Avaliação do sono em crianças nascidas prematuras e com muito baixo peso e sua relação com aspectos comportamentais na idade escolar

• Ano de defesa: 2016
• Autor(a) principal: Santos, Aline Ávila dos
• Orientador(a): Nunes, Magda Lahorgue
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul
• Programa de Pós-Graduação: Programa de Pós-Graduação em Medicina e Ciências da Saúde
• Departamento: Escola de Medicina
• País: Brasil
• Palavras-chave em Português: Sono; Prematuridade; Muito Baixo Peso de Nascimento; Comportamento
• Área do conhecimento CNPq: CIENCIAS DA SAUDE::MEDICINA
• Link de acesso: http://tede2.pucrs.br/tede2/handle/tede/7308

Introduction: The rate of premature births has been increasing at significant way and due to the better technical conditions of Neonatal Intensive Therapy Units, the survival of these children has also had a raise. Premature birth is a theme of global priority in terms of public health and corresponds to approximately 10% of all births worldwide. Several studies have approached behavioral issues, which occur during the first years of life in these children; however, studies which evaluate sleep in this group when they reach scholar age are still scarce, period in which behavioral difficulties may develop in their scholar and social relations, as a consequence of the association to sleep alterations. In view of that, this work has proposed evaluating this group. Goals: evaluating the prevalence of sleep disorders and behavioral alterations in patients born premature and with low weight at birth, currently at scholar age. Methodology: Transversal study which has evaluated 25 premature children with low weight at birth (<1500g), without neurological comorbities, born at Hospital São Lucas da PUCRS in the period of 2007 to 2009, today at scholar age and compared to 25 children at term, linked to pediatric ambulatory of the same hospital. Those with neurological comorbities were excluded, under use of psychotropic substances or those showing IQ<70 by WASI scale (Wechsler Abbreviated Scale of Intelligence). In order to evaluate sleep organization the Actigraph and the Sleep Diary were used in a 72-hour period. In actigraphy, the following variables were measured: Sleep Efficience, calculated automatically by the actigraphy; Total Sleep Time (TST), being calculated subsequently the Average of Total Sleep Time, referring to the 72 hours of use of the device and the Night Awakenings with above 5 minutes lasting (WASO >5: wake after sleep onset), where the presence of 3 or more night awakenings lasting over 5 minutes configures sleep alteration. In order to evaluate the presence of sleep disorders it was used the Sleep Disturbance Scale for Children (SDSC), where values above cut point 39 indicate sleep alterations. The evaluation of behavior was performed by CBCL (Child Behavior Checklist), where the scoring is established by a software in which scores above 63 are classified as showing clinical manifestations of behavior alterations. Results: the total sleep time reported on SDSC for prematures ranged between 7 and 11 hours, for those at term 5 to 11 hours, where 60% of prematures and 68% of born at term showed sleep restriction (lasting below expected for age range). In this same scale, the total score of prematures ranged between 31 and 76 and neonates at term between 35 and 82, indicating the presence of sleep disorders in 88% of prematures and 76% of those at term. In actigraphy, the Average Sleep Time was 4,84 to 9,96 in prematures and 6,33 to 10,02 hours in those at term; ensuing 68% prematures and 76% of those at term. Sleep Efficiency ranged between 43,3 and 99,57 in prematures and 43,66 to 96,77 on those at term; where 60% of prematures and 72% of those at term showed improper sleep efficiency, which is, below 90. The average night awakenings lasting over 5 minutes ranged between 0 and 5,66 in prematures and 0 to 6,33 in those at term, where 56% prematures and 72% at term presented more than three night awakenings above 5 minutes duration, configuring sleep disorder. In CBCL behavioral variables there was a prevalence of behavioral alterations in 64% prematures and 56% in those at term. The comparison between groups has not highlighted a statistically significant difference to any variable. Conclusion: It was observed an elevated prevalence of sleep alterations in both groups of study, however, it was not possible to perform associations between these disorders and behavioral alterations.