stress, on their sensitive response toward their tooddler and quality of traidic interactions. A correlational cross-sectional method was used. The sample included 80 mother–father–child triads, of toddlers with social–emotional difficulties. Parents early adverse experiences, parental stress, and depressive symptoms were assessed through self-report measures. Observational measures on parental sensitivity and triadic interaction were used. For mothers and fathers, adverse childhood experiences were associated with depressive symptoms in adulthood. Sensitivity toward their child and stress were positively associated among both parents. Symptoms of depression in mothers were associated with lower sensitivity toward their child, but in fathers, their sensitive response was influenced by the level of parental stress in the mother. In both parents, greater sensitivity in the dyadic interaction with the child was associated with a higher quality of the triadic interactions, in the triad as a whole, and in the regulation and involvement of the child.Item Cuidados del desarrollo en recién nacidos prematuros: fundamentos y características principales(2021) Coo, Soledad; Barra C., Lisseth; Marín P., AlejandraLos recién nacidos prematuros (RNP), en especial los extremos, requieren ser atendidos en las dis tintas unidades existentes en los servicios de neonatología. Además de procurar la sobrevida de estos niños, poco a poco estos servicios han ido incorporando intervenciones para promover su desarrollo. Esta revisión aporta una síntesis actualizada de los cuidados neonatales centrados en el desarrollo (CCD). En su primera parte describe los fundamentos teóricos de tipo neurobiológicos que explican cómo el denominado “estrés neonatal” puede afectar el curso de desarrollo de un niño nacido pre maturo. Posteriormente, se revisa la Teoría Sinactiva, que es uno de los modelos teóricos que con tribuye a entender las características de los CCD. Respecto de estos últimos, se describen y abordan sus evidencias y desafíos para la implementación desde una mirada crítica, destacando sus fortalezas y debilidades. Este artículo contribuye a destacar la importancia de seguir avanzando en la mejora de la calidad de la atención que reciben los RNP para promover la resiliencia y/o el mejor potencial de desarrollo posible en estos niños, además de relevar el rol de los padres en el cuidado neonatalPublication Cultural adaptation of an intervention to prevent postnatal depression and anxiety in Chilean new mothers(2019) Coo, Soledad; García, María Ignacia; Rowe, Heather; Fisher, Jane; Awad Sirhan, NataliaObjective: The aim of this study was to culturally adapt What Were We Thinking (WWWT), an Australian psychoeducational intervention to prevent symptoms of depression and anxiety among firsttime mothers, to be used in the Chilean primary health system. Background: Mental health symptoms are common in first-time mothers. Despite the availability of effective screening and referral in the Chilean primary health system, very few women access treatment due to diverse barriers. This highlights the importance of using a preventive approach. The evidence that culturallyadapted, evidence-based preventive programmes can reduce maternal mental health problems supports the development of this study. Methods: WWWT materials were translated into Spanish. Cultural Adaptation and field testing were conducted following the Cultural Adaptation Model. Results: Modifications to the intervention included adding an explicit infant mental health approach, a simplification of written information, and changes in the number and duration of the sessions. The adapted version of WWWT was considered understandable and relevant for local perinatal mental health specialists, new mothers and their partners. Conclusion: The Spanish version of WWWTis a culturally sensitive intervention, its potential for effective use in the Chilean context warrants further investigation. Limitations and implications for future studies are discussed.Item Cultural Adaptation of the Spanish Version of the Perceptions of Play Scale(2019) Coo, Soledad; Aldoney, Daniela; Mira, Andrea; López, MauricioObjective Play is crucial for healthy child development; yet, the time dedicated to free play during the pre-school years has decreased in both school and home environments. Parental beliefs influence the activities in which children engage in daily life; therefore, exploring these beliefs is a first step to understand possible reasons for the decreased frequency of free play. Instruments developed for this purpose are scarce and, to date, none of them is available in Spanish. We adapted and assessed the psychometric properties of the Perceptions of Play Scale (PPS) and developed the Spanish version of the instrument (i.e., PPS-S). Method We followed Beaton and colleagues’ Guidelines for the cross-cultural adaptation of self-report measures, which describes two stages, namely translation and adaptation of the instrument, and assessment of its psychometric properties. During the