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Factores preditivos da aderĂȘncia dos pais a um programa de seguimento de crianças nascidas de muito baixo peso
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Advisor(s)
Abstract(s)
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 Developmentâ (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.
Description
Keywords
Newborn Infants Parents' compliance Perinatal variables
Citation
Marecos, C.,Oliveira, A., Figueiredo, H., Cadete, A. & Cunha, M.(2011). Factores preditivos da aderĂȘncia dos pais a um programa de seguimento de crianças nascidas de muito baixo peso. Ifisionline, 2(1).