Análise do catch-up de crescimento de uma coorte de recém-nascidos prematuros

• Ano de defesa: 2015
• Autor(a) principal: Oliveira, Gisele do Couto
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Mato Grosso; Brasil; Instituto de Saúde Coletiva (ISC); UFMT CUC - Cuiabá; Programa de Pós-Graduação em Saúde Coletiva
• Palavras-chave em Português: Prematuro; Crescimento e desenvolvimento; Recém-nascido de baixo peso; Epidemiologia; catch-up de crescimento; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA; Premature; Growth and development; Low birth weight; Epidemiology; Catch-up growth
• Link de acesso: http://ri.ufmt.br/handle/1/180

Background - Premature birth is associated with risks of short and long-term damage on growth, development, production capacity and quality of life. Studies about the premature growth are still scarce and inconclusive. Objective - Analyze the catch-up growth of a cohort of premature infants seen at follow-up clinic of the Hospital Geral Universitário, Cuiabá - MT during the period from 01/01/2005 to 31/12/2011. Method - Retrospective cohort study of premature infants followed in a university hospital from 2005/01/01 to 2011/12/31. The data were obtained from a review of files and medical records. Growth curves were constructed and analyzed according to the standard curves of Fenton and WHO as of weight, height, head circumference and body mass index (BMI) recorded at each visit. The anthropometric measurements were assessed at birth and corrected ages of 40 weeks and 1 year. The outcome was catch-up growth. Associations between groups were investigated by univariate analysis. Results: 276 premature infants were analyzed, the mean birth weight was 1960 ± 540g and the mean gestational age was 33.7 ± 2.1 weeks, 52.17% were male, 64.59% were black and 83.70% were moderate/late premature. Approximately 64% were preterm low birth weight infants, 17.03% were small for gestational age (SGA), 8.70% had intrauterine growth restriction (IUGR) and 54.05% evolved with extrauterine growth restriction at discharge or at the corrected age of 40 weeks. Between SGA and IUGR, 75% were moderate/late premature. Most performed prenatal care (89.35%) in public service averaging 5.8 ± 2.06 consultations; born by surgery (68%); was discharged on exclusive breastfeeding (76.72%) and remained breastfeeding at 6 months of corrected age (64.13%), with or without supplementation with formula. Maternal characteristics were: median age of 24 years, 59.31% with education above 8 years, 69.88% had a companion and 40.12% had family income below 0.5 minimum wage. Most children reached growth catch-up in the first year of life with a median age in days for weight = 49 (23.0 to 126.0), height = 121.5 (48.8 to 197.5) head circumference = 65 (27.5 to 122.5) and BMI = 60 (39.0 to 142.0). There were no significant differences between sexes and gestational age subgroups, except for extremely preterm infants. The measures of children at the corrected age of 1 year were within the WHO standard, but below the average for weight, height and head circumference and above average for BMI. Conclusion: the growth pattern of premature followed in this hospital was similar to that reported in the literature, except for the head circumference that showed catch-up later that weight. There was a predominance of moderate to late preterm with high extrauterine growth restriction rate, but most achieved catch-up in the first year of life, especially in the first half, showing that follow-up clinics are essential for the proper growth of premature infants who were discharged from Neonatal Intensive Care Unit