first stage, a panel of 5 experts developed the preliminary version of the PPS-S. This version of the scale was piloted in a sample of 28 early childhood educators and parents of preschool children, whose feedback informed the development of the final version of the instrument. During the second stage, 452 parents of pre-school children completed the PPS-S to assess its psychometric properties. Results An Exploratory Factor analysis showed high to excellent reliabilities for the three PPS-S subscales and the complete questionnaire. The PPS-S is a valuable, culturally sensitive tool for exploring parental beliefs about three aspects of play (i.e., frequency, playful character, and academic contribution) and could contribute to studies to promote this activity in Chilean children.Item Development and preliminary evaluation of a group intervention targeting maternal mental health and mother-infant interactions: a combined qualitative and case series report(2018) Coo, Soledad; Somerville, Susanne; Matacz, Rochelle; Byrne, ShannonOBJECTIVE AND BACKGROUND: The purpose of this study was to investigate the outcomes of an Emotional Wellbeing Group intervention developed to treat maternal depression and anxiety while concurrently supporting positive development of the mother-infant relationship. METHOD: Five women diagnosed with depressive and/or anxiety disorders and their infants completed the Emotional Wellbeing Group. The participants completed pre- and post- intervention assessments which included self-report measures of mood and the motherhood experience, and a video-taped, unstructured play session between mothers and their infants. RESULTS: Four of the participants reported a clinically significant decrease in their symptoms of anxiety. All mothers reported more positive perceptions of their infants and their experience of motherhood, and showed enhanced maternal sensitivity and responsiveness towards their infants. Depression levels were not shown to improve consistently. CONCLUSION: This study provides initial positive evidence to support future research directions and clinical efforts to develop interventions that target both the treatment of perinatal depression and anxiety and the quality of mother-infant interactions. Clinical insights for mental health professionals working with mothers and infants are presented.Item Evaluación de las propiedades psicométricas de la Escala de Ansiedad Perinatal en una muestra de madres en Chile.(2022) Coo, Soledad; Medina, Franco; García, María Ignacia; Pérez Ewert, J. CarolaAntecedentes y objetivo: Las dificultades de salud mental materna durante el periodo perinatal son prevalentes y tienen graves consecuencias para las madres y sus bebés. Las iniciativas de pesquisa temprana se han centrado en la sintomatología depresiva y han puesto menor atención a los síntomas de ansiedad, pese a su alta prevalencia. Uno de los factores que contribuye a la escasez de protocolos para la pesquisa de sintomatología ansiosa es la falta de instrumentos validados para tal fin. El objetivo de esta investigación fue evaluar la estructura factorial, validez concurrente y confiabilidad de la Escala de Ansiedad Perinatal, desarrollada para facilitar la pesquisa de sintomatología ansiosa en mujeres embarazadas y puérperas. Participantes y métodos: Las participantes fueron 265 mujeres, 138 de las cuales fueron evaluadas durante el tercer trimestre de gestación y 127, a los 3 meses postparto. La estructura factorial del instrumento fue analizada mediante un Análisis Factorial Exploratorio, el número de factores se definió con el test MAP de Velicer. Resultados: Se obtuvo una solución de cuatro factores con algunas diferencias en relación a la escala original. Se observó una alta consistencia interna para las subescalas del instrumento y para el puntaje global, además de una adecuada validez concurrente y confiabilidad test-retest. Conclusiones: Se concluye que la versión en español de la Escala de Ansiedad Perinatal posee características psicométricas adecuadas para su uso en Chile. Futuros estudios son requeridos para evaluar la validez de este instrumento en otros contextos latinoamericanos.Item Examining the association between subjective childbirth experience and maternal mental health at six months postpartum(2021) Coo, Soledad; García, María Ignacia; Mira, AndreaProblem Childbirth experience can have long-lasting effects on maternal wellbeing. Background Positive childbirth experiences may strengthen maternal self-confidence, in contrast, negativeexperiences may promote a sense of failure or distrust. Aim To examine the contribution of maternal hospital childbirth experience on mental health at 6 months postpartum in a community-based, Chilean sample. An additional aim is to examine which childbirth-related aspects contribute to the global birth experience. Methods One hundred and forty-eight women completed self-report measures of mental health during the third trimester of pregnancy and 3 and 6 months postpartum. At 3months after childbirth, subjective childbirth experience