Objective: To evaluate the prevalence of delay and factors associated with neurodevelopmental scores in premature infants. Methods:Cross-sectional study to assess the development by Bayley Scales III, including very low birth weight preterm infants aged 18 to 24 months who were under follow-up at the outpatient clinic for preterm infants. Congenital malformation, genetic syndrome, symptomatic congenital infection at birth, deafness, and blindness were excluded. Numerical variables were compared by Mann-Whitney or Student t test and categorical variables by chi-square or Fisher's exact test. Factors associated with developmental scores were analyzed by linear regression, and statistical significance level was established at p < 0.05. Results:Out of the 58 children included, four (6.9%) presented cognitive delay, four (6.9%) motor, 17 (29.3%) language, 16 (27.6%) social-emotional and 22 (37.0%) adaptive-behavior delay. By multiple linear regression, the variables: social classes CDE (-13.27; 95%CI: -21.23 to -5.31), oxygen dependency at 36 weeks of corrected age (-8.75; 95%CI: -17.10 to -0.39) decreased the cognitive developmental score. Periventricular leukomalacia decreased the cognitive (-15.21; 95%CI: -27.61 to -2.81), motor to -1.59) and adaptivebehavior scores ). The female sex was associated with higher motor (10.67; 95%CI: 2.77 to 12.97), language (15.74; 95%CI: 7.39 to 24.09) and social-emotional developmental scores (10.27; 95%CI: 1.08 to 19.46). Conclusions:Very low birth weight preterm infants aged from 18 to 24 months of corrected age presented more frequently language, social-emotional and adaptive-behavior delays. The variables: social classes CDE, periventricular leukomalacia, bronchopulmonary dysplasia and male sex reduced the neurodevelopmental scores.J Pediatr (Rio J). 2012;88(6):471-8: Infant premature, very low birth weight infant, child development. ResumoObjetivo: Avaliar a prevalência de atraso e fatores associados aos escores de desenvolvimento em crianças nascidas prematuras.Métodos: Estudo transversal para avaliar o desenvolvimento por escalas Bayley III, incluindo-se prematuros de muito baixo peso de 18 a 24 meses de idade corrigida, acompanhados no Ambulatório de Prematuros da instituição. Excluíram-se: malformação congênita, síndrome genética, infecção congênita sintomática ao nascimento, surdez e cegueira. As variáveis numéricas foram comparadas por teste t de Student ou MannWhitney, e as categóricas, por qui-quadrado ou teste exato de Fisher. Para análise dos fatores associados aos escores de desenvolvimento, utilizou-se a regressão linear, considerando-se significante p < 0,05.Resultados: Das 58 crianças avaliadas, quatro (6,9%) apresentaram alteração cognitiva; quatro (6,9%), motora; 17 (29,3%), de linguagem; 16 (27,6%), socioemocional; e 22 (37,9%), de comportamento adaptativo. À regressão linear múltipla, os fatores classe socioeconômica CDE (-13,27; IC95% -21,23 a -5,31) e dependência de oxigênio com 36 semanas de idade corrigida (-8,75; IC95% -17,10 a -0,39) diminuíra...
Premature infants with birth weights of 1500-1999 g exhibited considerable delays in several developmental areas. In addition to biological factors, environmental factors contributed to the reduced scores and/or developmental delays.
RESUMOObjetivo: Revisar o papel da fisioterapia motora no prematuro com risco de desenvolver doença metabólica óssea.Fontes de dados: Trata-se de uma revisão de literatura publicada entre 1986 e 2009, utilizando as seguintes palavras-chave: prematuro, calcificação fisiológica, modalidades de fisioterapia, doenças ósseas metabólicas e os respectivos descritores no idioma inglês. Foram selecionados 29 artigos científicos, via PubMed e ISI Web, além de um capítulo de livro nacional.Síntese dos dados: As doenças ósseas metabólicas compreendem um conjunto de condições relacionadas a alterações no processo de calcificação fisiológica, levando desde à fragilidade estrutural até ao desenvolvimento de fraturas. A aplicação rotineira de exercícios de mobilização passiva articular, massagem e posicionamento está relacionada ao ganho ponderal, ao aumento na densidade e no conteúdo mineral ósseo.Conclusões: A implementação de exercícios de fisioterapia motora parece proporcionar estabilidade ou estímulo para a formação óssea, podendo, consequentemente, prevenir e/ou minimizar as complicações decorrentes da doença metabólica óssea.Palavras-chave: prematuro; calcificação fisiológica; modalidades de fisioterapia; doenças ósseas metabólicas. ABSTRACTObjective: To review the role of motor physiotherapy in the treatment of preterm infants at risk of developing metabolic bone disease.Data sources: This is a review of articles published between 1986 and 2009, using the following key-words: premature infant physiologic calcification, physiotherapy techniques, metabolic bone diseases and the respective Portuguese-language descriptors. Twenty nine scientific articles were selected in the PubMed and ISI Web databases, along with one chapter of a Brazilian book.Data synthesis: Metabolic bone diseases are a set of conditions related to abnormalities in the physiologic calcification process. They lead to problems going from structural frailness to fracture development. Routine application of passive joint mobilization exercises, massage and positioning exercises correlate with weight gain and increasing bone mineral content and density.Conclusions: Implementation of motor physiotherapy exercises could provide stability or stimulation for bone formation and may consequently avoid or minimize the complications resulting from metabolic bone disease of prematurity.
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