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      Developmental assessment of infants born preterm: comparison between the chronological and corrected ages Translated title: Avaliação do desenvolvimento de bebês nascidos pré-termo: a comparação entre idades cronológica e corrigida

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          Abstract

          OBJECTIVE: To compare the global and motor development of infants born preterm, regarding the performance in the chronological age and corrected age for prematurity METHODS: This is a cross-sectional study. The sample was comprised of 182 preterm infants (< 37 weeks of gestational age) and low birth weight (< 2,500 grams) belonging to the following age groups: 2-4 months (n = 182), 4-6 months (n = 146), and 6-8 months (n = 112). The global development was assessed through the Denver-II test in the three age groups, and the motor development was assessed through the Test of Infant Motor Performance in 2-4 months group and the Alberta Infant Motor Scale in 4-6 and 6-8 months group. The infants' performance classifications in the chronological and corrected ages were compared through the McNemar's test RESULTS: The global and motor development was delayed in 75% to 91% of the infants, regarding the chronological age in all three age groups. Otherwise, concerning the corrected age for prematurity, the delayed performance was detected in 33% to 51% of the infants in all three age groups (p < 0.001) CONCLUSION: The development assessments taking on the chronological age could overestimate risks and problems in the first year of age

          Translated abstract

          OBJETIVO: Comparar o desenvolvimento global e motor de bebês nascidos pré-termo, considerando-se o desempenho das crianças na idade cronológica e na idade corrigida para a prematuridade MÉTODO: O estudo é do tipo corte-transversal. A amostra foi constituída por um total de 182 recém-nascidos pré-termo (< 37 semanas de idade gestacional) e com baixo peso ao nascer (< 2.500 gramas) pertencentes aos seguintes grupos etários: 2-4 meses (n = 182), 4-6 meses (n = 146) e 6-8 meses (n = 112). O desenvolvimento global das crianças foi avaliado pelo Teste de Denver II nos três grupos etários e o desenvolvimento motor foi avaliado pelo Test of Infant Motor Performance no grupo de 2-4 meses e pela Alberta Infant Motor Scale nos grupos de 4-6 e 6-8 meses. A classificação dos desempenhos das crianças, considerando-se as idades cronológica e corrigida, foi comparada por meio do Teste de McNemar RESULTADOS: Quando se considera a idade cronológica, o percentual de atraso no desenvolvimento motor e global situou-se entre 75% e 91% da amostra, porém utilizando a idade corrigida este percentual variou de 33% a 51%, considerando os três grupos etários (p < 0,001) CONCLUSÃO: A avaliação do desenvolvimento utilizando a idade cronológica pode superestimar riscos ou problemas no primeiro ano de idade

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          The essence of governance in health development

          Background Governance and leadership in health development are critically important for the achievement of the health Millennium Development Goals (MDGs) and other national health goals. Those two factors might explain why many countries in Africa are not on track to attain the health MDGs by 2015. This paper debates the meaning of 'governance in health development', reviews briefly existing governance frameworks, proposes a modified framework on health development governance (HDG), and develops a HDG index. Discussion We argue that unlike 'leadership in health development', 'governance in health development' is the sole prerogative of the Government through the Ministry of Health, which can choose to delegate (but not abrogate) some of the governance tasks. The general governance domains of the UNDP and the World Bank are very pertinent but not sufficient for assessment of health development governance. The WHO six domains of governance do not include effective external partnerships for health, equity in health development, efficiency in resource allocation and use, ethical practises in health research and service provision, and macroeconomic and political stability. The framework for assessing health systems governance developed by Siddiqi et al also does not include macroeconomic and political stability as a separate principle. The Siddiqi et al framework does not propose a way of scoring the various governance domains to facilitate aggregation, inter-country comparisons and health development governance tracking over time. This paper argues for a broader health development governance framework because other sectors that assure human rights to education, employment, food, housing, political participation, and security combined have greater impact on health development than the health systems. It also suggests some amendments to Siddigi et al's framework to make it more relevant to the broader concept of 'governance in health development' and to the WHO African Region context. Summary A strong case for broader health development governance framework has been made. A health development governance index with 10 functions and 42 sub-functions has been proposed to facilitate inter-country comparisons. Potential sources of data for estimating HDGI have been suggested. The Governance indices for individual sub-functions can aid policy-makers to establish the sources of weak health governance and subsequently develop appropriate interventions for ameliorating the situation.
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            Born too soon. The global action report on preterm birth

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              An evidentiary review regarding the use of chronological and adjusted age in the assessment of preterm infants.

              The evidence supporting the recommendation to use age adjustment when assessing the growth, motor, and global development of premature infants was explored. Following a comprehensive literature search, 16 articles that compared the use of adjusted and chronological age were reviewed.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbcdh
                Journal of Human Growth and Development
                J. Hum. Growth Dev.
                Centro de Estudos de Crescimento e Desenvolvimento do Ser Humano
                2175-3598
                2015
                : 25
                : 2
                : 230-236
                Affiliations
                [1 ] State University of Goiás Brazil
                [2 ] University of São Paulo Brazil
                [3 ] University of São Paulo Brazil
                Article
                S0104-12822015000200015
                10.7322/JHGD.103020
                96f25613-4567-4d76-99d8-652c9ffb3bf0

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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                Categories
                MULTIDISCIPLINARY SCIENCES

                prematuro,desenvolvimento infantil,avaliação,infant,premature,child development,evaluation

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