was assessed. Logistic regression analysis examined the contribution of childbirth experience to maternal mental health. Findings Negative subjective experience of childbirth contributes to maternal depression and anxiety up to 6 months after childbirth, controlling for mental health during pregnancy and at 3 months postpartum. Quality of care from health professionals made the largest, statistically significant contribution to the global perception of childbirth. Discussion and Conclusions Subjective experience of childbirth is a modifiable risk factor for the development of postpartum maternal depression and anxiety. Health providers in direct contact with childbearing women may promote maternal emotional wellbeing through sensitive and respectful care.Publication Interactions between mothers and their moderate preterm babies during hospitalization(2022) Mira, Andrea; Coo, Soledad; Bastías Lemp, Rodolfo; González, RicardoModerately preterm infants are physiologically immature, their brains must mature and adapt to the extrauterine environment, which can affect their neurological development. Interaction with their caregivers is crucial for their development, however, these may show mental health problems such as depressive symptoms and parental stress. Objective: to evaluate how depressive symptomatology and stress perception of mothers of moderately preterm infants during hospitalization may affect dyad interaction. Patients and Method: 85 dyads participated. During the second and third weeks of hospitalization, mothers answered a sociodemographic questionnaire, the parental stress scale, and the Edinburgh postnatal depression scale. Mother-infant interaction was assessed and coded with the Hospitalized other-Infant Bonding Observation Scale. Results: mothers of moderately preterm infants hospitalized in a neonatology unit may present significant depressive symptomatology which correlate with the stress experienced by the mother. Parental stress and being small for gestational age showed a negative association with dyad interactions. Conclusions: Having a moderately preterm baby can impact the mental health of mothers and this, at the same time, is related to the interactions they have with their children. Likewise, variables related to the babies were detected that can also decrease the interactions and contact between the dyad.Item Is maternal depression related to mother and adolescent reports of family functioning?(2018) Pérez, J. Carola; Coo, Soledad; Irarrázaval, MatíasWhile adolescent-parent disagreements about family functioning are common, they may also be indicative of family members' health problems and may compromise adolescent adjustment. This study examines the association between maternal depressive symptoms and family functioning perceptions, considering both the adolescents' and their mothers' points of view. A sample of 943 Chilean dyads of adolescents (69% female, Mage = 14.43 years old) and their mothers (Mage = 43.20 years) reported their perceptions of family cohesion and adaptability. Mothers also reported their depressive symptoms. Results indicated that mothers perceived their family as more cohesive and more adaptable than their children. There was a negative association between maternal and adolescent reports of family cohesion and maternal depressive symptoms. In the mother' reports, this association depended on adolescent's age. In the case of adolescents' reports, this association depended on adolescent's gender. Finally, maternal depressive symptoms were a significant predictor of mother-adolescent agreement about family cohesion.Item Is maternal depression related to mother and adolescent reports of family functioning?(2018) Pérez, Carola; Coo, Soledad; Irarrázaval, MatíasWhile adolescent-parent disagreements about family functioning are common, they may also be indicative of family members' health problems and may compromise adolescent adjustment. This study examines the association between maternal depressive symptoms and family functioning perceptions, considering both the adolescents' and their mothers' points of view. A sample of 943 Chilean dyads of adolescents (69% female, Mage = 14.43 years old) and their mothers (Mage = 43.20 years) reported their perceptions of family cohesion and adaptability. Mothers also reported their depressive symptoms. Results indicated that mothers perceived their family as more cohesive and more adaptable than their children. There was a negative association between maternal and adolescent reports of family cohesion and maternal depressive symptoms. In the mother' reports, this association depended on adolescent's age. In the case of adolescents' reports, this association depended on adolescent's gender. Finally, maternal depressive symptoms were a significant predictor of mother-adolescent agreement about family cohesion.Item Mothers, fathers and educators’ beliefs about play in Chilean preschool children(2022) Aldoney, Daniela; Coo, Soledad; Mira, Andrea; Valdivia, María JosefinaRobust data exist on the relation