Desenvolvimento neuropsicomotor de lactentes nascidos prÃ-termo e a termo: fatores associados

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Introduction: Infant neuropsychomotor development (NPMD) considered a process of qualitative and quantitative changes of functional aspects is characterized by domains such as cognition, language, motor abilities (gross and fine), sensory function and socioemotional development. NPMD evaluation of vulnerable infants should be considered as an important instrument to help understand their quality of life, identify risk factors, and to elabora actions to protect the biopsychosocial aspects. Many studies indicate prematurity as one of the main risk factors affecting the NPMD, as a consequence of the vulnerability these infants undergo. However, many authors remind that caution is needed when the prematurity is evaluated as a risk factor, once it may function as a mediator factor for other conditions, like morbidity, that would influence the NPMD. Objective: To evaluate the NPMD of infants born pre-term and full-term aged from 6 to 12 months and to verify the association of biological, socioeconomic, and demographic factors with NPMD. Methods: This is a descriptive study with an analytical component conducted with 135 infants (90 born full-term and 45 born pre-term) followed at the well baby and high-risk newborn outpatient unit of Hospital das ClÃnicas â Universidade Federal de Pernanbuco. The NPMD was evaluated using the cognition, language and motor sub-scales of the Bayley Scales of Infant and Toddler Development III (Bayley III). Data regarding the biological, socioeconomic and demographic conditions were obtained through a questionnaire answered by the infantâs guardian through interviews, as well as by information obtained from the infantâs records. Results: No difference was observed in the NPMD evaluation between the two groups of infants, however, the mean expressive language index was lower for the pre-term infants. For the sample as a whole, the male infants demonstrated significantly inferior mean scores on cognition, language and motor ability. Other variables significantly associated with low scores on the language evaluation were small for gestational age and the duration of exclusive breastfeeding ≤ 2 months. The development of motor abilities were most affected by biological variables such as male sex, birth weight ≤ 1500g, Apgar ≤ 7, weight-for-age, length-for-age and head circumference-for-age <-1 z score and the duration of exclusive breastfeeding ≤ 2 months. Conclusion: The biological variables were the ones that most influenced the NPMD of infants. Protective factors seemed to have influenced the NPMD, including the high frequency of exclusive breastfeeding, adequate perinatal assistance, regular maternal educational level, smaller family size and the use of corrected cronological age.

ASSUNTO(S)

prematuridade prematurity risk factors desenvolvimento infantil fatores de risco estimulaÃÃo precoce pediatria early stimulation biological factors fatores biolÃgicos infant development

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