Influência do tempo de hospitalização sobre o desenvolvimento neuromotor de recém-nascidos pré-termo

Abstract

O objetivo deste estudo foi avaliar a influência do tempo de hospitalização sobre o desenvolvimento neuromotor de recém-nascidos pré-termo (RNPT). Foi feito um estudo prospectivo com 67 RNPT de idade gestacional <36 semanas. O desenvolvimento neuromotor foi avaliado pela escala motora infantil de Alberta (Alberta infant motor scale, AIMS), aplicada no ambulatório de seguimento, quando os RN tinham mediana de idade corrigida de 39 a 44 semanas. Para a análise comparativa, os RNPT foram distribuídos em dois grupos segundo o tempo de hospitalização (TH): grupo A (n=35), com TH <34 dias, e grupo B (n=32), com TH >34 dias. Na análise estatística considerou-se o nível de significância p<0,05. Os escores medianos na AIMS (numa faixa possível de 0 a 21) foram 7 no grupo A, 5 no grupo B; foram encontradas fracas correlações significativas nos dois grupos (r=0,32; r=0,34) entre o escore na AIMS e o TH. Os resultados indicam que os RNPT que permaneceram por mais de 34 dias hospitalizados mostraram atraso no desenvolvimento neuromotor, sugerindo que, sem excluir outros fatores, quanto maior o tempo de internação do RN, maior seu comprometimento motor.

Evaluation of neuromotor development by means of the Harris Infant Neuromotor Test

“…Research that addresses conditions of birth and the influence of multiple risk factors reveals incidences and neurodevelopmental sequelae that interfere significantly in the quality of life and social inclusion (4)(5)13) . A recent study reported that the results about infant development translate to the rate of development of the country, as well as those of education, health conditions and level of attention to health (5) .…”

“…Three, however, were unaware of any type of developmental delay of the child. Studies about the monitoring of infant development, in follow-up programs (4,6,17) , refer that the families can count on support for orientation, constituting a factor of protection to the infant development. Furthermore, the implementation of follow-up is recommended, however the network of assistance provided to the infant discharged from the NICU is deficient in the country (17) .…”

“…Studies were conducted throughout the trajectory of growth and development of the child, during the significant increase of babies surviving in neonatal units (1)(2) . The incidence and magnitude of neurodevelopmental sequelae remain associated to risk factors and to critical progression (3) , such as with the relationship between hospitalization time in the NICU and motor development of the newborn, particularly the premature NB (4) . When the number of active risk factors is higher, there is a greater possibility of alterations in development (3) .…”

“…The literature addresses cross-sectional and longitudinal follow-up studies of children, in the investigation of medium and long term effects of neonatal risks on development (4)(5)(6) . All in all, the progress of the child with developmental alterations depends on the knowledge of risk factors, diagnosis and interventions (3,5) , that, early on, contribute to the psychic life of the baby and to the relationships with the parents (7) .…”

“…For this study, among the trends for infant evaluation, the decision was to use the Harris Infant Neuromotor Test (HINT), a relatively new test of Canadian origin (8)(9) , validated and administered in a Brazilian population, specifically in the northeastern region of Brazil, since 2007 (4,6) . It is an instrument with emphasis on movement, skill acquisition, motor posture and muscle control.…”