Assessment of the neuropsychomotor development in the first year of life of premature infants with and without bronchopulmonary dysplasia

Abstract

ObjectiveTo compare the neuropsychomotor development in the first year of life of premature infants with and without bronchopulmonary dysplasia.MethodsA cross-sectional retrospective study was conducted between January 1, 2014, and December 30, 2015, with premature infants weighing < 1,500g at birth and diagnosed with bronchopulmonary dysplasia at the corrected ages of 6 and 9 months, assessed using the DENVER II Developmental Screening Test. Quantitative variables were described as the means, medians and standard deviations. Variables with normal distribution were tested using Student's t test; otherwise, the Mann-Whitney test was used, considering significance at p-value < 0.05. Qualitative variables were expressed as frequencies and percentages. Logistic regression was used with odds ratio analysis to evaluate the effects of other variables as risk factors for changes in neuropsychomotor development.ResultsInfants with bronchopulmonary dysplasia showed greater developmental delay compared with those without bronchopulmonary dysplasia (p-value = 0.001). The factors associated with a higher incidence of changes in neuropsychomotor development, in addition to bronchopulmonary dysplasia, were antenatal steroid, gender, birth weight, 5-minute Apgar score, Score for Neonatal Acute Physiology-Perinatal Extension, duration of oxygen therapy, duration of mechanical ventilation and length of hospital stay. Other variables may also have influenced the result, such as drug use by mothers of infants with bronchopulmonary dysplasia.ConclusionBronchopulmonary dysplasia associated with other pre- and postnatal factors may be considered a risk factor for delayed neuropsychomotor development in the first year of life in premature infants born weighing less than 1,500g.

Avaliação do desenvolvimento motor infantil em crianças de alto risco

“…It is noted that no associations were found between birth weight and neuro-psychomotor development, 12 which showed that 8% of preterm children had an average birth weight of 3,276 kg, with the lowest weight being 460 g and the highest weight, 4,700 g, with no significant relationship between gestational age and birth weight and the result of neuro-psychomotor development. However, it was found in a study, 7 that low birth weight can increase the risk of developmental delay. It is also emphasized that other variables associated with prematurity have been shown to be determinants for changes in neuro-psychomotor development.…”

“…6 It is revealed, for the variables of the responsible person's gender and age group, that no statistical significance was evidenced, corroborating other findings in the literature, such as a study carried out in the reference university hospital of the State of Minas Gerais, in 2015, in which they were evaluated 79 medical records of premature children aged six to 12 months, submitted to the Denver II test, which obtained the same result as this study, not finding an association between child development and these variables. 7 It is understood that several studies, point to the influence of biological, nutritional, socioeconomic, family factors and the availability of access to services as contributors to neuropsychomotor development, reinforcing its multifactorial potential. 8 In a study carried out in Belém (PA), 2 in which 318 children, of both sexes, from 36 to 48 months of age were screened, that there was a significant association between parents' schooling and child development, corroborating this study, since, as a result of the higher education level of parents, the probability of having a reasonably better occupation is greater and, as a result, there may be a more satisfactory DISCUSSION remuneration, which ensures better living conditions, access to health, nutrition, among other factors.…”

“…However, it was evidenced in another study, 12 with children of both sexes, aged four to six years, attending public daycare centers in the city of Goiânia (GO), that normal birth was considered a risk factor for language development (68%), agreeing with other studies, which evaluated 112 children in the State of Paraíba and associated vaginal delivery with a change in neuropsychomotor development with a Chance Ratio (CR) of 4.4. 17 It is noted that there is still a noticeable divergence in the literature regarding the association of some factors related to development, and this fact can be attributed to the performance of several studies in different locations and, consequently, reveals a singular health care, reinforcing even more the need for further studies to elucidate certain hypotheses.…”

Newborns in intensive care: Apgar score predicts in fifth minute

“…Immediate identi cation of high-risk newborns may reduce perinatal morbidity and mortality [3,4]. If the AS is low and comorbidity such as bronchopulmonary dysplasia is present, there is an increased chance of delayed neuropsychomotor development in the premature neonate weighing less than 1500 g. This shows that the scale has great relevance in the prior identi cation of diseases and conditions associated with the neurological system [5].…”

Desenvolvimento de linguagem e das habilidades auditivas em prematuros adequados e pequenos para a idade gestacional: idade cronológica entre 18 e 36 meses

“…The literature shows that preterm infants have worse performance in language tests and skills such as gross motor, fine-adaptive motor and personal-social compared to term children (1)(2)(3) . On the other hand, some studies report that the language impairment not as a condition related to prematurity but related to factors such as gestational age (4)(5)(6)(7) and birth weight (4)(5)(6)(7)(8) . These last two variables are believed to negatively influencing the development of pre-linguistic skills and language outcomes in preterm children (7) .…”