Riscos biológicos e aspectos cognitivos, comportamentais e emocionais de uma coorte de escolares / Biological risks and cognitive, behavioral and emotional outcomes of a cohort of school-age children
Adriana Martins Saur
IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia
DATA DE PUBLICAÇÃO
Under the theoretical viewpoint of developmental psychopathology, the existence of biological risks in the development of children, such as low birth weight and prematurity, may maximize conditions of vulnerability and, in long term, bias their adaptation. In reviewing the literature it is noticed the wide range of results concerning cognitive, behavioral, and emotional outcomes associated with these hindrances. In this context, it was proposed a prospective cohort study, with three general objectives: 1) verify the possible association between cognitive, behavioral, and emotional outcomes of a cohort of school-age children, assessed at 10-11 years of age, stratified by three criteria: 1) birth weight (very low birth weight - VLBW, low birth weight - LBW, insufficient birth weight - IBW, normal birth weight NBW, and high birth weight HBW; gestational age (preterm and at term); and size at birth (small for gestational age SGA and appropriate for gestational age AGA); 2) identify the predictors for the cognitive, behavioral, and emotional outcomes, based on biological, clinical and socioeconomic variables; and 3) establish the rates of behavioral problems in the studied cohort, regardless of the criterion that was adopted. For this purpose, we evaluated 677 children, 10-11 years old, of both sexes, from a cohort of Ribeirão Preto, State of São Paulo, Brazil. For the cognitive evaluation were utilized the Raven tests and the Human Figure Drawing (HFD); for behavioral and emotional assessment, parents answered the Strengths and Difficulties Questionnaire (SDQ), and a supplementary questionnaire. Data were analyzed under descriptive, comparative, and predictive approaches, by using non-parametric statistics (p 0.05). Results indicated that birth weight was not associated with cognitive and behavioral outcomes, except for the hyperactivity scale, in which the VLBW had more indicators of difficulties in comparison to other weight groups. Concerning the emotional outcome the LBW group showed more emotional problems than VLBW and NBW groups. Gestational age was not associated with any of the investigated outcomes and size at birth was associated with the three outcomes examined, with children born SGA displaying more cognitive, behavioral, and emotional problems when compared to children born AGA. In the analysis of prediction, it was found that: maternal education and socioeconomic status were predictive for the three outcomes, the SGA status favored an increase in emotional problems, and boys had greater risks of behavioral problems. The rates of identification of behavioral problems were high, 38.2% for general problems and 53.9% for emotional symptoms. It is concluded that the criterion of size at birth was more accurate for detecting differences in the analyzed outcomes of school-age children. Among the contributions of this study, it is highlighted the identification of predictive variables and comparisons including factors of biological and socioeconomic risk across a single cohort, stratified by three criteria, which may support the development of prevention programs.
cohort studies comportamento estudos de coortes behavior birth weight gestational age idade gestacional measures of association/exposure/risk or outcome medidas de associação/exposição/risco ou desfecho peso ao nascer
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