between play and children’s positive development. Yet, the time children devote to play has decreased in the last decades. Guided by the premise that adults’ beliefs about play are related to the way in which adults promote it, we asked 380 mothers, 89 fathers, and 83 early childhood educators in Santiago, Chile, about their beliefs about play and its relation to academic learning. Results showed similarities and differences in the value given to free and structured play and electronic activities by the three groups of participants. Participants differed in the academic value of play by socioeconomic status but agreed on the value of play in children’s academic skills. Fathers valued electronic activities more than mothers and early childhood educators. Data from this study may inform interventions and curriculum to foster play as an essential tool for child development in Chile.Item Mother’s mental health and the interaction with her moderate preterm baby in the NICU(2022) Mira, Andrea; Coo, Soledad; Bastías, RodolfoIntroduction: Moderate preterm infants, born between 320/7 and 336/7 weeks, represent a significant number of preterm-born infants; however, they remain a poorly studied group despite their vulnerability. The objective of this correlational study is to describe the impact of having a moderate preterm infant hospitalised in the NICU on the mothers’ mental health and how this relates to the interaction between the dyad. Method: During the hospitalisation period, 85 moderate preterm mother-infant dyads participated in this study. The participants provided self-reports of depression, parental stress, and skin to skin and breastfeeding practices. Also, mother-infant interaction was assessed in the NICU with an observational scale. Results: Mothers evidenced high levels of stress and depressive symptoms during the hospitalization. The stress experienced by these women was significant, although weakly, associated with the interaction with their babies; and mothers of small for gestational age babies showed difficulties in this area. Conclusions: The results of this study could represent a contribution to a better understanding of the relation between the characteristics of moderate preterm babies, maternal emotional wellbeing, and the quality of mother-infant interactions in NICU settings.Item Online intervention to prevent postnatal depression and anxiety in Chilean new mothers: Protocol for a feasibility trial(2022) Pérez Ewert, J. Carola; Aldoney, Daniela; García, María I.; Olhaberry, Marcia; Fernández, Olga; Alamo, Nicolle; Franco, Pamela; Pérez, Francisca; Fisher, Jane; Rowe, Heather; Coo, SoledadSymptoms of postpartum depression and anxiety in new mothers are prevalent and negatively impact maternal emotional wellbeing and infant development. Barriers to accessing treatment prevent women from receiving mental health care, a situation that has worsened due to the COVID-19 pandemic. mHealth interventions hold the potential to support women during the transition to parenthood despite these barriers and to promote the use of preventive interventions. This study uses a mixed methods design to assess the feasibility and preliminary effectiveness of a psychoeducational, guided mHealth intervention to prevent postpartum mental health difficulties in women who receive care in primary health centers in Chile. The study will contribute to evidence-based research on the effectiveness of mHealth interventions for new mothers from an under-studied cultural background. The findings will also enable the development of a larger randomized controlled trial to assess the effectiveness of the intervention, which, if effective, could significantly contribute to the emotional wellbeing of women and their families.Item Prematuridad y sensibilidad materna: Impacto en el desarrollo de infantes de pretérmino moderado a los 12 meses de edad corregida(Universidad del Desarrollo. Facultad de Psicología, 2021-08) Mira Olivos, Andrea; Coo, SoledadLos infantes prematuros moderados son un grupo vulnerable y pueden presentar problemas en su neurodesarrollo. Tanto el hecho de nacer prematuros como las interacciones con sus cuidadores puedan impactar las trayectorias de su desarrollo. Esta investigación tiene como objetivo explorar la relación entre las características de los infantes de pretérmino moderado y la sensibilidad materna en su desarrollo a los 12 meses de edad corregida. Este estudio corresponde a una investigación cuantitativa de tipo longitudinal no experimental con un alcance correlacional. La población objetivo de este estudio fueron diadas constituidas por las madres y sus recién nacidos de pretérmino moderado hospitalizados en un servicio de neonatología. Se evaluaron variables relacionadas con los bebés, el estado emocional madres y la interacción entre ambos. Dentro de los resultados podemos mencionar que la sintomatología depresiva y el estrés parental pueden afectar la interacción de la diada durante la hospitalización. Se observó una relación entre la sensibilidad del cuidador y el desarrollo