Avaliação do desenvolvimento de prematuros de 18 a 24 meses de idade corrigida por meio das escalas Bayley III

• Ano de defesa: 2017
• Autor(a) principal: Mendes, Martha Luisa Antunes Garcia [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Child; Premature; Pediatric development; Bayley III; Criança; Prematuro; Desenvolvimento infantil
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5199989; http://repositorio.unifesp.br/handle/11600/50382

Objectives: To determine the prevalence of developmental delay, and also describe the scores and factors associated to the developmental scores in children of 18-24 months of corrected age, born before 34 weeks of gestation, using the Bayley III developmental scales. Methods: A cross-sectional study was carried out including children born before 34 weeks of gestational age and birth weight < 2000g, followed-up at the outpatient clinic for preterm infants of the Federal University of São Paulo. Exclusion criteria were: congenital malformations, genetic syndrome, congenital infection and severe developmental delay that prevented the application of the Bayley III scales. The project was approved by the Ethics Committee of the Federal University of São Paulo and parents/guardians signed the term of agreement. Data collected included: maternal and children characteristics and developmental scores of cognitive, language, motor, socioemotional and adaptive behavior, using the Bayley III developmental scales. For any scale, scores below 85 were considered as developmental delay. The numeric variables were expressed as mean and standard deviation or median and minimum and maximum values and were compared by Mann-Whitney test, t test or ANOVA, according to its distribution or number of independent variables. The categorical variables were expressed in number and percentage and compared by chi-squared or Fisher’s exact test. Factors associated to the developmental scores were analyzed by univariate and multiple linear regressions. The statistic analysis was carried out by SPSS for Win/v.17.0, considering p value <0.05 as significant. Results: 101 (93.5%) children were included, gestational age of 29.5±2.6 weeks, birth weight of 1244±38g, 42 (41.6%) were boys and 23 (22.8%) were small for gestational age. The mothers’ age was 30.3±7.2 years, 82 (81.2%) had a stable partner, 13 (12.9%) had less than 9 years of schooling, 56 (55.4%) belonged to social class C and 7 (6.9%) to class D/E, with an average family income of R$ 1,800.00 (600-8,000) reais. During pregnancy, 87 (86.1%) underwent prenatal care, 9 (8.9%) presented chronic arterial hypertension, 29 (28.7%) hypertensive disorder of pregnancy, 9 (8.9%) chorioamnionitis and 60 (59.4%) received antenatal corticosteroid and 69 (69.3%) delivered by C-sections. Developmental delay occurred in 19% of the children (cognitive), 27% (language), 12% (motor), 8% (socioemotional) and 22% (adaptive behavior). The mean developmental scores were: 92.6±14.0 (cognitive), 91.5±16.8 (language), 97.5±16.5 (motor), 103.8±17.1 (socioemotional) and 94.0±16.4 (adaptive behavior). By multiple linear regression analysis, the factors significantly associated to the developmental scores (Beta) were: Cognitive – mothers’ schooling <9 years (-9.711), leukomalacia (-11.263), convulsive syndrome (-13.848); Language – mothers’ years of schooling (1.575), leukomalacia (-14.044), retinopathy (-8.660), convulsive syndrome (-10.608); Motor - leukomalacia (-10.335), retinopathy (-11.134); convulsive syndrome (-15.381); Socioemotional - periventricular hemorrhage (-11.565), convulsive syndrome (-17.055) and Adaptive behavior – weeks of gestational age (1.643), mothers’ years of schooling (1.399), meningitis (-11.406). Conclusions: Children of 18-24 months of corrected age, born before 34 weeks of gestational age, presented high-prevalence of developmental delay in all areas assessed by Bayley III scales. The factors associated to developmental delay were: gestational age, mothers’ schooling, leukomalacia, periventricular hemorrhage, convulsive syndrome, meningitis and retinopathy of prematurity.