Neuropsychomotor follow up of infants with a history of prematurity / Seguimento neuropsicomotor de lactentes com histórico de prematuridade

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Seeking know what neuroevolutivo profile in early childhood of children with a history of prematurity, the objective of this study was to evaluate the follow neuropsychomotor of children 4 to 24 months, with risk of neurological criteria, based on a history of prematurity, with the High Risk Clinic at the Division of Pediatric Neonatology at University Hospital (HU/ UFSC). The research is characterized as descriptive, and longitudinal development. The population was composed of extremely premature children and of prematurity, with the Project "Maturity follow of Children with High Biological Risk" and "Assessment and Intervention neuropsychomotor in children with a history of prematurity, held in the High Risk Clinic at the Neonatology of the HU / UFSC, in the city of Florianópolis / SC, from July 2005 to July 2008. The children were assessed by a standardized form for acquisition of biopshychosocial data, answered by the consultation to the hospitalar handbook and an interview with parents or guardians, and the Psychomotor Development Scale of the Early Childhood (Brunet-Lèzine). The sample comprised 89 infants, and throughout the following assessments were 250 evaluations, which lasted on average 30 minutes and is performed in an office in the presence of parent. The gestational age mean was 216,15 days (MED = 216, standard deviation = 17,2), and birth weight was 1271.9 g with great variation between 515g and 3150g. Regarding gender, 57% were male infants and 43% in female infants. The child s daily permanence have, 84.3% (N = 75) of cases showed the mother as primary caregiver, strengthening the parent-child bond, promoting the prevention of disorders of development. As the pre-natal complications, they were present in 68.3% of pregnancies, and the main one was Pre Eclampsia (25,3% N = 23), followed by infections, present in 12,1% (N = 11) of pregnant women. The newborn classification showed that 27,6% were classified PIG, 51% had very low birth weight and 27% were Extremely low birth weight, increasing the willingness to risk the development of sequelae. There were complications in 85% of neonatal cases, several of which may be negatively influencing the neuropsychomotor development of infants, especially those I had associations of complications (59,3%). In the first evaluation of neuropsychomotor development, had a frequency of 89 infants, however, only 65 infants characterized the follow-up evaluations with 73%, 57.3% (N = 51) with three, 33.7% (N = 30 ) with a fourth assessment, and 16.8% who came to have five evaluations over a period of two years. With the assessment of development, there was QDG (N = 47) classified as normal average (NA), the majority (52.8%), however, draws us to the attention of 28.5% below average. The QDC was NM, to 38.2%, but 43.8% were below expectations. Being the area that showed worse rating, followed by the area of language. After the fifth assessment in an average follow up of 12 months, you can see that the QDP was rated above the norm for 73.3% of cases, with only 1 case (6.6%) of inferiority. For the QDC, the classification in NA was present in 66.6%, decreasing significantly to 6.6%, the classification below normal. Thus, the area that showed greater progress in developing neuropsychomotor. The area of language also made significant progress, with 60% of infants above average, and 20% of cases in NA. QDS has not had cases of inferiority in the fifth assessment, presenting 53.3% classified as NA, and 6.6% in zone limit (n = 1). Thus the development of Global Classification of infants who reached the fifth assessment showed 60% of infants in the middle, NM with rating and 40% above the average, showing no cases of delayed development. The ratio of expansions were analyzed in pairs by paired t test, and differences were not statistically significant. you can see that all the assessments showed the same linearity and is always the area of coordination óculomotriz, the scores of children, followed by the area of language. To correlate the ratios of development, found in most, moderate correlations, statistically significant by Pearson s linear correlation.

ASSUNTO(S)

desenvolvimento neuropsicomotor educacao fisica neurologic risk prematuridade risco neurológico pshychomotor development brunet-lèzine scale escala de brunet-lèzine prematurity

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