de los bebés prematuros moderados a los 12 meses y un efecto moderador de la Sensibilidad Materna sobre el desarrollo de las áreas de Comunicación, Resolución de Problemas y Socio Individual. Tanto el retraimiento social como el ser pequeño para la edad gestacional se identificaron como factores de vulnerabilidad para los bebés prematuros moderados. Cómo conclusión los bebés prematuros moderados y sus madres son una población vulnerable y requieren apoyo para favorecer la salud mental de la madres, interacciones sensibles y el desarrollo de los bebés.Item Salud mental en madres en el período perinatal(2021) Coo, Soledad; García Valdés, María Ignacia; Mira, Andrea; Zamudio Berrocal, PaulinaLa gestación y el postparto son periodos de especial vulnerabilidad para el desarrollo de cuadros de salud mental materna, que impactan negativamente en la salud e interacción materno-infantil. La mayoría de los estudios se han enfocado en la depresión, siendo la ansiedad menos estudiada, pese a su alta prevalencia. Objetivos: Evaluar la prevalencia de tamizaje positivo para cuadros ansiosos y depresivos en una muestra de mujeres inscritas en centros de salud primaria públicos en Chile y la asociación de estos síntomas con los factores de riesgo específicos. Sujetos y Método: 158 mujeres completaron cuestionarios de auto reporte (Escala de Edimburgo y Escala de ansiedad perinatal) durante el tercer trimestre de gestación y a los 3 y 6 meses postparto. Se realizaron análisis para evaluar la prevalencia y evolución de los síntomas y posibles diferencias en salud mental de acuerdo a variables sociodemográficas. Resultados: Durante el periodo perinatal se identificó una prevalencia entre 41,3% y 44,3% de sintomatología ansiosa elevada y de 13,9% a 20,9% para los síntomas elevados de depresión. Se destaca la relevancia del apoyo percibido, nivel educacional materno y antecedentes de aborto espontáneo, para la salud mental de la mujer durante la transición a la maternidad. Conclusiones: Los síntomas de ansiedad y depresión perinatal son prevalentes, iniciativas para identificar a mujeres en riesgo y para promover factores protectores, como el apoyo social, son necesarias para aumentar el bienestar de las mujeres y sus familias.Item The role of interpersonal emotional regulation on maternal mental health(2020) Coo, Soledad; García, Maria Ignacia; Prieto, Fernanda; Medina, FrancoPurpose: Symptoms of depression and anxiety during the perinatal period have a negative impact on mothers and their developing children. A significant body of research has demonstrated an association between mental health and both individual and interpersonal emotion regulation. Yet, this association has not been studied during the perinatal period. The aim of this study was to explore the association between emotion regulation, maternal mental health, and interpersonal emotion regulation during the transition to motherhood in a sample of Chilean women. Methods: Women in their third trimester of pregnancy (n = 253) provided self-reports of emotion regulation and symptoms of depression and anxiety during pregnancy and three months postpartum. Additional self-reports of interpersonal emotion regulation were obtained from individuals who were identified as social support persons by these women. Results: Maternal emotion regulation contributed to maternal symptoms of depression and anxiety during pregnancy and after childbirth. The association between emotion regulation and maternal mental health was moderated by specific interpersonal emotion regulation strategies reported by the participant’s social support persons. Strategies including modulating the emotional response, situation modification, attentional deployment and cognitive change, modified the association between poor regulation strategies and anxiety symptoms. Also, an infrequent use of these interpersonal emotion regulation strategies strengthened the association between these maternal emotional regulation difficulties and anxiety symptoms. Conclusion: Our findings suggest that interpersonal emotional regulation strategies impact the association of maternal emotional regulation strategies and maternal emotional wellbeing.Item The Role of Perinatal Anxiety and Depression in Breastfeeding Practices(2020) Coo, Soledad; García, Maria Ignacia; Mira, Andrea; Valdés, VerónicaObjective: Maternal mental health difficulties are common during the perinatal period and have a negative impact on breastfeeding practices. Most research has focused on the role of postpartum depression, whereas maternal anxiety has been less studied, despite its high prevalence. A better understanding of the mental health variables that impact breastfeeding practices is necessary to support maternal and infant health and well-being. The aim of this study is to explore the association between breastfeeding practices and maternal mental health, with an emphasis on maternal anxiety. Materials and Methods: Two hundred twenty-nine women were followed from the third trimester of gestation to 3 and 6 months postpartum. The