Factores preditivos da aderência dos pais a um programa de seguimento de crianças nascidas de muito baixo peso

• Autor(a) principal: Marecos, C
• Data de Publicação: 2011
• Outros Autores: Oliveira, A, Figueiredo, H, Cadete, A, Cunha, M
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.10/622
• topic: Recém-nascido; Baixo peso ao nascer; Desenvolvimento infantil

Introduction: Newborn infants of very low birth weight (VLBW) are at high risk of neurodevelopment disorder, justifying the implementation of early intervention programs for these children. Objectives: Evaluate the effects of long-term "Care Programme for Development” (CPD) applied to VLBW infants, analyze parents' compliance to follow-up and identify perinatal variables with influence on neurodevelopment. Methods: Cross sectional and retrospective study on the implementation and adherence to CPD in a level III hospital between 2001 and 2005. Morbidity defined as neurological or sensorial sequels. Out of 323 VLBW newborns, 265 were enrolled for the study (49 died; 9 transferred). Results: CPD was made on 89%. Comparing groups with follow-up (156/59%) and without follow-up (109/41%), there were significant differences in maternal age (28.7 / 26.1, p=0.001) and pregnancy surveillance (89% / 78%, p=0.008). There was significant association of adherence with maternal age (odds ratio 1.059, 95% CI 1.009-1.112, p=0.019); pregnancy surveillance (odds ratio 0.336, 95% CI 0.141-0.802, p=0.014) and early consultation (Odds ratio 6.390, 95% CI 2.685 -15.208, p<0.001). Group with follow-up evaluated at an average age of 3.6 years. Seventy-nine per cent had normal neurodevelopment, 10% development delay or cognitive impairment, 6.4% cerebral palsy and 4% had attention deficit hyperactivity. Visual deficit in 7.8% and hearing impairment in 10% of 156 evaluated children. Regression analysis showed a positive association between the existence of sequels and male gender (odds ratio 0.384, 95% CI 0.169 to 0.869, p=0.022) and peri-intraventricular hemorrhage (odds ratio 2.965, 95% CI 1.104 to 7.963, p=0.031). After discharge, 31% required specific intervention. Discussion and conclusion: Adherence to CPD was higher in older mothers, surveillance of pregnancy, intervention started in NICU and early consultation after discharge. Low birth weight, male gender, IPVH, ventilation time and BPD seem to be variables associated with poor prognosis of neurodevelopment.