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Formiga C.K.M.R.1, Vieira M.E.B.2,3, Silva-Hamu T.C.D.2, Tudella E.4, Linhares M.B.M.3
1Universidade Estadual de Goiás, Programa de Pós-graduação em Ciências Aplicadas a Produtos para a Saúde (CAPS), Goiania, Brazil, 2Universidade Estadual de Goiás, Physical Therapy, Goiania, Brazil, 3Universidade de São Paulo, Neurosciences and Behavioral Sciences, Ribeirão Preto, Brazil, 4Federal University of São Carlos, Physical Therapy, São Carlos, Brazil
Background: Infants born preterm (gestational age 37 weeks) and with low birth weight ( 2,500 g) are a high-risk group to present health and development problems. The motor development during the first year of age of preterm infants deserves special attention because it reflects their overall health and cognitive development.
Purpose: The aims of the present longitudinal-prospective study were: 1) to analyze the risk for problems in the development of infants born preterm in their first 8 months of age; and 2) to examine the predictive effect of the neonatal variables and the very early neurobehavioral performance on the later developmental outcomes.
Methods: The sample study consisted of 80 preterm infants (50% male) with gestational age of 33 weeks (±2.2), in mean and low birth weight (mean = 1,715 g [±437]). The infants were assessed in four different age groups: neonatal phase, 2-4 months, 4-6 months, and 6-8 months of corrected age for prematurity. In the neonatal phase (prior to term age), the neurobehavioral performance was evaluated by the Neurobehavioral Assessment of Preterm Infant-NAPI. The overall development was assessed by the Developmental Denver Screening Test II-DDST-II from 2 to 8 months of age. The motor development was evaluated by the Test of Infant Motor Performance-TIMP between 2-4 months and the Alberta Infant Motor Scale-AIMS between 4-6 and 6-8 months of age. Neonatal and perinatal health data were also examined. Regression analyses were performed regarding the overall and motor development as final outcomes. The significance level was p ≤ 0.05.
Results: The delay in the neurobehavioral development was observed in 24% of the infants in the neonatal phase. During the first years of age, the risk for problems in the overall development was found in at least 31% of the sample in each age group. Furthermore, at least 35% of the sample showed delayed motor development in each age group. The longer postnatal hospital stay was associated with the worse motor performance between 2-4 months. Decreased levels of alertness, orientation, and motor performance according to the neonatal neurobehavioral assessment (NAPI) were shown to be predictive of risk in development from 4 to 8 months. The risk in the overall development according to DDST-II between 2-6 months was predictive of motor development delay between 6-8 months.
Conclusion(s): These findings showed that the very early neurobehavioral variables according to the NAPI, hospital stay and risk in the overall development DDST-II were good predictors of both overall and motor development during the first year of age.
Implications: The present study helps to clarify the effect of neonatal care on moderate preterm infants born in a developing country, such as Brazil. Thus, the use of risk screening tools constitutes a simple and inexpensive tool for delay detection. Additionally, the assessment in the neonatal period before the baby achieves term age is a valuable tool for predicting problems in development in the short and mid-term.
Funding acknowledgements: National Counsel of Technological and Scientific Development (CNPq), Fundação de Amparo à Pesquisa do Estado de Goiás (FAPEG), BIP- UEG.
Topic: Paediatrics
Ethics approval: The study was approved by the Clinical Research Ethics Committee of the General Hospital of Goiania (Protocol number 73/2004), BR.
All authors, affiliations and abstracts have been published as submitted.