participants provided self-reports of depression, anxiety, and breastfeeding practices. Mental health symptoms were compared between participants who reported exclusive versus mixed breastfeeding at 3 months postpartum, and between mothers who maintained breastfeeding versus those who had weaned their infants at 6 months postpartum. Logistic regression analysis was used to explore the variables contributing to breastfeeding practices. Results: High levels of depressive symptoms during pregnancy were associated to nonexclusive breastfeeding at 3 months postpartum. At 3 months postpartum, both high levels of anxiety and depression were associated with nonexclusive breastfeeding at that time. Logistic regression analyses revealed that exclusive breastfeeding at 3 months postpartum predicted breastfeeding continuation at 6 months after childbirth. Conclusion: Both maternal depression and anxiety negatively impact breastfeeding practices. Early identification of maternal mental health problems during the perinatal period is relevant to promote maternal emotional well-being and to prevent breastfeeding difficulties.Publication Trajectories of Parental Daily Stress: An Ecological Momentary Assessment Study during the COVID-19 Lockdown(2023) Aldoney, Daniela; Coo, Soledad; Pérez, J. Carola; Muñoz-Najar, Andrés; González, Constanza; Montemurro, Manuel; Tapia, Leonel; Gana, Sofía; Silva, Luz María; Panesso, Carolina; Silva, JaimeThe COVID-19 pandemic was a source of significant stress due to health and safety concerns and measures to control the virus’ spread, such as mobility restrictions. This measure was especially demanding for parents with school aged children, who had to find new work–family balance as their children participate in online education while attempting to work remotely. To evaluate parents’ stress trajectories during the pandemic, we conducted Ecological Momentary Assessments (EMAs) during lockdown for 29 days in 68 families in Santiago, Chile. In addition, we evaluated the role of educational level and income, co-parenting, and number of children in parents’ stress trajectories. Our results showed that during the first weeks of lockdown expected protective factors (i.e., income and co-parental support) were not able to influence parents’ daily stress management. Moreover, parents with higher educational levels reported worse stress adaptation than less educated parents. On the other hand, co-parental conflict was significantly associated with parent’s stress. Our study captured an acute response to COVID-19 related challenges. This study contributes to understanding how parents adjust to stress during adverse circumstances such as the COVID-19 pandemic.Item Treatment adherence during childhood in individuals with phenylketonuria: Early signs of treatment discontinuation(2017) García, María Ignacia; Araya, Gabriela; Coo, Soledad; Waisbren, Susan E.; de la Parra, AliciaIntroduction: Phenylketonuria (PKU) is an autosomal recessive disorder characterized by a deficiency in phenylalanine (Phe) hydroxylase activity. Early diagnosis and continuous treatment with a low Phe diet prevents severe neurological and cognitive impairment. Aims: 1. Analyze how treatment adherence evolves through infancy, childhood, and early adolescence in individuals with PKU. 2. Identify early signs of treatment discontinuation. Methodology: This longitudinal, retrospective study included 75 children diagnosed through newborn screening, ages 7 to 13 years. Data on blood Phe concentration, number of blood samples sent, proportion of samples with Phe concentrations over the recommended range, and number of visits to the metabolism clinic were recorded. Logistic regression analysis was used to identify the variables that predict treatment discontinuation before 13 years of age. Results: A progressive increase in mean blood Phe concentrations with age was identified. The greatest increase occurred between the first and second years of life. By age ten, mean Phe blood concentration of the group was above the recommended range. The proportion of samples with Phe concentrations over the recommended range also increased with age, from an average of 13% during the first year of life to 67% in early adolescence. Sixty-eight percent of the children attended the outpatient clinic and sent samples from birth to the time of the study. Individuals who discontinued follow-up showed significantly higher mean blood Phe concentrations (360 vs. 220.9 mu mol/L; p=0.004) and the proportion of samples over the recommended range (37% vs. 12% p=0.002) was significantly higher during the second year of life. Mean age for children who discontinued treatment was 5.5 years of age. Blood Phe concentration values at 12 to 23 months of age and at 6 to 8 years of age significantly predicted treatment discontinuation before 13 years of age. Conclusion: Treatment adherence in PKU diminishes with age. Early signs of treatment discontinuation can be identified during the second year of life, allowing preventive interventions in high risk groups.