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      Psychomotor development of preterm infants aged 6 to 12 months Translated title: Desenvolvimento neuropsicomotor de lactentes pré-termo com 6 a 12 meses de vida

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          ABSTRACT

          CONTEXT AND OBJECTIVE:

          The immaturity of preterm infants’ organ systems may lead to difficulties in adapting to different environmental stimuli. The aim was to compare the psychomotor development of preterm infants (with corrected age) and term infants aged 6 to 12 months and to investigate associated factors.

          DESIGN AND SETTING:

          Cross-sectional analytical study conducted at Hospital das Clínicas, Universidade Federal de Pernambuco.

          METHODS:

          The sample consisted of 135 infants (45 preterm and 90 full-term) aged 6 to 12 months. Neuropsychomotor development was assessed using the Bayley III cognitive, language and motor subscales. Biological, socioeconomic and demographic data were gathered from medical records and through interviews with mothers.

          RESULTS:

          The mean cognitive, language and motor indices were within the range of normality for the sample as a whole. No significant difference in the development of infants born preterm and full-term was observed, except for expressive communication, in which preterm infants presented a lower index. Motor development was influenced by biological factors, and the poorest performances were observed in male infants; birth weight birth weight < 1500 g; Apgar score at five minutes ≤ 7; weight-, length- and head circumference-for-age < -1 Z-score; and exclusively breastfeeding for ≤ two months.

          CONCLUSIONS:

          Prematurity did not influence the psychomotor development of infants in this study population. Motor development was the most affected domain in the sample as a whole, especially due to biological factors. Investigations on child neuropsychomotor development should try to identify many determinant factors because of its multifactorial nature.

          RESUMO

          CONTEXTO E OBJETIVO:

          A imaturidade dos sistemas orgânicos das crianças nascidas prematuras pode levar a dificuldades de adaptação a diferentes estímulos do ambiente. O objetivo foi comparar o desenvolvimento neuropsicomotor de lactentes nascidos pré-termo (com idade corrigida) e no termo com idade entre 6 e 12 meses e investigar seus fatores associados.

          TIPO DE ESTUDO E LOCAL:

          Estudo transversal analítico realizado no Hospital das Clínicas, Universidade Federal de Pernambuco.

          MÉTODOS:

          A amostra foi constituída de 135 crianças (45 pré-termo e 90 no termo) com idade entre 6 a 12 meses. O desenvolvimento neuropsicomotor foi avaliado pelas subescalas cognitiva, linguagem e motora da Bayley III. Dados biológicos, socioeconômicos e demográficos foram coletados de prontuários médicos e por entrevistas com as mães.

          RESULTADOS:

          A média dos índices cognitivo, de linguagem e motor estava dentro da faixa de normalidade para a amostra como um todo. Não foi observada diferença significativa entre o desenvolvimento de crianças nascidas pré-termo e no termo, com exceção para a comunicação expressiva, na qual os prematuros apresentaram menor índice. O desenvolvimento motor foi influenciado por fatores biológicos, e os piores desempenhos foram observados em crianças do sexo masculino, com peso ao nascer < 1500 g; índice de Apgar aos cinco minutos ≤ 7; peso, comprimento e circunferência da cabeça-para-idade < -1 escore Z; e amamentação exclusiva por ≤ dois meses.

          CONCLUSÕES:

          A prematuridade não influenciou o desenvolvimento psicomotor das crianças nessa população. O desenvolvimento motor foi o domínio mais afetado na amostra como um todo, especialmente devido a fatores biológicos. Investigações sobre o desenvolvimento neuropsicomotor infantil devem tentar identificar inúmeros fatores determinantes devido a sua natureza multifatorial.

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          Most cited references45

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          Developmental potential in the first 5 years for children in developing countries

          Summary Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data—the prevalence of early childhood stunting and the number of people living in absolute poverty—to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty.
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            An overview of mortality and sequelae of preterm birth from infancy to adulthood.

            Survival rates have greatly improved in recent years for infants of borderline viability; however, these infants remain at risk of developing a wide array of complications, not only in the neonatal unit, but also in the long term. Morbidity is inversely related to gestational age; however, there is no gestational age, including term, that is wholly exempt. Neurodevelopmental disabilities and recurrent health problems take a toll in early childhood. Subsequently hidden disabilities such as school difficulties and behavioural problems become apparent and persist into adolescence. Reassuringly, however, most children born very preterm adjust remarkably well during their transition into adulthood. Because mortality rates have fallen, the focus for perinatal interventions is to develop strategies to reduce long-term morbidity, especially the prevention of brain injury and abnormal brain development. In addition, follow-up to middle age and beyond is warranted to identify the risks, especially for cardiovascular and metabolic disorders that are likely to be experienced by preterm survivors.
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              • Article: not found

              Child development: risk factors for adverse outcomes in developing countries.

              Poverty and associated health, nutrition, and social factors prevent at least 200 million children in developing countries from attaining their developmental potential. We review the evidence linking compromised development with modifiable biological and psychosocial risks encountered by children from birth to 5 years of age. We identify four key risk factors where the need for intervention is urgent: stunting, inadequate cognitive stimulation, iodine deficiency, and iron deficiency anaemia. The evidence is also sufficient to warrant interventions for malaria, intrauterine growth restriction, maternal depression, exposure to violence, and exposure to heavy metals. We discuss the research needed to clarify the effect of other potential risk factors on child development. The prevalence of the risk factors and their effect on development and human potential are substantial. Furthermore, risks often occur together or cumulatively, with concomitant increased adverse effects on the development of the world's poorest children.
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                Author and article information

                Journal
                Sao Paulo Med J
                Sao Paulo Med J
                Sao Paulo Med J
                São Paulo Medical Journal
                Associação Paulista de Medicina - APM
                1516-3180
                1806-9460
                13 November 2012
                2012
                : 130
                : 5
                : 299-306
                Affiliations
                [I ] originalMD, PhD. Adjunct Professor, Department of Maternal and Child Health, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil.
                [II ] originalMSc. Physiotherapist and Assistant Professor, Physiotherapy Course, Associação Caruaruense de Ensino Superior (ASCES), Caruaru, Pernambuco, Brazil.
                [III ] originalMD, PhD. Adjunct Professor, Department of Maternal and Child Health, Universidade Federal de Pernambuco (UFPE), Recife, Pernambuco, Brazil.
                Author notes
                [Address for correspondence: ] Sophie Helena Eickmann. Av. Flor de Santana, 190 - apto 2.602. Parnamirim - Recife (PE) - Brasil. CEP 52070-290. Tel. (+55 81) 2126-8514. E-mail: sophie.eickmann@ 123456gmail.com

                Conflict of interest: None

                Article
                10.1590/S1516-31802012000500006
                10836468
                23174869
                d7d03724-e683-47e1-a04f-b92466c5ea26

                This is an open access article distributed under the terms of the Creative Commons license.

                History
                : 01 August 2011
                : 07 December 2011
                : 24 February 2012
                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 32, Pages: 08
                Categories
                Original Article

                infant, premature,biological factors,risk factors,child development,language development,prematuro,fatores biológicos,fatores de risco,desenvolvimento infantil,desenvolvimento da linguagem

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