Low birth weight, family income and paternal absence as risk factors in neuropsychomotor development

Abstract

Introduction: The first years of life are crucial to neuropsychomotor development (NPMD), during this period children are susceptible to organic, environmental or activity-related influences that may represent protective or risk factors towards full development, with potential lifelong repercussions.Objective: This study aimed to investigate and verify the risk factors in the neuropsychomotor development (NPMD) of children aged from zero to three years, attending public early childhood education centers.Methods: Cross-sectional study, contextual approach – based on ICF (International Classification of Functioning, Disability and Health) –, Denver II developmental screening test and additional assessments about nutritional status. For the analysis, a logistic regression was performed. The International Classification of Functioning, Disability and Health (ICF) concerning body functions and structure (evaluation questionnaire), activity and participation (evaluation of NPMD in school), personal factors (family characteristics), and environmental factors (characteristics of the ECECs) were considered for the evaluation phase. The instruments consisted of a questionnaire containing items to elicit information about the child, including current, neonatal and family traits. For the evaluation DPMD, the Denver II test was used. Inter- and intra-rater reliability was established using Cohen's kappa, and data subsequently submitted to stepwise (backward) regression analysis using a Logit model, using binary responses. The construction of an ROC (Receiver Operating Characteristic) to define the explanatory profile of the model built also was included, in addition to the calculation of the Odds Ratio (OR), the odds of chance occurrence the association of a given variable with DPMD.Results: NPMD was within the normal parameters, in 68.8% (n = 53) and risk of delays was in 31.2% (n = 24). The area with the best performance was the fine motor-adaptive (3.75%) and the most questionable one was the language (57.5%). It was verified that 48% (n=37) of the children had normal weight while 52% (n = 40) presented some nutritional risk. Low birth weight (OR = 181), monthly family income (OR = 9) and paternal absence (OR = 34) were statistically significant factors on the risk of NPMD delays.Conclusion: low birth weight, family income and paternal absence are factors associated with risks of NPMD delays. These findings reinforce the systemic and multifactorial nature of NPMD and emphasize the need for monitoring and formulating public policies -- especially the ones dedicated to children with low income conditions --, which could contribute to the full development of children, since public early childhood education centers should be transforming agents in the quality of child development.

Análise do desenvolvimento neuropsicomotor de crianças participantes de um programa mãe-bebê

“…Em relação ao desenvolvimento neuropsicomotor, a amostra estudada na atual pesquisa apresentou uma prevalência de suspeita para atraso no desenvolvimento de 30,8%, similarmente a estudos prévios realizados no Brasil (16,17) . Em uma revisão sistemática baseada em investigações brasileiras, os autores observaram que, aproximadamente, 33% das crianças avaliadas em ambiente domiciliar apresentaram suspeita de atraso no desenvolvimento, sendo que a linguagem foi o domínio mais acometido, seguido da área motora ampla (11) .…”

“…Estudos têm sugerido que o vínculo da criança com o pai é tão importante quanto a relação mãe-bebê. Estima-se que as crianças cujos pais não apoiaram as mães nos cuidados com os filhos possuam, pelo menos, dez vezes mais chance de apresentar suspeita de atraso no desenvolvimento (4,16,31) . Os pais, além de ajudarem a prover condições materiais, também ajudam a manter um clima de harmonia e satisfação no ambiente familiar por meio do amor e do companheirismo, promovendo, assim, um ambiente favorável ao desenvolvimento saudável (4,16,31) .…”

Neuropsychomotor development assessment of children aged 0 to 5 in early childhood public education centers

“…Therefore, human development must be understood from a broad and contextualized perspective, taking into account the dynamic interaction of people with their different contxts 2,3 .…”

Desigualdades em saúde: o desenvolvimento infantil nos diferentes grupos sociais

“…Studies in Brazil show a prevalence of 20% to 53% of child development (CD) delay (7)(8)(9)(10)(11) , with higher risk among children from poorer families (7)(8)(9)11) with more than three siblings (7) , born underweight (7,11) , whose mothers had less than six prenatal appointments (9) , who were not breastfed or received breast milk for less than 3 months (7) , older (8) , with nutritional risk (7) , and with an absent father (11) .…”

“…Despite the evidence that children from disadvantaged economic groups are those who most often experience developmental delay (7)(8)(9)11) , it is difficult to explain the relationship between social inequality and CD problems, which are treated as a result of isolated factors, without considering the social-environmental conditions, meaning how the different social groups (SG) are linked to work and life processes (12)(13) . Considering that there are few studies which investigate social inequality in health regarding this theoretical aspect, the objective of this study was to analyze CD in different SG based on the hypothesis that children from families with lower social insertion would have a higher chance of having problems with their health development.…”